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Total documents retrieved: 108 Results Generated From: Embase <1980 to 2026 Week 26> Embase Weekly Updates (updates since 2026-06-19) - (108 records) <1> Accession Number 2046248137 Title Evaluation of a multi-component intervention aimed at reducing time to treatment in transcatheter aortic valve implantation: Protocol for a cluster randomized controlled trial. Source Archives of Cardiovascular Diseases. (no pagination), 2026. Date of Publication: 2026. Author Chevreul K.; Michel M.; Hariz A.J.; Beziau-Gasnier D.; Iung B.; Durand E.; Didier R.; Gilard M.; Eltchaninoff H. Institution (Chevreul, Michel, Hariz) ECEVE, UMR 1123, Inserm, Universite Paris Cite, Paris, France (Chevreul, Michel, Hariz) Assistance Publique-Hopitaux de Paris, Hopital Robert-Debre, Service de sante publique, equipe REPERES, 75019, Paris, France (Beziau-Gasnier, Durand, Eltchaninoff) INSERM U1096, Universite de Rouen Normandie, Rouen, France (Beziau-Gasnier, Durand, Eltchaninoff) CHU Rouen, Department of Cardiology, Rouen, France (Beziau-Gasnier, Durand, Eltchaninoff) Institut Alain Cribier, Rouen, France (Iung) INSERM LVTS 1148, Universite Paris-Cite 75018, Paris, France (Iung) Cardiology Department, Bichat Hospital, AP-HP, 75018, Paris, France (Didier, Gilard) INSERM UMR1304-GETBO, University of Brest, Brest, France (Didier, Gilard) Cardiology Department, CHU Brest, Brest, France Publisher Elsevier Masson s.r.l. Abstract Background Transcatheter aortic valve implantation (TAVI) has become widely used to treat symptomatic patients with aortic stenosis (AS), but increasing demand has led to treatment delays, which are associated with increased morbi-mortality. Aims To reduce time to treatment in patients awaiting a TAVI, we constructed a multi-component intervention which includes (1) a paper- and internet-based component aimed at improving AS and TAVI knowledge and (2) an organizational component aimed at TAVI centres to improve scheduling of examinations and procedures. Their effectiveness, cost-effectiveness and implementation were evaluated in a cluster randomized controlled trial (cRCT). Methods The cRCT (NCT_05237804) used a factorial design to evaluate the two components of the intervention, alone and together. The cluster was the TAVI centre. As patients may be referred to TAVI centres by regional hospitals, participating regional hospitals were included in the cluster of their referral TAVI centre. Clusters were allocated to one of four treatment groups after stratification on annual number of TAVI procedures, presence of a coordinating nurse and participation of a regional hospital. Patients aged >= 18 years with symptomatic AS and a TAVI indication were included in the study. The expected sample size was 798 patients. The primary outcome is the percentage of patients treated within 2 months of the TAVI indication. Secondary outcomes are time to treatment, mortality, quality of life, knowledge regarding TAVI and AS, medication compliance and incremental cost-effectiveness ratios. Implementation measures include dose, fidelity, adaptations, reached population, satisfaction and acceptability. Trial status Overall, 828 patients have been enrolled. Data had not been analysed at the time the protocol was submitted. Copyright © 2026 The Authors. <2> Accession Number 651016368 Title Effect of ultrasound-guided erector spinae plane block for preoperative CT-guided percutaneous localization of pulmonary nodules: a randomized controlled trial. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 24 Apr 2026. Author Ji Y.; Zhang H.; Jia R.; Cheng D.; Hu J.; Zhou X.; Shen Y. Institution (Ji, Zhang, Cheng, Hu, Zhou, Shen) Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Jia) National Clinical Research Center, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China Abstract BACKGROUND: The increasing detection of pulmonary nodules through low-dose computed tomography screening has necessitated precise preoperative localization techniques. While local anesthesia is routinely used for CT-guided pulmonary nodule localization, it inadequately addresses deep tissue pain during pleural penetration. This study is to evaluate the analgesic efficacy and safety of ultrasound-guided erector spinae plane block (ESPB) during CT-guided pulmonary nodule localization. METHOD(S): This single-center, prospective, randomized controlled trial was conducted from June 2024 to January 2025, enrolling 82 patients undergoing preoperative CT-guided pulmonary nodule localization. Participants were randomly assigned to either control group (local anesthesia with 4 ml 1% lidocaine) or ESPB group (ultrasound-guided ESPB with 20 ml 0.375% ropivacaine plus local anesthesia). The primary outcome was numerical rating scale (NRS) score during pleural penetration. Secondary outcomes included anxiety levels, radiation exposure, procedural time, hemodynamic parameters, pneumothorax incidence, and patient satisfaction. Statistical analysis was performed using independent-sample t-test and Mann-Whitney U test. RESULT(S): The ESPB group demonstrated significantly lower NRS scores during pleural penetration compared to the control group (2.68 +/- 1.52 vs. 5.17 +/- 1.32). Patients receiving ESPB exhibited reduced preoperative anxiety (44.71 +/- 3.45 vs. 50.63 +/- 3.74), decreased radiation exposure (401.06 +/- 266.01 vs. 875.36 +/- 377.45 mGy*cm), shorter fluoroscopy time (55.10 +/- 10.54 vs. 117.39 +/- 20.68 s, ), and lower pneumothorax incidence (4.88% vs. 19.51%), all P < 0.05. Post-procedural comfort scores and patient satisfaction were significantly higher in the ESPB group. CONCLUSION(S): Ultrasound-guided ESPB improves analgesia, reduces anxiety, radiation exposure and complications while enhancing patient satisfaction during CT-guided pulmonary nodule localization, representing a valuable adjunct for thoracic interventional procedures. TRIAL REGISTRATION: ClinicalTrials.gov NCT06441071, registered May 8, 2024. Copyright © 2026. The Author(s). <3> Accession Number 649469461 Title Defining optimal muscle surface area thresholds for sarcopenia-related mortality after cardiovascular interventions. Source Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 115(2) (pp 185-193), 2026. Date of Publication: 01 Jun 2026. Author Jarvinen O.; Tynkkynen J.; Lindstrom I.; Virtanen M.; Maaranen P.; Soderlund M.; Huhtamo H.; Vakhitov D.; Laurikka J.; Oksala N.; Hernesniemi J. Institution (Jarvinen) Faculty of Medicine and Health Technology Tampere University Kalevantie 4 Tampere FI-33014 Finland Finnish Cardiovascular Research Centre Tampere Tampere Finland (Tynkkynen, Vakhitov, Oksala) Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland (Lindstrom, Soderlund, Huhtamo, Vakhitov, Laurikka, Oksala, Hernesniemi) Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Virtanen, Maaranen, Laurikka, Hernesniemi) Heart Hospital, Tampere University Hospital, Tampere, Finland (Laurikka, Oksala, Hernesniemi) Finnish Cardiovascular Research Centre Tampere, Tampere, Finland Abstract BACKGROUND AND AIMS: Psoas muscle surface area (PMA) can estimate sarcopenia related long-term mortality risk. This study explored whether this association is linear or non-linear and if a meaningful threshold defines patients at high risk. METHOD(S): This retrospective individual participant-level meta-analysis included four different cohorts of 3893 patients undergoing cardiovascular interventions: 1302 abdominal aortic aneurysm repairs (AAA), 1099 transcatheter aortic valve insertions (TAVI), 593 surgeries for thoracic aortic and aortic valve pathology (TA) and 899 procedures for peripheral artery disease (PAD). The association between PMA and mortality was visualized using pooled spline curves. Cox models were fitted separately within each cohort with three levels of adjustment, and hazard ratios were combined using inverse-variance meta-analysis. Results were replicated in a retrospective dataset of 561 patients undergoing carotid endarterectomy or thrombectomy for ischemic stroke, where sarcopenia status was estimated using masseter muscle surface area. RESULT(S): Age and sex were the most important features associating with PMA (p < 0.001), but significant variation between the cohorts was also observed (p < 0.001). The association between PMA and long-term mortality was inverse and linear (p < 0.001). Patients with poor muscle status (Z-values -1.5 or less for PMA) had significantly higher adjusted risk of death (hazard ratio (HR) of 1.6 with 95% confidence interval (CI) 1.3-2.0, p < 0.001) when compared to all other patients. Similar results were observed in the replication cohort (HR 1.7, 95% CI 1.0-2.82, p = 0.04). CONCLUSION(S): Long-term mortality after a cardiovascular intervention increases linearly as the PMA value decreases. Patients with poor muscle status (Z-values below -1.5) seem to have consistently elevated mortality risk independent of other risk factors. <4> Accession Number 2041613608 Title Percutaneous femoral access closure and prognosis following transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Journal of Vascular Access. 27(3) (pp 906-913), 2026. Date of Publication: 01 May 2026. Author Simonetti F.; Cassese S.; Rheude T.; Alvarez-Covarrubias H.; Pellegrini C.; Kastrati A.; Joner M.; Xhepa E. Institution (Simonetti, Cassese, Rheude, Alvarez-Covarrubias, Pellegrini, Kastrati, Joner, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany (Simonetti) Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (Kastrati, Joner) DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany Publisher SAGE Publications Ltd Abstract Background: The impact of different percutaneous femoral access closure strategies on mortality and bleeding after transcatheter aortic valve replacement (TAVR) has been less studied. The aim of this study is to investigate whether different percutaneous femoral access closure strategies might affect systemic outcomes in patients undergoing TAVR. Method(s): In this systematic review and meta-analysis, randomized trials comparing a suture-based closure (suture group) with a plug-based or suture/plug-based closure (control group) for hemostasis of the femoral access in patients undergoing TAVR were included. The primary endpoint of the study was all-cause death. Secondary endpoints included any bleeding (defined according Valve Academic Research Consortium (VARC) criteria) and unplanned endovascular or surgical repair at the access site. All endpoints were calculated at the longest available follow-up. Result(s): Four studies with a total of 1429 TAVR patients (suture-based group, n = 707; control group, n = 722) were available for quantitative synthesis. There was no statistically significant difference in all-cause death in patients who underwent TAVR with suture-based closure compared to the control group (risk ratio-RR = 1.04, 95% confidence interval-CI 0.60-1.82; p = 0.83). Similarly, there was no statistically significant difference between treatment groups for any bleeding and unplanned endovascular or surgical repair at the access site. However, there was a significant treatment effect for VARC bleeding type 2 associated with the use of a plug-based or suture/plug-based closure in the control group (p for interaction = 0.01). Conclusion(s): In the context of contemporary TAVR procedures, percutaneous closure of the femoral access using any suture or plug-based strategy has no impact on hard clinical outcomes such as death from any cause. Copyright © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <5> Accession Number 2042533548 Title Clinical outcomes off-pump comparing on-pump coronary artery bypass surgery in diabetic patients: updated systematic review and meta-analysis. Source Acta Diabetologica. 63(6) (pp 983-999), 2026. Date of Publication: 01 Jun 2026. Author Elmozugi T.; Khelifa H.; Badr A.; Harfoush M.K.; Shehata M.; Alganadi R.; Ziada A.; Hegazy I.; Ali O.M.; Albaoni H.K.; Otmani Z.; Al Swayah M.B. Institution (Elmozugi) Faculty of Medicine, Benghazi University, Benghazi, Libyan Arab Jamahiriya (Khelifa) Faculty of Medicine, University of Oran, 1 Ahmed Ben Bella, Es Senia, Algeria (Badr) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Harfoush) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Shehata, Alganadi) Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt (Ziada) Faculty of Medicine, Tanta University, Tanta, Egypt (Hegazy, Ali) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Albaoni) Jordan University of Science & Technology, Ar-Ramtha, Jordan (Otmani) Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou, Algeria (Al Swayah) Faculty of Medicine, Tripoli University, Tripoli, Libyan Arab Jamahiriya Publisher Springer-Verlag Italia s.r.l. Abstract Background: Patients with diabetes mellitus are at high risk for coronary artery disease and frequently undergo coronary artery bypass grafting (CABG). Off-pump CABG (OPCAB) has been proposed to reduce perioperative complications compared with on-pump CABG (ONCAB), but long-term outcomes remain uncertain. Method(s): We conducted a systematic review and meta-analysis in accordance with PRISMA 2020 and Cochrane guidelines. Five databases were searched through May 2025 for randomized trials and observational cohorts comparing OPCAB and ONCAB in adults with diabetes. Risk of bias was assessed using RoB-2 and ROBINS-I, and evidence quality was graded with GRADE. Result(s): Seventeen studies were included. No significant differences were observed in 30-day (RR = 0.82, 95% CI: 0.51-1.31; I2 = 64%), 1-year (RR = 0.93, 95% CI: 0.56-1.55; I2 = 65.6%), or 5-year mortality (RR = 1.09, 95% CI: 0.78-1.53; I2 = 58.8%). Randomized data suggested a possible increase in late mortality with OPCAB. OPCAB was associated with lower rates of cerebrovascular events, pulmonary complications, reoperation for bleeding, prolonged ventilation, and intensive care unit stay. No differences were found in myocardial infarction, renal failure, atrial fibrillation, or sternal wound infection. Incomplete revascularization occurred more frequently with OPCAB (RR = 1.96, 95% CI: 1.28-3.0). Conclusion(s): In diabetic patients undergoing CABG, OPCAB may reduce postoperative morbidity without altering overall survival. These findings underscore the need to balance perioperative benefits against potential long-term risks when selecting the surgical approach. Copyright © Associazione Medici Diabetologi / Association of Diabetologists (AMD), Societa Italiana di Diabetologia / Italian Society of Diabetology (SID) 2026. <6> Accession Number 650992664 Title Short- and long-term outcomes of david versus bentall procedures in acute type a aortic dissection: a meta-analysis with reconstructed individual patient data for time-to-event analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 22 Apr 2026. Author Santos K.; Habiyambere G.I.; Bartolozzi H.; Obi O.S.; Carvalho P.E.P.; Madera D.; Plonek T. Institution (Santos) New Vision University School of Medicine, Tbilisi, Georgia (Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum Twente, Enschede, Netherlands (Habiyambere) University of Global Health Equity, Butaro campus, Rwanda (Bartolozzi) Trakia University, Stara Zagora, Bulgaria (Obi) New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, United States (Carvalho) Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, United States (Madera) Department of Vascular Surgery Pasteur Hospital, Montevideo, Uruguay <7> Accession Number 2046131644 Title Contemporary practice patterns and outcomes of isolated tricuspid valve surgery in North America: systematic review with meta-analysis. Source Annals of Cardiothoracic Surgery. 15(3) (no pagination), 2026. Article Number: 31. Date of Publication: 01 May 2026. Author Lee T.; Tavolacci S.C.; Boateng P.; El-Eshmawi A. Institution (Lee, Tavolacci, Boateng, El-Eshmawi) Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher AME Publishing Company Abstract Background: Management of isolated tricuspid valve surgery has evolved over recent decades with respect to operative timing, surgical strategy, and perioperative care. However, a contemporary synthesis of North American outcomes and practice patterns is lacking. Method(s): We performed a systematic review and meta-analysis of studies published between January 1, 2020, and August 30, 2025, reporting outcomes of isolated tricuspid valve surgery in North America. Outcomes assessed included operative mortality, temporal volume trends, repair vs. replacement outcomes, beating-heart techniques, and results from high-volume centers. Institutional outcomes were also reviewed. Result(s): Twelve studies met the inclusion criteria. Operative mortality ranged from 5% to 8% in national cohorts and was approximately 2% at reference centers, with a declining trend over time. Mortality was lower among endocarditis patients as well as patients with better functional status and normal right ventricular function. Procedure volumes peaked around 2017 and have since plateaued or modestly declined, coinciding with increased use of transcatheter therapies. At our institution, 107 patients underwent isolated tricuspid valve surgery since 2014; 46% were reoperations, 54% were performed on a beating heart, 34% underwent repair, and in-hospital mortality was 1.9%. In the pooled meta-analysis of contemporary North American studies, operative mortality following isolated tricuspid valve surgery was 6.4% [95% confidence interval (CI): 4.9-8.3%], with significantly lower mortality observed with tricuspid valve repair (TVr) compared with tricuspid valve replacement (TVR) [odds ratio (OR) =0.74; 95% CI: 0.58-0.95]. In addition, pooled meta-analysis showed that TVr was associated with a significantly reduced risk of new permanent pacemaker (PPM) implantation (OR =0.39; 95% CI: 0.32-0.47). Conclusion(s): Isolated tricuspid valve surgery is increasingly safe, especially among high-volume centers and carefully selected patients. Annual case volumes seem to have plateaued, likely due to the growing application of transcatheter therapies. Copyright © AME Publishing Company. <8> Accession Number 2046262985 Title 10-Year Randomized Outcomes of Transcatheter or Surgical Aortic Valve Replacement in Intermediate-Risk Aortic Stenosis. Source Journal of the American College of Cardiology. 87(23) (pp 3309-3321), 2026. Date of Publication: 16 Jun 2026. Author Thourani V.H.; von Stein P.; Mack M.J.; Nazif T.M.; Babaliaros V.; Alkhouli M.; Fischbein M.P.; Desai N.D.; Satler L.; Zidar F.J.; Kodali S.K.; Kron I.L.; Zajarias A.; Brinkman W.; Kapadia S.; Dewey T.M.; Gossl M.; Bodenhamer R.M.; Ma Y.; Cohen D.J.; Sharma R.; Pibarot P.; Hahn R.T.; Leon M.B.; Makkar R.R. Institution (Thourani) Piedmont Heart Institute, Atlanta, GA, United States (von Stein, Cohen, Hahn, Leon) Cardiovascular Research Foundation, New York, NY, United States (Mack, Brinkman) The Heart Hospital Baylor Scott and White Plano, Plano, TX, United States (Nazif, Kodali, Hahn, Leon) Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, NY, United States (Babaliaros) Emory University Hospital, Atlanta, GA, United States (Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Fischbein) Stanford Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States (Desai) Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States (Satler) Section of Interventional Cardiology, Washington Hospital Center, Washington, DC, United States (Zidar) Austin Heart, Austin, TX, United States (Kron) Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, United States (Zajarias) Cardiovascular Division, Washington University/Barnes Jewish Hospital, St Louis, MO, United States (Kapadia) Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Dewey) Medical City Dallas Hospital, Dallas, TX, United States (Gossl) Valve Science Center, Allina Health Minneapolis Heart Institute, Minneapolis, MN, United States (Bodenhamer) University of Oklahoma College of Medicine, Oklahoma City, OK, United States (Ma) Edwards Lifesciences, Irvine, CA, United States (Cohen) St Francis Hospital and Heart Center, Roslyn, NY, United States (Sharma) Division of Cardiovascular Medicine, Stanford Health Care, Stanford, CA, United States (Pibarot) Quebec Heart & Lung Institute, Universite Laval, Quebec, QC, Canada (Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States Publisher Elsevier Inc. Abstract Background: Transcatheter aortic valve replacement (TAVR) is an established alternative to surgical aortic valve replacement for symptomatic severe aortic stenosis, but long-term, comparative clinical outcomes and echocardiography data are lacking. Objective(s): Our goal was to compare 10-year clinical and echocardiographic outcomes after balloon-expandable TAVR or surgery in intermediate-risk surgical patients in the PARTNER 2A randomized trial. Method(s): Between 2011 and 2013, patients with severe, symptomatic aortic stenosis at intermediate surgical risk were randomized at 57 centers to TAVR with the balloon-expandable SAPIEN XT system (Edwards Lifesciences) or to surgery. Randomization was stratified by anatomical suitability for transfemoral (TF) or transthoracic (transapical/transaortic [TA/TAo]) access. Ten-year outcomes were evaluated in the valve implant population and included all-cause mortality, aortic valve reintervention, and core laboratory-adjudicated echocardiographic outcomes. To obtain 10-year data, patient reconsent at 5 years was required, and vital status sweeps were implemented to improve data completeness for all-cause mortality. Result(s): Among 1,910 randomized patients who received a valve, 974 underwent TAVR (TF: 749/974 [76.9%]) and 936 had surgery. Mean patient age was 81.6 years, 45.4% were women, and the mean Society of Thoracic Surgeons score was 5.8%. At 10 years, vital status was available for 881 of 974 patients (90.5%) and 838 of 936 patients (89.5%). All-cause 10-year mortality with vital status sweeps was 86.1% after TAVR and 82.8% after surgery (HR: 1.13; 95% CI: 1.02-1.25; P = 0.02). When stratified by access route, rates of all-cause mortality for TAVR and surgery in the TF group were similar (83.9% vs 82.1%, respectively; P = 0.27), whereas mortality was higher for TAVR in the TA/TAo group (93.2% vs 85.1%; P < 0.01; P for interaction = 0.03). Cumulative incidence rates of aortic valve reintervention at 10 years were 6.3% for TAVR and 1.6% for surgery (P < 0.001). Of the 24 TAVR and 35 surgical patients with available echocardiographic data at 10 years, mean gradients were 12.6 mm Hg and 12.7 mm Hg, respectively. Conclusion(s): At the 10-year follow-up, TAVR in intermediate-risk patients with the SAPIEN XT prosthesis compared with surgery was associated with lower survival rates, with differences predominantly observed in the TA/TAo access cohort. TAVR with the XT valve was also associated with significantly higher rates of aortic valve reintervention. (PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - XT Intermediate and High Risk [PII A]; NCT01314313). Copyright © 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <9> Accession Number 648902144 Title Which Non-pharmacological Sleep Interventions Are Most Effective After Cardiac Surgery?: A Network Meta-Analysis. Source The Journal of cardiovascular nursing. 41(4) (pp 276-290), 2026. Date of Publication: 01 Jul 2026. Author Lee S.; Park C.G.; Chen P.; Saban K. Institution (Lee) RN Marcella Niehoff School of Nursing, Loyola University Chicago, Sueyeon Lee, Maywood, IL, United States (Park) PhD College of Nursing, University of Illinois Chicago, Chang Gi Park (Chen) MSN, RN College of Nursing, University of Illinois Chicago (Saban) Karen Saban, PhD, RN, CNRN, FAHA, FAAN Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois 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. <10> [Use Link to view the full text] Accession Number 644224784 Title Improved Early Outcomes With Off-Pump Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis. Source Cardiology in review. 34(4) (pp 341-346), 2026. Date of Publication: 01 Jul 2026. Author Abdul Qadeer M.; Khalid M.; Abdul Muqeet Farid A.; Fatima T.; Mariam Khalid F.; Ali S.I.; Mujtaba G.; Elahi N.; Kamal Siddiqi A.; Said S.M. Institution (Abdul Qadeer, Ali) From the Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Khalid) Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan (Abdul Muqeet Farid, Kamal Siddiqi) Department of Medicine, Ziauddin Medical University, Karachi, Pakistan (Fatima, Mujtaba, Elahi) Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan (Mariam Khalid) Department of Emergency Medicine, Jinnah Medical and Dental College, Karachi, Pakistan (Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Maria Fareri Children's Hospital, Valhalla, NY, United States (Said) Department of Surgery, Westchester Medical Center, Valhalla, NY, United States (Said) Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt Abstract The ongoing debate surrounding coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass persists, particularly in individuals with left ventricular dysfunction. The objective of this study was to evaluate the safety and efficacy of these 2 strategies through a comprehensive meta-analysis of existing studies. A systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Central Registry was conducted from inception to July 2023. The primary focus was on studies comparing on-pump versus off-pump CABG as the primary treatment for multivessel coronary artery disease in patients with left ventricular dysfunction (ejection fraction <=40%), with mortality as the primary outcome. The meta-analysis included 26 studies with a total of 35,863 patients. The results revealed a significant reduction in mortality risk [risk ratio (RR), 0.75; 95% confidence interval (CI), 0.60-0.93; P = 0.009] and other perioperative morbidities associated with off-pump CABG. These included stroke (RR, 0.67; 95% CI, 0.54-0.82; P = 0.0002), myocardial infarction (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), pulmonary complications (RR, 0.71; 95% CI, 0.55-0.92; P = 0.010), postoperative transfusion (RR, 0.70; 95% CI, 0.55-0.88; P = 0.002), neurological dysfunction (RR, 0.80; 95% CI, 0.64-1.00; P = 0.05), infection (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), renal failure (RR, 0.79; 95% CI, 0.67-0.95; P = 0.010), and reoperation for bleeding (RR, 0.66; 95% CI, 0.52-0.84; P = 0.0006). However, no significant difference was observed between the 2 groups regarding postoperative atrial fibrillation (RR, 0.97; 95% CI, 0.84-1.12; P = 0.69). In conclusion, off-pump CABG demonstrates a lower perioperative mortality risk and improved overall early outcomes compared with on-pump techniques in individuals with reduced left ventricular function. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. <11> Accession Number 2046485866 Title Utility of genetic testing in heart transplant recipients: a systematic review and meta-analysis. Source Transplantation Reviews. 40(4) (no pagination), 2026. Article Number: 101030. Date of Publication: 01 Dec 2026. Author Shokravi A.; Bertelli M.; Mahon N.; Archer L.; Dauter A.; Ballantyne B.; Fine N.; Howlett J.; Lyons K.; Sharma N.; Marcadier J.; McBride K.L.; Harper L.; Kiamanesh O.; Miller R.J.H. Institution (Shokravi) Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (Bertelli, Ballantyne, Fine, Howlett, Lyons, Sharma, Kiamanesh, Miller) Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada (Mahon, Archer, Dauter, Kiamanesh) Broderick Cardiomyopathy Program, University of Calgary, Calgary, AB, Canada (Marcadier, McBride) Department of Medical Genetics, University of Calgary, Calgary, AB, Canada (Harper) Department of Respirology, University of Calgary, Calgary, AB, Canada Publisher Elsevier Inc. Abstract Genetic cardiomyopathies commonly cause end-stage heart failure, yet genetic testing is inconsistently applied in heart transplant recipients. Identifying pathogenic/likely pathogenic (P/LP) variants clarifies etiology and informs familial risk, but data on diagnostic yield are limited. We performed a meta-analysis to quantify genetic testing yield in heart transplant recipients and implications for cascade testing. MEDLINE and Embase were searched for studies examining cardiomyopathy-focused genetic testing in heart transplant recipients. Pooled P/LP cardiomyopathy variant yields were estimated using random-effects models, stratified by cardiomyopathy phenotype. Cascade testing outcomes were summarized. Eleven studies met inclusion criteria. Overall, 32% (95% CI: 21-46%) of heart transplant recipients carried a P/LP variant. Yield was highest in non-ischemic cardiomyopathy (34%, 95% CI: 24-47%) and non-ischemic dilated cardiomyopathy cohorts (29%, 95% CI: 12-54%), and lowest in ischemic cardiomyopathy cohorts (8%, 95% CI: 4-18%). Heterogeneity ranged from I2 35% to 92%. Among studies reporting cascade testing outcomes, 52-92% of families underwent testing; 30-40% of relatives had P/LP variants, 15-69% of which demonstrated a phenotypic CM. While exact estimates should be interpreted cautiously given heterogeneity across cohorts, the consistency of findings suggests meaningful clinical relevance. Cardiomyopathy-focused genetic testing identifies P/LP variants in many heart transplant recipients, with important implications for cascade testing, supporting integration of cardiomyopathy-related genetic evaluation into heart transplant programs. Copyright © 2024 <12> Accession Number 2046492130 Title Balancing the evidence with the SPAQI recommendations: from perioperative discontinuation towards continuation of SGLT2 inhibitors. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 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. <13> Accession Number 2046683276 Title Regional Anesthesia Approaches for Transcatheter Aortic Valve Implantation: When and Where Does It Add Value? A Narrative Review of Techniques by Access Route. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Nguyen B.T.; Truong D.B.; Nguyen T.T.; Tran H.A.T.; Nguyen N.H.T.; Nguyen H.N.T. Institution (Nguyen, Truong, Nguyen, Tran, Nguyen) Department of Anesthesiology and Pain Management, Vinmec Central Park International Hospital, Ho Chi Minh City, Vietnam (Nguyen, Nguyen, Nguyen) Department of Anesthesiology, College of Health Sciences, VinUniversity, Hanoi, Vietnam (Nguyen) Cardiology Center, Vinmec Central Park International Hospital, Ho Chi Minh City, Vietnam Publisher W.B. Saunders Abstract Transcatheter aortic valve implantation (TAVI) is increasingly performed using local infiltration (LI) with monitored anesthesia care (MAC) as outcomes are equivalent to those of general anesthesia. The key clinical question is when regional anesthesia (RA) offers meaningful benefits beyond LI-MAC across different access routes. The objectives were to identify access-specific situations in which RA may provide clinical advantages over LI-MAC and to summarize implications for patient comfort, hemodynamics, and procedural safety. A narrative review of studies retrieved from PubMed (MEDLINE), Embase, and the Cochrane Library through September 2025 was performed. Eligible studies included case reports, randomized trials, observational cohort studies, and reviews describing RA techniques used for TAVI. Data were extracted on access route, RA technique, outcomes, and complications. For transfemoral (TF) TAVI, evidence supports LI-MAC as the default strategy, and RA has not been shown to improve major clinical outcomes. Selective RA adjuncts may enhance intraprocedural comfort: Ilioinguinal-iliohypogastric block reduces sedative and analgesic requirements, and fascia iliaca block may reduce opioid requirements in selected settings. For non-TF access, particularly subclavian or axillary and carotid routes, RA may preserve spontaneous ventilation, stabilize hemodynamics, and enable continuous neurologic monitoring. In transapical and transaortic procedures, thoracic epidural analgesia shows strong observational support for improved pulmonary and clinical outcomes, with paravertebral and plane blocks serving as neuraxial-sparing alternatives. RA should be used selectively when it enhances analgesia, reduces sedative requirements, or confers physiological advantages, particularly for non-TF access. Further studies directly comparing RA with LI-MAC are needed to clarify its access-specific role. Copyright © 2026 Elsevier Inc. <14> Accession Number 2043992214 Title Hybrid versus endocardial ablation for persistent atrial fibrillation: a systematic review and Bayesian meta-analysis. Source Journal of Interventional Cardiac Electrophysiology. 69(4) (pp 737-752), 2026. Date of Publication: 01 Jun 2026. Author Khanra D.; Mills M.T.; Dutta A.; Deshpande S.; Gupta A.; Mukherjee A.; Rao A.; Kozhuharov N.; Choudhury M.; Gupta D. Institution (Khanra, Rao) The Canberra Hospital, Yamba Drive, Garran, ACT, Canberra, Australia (Mills, Gupta) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (Dutta) International Cooperation Section, Ministry of AYUSH, New Delhi, India (Deshpande) Jaslok Hospital, Mumbai, India (Gupta) Vardhaman Mahavir Medical College and Safdarjang Hospital, New Delhi, India (Mukherjee) York and Scarborough Teaching Hospitals, NHS Foundation Trust, York, Scarborough, United Kingdom (Kozhuharov) Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland (Choudhury) University Hospital of North Midlands, Stoke On Trent, United Kingdom Publisher Springer Abstract Background: The outcomes of endocardial catheter ablation in persistent atrial fibrillation (PsAF) and long-standing PsAF (LSPsAF) remain modest. Hybrid convergent ablation for AF comprises surgical epicardial ablation with concomitant or staged endocardial catheter ablation. Comparative studies remain limited. Objective(s): To systematically assess and compare the efficacy and safety of hybrid ablation (HA) and endocardial ablation (EA) in PsAF and LSPsAF. Method(s): A systematic review and meta-analysis of randomized and observational studies comparing HA and EA was performed, with Bayesian adjustment and covariate analysis. The primary outcome was atrial arrhythmia recurrence. Secondary outcomes included procedural-related complications and length of hospital stay. Result(s): Fifteen studies (including four randomized controlled trials) with 1671 patients (HA, 734; EA, 937) were analyzed. Study inclusion criteria and ablation lesion sets varied widely. Atrial arrhythmia recurrence irrespective of antiarrhythmic drug use was significantly lower in the HA group [relative risk (RR) 0.74 (95% confidence interval (CI) 0.59-0.94), I2 = 73%, P = 0.01]. This result was not different in Bayesian random-effects model [log RR -0.30 (95% CI -0.59, -0.04)]. On multivariate analysis, LSPsAF was the strongest independent predictor of arrhythmia recurrence. Complications were significantly higher in the HA group [log RR 1.03 (95% CI 0.68-1.37), I2 = 0%, P = 0.0001] as was length of stay [mean difference 3.22 days (95% CI 1.74-4.7 days), I2 = 97%, P < 0.0001]. Conclusion(s): Hybrid convergent ablation for AF results in lower atrial arrhythmia recurrence than endocardial catheter ablation, at the expense of higher acute complication rates and longer hospital stay. Copyright © Crown 2026. <15> Accession Number 2046695400 Title Achieving completed revascularization via inferior mini-sternotomy versus conventional median sternotomy for CABG in patients with multivessel CAD (the ACRIS-MICABG trial): Rationale and design of a multicentre, randomized controlled trial. Source Contemporary Clinical Trials. 167 (no pagination), 2026. Article Number: 108362. Date of Publication: 01 Aug 2026. Author Ju F.; Li B.; Wu H.; Sun H. Institution (Ju, Li, Wu, Sun) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China Publisher Elsevier Inc. Abstract Introduction: A critical barrier to advancing minimally invasive coronary artery bypass grafting (CABG) lies in achieving complete revascularization (CR) in multivessel disease (MVD) patients. Contrasting with other minimally invasive approaches, inferior mini-sternotomy (IMS) offers distinct advantages in addressing complex multivessel disease and concomitant cardiac pathologies, which is similar to conventional median sternotomy (CMS) approach. The primary aim of this trial is to test the hypothesis that the CR rates of IMS-CABG could approximate that of CMS-CABG in MVD patients. Methods and analysis: This study is a prospective, multicenter, open-label, randomized controlled, blinded endpoint, non-inferiority trial conducted across four sites in China. 260 patients aged 18-80 are randomly assigned to either the intervention or control arm. All operations are performed through IMS in the intervention arm and CMS in the control arm. The primary outcome is postoperative complete revascularization assessed by postoperative coronary computed tomography angiography (CCTA). Patient enrollment began at the first hospital in May 2023 and is expected to be completed by August 2025. Ethics and dissemination: The Ethics Committee at Fuwai Hospital has approved this study. Expedited ethical approval was obtained for the other three subsidiary centers after that.Trial Registration Information.ClinicalTrials.gov (NCT05835167). Copyright © 2026 Published by Elsevier Inc. <16> Accession Number 2046502373 Title Anticholinergic Burden as a Modifiable Risk Factor in Cardiac Surgery: A Randomized Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Cobas M.; Demir Z.A.; Aykut A.; Ozsan N.; Yigit C.A.; Kurtbeyoglu S.; Katipoglu B.; Akca O. Institution (Cobas, Demir, Aykut, Ozsan, Yigit, Kurtbeyoglu) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey (Katipoglu) Department of Geriatrics, University of Health Sciences, Balikesir Ataturk City Hospital, Balikesir, Turkey (Akca) Department of Anesthesiology & Critical Care Medicine, School of Medicine, Johns Hopkins University, Johns Hopkins Hospital, Baltimore, MD, United States Publisher W.B. Saunders Abstract Objectives: This study assessed whether reducing immediate perioperative anticholinergic burden improves functional recovery in older patients undergoing coronary artery bypass grafting (CABG). Design(s): Prospective randomized controlled study. Setting(s): Single-institution tertiary care hospital. Participant(s): One hundred twenty-two patients aged >=60 years with preoperative Anticholinergic Cognitive Burden scores >=3. Intervention(s): Patients were assigned to either standard anesthetic and/or analgesic care including anticholinergic drugs (standard group) or a deprescribing strategy avoiding perioperative anticholinergic anesthetic and analgesic drugs (deprescribing group). Measurements and Main Results: Primary outcomes were functional recovery on postoperative day 90 assessed using the Katz Index and the Clinical Frailty Scale. On postoperative day 90, full independence (Katz Index score of 6) was significantly more frequent in the deprescribing group than in the standard group (75.0% v 41.1%, p < 0.001). Frailty scores were significantly lower in the deprescribing group at 90 days (median, 3 [interquartile range (IQR), 3-3] v 4 [IQR, 3-4]; p < 0.001). Multivariate logistic regression identified perioperative use of anticholinergic anesthetic and analgesic drugs as an independent predictor of 90-day total complications (odds ratio, 2.430; 95% confidence interval, 1.031-5.726; p = 0.042). Within-group analyses showed decreased frailty scores and increased Katz Index scores from baseline to day 90 in the deprescribing group (p < 0.001 for both), whereas the standard group showed increased frailty (p < 0.001) with no significant change in Katz Index scores (p = 0.317). Conclusion(s): In older CABG patients, immediate perioperative deprescribing of anticholinergic medications improved 90-day functional recovery trajectories and was associated with fewer cardiac and pulmonary complications. Anticholinergic burden may represent a modifiable perioperative risk factor that should be routinely addressed in surgical care pathways to optimize outcomes in older adults. Copyright © 2026 Elsevier Inc. <17> Accession Number 2045449222 Title A minimally invasive anaesthetic approach for transcatheter aortic valve implantation: is this really supported by the evidence?. Source British Journal of Anaesthesia. 137(1) (pp 31-34), 2026. Date of Publication: 01 Jul 2026. Author Heringlake M.; Muras L.H.; Schemke S. Institution (Heringlake, Muras, Schemke) Department of Anaesthesiology and Intensive Care Medicine, Heart and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg Hospital, Karlsburg, Germany Publisher Elsevier Ltd Abstract In association with growing operator experience and increasingly sophisticated delivery systems and valve prostheses, the anaesthetic management of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) has changed in many centres from general anaesthesia with invasive monitoring to local anaesthesia with conscious sedation or solely local anaesthesia. In a recent issue of the British Journal of Anaesthesia, a group of Italian experts in cardiac anaesthesia, cardiology, and cardiac surgery present an interdisciplinary consensus on the anaesthetic management of TAVI patients, recommending that a minimally invasive approach should be favoured in most cases. We critically evaluate the observational data supporting this consensus in comparison with the evidence from the available randomised controlled trials and highlight the need for an individual approach for anaesthetic management best suited to ensure safe and successful TAVI procedures. 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. <18> Accession Number 2046209326 Title Effects of deep parasternal intercostal plane block on opioid consumption and pain after cardiac surgery: a meta-analysis of randomized controlled trials with meta-regression and trial sequential analysis. Source Journal of Clinical Anesthesia. 113 (no pagination), 2026. Article Number: 112259. Date of Publication: 01 Jul 2026. Author Dost B.; Karapinar Y.E.; Turunc E.; Turan E.I.; Beldagli M.; De Cassai A. Institution (Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey (Karapinar) Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa Faculty of Medicine, Istanbul, Turkey (Turan) Department of Anesthesiology and Reanimation, Health Science University, Istanbul Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey (Beldagli) Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey (De Cassai) Department of Medicine (DIMED), University of Padua, Padua, Italy (De Cassai) Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy Publisher Elsevier Inc. Abstract Objective The deep parasternal intercostal plane (D-PIP) block has been used to relieve pain after cardiac surgery. However, the analgesic efficacy of the D-PIP block in adults undergoing cardiac surgery remains unclear. Methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing analgesic efficacy of the D-PIP block. PubMed, Embase, CENTRAL, Web of Science, Scopus, ClinicalTrials.gov , and gray literature were searched until February 2026. Trials comparing the D-PIP block with standard or placebo analgesia were pooled using a random-effects model. The primary outcome was 24-h opioid use, expressed as morphine milligram equivalents (MME). Risk of bias was assessed using RoB 2 and certainty using GRADE. Prespecified subgroup analyses, sensitivity analysis, meta-regression for the primary outcome, and trial sequential analysis were performed. Results Seventeen RCTs (n = 1165) were included. The D-PIP block was associated with a reduction in 24-h opioid consumption versus controls (MD -9.38 mg MME; 95% CI -14.72 to -4.03). Substantial heterogeneity was observed across studies (I2 = 98%). Pain scores at rest and movement were lower at all time points with substantial heterogeneity. Postoperative nausea and vomiting (PONV) incidence was significantly reduced in the D-PIP block group (OR 0.30; 95% CI 0.18-0.52), with no observed between-study heterogeneity (I2 = 0%). Extubation time and intensive care unit (ICU) length of stay (LOS) were shorter, while hospital LOS was unchanged. Comparator type explained most heterogeneity. Evidence certainty was low-very low overall and high for PONV. Conclusions There is very low-certainty evidence supporting a modest reduction in 24-h opioid consumption and early postoperative pain with D-PIP block. In contrast, high-certainty evidence supports a significant reduction in the incidence of PONV. Trial registration International Prospective Register of Systematic Reviews (PROSPERO: CRD420261298563) on February 1, 2026. Copyright © 2026 Elsevier Inc. <19> Accession Number 2011638305 Title Bilateral transversus thoracis muscle plane block provides effective analgesia and enhances recovery after open cardiac surgery. Source Journal of Cardiac Surgery. 36(8) (pp 2818-2823), 2021. Date of Publication: 01 Aug 2021. Author Zhang Y.; Li X.; Chen S. Institution (Zhang, Chen) Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (Li) Department of Nursing, The first Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China Publisher John Wiley and Sons Inc Abstract Background: The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery. Method(s): Sixty patients were randomly divided into two groups: bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary endpoint was perioperative sufentanil consumption. The secondary outcome measures included postoperative pain, flurbiprofen axetil administration, quality of sleep after extubation, time to extubation, time to the return of gastrointestinal function, time to drain removal, the Intensive Care Unit (ICU) stay time, and hospital stay. Result(s): The TP group reported significantly less sufentanil and flurbiprofen axetil consumption than the CO group. The CO group had higher Numerical Rating Scale (NRS) pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and during movement than the TP groups. Compared with the CO group,time to extubation, time to the first bowel movement, ICU stay time, and hospital stay were significantly decreased in the TP group. The TP group was rated as better in the quality of the two nights of sleep after extubation. Conclusion(s): Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery. Copyright © 2021 Wiley Periodicals LLC <20> Accession Number 2046508544 Title Early Enteral Levothyroxine as Rescue Therapy in Cardiac Surgery Patients With Delayed Neurologic Recovery: A Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Elghareeb S.; Saleh M.; Abd Al Jawad M.; Monier A. Institution (Elghareeb, Saleh, Monier) Department of Anesthesiology, ICU and Pain Management, Ain Shams University, Cairo, Egypt (Abd Al Jawad) Department of Cardiothoracic Surgery, Ain Shams University, Cairo, Egypt Publisher W.B. Saunders Abstract Objectives: To evaluate the efficacy and safety of early enteral levothyroxine as rescue therapy for delayed neurologic and respiratory recovery in adults following on-pump cardiac surgery. Design and Setting: A single-center, randomized, double-blind, placebo-controlled trial conducted at Ain Shams University Hospitals (Cairo, Egypt). Participant(s): Seventy adult patients undergoing cardiac surgery with cardiopulmonary bypass who exhibited delayed recovery, defined as requiring mechanical ventilation for >48 hours or having a Glasgow Coma Scale (GCS) score <15 at 48 hours postoperatively. Intervention(s): Participants were randomized to receive either enteral levothyroxine (25-50 microg/d, titrated by body mass index) or an identical placebo from postoperative day 2 until intensive care unit (ICU) discharge. Measurements and Main Results: The primary outcome was the change in GCS score from intervention initiation (48 hours postoperatively) to ICU discharge. Secondary outcomes included cardiac function (ejection fraction), catecholamine requirements, 30-day mortality, hospital length of stay, and thyroid hormone levels. The levothyroxine group (n = 35) showed significantly greater neurologic recovery (adjusted mean difference [aMD] in GCS score, +7.81; 95% confidence interval [CI], 5.24-10.38; p < 0.001) with a 128% faster recovery rate (p < 0.001). Cardiac function improved (attenuated ejection fraction decline; aMD, +12.99%; p < 0.001) with 41% to 63% lower catecholamine needs (p <= 0.01). Treatment with levothyroxine was associated with a significantly lower 30-day mortality rate (14.3% v 45.7%; adjusted hazard ratio, 0.24 [95% CI, 0.09-0.65]; p = 0.005). Given the small number of events (n = 21), this finding should be considered exploratory. Hospital stay was longer in the levothyroxine group (13.1 days v 10.3 days, p = 0.005), attributed to survivorship bias. Levothyroxine normalized thyroid hormone levels, and each 1-pg/mL increase in free triiodothyronine correlated with a 2.1-point gain in GCS score (p < 0.001). Conclusion(s): Early enteral levothyroxine administration in cardiac surgery patients with delayed postoperative recovery was associated with significantly accelerated neurologic recovery and improved cardiac function. The observed reduction in 30-day mortality is hypothesis generating and requires confirmation in a larger, multicenter trial. These findings support further investigation into the integration of thyroid hormone replacement into perioperative care for this high-risk subgroup. Copyright © 2026 Elsevier Inc. <21> Accession Number 2042307442 Title Rationale, Design, and Baseline Clinical Characteristics of the Ziltivekimab Cardiovascular Outcomes Trial: Interleukin-6 Inhibition and Atherosclerotic Event Rate Reduction. Source JAMA Cardiology. 11(1) (pp 89-97), 2026. Date of Publication: 14 Jan 2026. Author Ridker P.M.; Baeres F.M.M.; Hveplund A.; Engelmann M.M.D.; Hovingh G.K.; Lincoff A.M.; Marx N.; Navar A.M.; Sattar N.; Tuttle K.; Perkovic V. Institution (Ridker) Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, MA, United States (Ridker) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Baeres, Hveplund, Engelmann, Hovingh) Novo Nordisk, Copenhagen, Denmark (Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States (Marx) Department of Internal Medicine I, University Hospital RWTH Aachen, Aachen, Germany (Navar) Department of Medicine, UT Southwestern Medical Center, Dallas, TX, United States (Navar) JAMA Cardiology, United States (Sattar) School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Tuttle) Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, United States (Perkovic) University of New South Wales Sydney, Sydney, NSW, Australia Publisher American Medical Association Abstract Importance Cardiovascular inflammation is a major determinant of atherosclerotic disease, and inhibition of the central signaling cytokine, interleukin 6 (IL-6), is a promising target for intervention. Patients with chronic kidney disease (CKD) commonly have plasma elevations of inflammatory biomarkers, such as high-sensitivity C-reactive protein (hsCRP) and IL-6, and are at high risk for life-threatening atherosclerotic events as well as loss of kidney function and might therefore benefit from IL-6 inhibition. Observations The Ziltivekimab Cardiovascular Outcomes Trial (ZEUS; NCT05021835) will determine the safety and efficacy of IL-6 inhibition with ziltivekimab among patients with atherosclerotic cardiovascular disease (ASCVD), CKD, and systemic inflammation. ZEUS is a multinational, double-blind, placebo-controlled, event-driven, randomized clinical trial inclusive of 6376 participants with ASCVD, CKD, and an hsCRP level greater than or equal to 2 mg/L who were randomized in a 1:1 fashion to receive either ziltivekimab, 15 mg, administered subcutaneously every month or matching placebo. At randomization, mean age was 69.5 years, 27.5% were female, 92.0% had hypertension, 65.7% had diabetes, and 41.3% had heart failure. At baseline, the mean estimated glomerular filtration rate (eGFR) was 44.5 mL/min/1.73 m2, mean low-density lipoprotein cholesterol level was 77.7 mg/dL, median hsCRP level was 4.5 mg/L, and median IL-6 level was 4.9 pg/mL. At enrollment, sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists were being used by 36.8% and 11.3% of the cohort, respectively. The primary outcome is 3-point major adverse cardiovascular events. Secondary cardiovascular outcomes include (1) an expanded major adverse cardiovascular event outcome including hospitalization for unstable angina requiring urgent coronary revascularization, (2) hospitalizations for heart failure or urgent heart failure visits or cardiovascular death, and (3) all-cause mortality. The secondary kidney outcome is a composite of greater than 40% decline in eGFR, eGFR less than 15 mL/min/1.73 m2, dialysis, kidney transplant, death from kidney disease, or cardiovascular death. Conclusions and Relevance The ZEUS randomized clinical trial will formally test the hypothesis that IL-6 inhibition with ziltivekimab will lower incident cardiovascular event rates and potentially slow kidney decline among participants with known ASCVD, CKD, and elevated hsCRP. If successful, the ZEUS trial would provide a fully novel approach for prevention of myocardial infarction, stroke, cardiovascular death, and kidney function decline among high-risk patients with CKD. Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. American Medical Association. <22> Accession Number 2044447813 Title Figure-of-8 Suture With a 3-Way Tap Versus Manual Compression After Atrial Fibrillation Ablation: The HARNESS Randomized Controlled Trial. Source JACC: Clinical Electrophysiology. 12(6) (pp 1316-1330), 2026. Date of Publication: 01 Jun 2026. Author Mills M.T.; Calvert P.; Tidbury L.; Wilson K.; Evans T.; de Francesco L.; Najm A.; Tripathi R.; Farinha J.M.; Xydis P.; Thu K.; Snowdon R.; Borbas Z.; Waktare J.; Mahida S.N.; Denham N.; Ashrafi R.; Todd D.; Modi S.; Luther V.; Gupta D. Institution (Mills, Calvert, Evans, de Francesco, Najm, Tripathi, Farinha, Xydis, Thu, Snowdon, Borbas, Waktare, Mahida, Denham, Ashrafi, Todd, Modi, Luther, Gupta) Department of Cardiology, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (Mills, Calvert, Tidbury, Luther, Gupta) Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (Tidbury, Wilson) Research Department, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom Publisher Elsevier Inc. Abstract Background: Reliable hemostasis is essential to minimize femoral venous access site complications after transcatheter cardiovascular procedures, particularly atrial fibrillation (AF) ablation, which require large-bore sheath insertion and systemic heparinization. A figure-of-8 suture secured with a 3-way tap (Fo8<inf>TAP</inf>) offers a simple and low-cost alternative to manual compression (MC). Objective(s): The HARNESS (Haemostasis After Venous Access in Atrial Fibrillation Catheter Ablation) randomized controlled trial evaluated the efficacy of Fo8TAP and its impact on post-procedural bed rest duration. Method(s): Patients undergoing AF ablation via unilateral femoral venous access were randomized 1:1:1 to: 1) MC with 4-hour bed rest (MC-4), 2) Fo8<inf>TAP</inf> with 4-hour bed rest (TAP-4), and 3) Fo8<inf>TAP</inf> with 2-hour bed rest (TAP-2). The primary endpoint of any access site complication before hospital discharge was assessed for superiority (TAP-4 vs MC-4) and noninferiority (TAP-2 vs TAP-4). Bleeding was graded from 1 (minor) to 4 (life-threatening). Secondary endpoints included times to hemostasis, catheter laboratory exit, and mobilization. Result(s): A total of 336 patients (median age 64 years, 34.2% female, median body mass index 28.9 kg/m2) were enrolled and randomized to MC-4 (n = 110), TAP-4 (n = 110), and TAP-2 (n = 116). The primary endpoint occurred in 16 patients (14.5%) in the TAP-4 group and 36 patients (32.7%) in the MC-4 group (P = 0.002 for superiority). In the TAP-2 group, the primary endpoint occurred in 36 (31.0%) patients (P = 0.156; which did not meet the prespecified noninferiority margin vs TAP-4). No major vascular complications occurred. Most events were grade 1 bleeding (85/92, 92.4%), with the remainder minor hematomas (7/92, 7.6%). Median time to hemostasis was significantly shorter with Fo8<inf>TAP</inf> (MC-4: 12 min; TAP-4 and TAP-2: 1 min; P < 0.001). Median time to catheter laboratory exit was shortest with Fo8<inf>TAP</inf> (MC-4: 16 min; TAP-4: 9 min; TAP-2: 8 min; P < 0.001). Median time to mobilization was shortest with TAP-2 (MC-4: 242 min; TAP-4: 241 min; TAP-2: 122 min; P < 0.001). Conclusion(s): After AF catheter ablation, Fo8<inf>TAP</inf> was superior to MC in lowering the incidence of access site complications and was associated with health care efficiencies. However, a 2-hour bed rest strategy failed to meet noninferiority criteria versus 4 hours. (Haemostasis After Venous Access in Atrial Fibrillation Catheter Ablation [HARNESS]; NCT06470555) Copyright © 2026 The Authors <23> Accession Number 2045193623 Title Association of duration of amino acids infusion and renal protection: a secondary analysis of the PROTECTION trial. Source British Journal of Anaesthesia. 137(1) (pp 110-117), 2026. Date of Publication: 01 Jul 2026. Author Landoni G.; Oriani A.; Ti L.K.; Losiggio R.; Bradic N.; Pruna A.; Burrell A.; Pieri M.; Hodgson C.L.; D'Amico F.; Ranucci M.; Oliva F.M.; Comis M.; Calabro M.G.; Viscido C.; Ajello S.; Ferrod F.; Fresilli S.; Guarracino F.; Damiani D.; Pisano A.; Bonizzoni M.A.; Silvetti S.; Pontillo D.; Neri G.; Scquizzato T.; Bosco V.; Marmiere M.; Carmosino M.; Labanca R.; Federici F.; Giardina G.; Baiardo Redaelli M.; Belletti A.; Costamagna A.; Fominskiy E.; Arangino C.; Scandroglio A.M.; Monti G.; Cortegiani A.; Paternoster G.; Bove T.; Bellomo R.; Zangrillo A.; Monaco F. Institution (Landoni, Oriani, Losiggio, Pruna, Pieri, D'Amico, Oliva, Calabro, Ajello, Fresilli, Damiani, Bonizzoni, Pontillo, Scquizzato, Marmiere, Labanca, Giardina, Belletti, Fominskiy, Scandroglio, Monti, Zangrillo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Landoni, Pieri, Monti, Zangrillo) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Ti) Department of Anaesthesia, National University Hospital, Singapore (Bradic) Clinic for Anaesthesiology, Resuscitation and Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia (Bradic) Department of Nursing, University North, Varazdin, Croatia (Burrell, Hodgson, Bellomo) Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Burrell) Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Australia (Hodgson) Intensive Care Unit and Physiotherapy Department, The Alfred Hospital, Melbourne, Australia (Hodgson, Bellomo) Department of Critical Care, University of Melbourne, Melbourne, Australia (Ranucci) Department of Cardiovascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy (Comis, Viscido, Ferrod) S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine Mauriziano Umberto I di Torino, Turin, Italy (Guarracino) Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Pisano) Cardiac Anesthesia and Intensive Care Unit, AORN 'Dei Colli', Monaldi Hospital, Naples, Italy (Silvetti) Department of Cardiac Anaesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS-IRCCS Cardiovascular Network, Genoa, Italy (Neri, Bosco) Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy (Carmosino, Paternoster) Department of Health Sciences, School of Medicine, University of Basilicata, Potenza, Italy (Federici) Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy (Baiardo Redaelli) Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy (Baiardo Redaelli) General and Neurosurgical Intensive Care Units, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy (Costamagna) Department of Anaesthesia, Intensive Care and Emergency, 'Citta della Salute e della Scienza' University Hospital, Turin, Italy (Arangino) Department of Cardiothoracic Anaesthesia and Intensive Care, IRCCS Centro Cardiologico Monzino, Milan, Italy (Cortegiani) Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy (Cortegiani) General Intensive Care Unit, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy (Paternoster) Department of Health Sciences, School of Medicine, University of Basilicata, Anaesthesia and ICU, San Carlo Hospital, Potenza, Italy (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri-Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anaesthesiology and Reanimetion Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Monaco) Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy (Monaco) Cardiothoracic and Vascular Anaesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria Sant'Orsola, Bologna, Italy Publisher Elsevier Ltd Abstract Background: Intravenous amino acids (AA) reduce acute kidney injury (AKI) in adult patients undergoing cardiac surgery. Because the optimal duration of AA infusion is unknown, we investigated the effect of AA infusion duration on AKI and survival. Method(s): In a secondary post hoc analysis of the PROTECTION randomised double-blind placebo-controlled trial, we divided patients into brief (<=48 h) or prolonged (>48 h but <=72 h) AA infusion. The primary objective was to assess whether the direction of the effects on AKI and ICU mortality was consistent across subgroups. Result(s): A total of 3481/3511 patients had available data. Brief and prolonged AA infusion had similar magnitude and direction of effect on AKI (interaction P=0.89), with a risk reduction of 3.8% (25% to 21%) and 5.7% (44% to 38%), respectively. Brief AA infusion showed a reduction in the use of renal replacement therapy, whereas prolonged infusion showed no effect. The effects of AA on intensive care unit mortality were discordant (a reduction from 1.9% to 1.0% in the brief infusion group, and an increase from 2.5% to 3.5% in the prolonged infusion group; interaction P=0.04). Conclusion(s): The effect of AA on AKI was consistent across subgroups, whereas they had opposing effects on survival in patients receiving brief or prolonged study drug infusion and in favour of the brief infusion group. Although these results are hypothesis generating, centres that are following European guidelines and PROTECTION trial results and are implementing AA in clinical practice should consider AA infusion lasting <=48 h. Clinical trial registration: NCT03709264. 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. <24> Accession Number 2045486486 Title Acute normovolaemic haemodilution after cardiac surgery. Comment on Br J Anaesth 2026; 136: 836a"46. Source British Journal of Anaesthesia. 137(1) (pp 361-362), 2026. Date of Publication: 01 Jul 2026. Author Lamba P. Institution (Lamba) Dr D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Maharashtra, Pune, India Publisher Elsevier Ltd <25> Accession Number 2045420927 Title Myocardial Fibrosis and Early Intervention in Asymptomatic Patients With Severe Aortic Stenosis: Insights From the EVOLVED Randomized Clinical Trial. Source JAMA Cardiology. 11(6) (pp 599-605), 2026. Date of Publication: 10 Jun 2026. Author Craig N.J.; Loganath K.; Everett R.J.; Bing R.; Ramtoola T.; Tsampasian V.; Molek P.; Botezatu S.; Aslam S.; Macgillivray T.; Tuck C.E.; Rayson P.; Calvert P.A.; Berry C.; Chin C.W.L.; Hillis G.S.; Fairbairn T.; Greenwood J.P.; Steeds R.; Leslie S.J.; Lang C.C.; Bucciarelli-Ducci C.; Joshi N.V.; Kunadian V.; Prendergast B.; Mills N.L.; Vassiliou V.S.; Dungu J.N.; Hothi S.S.; Boon N.; Prasad S.K.; Keenan N.G.; Dawson D.; Motwani M.; Miller C.A.; Rajani R.; Ripley D.P.; Treibel T.A.; Mccann G.P.; Singh A.; Newby D.E.; Dweck M.R. Institution (Craig, Loganath, Ramtoola, Tuck, Mills, Newby, Dweck) British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, United Kingdom (Craig, Everett, Bing, Ramtoola, Mills, Newby, Dweck) Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (Tsampasian, Vassiliou) Norwich Medical School, University of East Anglia, United Kingdom (Tsampasian, Vassiliou) Department of Cardiology, Norfolk and Norwich University Hospital, United Kingdom (Molek) Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, Krakow, Poland (Botezatu) University of Medicine and Pharmacy Carol Davila, Cardiology Department, Euroecholab, Bucharest, Romania (Aslam, Mccann, Singh) Department of Cardiovascular Sciences, University of Leicester, The NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom (Macgillivray) Edinburgh Imaging, The University of Edinburgh, Edinburgh, United Kingdom (Rayson) Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom (Calvert) Royal Papworth Hospital NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom (Berry) School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Chin) Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore (Chin) Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia (Hillis) Medical School, University of Western Australia, Perth, WA, Australia (Hillis, Greenwood) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (Fairbairn) Department of Cardiology, Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (Greenwood) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom (Steeds) Department of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals of Birmingham NHS Foundation Trust, Birmingham, United Kingdom (Leslie) Cardiac Unit, Raigmore Hospital, Inverness, United Kingdom (Lang) Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom (Lang) National University of Malaysia, Malaysia (Bucciarelli-Ducci, Joshi) Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, United Kingdom (Bucciarelli-Ducci, Prasad) Royal Brompton and Harefield Hospitals, Guys' and St Thomas NHS Foundation Trust, London, United Kingdom (Kunadian) Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle, United States (Kunadian) University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Prendergast) Cleveland Clinic London, St Thomas' Hospital, London, United Kingdom (Mills) Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom (Dungu) Essex Cardiothoracic Centre, Nethermayne, Basildon, Essex, United Kingdom (Dungu) Anglia Ruskin University, Chelmsford, Essex, United Kingdom (Hothi) Department of Cardiology, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom (Hothi) Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (Boon) HertfordshireUnited Kingdom (Keenan) Department of Cardiology, West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom (Keenan) Imperial College, London, United Kingdom (Dawson) Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, Aberdeen, United Kingdom (Motwani) Department of Cardiology, Manchester Heart Institute, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom (Miller) Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom (Rajani) Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Ripley) Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Treibel) Institute of Cardiovascular Sciences, University College London, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom Publisher American Medical Association Abstract Importance: Myocardial fibrosis burden has been associated with adverse clinical outcomes in symptomatic patients with aortic stenosis. Objective(s): To determine whether midwall myocardial fibrosis burden is associated with adverse clinical outcomes in asymptomatic patients and whether those with more fibrosis derive greater benefit from early intervention. Design, Setting, and Participant(s): This post hoc analysis of a randomized clinical trial was conducted between August 2017 and October 2022. The trial took place at 24 cardiac centers across the United Kingdom and Australia. Participants included asymptomatic patients with severe aortic stenosis and midwall fibrosis on cardiac magnetic resonance. These data were analyzed from October 2024 through June 2025. Intervention(s): Early intervention with transcatheter or surgical aortic valve replacement. Main Outcomes and Measures: Primary outcome was all-cause death or unplanned aortic stenosis-related hospitalization. Secondary outcomes included the individual components of the primary outcome. Result(s): In 224 trial participants (mean [SD] age, 73 [9] years; 63 women and 161 men, and mean [SD] aortic valve peak velocity 4.3 [0.5] m per second) with a median follow-up of 42 months, fibrosis burden (per 1% increase) was associated with an increase in the primary end point (hazard ratio [HR], 1.23; 95% CI, 1.08-1.37) and its component of unplanned aortic stenosis-related hospitalizations (HR, 1.22; 95% CI, 1.03-1.40) but not all-cause death (HR, 1.17; 95% CI, 0.98-1.35). There were no interactions between randomization arm and the midwall fibrosis burden for the primary (P for interaction =.39) or secondary end points. In patients with high fibrosis burden above the median, the primary end point occurred in 12 of 59 (20%) of those randomized to early intervention and 17 of 53 (32%) of those randomized to guideline-directed conservative management (HR, 0.62; 95% CI, 0.29-1.28). For the individual components, all-cause death occurred in 9 (15%) and 10 (19%) patients, respectively (HR, 0.84; 95% CI, 0.33-2.07), and unplanned aortic stenosis-related hospitalization in 4 (7%) and 13 (25%) patients respectively (HR, 0.27; 95% CI, 0.08-0.77). In patients with low fibrosis burden below the median, there were no differences in the primary outcome (HR, 1.05; 95% CI, 0.39-2.86) or its components between intervention groups. Conclusions and Relevance: In this study, in asymptomatic patients with severe aortic stenosis, higher midwall fibrosis burden was associated with adverse outcomes. There was no demonstrable heterogeneity by the degree of midwall fibrosis for the treatment effects of early surgical or transcatheter aortic valve replacement compared to clinical surveillance. Copyright © 2026 American Medical Association. <26> Accession Number 2046510039 Title Perioperative Normoxia Versus Hyperoxia in Cyanotic Congenital Heart Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source World Journal for Pediatric and Congenital Heart Surgery. (no pagination), 2026. Date of Publication: 2026. Author Goncalves L.B.; Delgado L.M.; Oliveira R.E.N.D.N.; Carvalho E.D.A.; Loftin M.; Tenorio D.F. Institution (Goncalves) Universidade Federal de Uberlandia, Minas Gerais, Uberlandia, Brazil (Delgado, Carvalho) Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Oliveira) Department of Thoracic Surgery, Barretos Cancer Center, Sao Paulo, Barretos, Brazil (Loftin, Tenorio) Department of Cardiothoracic and Vascular Surgery, University of Texas at Austin, Austin, TX, United States Publisher SAGE Publications Inc. Abstract Background: Optimal oxygenation strategies during cardiopulmonary bypass (CPB) in children with cyanotic congenital heart disease remain controversial. Although hyperoxia has traditionally been used to compensate for chronic hypoxemia, concerns exist regarding reoxygenation injury and oxidative stress. This systematic review and meta-analysis aimed to compare perioperative normoxic versus hyperoxic strategies during CPB in this population. Method(s): We performed a literature search in MEDLINE, Embase, and the Cochrane Library from inception to November 2025. Random-effects models were used to pool risk ratios (RRs) for binary outcomes and mean differences for continuous outcomes. Heterogeneity was assessed using the I2 statistic, and risk of bias was evaluated using the RoB 2 tool. Result(s): Five randomized controlled trials comprising 241 children were included, with 121 patients allocated to normoxia and 120 to hyperoxia. There were no statistically significant differences between groups in all-cause mortality (RR 1.31; 95% confidence interval [CI] 0.37-4.67; P = .67; I2 = 0%). Postoperative recovery outcomes, including intensive care unit (ICU) stay, ventilation time, length of hospital stay, and duration of inotropic support, were also comparable. Operative parameters (CPB time and aortic cross-clamp time) and safety outcomes, such as neurological complications, arrhythmias, and cardiac arrest, did not differ significantly between strategies. Conclusion(s): In children with cyanotic congenital heart disease undergoing surgery with CPB, normoxic, and hyperoxic oxygenation strategies were associated with statistically similar mortality, recovery, operative, and safety outcomes. These findings suggest that carefully monitored normoxic strategies may represent a safe and physiologically sound alternative to routine hyperoxia during CPB. Copyright © The Author(s) 2026 <27> Accession Number 651030626 Title Screening rates and geographical disparities shape venous thromboembolism risk after cardiac surgery: a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 25 Apr 2026. Author Chang R.; Xu Z.; Li W.; Liu X.; Shen Y.; Wang Y.; Mao Q.; Wang W.; Yang X. Institution (Chang, Xu, Li, Liu, Shen) Department of Cardiology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, China (Xu) Medical College, Research Center for High Altitude Medicine in Qinghai University, Xining, Qinghai, China (Wang) Department of Medicine, Beijing Zhongwei Medical Research Center, Biological and Translational Medicine, Beijing, China (Mao, Wang) Department of Biology, Oasis Road Research Center, Watertown, MA, United States (Yang) Department of Cardiology, Deyang People's Hospital, China <28> Accession Number 2046509657 Title Objective Evaluation of Three-Dimensional Models for Training Congenital Cardiac Surgeons: A Systematic Review. Source World Journal for Pediatric and Congenital Heart Surgery. (no pagination), 2026. Date of Publication: 2026. Author Francis J.; Brophy S.; George A.; Hussein N. Institution (Francis) Department of Cardiac Surgery, St Thomas' Hospital, London, United Kingdom (Francis) Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom (Brophy) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom (George) Department of Anaesthesiology, University of Arkansas for Medical Sciences, Little Rock, United States (Hussein) Department of Paediatric Cardiothoracic Surgery, Great Ormond Street Hospital, London, United Kingdom Publisher SAGE Publications Inc. Abstract Objectives: This systematic review aimed to evaluate the types, validity, and outcomes of objective assessment tools used to measure surgeon performance during congenital cardiac surgical training using three-dimensional (3D) models. Method(s): A systematic search of PubMed, Scopus, Web of Science, and Embase was conducted from inception to December 2025 in accordance with PRISMA guidelines. Original studies reporting objective educational, technical, or performance-based assessments of surgeons undergoing surgical training using 3D congenital heart models were included. Result(s): Of 1359 records identified, 9 studies met the inclusion criteria. Objective assessments included procedure-specific checklists, global rating scales, time-based measures, and correlated clinical outcomes. Objective assessments consistently demonstrated improvements in technical performance and procedural accuracy, and reductions in task completion time, following simulation-based training. Evidence of skill retention was reported in a subset of studies employing repeated objective testing. Objective assessment of nonoperative technical skills and transferability to the operating room was reported infrequently and remained methodologically limited. Conclusion(s): Objective assessment using 3D heart models provides a measurable and reproducible means of developing technical skills and anatomical understanding in congenital and pediatric cardiac surgery. While simulation cannot fully replicate the complexity of the operative experience, these models may support early procedural planning, build strategies for anatomical exposure, and structured skills acquisition in a training environment increasingly limited by case complexity and operative opportunities. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <29> Accession Number 2046501984 Title Perioperative Management: HeartMate 3 Left Ventricular Assist Devices in Non-Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author O'Callaghan L.; Walsh D.; Mulligan D.; Merdad M.; Luk A.; Billia F.; Rao V.; Wasowicz M.; Griffin M.; Efrimescu C. Institution (O'Callaghan, Walsh, Mulligan, Griffin, Efrimescu) Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland (Merdad, Luk, Billia, Rao, Wasowicz) Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Canada (Luk, Billia, Rao, Wasowicz) University of Toronto, Toronto, Canada (Griffin) School of Medicine, University College Dublin, Dublin, Ireland Publisher W.B. Saunders Abstract The HeartMate 3 (HM3) left ventricular assist device is currently the most widely used left ventricular assist device worldwide. Advances in technology have enabled its use both as a bridge to transplant and as destination therapy. The HM3's fully magnetically levitated rotor, wider blood flow pathways, and artificial pulse technology have significantly improved hemocompatibility and reduced the incidence of pump thrombosis, stroke, and gastrointestinal bleeding. As a result, the HM3 offers greater durability and fewer complications than its predecessors. With the growing disparity between organ availability and transplant demand, anesthesiologists are increasingly likely to encounter patients supported by HM3 devices in both cardiac and non-cardiac surgical settings. A thorough understanding of the HM3's function, physiological implications, and potential perioperative complications is essential for safe anesthetic management. This narrative review explores the underlying physical principles of the HM3, key technical parameters necessary for monitoring device function, and perioperative management strategies. Topics include multidisciplinary team coordination, anesthetic approach and monitoring, relevant cardiac physiology, and the management of common emergencies. Although cardiac anesthesiologists are ideally suited to manage these complex cases, this may not always be possible. Therefore, it is imperative that all anesthesiologists, particularly those practicing in mechanical circulatory support centers-develop a comprehensive understanding of the HM3 system. Copyright © 2026 <30> Accession Number 2045492044 Title Ultrasound-Guided Superficial Parasternal Intercostal Plane Block for Early Pain Management in Patients Undergoing Cardiac Surgery-A Randomized Controlled Trial. Source Acta Anaesthesiologica Scandinavica. 70(6) (no pagination), 2026. Article Number: e70253. Date of Publication: 01 Jul 2026. Author Kalli A.-J.; Makela P.; Huhtala H.; Mennander A.A.; Jarvela K.M. Institution (Kalli, Makela, Jarvela) Department of Cardiac Anesthesia and Intensive Care, Tays Heart Hospital, Tampere University Hospital, Tampere, Finland (Huhtala) Faculty of Social Sciences, Tampere University, Tampere, Finland (Mennander) Department of Cardio-Thoracic Surgery, Tays Heart Hospital, Tampere University Hospital, Tampere, Finland (Mennander, Jarvela) Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland Publisher John Wiley and Sons Inc Abstract Background: Sternotomy causes substantial postoperative pain. Recently, several less invasive nerve blocks have been described that are safer to use even on anticoagulated patients. This study aims to evaluate early pain management using ultrasound-guided superficial parasternal intercostal plane block (SPIP) in patients undergoing aortic valve replacement via full sternotomy. Method(s): This was a randomized, placebo-controlled trial performed in a tertiary referral hospital. Seventy-four elective patients scheduled for aortic valve replacement via full sternotomy were included. Patients were randomized to receive a preoperative SPIP block using either 40 mL of ropivacaine 7.5 mg/mL or 40 mL of 0.9% saline. Cumulative oxycodone consumption during the first 24 postoperative hours was recorded and analyzed as the primary outcome. Pain at rest was assessed using the numerical rating scale (NRS) scores 48 h postoperatively. Additional secondary outcomes included the need for vasopressors and antiemetics, recovery of bowel function, time spent in the intensive care unit (ICU), and nerve block-related complications. Result(s): The 24-h cumulative consumption was not significantly different between groups (93.8 mg +/- 33.3 vs. 109.4 mg +/- 37.9, p = 0.066). NRS pain scores at rest were reduced in the patients with SPIP at 4 (5.0 +/- 1.8 vs. 3.3 +/- 2.4, p = 0.002). No differences were found in additional secondary outcomes. Conclusion(s): In this randomized controlled trial a single-shot SPIP block did not reduce the 24-h cumulative opioid consumption after cardiac surgery. Editorial Comments: This trial in a cardiac surgical cohort tested for possible benefit of a single injection superficial parasternal intercostal plane block for post-operative analgesia for post-sternotomy pain. The study found no post-op opioid treatment reduction with the treatment, but some analgesia effect cannot be ruled out. Copyright © 2026 Acta Anaesthesiologica Scandinavica Foundation. <31> Accession Number 2046065361 Title Investigation of Esketamine Administration During Surgical Procedures for the Alleviation of Postoperative Anxiety and Depression in Adolescent Patients: A Randomized Controlled Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 587626. Date of Publication: 2026. Author Li Y.; Zhao K.; Cao P.; Wang Q.; Li K.; Zhou J. Institution (Li) Department of Anaesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, Henan, Zhengzhou, China (Zhao, Cao, Wang, Li, Zhou) Department of Anaesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, Henan, Zhengzhou, China Publisher Dove Medical Press Ltd Abstract Background: Surgical stress can lead to postoperative anxiety and depression, especially in adolescents. These complications reduce quality of life and increase medical burdens, but perioperative psychological interventions for adolescents are limited, and related mechanisms remain unclear. Esketamine (S-ketamine), an N-methyl-D-aspartate receptor (NMDAR) antagonist, has analgesic, sedative, antidepressant, and anxiolytic effects, yet its efficacy and safety in adolescent surgical patients have not been systematically studied. Purpose(s): This study seeks to investigate the prophylactic efficacy of subanesthetic-dose S-ketamine in mitigating postoperative anxiety and depression among adolescent patients. Method(s): In this prospective double-blind randomized placebo-controlled trial, 92 American Society of Anesthesiologists (ASA) I-II adolescents aged 13-18 years undergoing elective surgery were randomly assigned to receive intravenous esketamine (0.25 mg/kg) or normal saline at skin incision. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS); serum C-reactive protein (CRP) and interleukin-6 (IL-6) were measured; pain was evaluated using the NRS. Adverse events were recorded. Result(s): Eighty patients completed the study. The esketamine group had significantly lower anxiety scores on postoperative days 1, 3, 7, and 14 (P < 0.05). Depression scores differed significantly only on day 14 (P = 0.043). There were no significant between-group differences in inflammatory markers or adverse events. Esketamine was a protective factor against postoperative anxiety (OR = 0.38, P < 0.05). Conclusion(s): Subanesthetic-dose esketamine during surgery effectively reduces postoperative anxiety and partially alleviates depressive symptoms in adolescents with acceptable safety. Limited by sample size and single-center design, multicenter studies with longer follow-up are warranted. Copyright © 2026 Li et al. <32> Accession Number 2046455211 Title Scar-specific outcomes following minimally invasive versus conventional median sternotomy in cardiac surgery: A systematic review and meta-analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Chhatwal K.; On Chun Siu A.; Arab S.; Salih A.; Shah A.; Arjomandi Rad A.; Chong G.L.W.; Showkat M.; Punjabi S.; Punjabi P. Institution (Chhatwal, Arab, Salih, Showkat) Imperial College School of Medicine, Imperial College London, London, United Kingdom (Chhatwal) National Heart and Lung Institute, Imperial College London, London, United Kingdom (On Chun Siu) Department of Cardiology, Royal Berkshire Hospital Foundation Trust, NHS England, London, United Kingdom (Arab) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Shah) Division of Medicine, University College London Medical School, England, London, United Kingdom (Arjomandi Rad) Department of Cardiothoracic Surgery, Oxford University Foundation Trust, NHS England, England, Oxford, United Kingdom (Chong) School of Medical Sciences, University of Birmingham, England, Birmingham, United Kingdom (Punjabi) Department of Dermatology, London North West Hospitals NHS Trust, London, United Kingdom (Punjabi) Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom Publisher SAGE Publications Ltd Abstract Background: With improved cardiac surgical outcomes, attention has shifted to patient-centred outcomes, including cosmetic appearances of surgical scars. Minimally invasive cardiac surgery (MICS) is often promoted for its cosmetic benefits, yet empirical evidence remains limited. This study aimed to systematically evaluate scar-specific outcomes comparing MICS to conventional full median sternotomy (FMS) in adult cardiac surgery. Method(s): A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, Embase, Central, and Scopus were searched from inception to August 2025. Studies comparing MICS to FMS, reporting scar-related patient-reported outcomes, wound complications, or cosmetic satisfaction, were included. The primary outcome was scar assessment using validated instruments. Random-effects models calculated standardised mean differences (SMD) and risk ratios (RR) with 95% confidence intervals. Result(s): Twenty-two studies comprising 3131 patients (1459 MICS, 1672 FMS) met inclusion criteria. MICS demonstrated significantly better scar assessment scores (SMD -0.74, 95% CI -1.27 to -0.22; p < 0.01; I2 = 88%, six studies), higher patient satisfaction rates (RR 1.42, 95% CI 1.21-1.66; p < 0.001; I2 = 84%, 12 studies), and reduced wound complications (RR 0.31, 95% CI 0.20-0.47; p < 0.001; I2 = 0%, nine studies). Only six studies reported validated scar assessment scores, highlighting limited integration of these measures. Substantial heterogeneity was observed due to diverse assessment tools and surgical techniques. Conclusion(s): MICS can offer significant advantages in scar-specific outcomes compared to FMS in carefully selected patient populations. Cosmetic outcomes should be interpreted within the context of overall effectiveness and may support shared decision making only when clinical outcomes between surgical approaches are comparable. The lack of standardised scar assessment protocols and limited reporting of cosmetic outcomes represent critical gaps. Future research should prioritise standardised scar evaluation tools and expand cosmetic outcome reporting across all cardiac surgical procedures. Copyright © The Author(s) 2026 <33> Accession Number 2038239235 Title Donning gloves before patient contact, with or without prior hand hygiene. Source Journal of Infection in Developing Countries. 20(5) (pp 750-754), 2026. Date of Publication: 01 May 2026. Author Bayhan G.I.; Altuntas C.A.; Cevahir N. Institution (Bayhan) Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey (Altuntas) Ankara City Hospital, Department of General Pediatrics, Ankara, Turkey (Cevahir) Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Microbiology, Ankara, Turkey Publisher Journal of Infection in Developing Countries Abstract Objective: Hand hygiene (HH) is a fundamental infection prevention measure in healthcare settings, playing a crucial role in reducing healthcare-associated infections (HAIs). Despite its importance, HH compliance remains suboptimal worldwide. A common error is omitting HH before donning gloves, specifically during WHO Moment 1 ("Before touching a patient"). This study investigates bacterial contamination associated with direct gloving and its potential implications for infection control. Method(s): A randomized controlled trial included nurses and doctors preparing to touch patients in the pediatric cardiovascular surgery intensive care unit. Participants were divided into two groups: (1) "HH prior to gloving" (HH performed before donning gloves) and (2) "direct gloving" (no HH before gloves). For each group, 129 samples were collected. Bacterial counts on gloved hands were compared between groups and against bare hands. Result(s): The total bacterial colony counts on gloved hands were similar between the HH prior to gloving group and the direct gloving group (p = 0.559). However, bacterial colony counts on gloved hands in both groups were significantly lower compared to bare hands (p = 0.0001, p = 0.0001). Conclusion(s): Direct gloving did not increase bacterial contamination on gloves relative to HH before gloving. However, given the established benefits of HH in broader infection control practices, further research is needed to assess the impact of both or separate HH and gloving techniques across different clinical settings. Copyright © 2026 Bayhan et al. <34> Accession Number 2045464353 Title Unmasking Risk in Mitral Regurgitation: Prognostic Value of Exercise Stress Echocardiography-A Systematic Review. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3253. Date of Publication: 01 May 2026. Author Sonaglioni A.; Baravelli M.; Gramaglia G.F.; Nicolosi G.L.; Lombardo M. Institution (Sonaglioni, Baravelli, Lombardo) Division of Cardiology, IRCCS MultiMedica, Milan, Italy (Gramaglia) Department of Emergency, Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (Nicolosi) Division of Cardiology, Policlinico San Giorgio, Pordenone, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Risk stratification of patients with mitral regurgitation (MR), including both primary (degenerative) and secondary (functional) forms, remains challenging, particularly in asymptomatic or minimally symptomatic stages, as clinical assessment and resting echocardiography may underestimate disease severity and functional impairment. Exercise stress echocardiography (ESE) enables dynamic evaluation of regurgitation severity, ventricular performance, and cardiopulmonary response, potentially improving prognostic assessment. Method(s): A systematic review was conducted according to PRISMA guidelines. PubMed, Scopus, and EMBASE were searched from inception to March 2026. Studies including adult patients with primary or secondary MR undergoing exercise-based stress echocardiography and reporting clinical outcomes were selected. Studies using exclusively pharmacological stress were excluded. Data were qualitatively synthesized, and continuous variables were summarized as weighted medians and interquartile ranges. In addition, emerging and non-conventional prognostic markers, including anatomical indices such as the modified Haller index (MHI), were explored to provide a more comprehensive risk stratification framework. Result(s): Nineteen studies were included, encompassing a heterogeneous population in terms of MR etiology, severity, and clinical presentation. During follow-up, a substantial proportion of patients experienced adverse events, including heart failure, mitral valve intervention, or death. Exercise-derived parameters consistently showed strong prognostic value. In particular, exercise-induced worsening of MR severity (increase in effective regurgitant orifice area and regurgitant volume), absence of contractile reserve, elevated filling pressures (E/e'), and exercise-induced pulmonary hypertension were associated with worse outcomes. Reduced functional capacity and impaired right ventricular-pulmonary arterial coupling provided additional prognostic information. Emerging markers, including chest wall configuration assessed by MHI, appeared to further refine risk stratification in selected patient subsets. In contrast, resting parameters were less consistently predictive. Conclusion(s): ESE provides incremental prognostic information in patients with MR by identifying dynamic abnormalities not evident at rest. Its integration into clinical evaluation, together with novel anatomical and functional markers, may improve risk stratification and support earlier identification of high-risk patients who could benefit from timely intervention. Further studies are needed to standardize methodologies and define clinically relevant thresholds. Copyright © 2026 by the authors. <35> Accession Number 2045464374 Title The Prognostic Value of Exercise Stress Echocardiography in Asymptomatic Moderate and Severe Aortic Stenosis: A Systematic Review of Stress-Derived Hemodynamic and Functional Markers. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3247. Date of Publication: 01 May 2026. Author Sonaglioni A.; Lombardo M.; Gramaglia G.F.; Nicolosi G.L.; Baravelli M. Institution (Sonaglioni, Lombardo, Baravelli) Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico, MultiMedica, Milan, Italy (Gramaglia) Department of Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (Nicolosi) Division of Cardiology, Policlinico San Giorgio, Pordenone, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Risk stratification of patients with asymptomatic aortic stenosis (AS) remains challenging, as symptom-based assessment may underestimate disease severity. Exercise stress echocardiography (ESE) provides a comprehensive evaluation of valvular, ventricular, and cardiopulmonary responses under physiological stress and may improve prognostic assessment. Method(s): A systematic review was conducted according to PRISMA guidelines to evaluate the prognostic value of ESE in asymptomatic moderate and severe AS. Electronic databases (PubMed, Scopus, and EMBASE) were searched from inception to March 2026. Studies were included if they assessed adult patients with asymptomatic moderate or severe AS undergoing exercise-based stress echocardiography and reported clinical outcomes. Studies using exclusively pharmacological stress or lacking outcome data were excluded. Data were extracted and synthesized qualitatively. Continuous variables were summarized as weighted medians and interquartile ranges. Result(s): A total of 11 studies were included, encompassing a heterogeneous population of patients with moderate-to-severe and severe AS. During follow-up, a substantial proportion of patients experienced adverse events, including symptom onset, aortic valve replacement, or death. Across studies, exercise-derived parameters consistently showed strong prognostic value. In particular, exercise-induced increases in mean transvalvular gradient, an elevated E/e' ratio, the development of pulmonary hypertension, and reduced functional capacity emerged as the most reproducible predictors of adverse outcomes. Notably, thresholds such as an increase in mean transvalvular gradient >= 18-20 mmHg, peak exercise E/e' >= 15, and systolic pulmonary artery pressure >= 60 mmHg were consistently associated with a higher risk across multiple studies. Myocardial deformation parameters and biomarkers such as exercise-induced BNP further contributed to risk stratification in selected studies. In contrast, resting parameters alone were less consistently predictive. Conclusion(s): ESE provides incremental prognostic information in asymptomatic moderate and severe AS by unmasking subclinical hemodynamic and myocardial abnormalities. The integration of stress-derived parameters, including reproducible threshold values, into clinical assessment may improve risk stratification and support more individualized management strategies. Further studies are needed to validate these cut-offs and define their role in guiding clinical decision-making. Copyright © 2026 by the authors. <36> Accession Number 650992340 Title Restrictive versus liberal red blood cell transfusion strategies for cardiac surgery: a systematic review and meta-analysis of randomized controlled trials. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 22 Apr 2026. Author Shao J.; Zhang Y.; Lin W.; Yan M.; Cai X.; Luo Z.; Yu W.; Xu J. Institution (Shao, Zhang, Lin, Yan, Cai, Cai, Luo, Yu, Xu) School of Medical, Southeast University, 87 Dingjiaqiao Rd, Nanjing, China (Shao, Zhang, Lin, Yan, Cai, Cai, Luo, Yu, Xu) Department of Critical Care Medicine, Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China <37> [Use Link to view the full text] Accession Number 2044967661 Title Hypotension Prediction Index-Guided Hemodynamic Management on Postoperative Organ Outcome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Source A and A Practice. 20(4) (no pagination), 2026. Article Number: e02180. Date of Publication: 01 Apr 2026. Author Wang S.S.; Latreille A.; Pietrancosta M.; Morisson L.; Hemmerling T.; Laferriere-Langlois P. Institution (Wang, Latreille, Pietrancosta, Morisson, Laferriere-Langlois) Faculty of Medicine, Universite de Montreal, Montreal, QC, Canada (Morisson, Laferriere-Langlois) Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada (Hemmerling, Laferriere-Langlois) Department of Anesthesiology and Experimental Surgery, McGill University, QC, Canada (Wang, Pietrancosta, Morisson, Laferriere-Langlois) Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada Publisher Wolters Kluwer Health Abstract Intraoperative hypotension (IOH) is a frequent occurrence during noncardiac surgery. Hypotensive episodes can compromise tissue perfusion, and cumulative exposure has been associated with adverse outcomes such as acute kidney injury (AKI), myocardial injury, and increased mortality. The Hypotension Prediction Index (HPI) is an artificial intelligence tool designed to predict hypotensive events before they occur, allowing clinicians to intervene proactively to prevent or mitigate hypotension. Although randomized trials and pooled analyses have shown its effectiveness in reducing both the incidence and duration of IOH, its impact on patient-centered outcomes remains unclear. From 1946 to August 8, 2025, we prospectively queried MEDLINE (PubMed), Embase, Cochrane Library, and Web of Science. We included randomized controlled trials in adult surgical patients with invasive arterial monitoring, comparing HPI-guided perioperative hemodynamic management to standard care. Primary outcome was postoperative AKI, and secondary outcomes were postoperative myocardial injury, pneumonia, arrhythmia, stroke, postoperative cognitive dysfunction, including delirium, surgical site infection, length of hospital stay, and mortality. Two authors independently evaluated the risk of bias according to the methods described in the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis was performed using RevMan 5.4.1 software. Dichotomous data were presented as risk ratio, 95% confidence interval [CI]; continuous data were presented as mean difference, 95% CI. All results were pooled using random-effects models. Of 883 imported references, 14 studies (N = 2030) were included for final analysis. No significant difference in incidence of postoperative AKI was observed between HPI-guided management and standard care, RR = 0.87, 95% CI (0.71-1.07). Postoperative myocardial injury was significantly reduced in HPI-guided management group, RR = 0.61, 95% CI (0.39-0.96), although exclusion-based sensitivity analysis suggests that this finding may not be robust. No other significant differences were observed for hospital length of stay, arrhythmia, stroke, cognitive dysfunction (including delirium), surgical site infection, pneumonia, or mortality. Although HPI-guided management is associated with a reduction in postoperative myocardial injury, its significance does not withstand sensitivity analysis. All other postoperative complications, including AKI incidence, are not reduced in the intervention groups. This study has limitations inherent to the heterogeneity of included patient populations, surgical interventions performed, standard of care practices, and reporting of postoperative outcomes. Copyright © 2026 International Anesthesia Research Society. <38> Accession Number 2037892660 Title Iatrogenic Left Main Coronary Artery Stenosis Following Interventional and Surgical Procedures: A Literature Review. Source Kosuyolu Heart Journal. 29(1) (pp 76-80), 2026. Date of Publication: 01 Mar 2026. Author Bozkurt B.; Yavuz S.; Kus M.K.; Memetoglu M.E. Institution (Bozkurt) Department of Cardiovascular Surgery, Kastamonu Training and Research Hospital, Kastamonu, Turkey (Yavuz) Department of Cardiology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey (Kus, Memetoglu) Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey Publisher Kare Publishing Abstract Iatrogenic left main coronary artery (LMCA) stenosis is a rare but life-threatening complication that may occur after percutaneous coronary intervention (PCI) or cardiac valve surgery. While initially uninvolved, the LMCA can develop significant stenosis months after manipulation of other coronary vessels, raising diagnostic and therapeutic challenges. This review aims to synthesize existing case reports and clinical experiences regarding the development of iatrogenic LMCA stenosis in patients with no prior LMCA lesions, focusing on procedural causes and subsequent treatment strategies. A comprehensive review of the literature identified and analyzed a total of 14 publications comprising 8 multi-patient case series, 4 single case reports, and 1 retrospective cohort were identified, who developed iatrogenic LMCA stenosis following PCI or aortic valve surgery. Mechanisms, clinical presentations, diagnostic approaches, and outcomes of various treatment modalities were analyzed. The most common mechanisms included catheter-induced trauma, balloon overdistension, and ostial cannulation during valve surgery. Clinical presentation ranged from recurrent angina to cardiogenic shock. Treatment strategies included coronary artery bypass grafting, percutaneous coronary angioplasty with stenting, and in select hemodynamically stable patients, conservative medical therapy. PCI was often reserved for high-risk surgical patients or when rapid revascularization was essential. Iatrogenic LMCA stenosis should be considered in patients presenting with angina after coronary or valvular interventions, especially in the absence of prior LMCA disease. Early recognition through angiography and appropriate selection of revascularization strategy, surgical or percutaneous, is critical for optimizing outcomes. Copyright © 2026 by Kosuyolu Heart. <39> Accession Number 2045876853 Title Cardiovascular Vulnerability, Including Heart Failure Risk, in Breast Cancer Surgery: The Role of Operative Technique, Frailty, and Postoperative Complications. Source Medicina (Lithuania). 62(5) (no pagination), 2026. Article Number: 877. Date of Publication: 01 May 2026. Author Marginean A.; Margan M.; Gavrilescu D.-M.; Mateescu D.-M.; Cotet I.; Tudoran C.; Surducan D.A.; Muresan C.-O. Institution (Marginean) Department of Surgery, "Dr. Victor Popescu" Emergency Military Hospital, 9 Gheorghe Lazar Street, Timisoara, Romania (Margan, Surducan) Discipline of Public Health, Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania (Gavrilescu) Department of Orthodontics, Dental District, Strada Zagazului Nr. 3, One Floreasca Vista, Sector 1, Bucharest, Romania (Mateescu, Cotet) Doctoral School, Department of General Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, Timisoara, Romania (Cotet, Tudoran) Center of Molecular Research in Nephrology and Vascular Disease, Faculty of the of Medicine, "Victor Babes" University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, Timisoara, Romania (Tudoran) Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, Timisoara, Romania (Tudoran) County Emergency Hospital "Pius Brinzeu", L. Rebreanu, Nr. 156, Timisoara, Romania (Muresan) Department of Neuroscience, Forensic Medicine, Bioethics, Deontology and Medical Law, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania (Muresan) Institute of Legal Medicine, Timisoara, Romania (Muresan) Ethics and Human Identification Research Center, Department of Neurosciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Breast cancer surgery is increasingly performed in older patients with multimorbidity, in whom cardiovascular disease and frailty may substantially modify perioperative risk, including vulnerability to heart failure decompensation and other major medical complications. However, most available studies report global perioperative complication rates and composite medical endpoints, with heart failure events only rarely captured as dedicated outcomes, and operative technique, cardiovascular comorbidity, and frailty are often treated as separate domains rather than components of an integrated risk framework. Material(s) and Method(s): We conducted a systematized narrative review with a structured literature search in PubMed/MEDLINE, Scopus, and Web of Science from inception to 31 January 2026, including original studies of adult patients undergoing breast-conserving surgery, mastectomy, and/or reconstruction that reported early postoperative outcomes in relation to comorbidities, cardiovascular risk, or frailty. Eligibility assessment, data extraction, and qualitative synthesis followed key PRISMA 2020 principles, and findings were organized into three prespecified domains: surgical complexity, cardiovascular vulnerability (including patients with heart failure where reported), and frailty. Result(s): Nineteen studies (retrospective cohorts, registry-based analyses, and large database studies, primarily ACS NSQIP) met inclusion criteria, encompassing diverse breast surgery populations, including elderly, metastatic, and reconstructive cohorts. Across datasets, escalation from breast-conserving surgery to mastectomy and then to increasingly complex reconstruction was associated with a stepwise increase in perioperative complications, reoperations, bleeding, and, in selected series, catastrophic events. Preexisting cardiovascular disease and systemic vascular pathology significantly amplified postoperative morbidity even in procedures considered low or intermediate cardiac risk, with signals that patients with underlying heart failure carry particularly heightened vulnerability, although HF-specific events were infrequently reported as separate endpoints. Frailty, mainly assessed using modified frailty indices, consistently emerged as a strong, age-independent predictor of 30-day complications, mortality, and readmissions across surgical types, including both breast-conserving and reconstructive procedures. Conclusion(s): Early postoperative outcomes after breast cancer surgery are associated with the interaction between surgical complexity, cardiovascular comorbidity (with limited HF-specific reporting), and frailty rather than by operative technique alone. In this context, our synthesis primarily reflects overall cardiovascular vulnerability in comorbid and frail patients, with heart failure risk inferred indirectly from the available data. These findings support a patient-centered, risk-adapted surgical strategy in which the extent and timing of surgery and reconstruction are tailored to each patient's cardiovascular profile and frailty status, with preferential use of breast-conserving or less complex procedures in vulnerable individuals. Integrating standardized frailty assessment and cardio-oncologic evaluation into preoperative workflows, and prospectively validating this tri-axial framework in dedicated cohorts, may improve perioperative risk stratification and reduce the burden of postoperative medical complications in an aging breast cancer population. Copyright © 2026 by the authors. <40> Accession Number 2042873561 Title Sex-based differences in outcomes between male and female patients with bicuspid aortic stenosis following transcatheter aortic valve replacement: A meta-analysis. Source Precision Medical Sciences. 15(2) (pp 70-79), 2026. Date of Publication: 01 Jun 2026. Author Khan M.H.A.; Khawar M.; Farooq A.U.; Khalid A.; Ahsan S.M.; Awan M.H.N.; Nisar M.S.; Elahi A.; Faizan M.A.; Shahid I.; Ahmed A.M.; Haider F.; Chhetri R. Institution (Khan, Ahsan, Elahi) Department of Medicine, Harlingen Medical Center, Harlingen, TX, United States (Khawar, Farooq, Awan, Nisar, Shahid, Ahmed) Department of Medicine, King Edward Medical University, Punjab, Lahore, Pakistan (Khalid) Department of Medicine, Rawalpindi Medical University, Punjab, Rawalpindi, Pakistan (Faizan) Gomal Medical College, Khyber Medical University, Khyber Pakhtunkhwa, Peshawar, Pakistan (Haider) Department of Medicine, Allama Iqbal Medical College, Punjab, Lahore, Pakistan (Chhetri) Department of Medicine, Nepalgunj Medical College, Kohalpur, Nepal Publisher John Wiley and Sons Inc Abstract Bicuspid aortic valve (BAV) is a common congenital anomaly leading to early aortic stenosis. Although transcatheter aortic valve replacement (TAVR) offers a less invasive treatment for BAV stenosis, sex-specific outcome data are scarce. This study evaluates clinical outcomes after TAVR by sex in BAV patients. A systematic literature search was performed across PubMed, ClinicalTrials.gov, and Cochrane CENTRAL to identify relevant English-language randomized controlled trials and observational studies. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models based on heterogeneity. Statistical significance was set at p <.05, and heterogeneity was assessed using the I2 statistic. Analyses were performed with Review Manager Version 5.3. Four observational studies comprising 7585 patients met inclusion criteria. Males had a higher incidence of acute kidney injury (AKI) (RR = 1.33; 95% CI: 1.13-1.57; p =.0008) and acute myocardial infarction (MI) (RR = 2.18; 95% CI: 1.54-3.07; p =.00001), but a lower risk of in-hospital mortality (RR = 0.71; 95% CI: 0.51-0.99; p =.04), stroke (RR = 0.70; 95% CI: 0.50-0.95; p =.02), and bleeding (RR = 0.79; 95% CI: 0.63-0.98; p =.03) compared to females. No statistically significant differences were observed in one-year mortality (RR = 1.08; 95% CI: 0.58-2.03; p =.81), 30-day mortality (RR = 1.18; 95% CI: 0.51-2.75; p =.69), or arrhythmia (RR = 0.83; 95% CI: 0.52-1.33; p =.45). Males had increased risks of AKI and MI, while females experienced higher in-hospital mortality, stroke, and bleeding. These findings, derived from a limited number of retrospective observational studies, are hypothesis-generating and highlight the need for sex-specific risk stratification and further prospective research to confirm these patterns and guide clinical practice. Copyright © 2026 The Author(s). Precision Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital. <41> Accession Number 2045876940 Title Expanding the Therapeutic Landscape of Pericarditis: A Systematic Review of the Use of Conventional Immunosuppressants. Source Medicina (Lithuania). 62(5) (no pagination), 2026. Article Number: 887. Date of Publication: 01 May 2026. Author Giordani A.S.; Menghi C.; Risoli A.; Baritussio A.; Scognamiglio F.; Castegnaro M.; Pontara E.; Cattini M.G.; Bison E.; Murace C.A.; Verrecchia E.; Del Buono M.G.; Landi F.; Sicignano L.L.; Caforio A.L.P. Institution (Giordani, Menghi, Baritussio, Scognamiglio, Castegnaro, Pontara, Cattini, Bison, Caforio) Cardiology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy (Risoli, Verrecchia, Landi, Sicignano) Department of Geriatrics, Orthopaedics and Rheumatology, Universita Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, Rome, Italy (Murace) Department of Medical and Surgical Sciences, Universita Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (Del Buono) Department of Cardiovascular Science, Universita Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: While interleukin-1 inhibitors represent the standard of care for refractory idiopathic recurrent acute pericarditis, current guidelines also endorse conventional immunosuppressive (IS) agents as potential alternatives. The use of conventional IS agents is particularly relevant in specific clinical scenarios, such as systemic immune-mediated disease (SID)-associated pericarditis. However, existing evidence regarding their efficacy and safety for pericarditis treatment remains fragmented, deriving exclusively from case reports, case series, and small monocentric observational studies. Our aims are: To characterize the clinical and diagnostic profiles of patients with pericarditis treated with conventional IS agents and to evaluate the therapeutic efficacy and safety of such agents. Material(s) and Method(s): A systematic review was conducted in accordance with PRISMA guidelines. Major electronic databases were searched from January 1970 to March 2026 for case reports, case series, and observational studies detailing the use of conventional IS therapies for pericarditis. Clinical and therapeutic data, including specific IS indications and dosing regimens, were systematically extracted. Result(s): The final analysis included 39 reports comprising 75 patients (60% female; median age 36.0 years). The underlying pericarditis aetiology was predominantly SID-related (53%, n = 40) or idiopathic/presumed viral recurrent disease (40%, n = 30). The most frequently prescribed first-line IS agents were azathioprine (44%) and methotrexate (25%). Across published reports, IS therapy was described as achieving pericarditis clinical resolution in all cases and facilitated corticosteroid withdrawal in 72% of patients. Overall, pericarditis recurrence while on IS therapy occurred in only 10% of the cohort. Adverse events requiring IS withdrawal were rare (n = 2, 3%). Conclusion(s): Conventional IS agents appear effective and generally well tolerated in the published literature on SID-associated and isolated recurrent pericarditis. These findings reinforce the clinical utility of conventional IS therapies as a viable, steroid-sparing strategy when targeted biologic therapies lack sufficient investigation. Copyright © 2026 by the authors. <42> Accession Number 2043833074 Title Echocardiographic Guidance for Percutaneous Left Atrial Appendage Occlusion: A Systematic Review of Outcomes in High-Risk Populations Including Chronic Liver Disease and Prior Gastrointestinal Bleeding. Source Diagnostics. 16(5) (no pagination), 2026. Article Number: 678. Date of Publication: 01 Mar 2026. Author Becic T.; Jukic I.; Prizmic P.S.; Matulic I.; Dogas H.; Radic M.; Radic J.; Vukovic J.; Fabijanic D. Institution (Becic, Fabijanic) Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia (Jukic, Vukovic) Division of Gastroenterology, Department of Internal Medicine, University Hospital of Split, Split, Croatia (Jukic) Faculty of Health Sciences, University of Split, Split, Croatia (Prizmic, Radic) Division of Rheumatology, Allergology and Clinical Immunology, Department of Internal Medicine, University Hospital of Split, Split, Croatia (Matulic) Private Clinic Matulic, Osjecka Ulica 24a, Split, Croatia (Dogas) Department of Neurology, University Hospital of Split, Split, Croatia (Radic, Radic, Vukovic) Department of Internal Medicine, School of Medicine, University of Split, Split, Croatia (Radic) Division of Nephrology, Dialysis and Arterial Hypertension, Department of Internal Medicine, University Hospital of Split, Split, Croatia (Fabijanic) Department of Clinical Propedeutics, School of Medicine, University of Split, Split, Croatia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Echocardiographic imaging has become central to planning and guiding percutaneous left atrial appendage occlusion (LAAO), particularly in patient populations in whom long-term anticoagulation is unsuitable. This systematic review synthesizes current evidence on transesophageal (TEE) and intracardiac echocardiography (ICE) guidance during LAAO, with special emphasis on outcomes in high-risk cohorts, including chronic liver disease (CLD) and prior gastrointestinal (GI) bleeding. Method(s): Following PRISMA 2020 guidelines, four databases (PubMed, Scopus, Web of Science, and Cochrane CENTRAL) were searched up to 5 December 2025. Eligible studies included adult patients with atrial fibrillation (AF) undergoing percutaneous LAAO with intraprocedural echocardiographic guidance. Eight studies (n = 1739 patients) met the inclusion criteria. Data were synthesized qualitatively due to heterogeneity across devices, imaging protocols, and outcomes. Result(s): TEE was the predominant imaging modality (62.5%), providing high spatial resolution for transseptal puncture, device positioning, and peri-device leak (PDL) assessment. ICE-guided LAAO (25.0%) was associated with high procedural success and favorable safety profiles in selected observational cohorts, while reducing anesthesia requirements and fluoroscopy time. Across all studies, procedural success ranged from 93 to 100%, with low rates of major complications. Reported follow-up durations varied substantially across studies and were predominantly short- to mid-term, limiting assessment of long-term device-related outcomes. Evidence specific to patients with chronic liver disease and prior gastrointestinal bleeding was limited, with only two included studies directly evaluating these populations, while remaining insights were extrapolated from broader LAAO cohorts. In high-risk groups, LAAO remained feasible: cirrhotic patients demonstrated high implantation success with acceptable bleeding profiles, while patients with prior GI bleeding showed low recurrence after closure. Conclusion(s): Both TEE and ICE provide reliable intraprocedural imaging for LAAO, with ICE offering workflow and safety advantages in patients unsuitable for general anesthesia. The available evidence suggests that LAAO is a feasible and potentially safe therapeutic option in selected patients with CLD and prior GI bleeding, although direct data remain limited. Future studies should compare imaging modalities prospectively in high-risk cohorts and evaluate emerging 3D/4D ICE technologies. Copyright © 2026 by the authors. <43> Accession Number 2045012982 Title Cryoanalgesia for Pain Management in Thoracic Surgery. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 21(2) (pp 99-100), 2026. Date of Publication: 01 Mar 2026. Author Ad N. Institution (Ad) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States Publisher SAGE Publications Ltd <44> Accession Number 2045634297 Title Outcomes of Aortic Valve Repair: A Systematic Review and Meta-Analysis Using Reconstructed Individual Patient Data. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 21(2) (pp 111-121), 2026. Date of Publication: 01 Mar 2026. Author Cerqueira R.J.; Mascarenhas J.Q.; Rodrigues M.; Miranda J.O.; Kawczynski M.J.; Vojacek J.; Arabkhani B.; Bidar E.; Leite-Moreira A.; Saraiva F.; Heuts S. Institution (Cerqueira, Mascarenhas, Rodrigues, Miranda, Leite-Moreira, Saraiva) UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal (Cerqueira, Leite-Moreira) Cardiothoracic Surgery Department, Centro Hospitalar Universitario Sao Joao, Portugal (Kawczynski, Bidar, Heuts) Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Netherlands (Kawczynski, Bidar, Heuts) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Netherlands (Vojacek) Department of Cardiac Surgery, University Hospital Hradec Kralove, Czechia (Arabkhani) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands Publisher SAGE Publications Ltd Abstract Objective: The progressive dissemination of isolated aortic valve repair (AVRep) and valve-sparing root (VSR) procedures has resulted in a cumulative expansion of the available literature. This work aims to synthesize the current knowledge and identify predictors of mortality and reintervention in patients undergoing such valve-preserving procedures. Method(s): A systematic review and meta-analysis were conducted in 2 databases (last search January 2025). Studies with >=200 adult patients undergoing AVRep or VSR with a minimum mean follow-up >=5 years were included. Short-term outcomes were summarized using weighted descriptive statistics. Forest plots, funnel plots, and the Newcastle-Ottawa Scale were used to evaluate the risk of bias. Long-term survival and freedom from reoperation were analyzed through reconstructing individual patient data from Kaplan-Meier curves, and a mixed-effects Cox frailty model was used to identify study-level predictors of these endpoints. Result(s): There were 48 studies included, encompassing 20,914 patients with a mean weighted age of 52.42 (50.28 to 54.57) years. Early outcomes included hospital mortality (1.34% [1.04% to 1.73%]), bleeding (3.77% [2.76% to 5.13%]), myocardial ischemia (0.44% [0.26% to 0.77%]), pacemaker implantation (1.00% [0.63% to 1.59%]), neurologic events (1.27% [0.91% to 1.78%]), and postoperative residual aortic regurgitation (3.48% [1.90% to 6.29%]). Pooled survival at 1, 5, 10, and 20 years of follow-up was 96.8%, 92.5%, 83.8%, and 67%, respectively; freedom from reoperation at the same time points was 97.9%, 93.9%, 88.2%, and 77.5%, respectively. Factors such as older age, female sex, aortic dissection, and isolated valve repair were associated with higher mortality. Conclusion(s): These findings suggest that AVRep and VSR are associated with low early mortality and morbidity and excellent long-term outcomes. However, heterogeneity in definitions and endpoints across studies underlines the need for standardized definitions and conduction of properly designed randomized trials. Copyright © The Author(s) 2026 <45> Accession Number 2046481893 Title Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (SNaPP): an international, randomised, controlled, phase 4 trial. Source The Lancet Respiratory Medicine. (no pagination), 2026. Date of Publication: 2026. Author Leslie K.; Darvall J.N.; Chan M.T.V.; Peyton P.J.; Myles P.S.; Corcoran T.B.; Short T.G.; Olesnicky B.L.; Webb A.R.; Devlin N.; Tran-Duy A.; Maxwell-Wright H.; Schultz-Ferguson C.; Fitzpatrick P.; Sidiropoulos S.; Braat S.; Story D.A. Institution (Leslie, Darvall, Peyton, Devlin, Tran-Duy, Maxwell-Wright, Schultz-Ferguson, Fitzpatrick, Sidiropoulos, Braat, Story) University of Melbourne, Melbourne, VIC, Australia (Leslie, Darvall) Royal Melbourne Hospital, Melbourne, VIC, Australia (Chan) Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong Special Administrative Region, Hong Kong (Peyton, Sidiropoulos, Story) Austin Hospital, Melbourne, VIC, Australia (Myles, Webb) Monash University, Melbourne, VIC, Australia (Myles) The Alfred, Melbourne, VIC, Australia (Corcoran) University of Western Australia and Royal Perth Hospital, Perth, WA, Australia (Short) University of Auckland and Auckland City Hospital, Auckland, New Zealand (Olesnicky) University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia (Webb) Frankston Hospital, Melbourne, Australia Publisher Elsevier Ltd Abstract Background: Sugammadex and neostigmine are used to reverse aminosteroid neuromuscular-blocking drugs at the end of surgery. We aimed to determine whether reversal of neuromuscular blockade with sugammadex reduces the incidence of postoperative pulmonary complications or death compared with neostigmine. Method(s): We conducted a pragmatic, international, multicentre, randomised, controlled, phase 4 trial involving 44 hospitals in Australia, Aotearoa New Zealand, and Hong Kong. Eligible patients were adults (aged >=40 years) who were having abdominal or thoracic surgery under general anaesthesia and lasting at least 2 h, with an expected postoperative hospital stay of 1 night or longer. Patients were randomly assigned (1:1) to sugammadex or neostigmine, administered intravenously in doses chosen by the attending anaesthesiologist, for reversal of rocuronium-induced or vecuronium-induced neuromuscular blockade at the end of surgery. Randomisation was done via a web-based service, in random permuted blocks of varying sizes of 2 and 4 and stratified by centre. Patients, research staff who were responsible for outcome assessments, and members of the endpoint adjudication committee were masked to group assignment. The primary outcome was postoperative pulmonary complications or death up to hospital discharge (or postoperative day 7 if still in hospital). The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000394640) and is closed to accrual. Finding(s): Patients were recruited between July 21, 2023, and July 3, 2025; 3498 patients were included in the intention-to-treat population (1745 [49.9%] in the sugammadex group and 1753 [50.1%] in the neostigmine group). Postoperative pulmonary complications or death occurred in 331 (19.0%) of 1743 patients in the sugammadex group and 377 (21.5%) of 1752 patients in the neostigmine group (risk ratio [RR] 0.88 [95% CI 0.77-1.00]; p=0.049). Death occurred in one (0.1%) and two (0.1%) patients (RR 0.50 [95% CI 0.05-5.53]; p >0.99), atelectasis in 320 (18.4%) of 1742 patients and 370 (21.1%) of 1750 patients (0.86 [0.76-0.99]; p=0.030), pneumonia in 37 (2.1%) of 1742 patients and 38 (2.2%) of 1750 patients (0.98 [0.62-1.53]; p=0.92), and pulmonary aspiration in four (0.2%) of 1742 and seven (0.4%) of 1750 patients (0.57 [0.17-1.96]; p=0.38) in the sugammadex and neostigmine groups, respectively. Acute respiratory distress syndrome was not reported. No adverse events were deemed to be treatment related. Interpretation(s): Sugammadex reduced the incidence of postoperative pulmonary complications or death compared with neostigmine. The risk reduction was small with atelectasis of uncertain clinical significance being the most common complication. Sugammadex can be considered as a first-line drug for reversal of aminosteroid-induced neuromuscular blockade at the end of surgery. Funding(s): Australian Medical Research Future Fund and the Hong Kong Health and Medical Research Fund. Copyright © 2026 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license <46> [Use Link to view the full text] Accession Number 2044447820 Title Efficacy and safety of invasive versus noninvasive treatments in elderly patients with non-ST-segment myocardial infarction: a systematic review and meta-analysis. Source Coronary Artery Disease. 37(3) (no pagination), 2026. Date of Publication: 01 May 2026. Author Malik S.; Mufaddal Z.Q.; Koskina L.; Siddiqui O.M.; Mansour M.; Nusrat K.; Khan R.; Sohail M.U.; Farhan S.H.; Singh D.; Ali E.; Hameed I. Institution (Malik, Mufaddal, Siddiqui, Khan, Sohail, Farhan, Ali) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Koskina, Mansour, Singh, Hameed) Department of Medicine, Medstar Health, Baltimore, Maryland, United States (Nusrat) Department of Medicine, University at Buffalo-Catholic Health System, Buffalo, NY, United States Publisher Lippincott Williams and Wilkins Abstract Background - Historically, the elderly population was underrepresented in clinical trials evaluating the optimal treatment for non-ST-segment elevation myocardial infarction (NSTEMI). Therefore, we aimed to compare invasive versus noninvasive strategies for the management of NSTEMI in older adults. Methods - PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials were screened for studies evaluating medical therapy or invasive revascularization in elderly patients with NSTEMI. Following outcomes were extracted: all-cause mortality, cardiovascular death, fatal or nonfatal MI, repeat coronary revascularization, major adverse cardiovascular events (MACE), bleeding, stroke, noncardiovascular death, and repeat hospitalization for heart failure. Data were pooled using random-effects model to evaluate weighted mean differences and risk ratios with 95% confidence intervals (CIs). This study is registered with PROSPERO, CRD42024622236. Results - Seven studies (n = 2997 patients) were included. Patients treated with medical versus invasive therapies showed no significant difference in all-cause mortality (risk ratio: 1.05, 95% CI: 0.94-1.18, P = 0.37); however, invasive therapies significantly decreased the risk of fatal or nonfatal MI (risk ratio: 0.75, 95% CI: 0.59-0.96, P = 0.02), repeat coronary revascularizations (risk ratio: 0.29, 95% CI: 0.21-0.40, P < 0.00001), and risk of MACE (risk ratio: 0.74, 95% CI: 0.61-0.89, P = 0.002). Lastly, invasive therapies were associated with increased risk of bleeding. Conclusion - Invasive therapy, in comparison to medical management, has reduced incidence of fatal or nonfatal MI, MACE, and the need for revascularization; however, no benefit was noted for all-cause and cardiovascular mortality. Age-specific guidelines must be established for the management of NSTEMI among older adults. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <47> Accession Number 2040767481 Title Transcatheter tricuspid valve intervention compared to optimal medical therapy: Meta-analysis of randomized controlled trials. Source Cardiovascular Revascularization Medicine. 87 (pp 49-55), 2026. Date of Publication: 01 Jun 2026. Author Hoyos C.; Upadhaya S.; Jabri A.; Boyapati S.P.; Billa S.; Farhan S.; Anker A.; Cox P.; Sanina C.; Soltero-Mariscal E.; Spinetto P.V.; Wiley J.M. Institution (Hoyos, Boyapati, Billa) Department of Medicine, Louisiana State University Health and Sciences Center, 2390 W Congress Street, Lafayette, LA, United States (Upadhaya, Anker, Sanina, Wiley) Section of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA, United States (Jabri, Soltero-Mariscal, Spinetto) Section of Cardiology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI, United States (Farhan) Section of Cardiology, Lenox Hill Hospital, 100 E 77th St, New York, NY, United States (Cox) Section of Cardiology, University of Miami Health System, 1320 S Dixie Hwy, Coral Gables, FL, United States Publisher Elsevier Inc. Abstract Background Tricuspid regurgitation (TR) is a common valvular disorder linked to significant morbidity and mortality. Transcatheter tricuspid valve intervention (TTVI) has emerged as a novel therapeutic option for high-risk patients. However, randomized controlled trials (RCTs) evaluating its clinical efficacy remain limited in sample size, making it difficult to draw definitive conclusions. Methods We conducted a systematic review of studies comparing outcomes between TTVI vs. optimal medical therapy (OMT) published between January 2000 to June 2025 in PubMed, Cochrane, and Embase. The primary outcomes were all-cause mortality and heart failure hospitalization (HFH). The secondary outcomes included cardiovascular death, TR severity, NYHA class improvement, and Kansas City Cardiomyopathy Questionnaire (KCCQ) score. Results Three RCTs, including 1264 patients (TTVI: 696; OMT: 568), were analyzed. At one year, there was no significant difference in all-cause mortality (RR: 1.12; 95 % CI: 0.77-1.63; p = 0.55), HFH (RR: 0.83; 95 % CI: 0.64-1.07; p = 0.15) and cardiovascular death (RR: 1.11; 95 % CI: 0.7-1.77; p = 0.65) between groups. Patients in TTVI group significantly improved at least 1 class in NYHA functional classification (RR: 2.77; 95 % CI: 1.72-4.49; p < 0.0001), had greater changes in KCCQ scores (+15.23 points; 95 % CI: 12.03-18.44; p < 0.0001), and markedly reduced the incidence of >= severe TR at follow-up (RR: 0.09; 95 % CI: 0.03-0.27; p < 0.0001) compared to OMT. Conclusions Although TTVI has not demonstrated statistically significant reductions in all-cause mortality or HFH, it is associated with substantial improvements in functional class, quality of life, and TR severity, supporting its role in select high-risk patients. Copyright © 2025 Elsevier Inc. <48> Accession Number 2046148022 Title Association between SGLT2 inhibitors and outcomes after heart transplant in patients with type 2 diabetes: A systematic review and meta-analysis. Source Heart Failure Reviews. 31(1) (no pagination), 2026. Article Number: 70. Date of Publication: 01 Dec 2026. Author Costa T.A.; de Sousa L.M.T.; Nogueira A.; Chagas G.C.L.; Abreu M.; Allen L.A.; Cornwell W.K.; Harrington J. Institution (Costa, Allen, Cornwell) Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States (de Sousa) Department of Medicine, University of Miami, Miami, FL, United States (de Sousa) Postgraduate Program in Cardiovascular Sciences, Federal University of Ceara, Ceara, Brazil (Nogueira) Postgraduate Program in Cardiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Nogueira) MOVE Academic Research Organization, Hospital Moinhos de Vento, Porto Alegre, Brazil (Chagas) Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States (Abreu) Division of Endocrinology and Metabolism, Department of Internal Medicine, The University of Texas Southwestern, Dallas, TX, United States (Allen, Cornwell, Harrington) Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States (Harrington) Colorado Prevention Center, 12631 E. 17th Ave, Aurora, CO, United States Publisher Springer Abstract Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for multiple populations-type 2 diabetes (T2D), chronic kidney disease, and heart failure-but their role after heart transplant (HTX) remains unclear. We searched PubMed, Cochrane, and Embase for studies of HTX recipients with T2D comparing outcomes in SGLT2i users vs. non-users. Outcomes of interest were all-cause mortality, urinary tract infection (UTI), and estimated glomerular filtration rate (eGFR) change from baseline. Odds ratios (ORs) and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were pooled using a random-effects model for binary outcomes. Three retrospective observational studies were included in the all-cause mortality meta-analysis, four in the UTI incidence meta-analysis, and five in the qualitative analysis evaluating eGFR change (n = 3,564). Mean follow-up ranged from 9 to 83 months. SGLT2i use was associated with a lower risk of all-cause mortality compared with non-use in both unadjusted (OR 0.43; 95% CI 0.26-0.71; p < 0.001; I2 = 79%) and adjusted analyses (aHR 0.69; 95% CI 0.51-0.93; p = 0.02; I2 = 20%), without increasing the risk of UTI (OR 0.77; 95% CI 0.14-4.05; p = 0.75; I2 = 48%). Most studies suggested stable or increased eGFR from baseline with SGLT2i exposure. SGLT2i use, compared with non-use, was associated with lower all-cause mortality without an increased incidence of UTIs in HTX recipients with T2D. Additionally, the pooled data suggest a possible renal benefit. The totality of these observational data, despite their limitations, provide important context for ongoing SGLT2i use following HTX. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <49> [Use Link to view the full text] Accession Number 2044383995 Title Robustness of highly purified eicosapentaenoic acid trials and their cardiovascular outcomes. Source Journal of Cardiovascular Medicine. 27(5) (pp 398-407), 2026. Date of Publication: 01 May 2026. Author Zuin M.; Bilato C. Institution (Zuin) Department of Translational Medicine, University of Ferrara, Ferrara, Italy (Zuin) Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Padua, Italy (Zuin) Department of Cardiology, Madre Teresa di Calcutta Hospital, AULSS 6, Ospedali Riuniti Padova Sud, Monselice, Italy (Bilato) Department of Cardiology, West Vicenza General Hospital, Arzignano, Italy Publisher Lippincott Williams and Wilkins Abstract Aims - Despite contemporary statin therapy, patients with atherosclerotic cardiovascular disease or high cardiovascular risk experience a residual risk of major adverse events. Eicosapentaenoic acid (EPA) has been evaluated for additional cardiovascular risk reduction, but the consistency and robustness of trial results remain uncertain. The aim of this study was to assess the robustness of randomized controlled trials (RCTs) of highly purified EPA for cardiovascular outcomes. Methods - MEDLINE and Scopus were searched for phase 3/4 RCTs of EPA published through June 2025. Eligible studies were randomized and placebo-controlled, and reported dichotomous cardiovascular outcomes. Three trials met the inclusion criteria: REDUCE-IT, RESPECT-EPA, and JELIS. Primary and secondary cardiovascular endpoints were extracted. Conventional effect estimates (hazard ratios, relative risk reduction, number needed to treat) were calculated, and robustness was evaluated using the fragility index and fragility quotient. Results - EPA significantly reduced the primary composite endpoint in REDUCE-IT (17.2 vs. 22.0%; hazard ratio 0.75; fragility index 123, fragility quotient 0.01), RESPECT-EPA (9.1 vs. 12.6%; hazard ratio 0.71; fragility index 49, fragility quotient 0.01), and JELIS (2.8 vs. 3.5%; hazard ratio 0.81; fragility index 15, fragility quotient 0.01). Secondary endpoints showed consistent but heterogeneous reductions in nonfatal myocardial infarction, stroke, and revascularization, with robustness highest in REDUCE-IT and more fragile results in RESPECT-EPA and JELIS. Differences in population phenotypes, background statin therapy, trial design, and endpoint definitions contributed to variability in the effect size and fragility. Conclusion - EPA added to statins lowers cardiovascular events, most robustly in high-risk patients with elevated triglycerides. Trial design, endpoints, and patient characteristics drive heterogeneity, while fragility analyses complement conventional metrics in interpreting outcomes. Copyright © 2026 Italian Federation of Cardiology - I.F.C. All rights reserved. <50> Accession Number 2045747253 Title Safety and efficacy of single versus dual arterial access in transfemoral transcatheter aortic valve implantation: a systematic review and meta-analysis of propensity-matched cohort. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 427. Date of Publication: 01 Dec 2026. Author Adamu U.G.; Mashilo D.; Mutyaba A.; Patel A.; Farrel H.; Tsabedze N. Institution (Adamu, Mashilo, Mutyaba, Patel, Tsabedze) Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (Farrel) Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, South Africa (Farrel) Sunninghill Hospital, Sunninghill, Johannesburg, South Africa (Adamu) Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of Witwatersrand, York Road, Parktown, South Africa Publisher BioMed Central Ltd Abstract Purpose of review: Transfemoral transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS). Although dual arterial access (DAA) is commonly used for catheter control and haemodynamic monitoring, single arterial access (SAA) has emerged as a minimalist strategy aimed at reducing procedural complexity and access-site complications. However, comparative outcome data remain limited. Recent findings: Four propensity score-matched observational studies comprising 540 patients (50.4% SAA) were included. Compared with DAA, SAA was associated with a significantly lower risk of total vascular complications (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17-0.67; p < 0.001), largely driven by reductions in minor access-site events (OR 0.44, 95% CI 0.20-0.95; p = 0.04), while rates of major vascular complications were similar between groups. There were no significant differences in all-cause mortality, stroke or transient ischaemic attack, paravalvular leak, or major bleeding. SAA was also associated with shorter procedural time (mean difference [MD] -17.1 min, 95% CI -32.8, -1.4; p = 0.03) and lower contrast volume use (MD -28.6 mL, 95% CI -55.3, -1.9; p = 0.04), although substantial heterogeneity was observed. Summary: In patients with symptomatic severe AS undergoing transfemoral TAVI, SAA appears to be a safe and feasible alternative to DAA and is associated with fewer vascular complications without compromising major clinical outcomes. Future prospective and randomised studies incorporating procedural complexity and device-specific outcomes are needed to confirm these results and better define optimal patient selection. Copyright © The Author(s) 2026. <51> Accession Number 2038193614 Title Early In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors After ST-Elevation Myocardial Infarction: A Clinical Review of Hemodynamic and Renal Safety. Source Reviews in Cardiovascular Medicine. 27(4) (no pagination), 2026. Article Number: 48560. Date of Publication: 01 Apr 2026. Author Farhan M.; Patel T.; Almarouj D.; Seyfi A.; Abdi S.I.A.; Abufanas A.; Rimawi A.; Al-Zuhairi I.; Al-Zuhairi A.; Azzawi A.A.; Patel B.D.; Awosika A. Institution (Farhan, Seyfi, Abufanas, Rimawi, Al-Zuhairi, Azzawi) Internal Medicine, College of Medicine, Ajman University, Ajman, United Arab Emirates (Patel) Internal Medicine, School of Medicine, Trinity Medical Sciences University, VC 01000, Kingstown, Saint Vincent and the Grenadines (Almarouj) Internal Medicine, Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty, Kazakhstan (Abdi) Internal Medicine, Thumbay University Hospital, Ajman, United Arab Emirates (Al-Zuhairi) Internal Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (Patel) Internal Medicine, Windsor University School of Medicine, Basseterre, Saint Kitts and Nevis (Awosika) Department of Family and Community Medicine, University of Illinois College of Medicine, Peoria, IL, United States Publisher IMR Press Limited Abstract Survivors of ST-elevation myocardial infarction (STEMI) continue to face appreciable risks of hospitalization for heart failure and acute kidney injury (AKI), even in the era of prompt primary percutaneous coronary intervention (PCI). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) deliver proven cardio-renal benefits in chronic heart failure and chronic kidney disease (CKD) however, the safety profile of these agents when initiating administration during the index STEMI admission remains poorly characterized. This clinical review summarizes contemporary evidence on the hemodynamic and renal safety of initiating SGLT2i therapy 24-72 h after PCI in patients with STEMI and provides a pragmatic, evidence-informed bedside framework, supported by randomized controlled trials (RCTs) and mechanistic and observational data from January 2018 to July 2025. Trial eligibility criteria and safety endpoints were extracted qualitatively no formal meta-analysis was performed. Among at least 11,221 participants, early SGLT2i initiation was well tolerated: rates of hypotension, volume depletion, AKI, and diabetic ketoacidosis (DKA) were comparable to placebo. The characteristic 3- 6 mL/min/1.73 m2 decline in estimated glomerular filtration rate (eGFR) represented a reversible tubuloglomerular feedback (TGF) adjustment rather than nephrotoxicity. Mechanistic studies attribute these findings to mild natriuresis without sympathetic activation and to afferent arteriolar vasoconstriction, which lowers intraglomerular pressure. Synthesizing trial exclusion criteria with clinical judgement, we propose the START checklist (stable hemodynamics, tubular reserve, acid-base stability, risk factors, timing (24-72 h)) as provisional guidance to support bedside decision-making while large outcome studies, such as the empagliflozin after acute myocardial infarction (EMPACT-MI) trial and the extended empagliflozin to prevent worsening of left ventricular volumes and systolic function after myocardial infarction (EMPRESS-MI) trial read-outs, are awaited. Current evidence supports the hemodynamic and renal safety of commencing SGLT2i soon after PCI in hemodynamically stable STEMI patients with preserved tubular reserve. In the absence of ongoing trials, cautious adoption guided by the START framework can help clinicians capture potential cardio-renal benefits without compromising acute care. Copyright © 2026 The Author(s). <52> Accession Number 2045791549 Title Valve-in-Valve Transcatheter Mitral Valve Replacement Versus Redo Surgical Mitral Valve Replacement: Meta-Analysis of Early and Late Outcomes. Source Journal of the American Heart Association. 15(9) (no pagination), 2026. Article Number: e050299. Date of Publication: 01 Jan 2026. Author Sa M.P.; Neves G.; Consoli L.; Iqbal A.; Dexheimer L.; da Hora D.A.B.; Camarotti T.; Jacquemyn X.; Napoli F.; Polanco A.; Brozzi N.A.; Navia J.L. Institution (Sa, Napoli, Polanco, Brozzi, Navia) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute, Cleveland Clinic Florida, Weston, FL, United States (Neves) Universidade do Estado do Para (UEPA) Belem, Para, Brazil (Consoli) Universidade Federal da Bahia (UFBA), Salvador, Brazil (Iqbal) Bacha Khan Medical College, Mardan, Pakistan (Dexheimer) Universidade de Sao Paulo (USP) Sao Paulo, Brazil (da Hora) Universidade Federal do Amazonas (UFAM), Manaus, Brazil (Camarotti) Universidade de Pernambuco, Recife, Brazil (Jacquemyn) UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Bioprosthetic mitral valve degeneration is traditionally treated with redo surgical mitral valve replacement (redo-SMVR), but valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) offers a less invasive alternative. METHOD(S): Systematic review and meta-analysis of studies comparing ViV-TMVR and redo-SMVR. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Meta-analyses were conducted with random-effects models to assess patient-relevant outcomes; Kaplan-Meier-derived time-to-event data were pooled to assess late outcomes. RESULT(S): Thirteen observational studies met our eligibility criteria, including 15 941 patients (ViV-TMVR: 5465; redo-SMVR: 10476). In comparison with redo-SMVR, ViV-TMVR was associated with lower risk of in-hospital mortality (risk ratio [RR], 0.72 [95% CI, 0.57-0.90]; P=0.004), stroke (RR, 0.49 [95% CI, 0.29-0.83]; P=0.008), bleeding (RR, 0.43 [95% CI, 0.20-0.94]; P=0.035), acute kidney injury (RR, 0.57 [95% CI, 0.42-0.77]; P<0.001), permanent pacemaker implantation (RR, 0.30 [95% CI, 0.19-0.49]; P<0.001), and shorter hospital length of stay (mean difference,-5.09 days [95% CI, -6.56 to -3.63]; P<0.001). There was no statistically significant difference between the groups in terms of 5-year survival (hazard ratio [HR], 0.92 [95% CI, 0.81-1.05]; P=0.256); however, the landmark analysis revealed that ViV-TMVR was associated with lower risk of death in the initial 6 months (HR, 0.69 [95% CI, 0.58-0.83]; P<0.001) but a higher risk beyond 6 months (HR, 1.47 [95% CI, 1.20-1.79]; P<0.001). CONCLUSION(S): In patients amenable to ViV-TMVR, this procedure shows a lower initial risk of death and complications, but higher mortality after 6 months in comparison with redo-SMVR. These findings highlight the importance of striking a balance between upfront surgical risk and estimated life expectancy when selecting interventions. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <53> Accession Number 2046063611 Title Prognostic value of AI-enabled quantitative coronary CT angiography for major adverse cardiovascular events: A systematic review and meta-analysis. Source International Journal of Cardiology: Cardiovascular Risk and Prevention. 30 (no pagination), 2026. Article Number: 200660. Date of Publication: 01 Sep 2026. Author Malik M.; Batista P.; Lucena L.A.D.; Montenegro M.V.; Santos Silva R.R.A.; Fischer-Bacca C.O.; Giorgi J.; Strom J. Institution (Malik) Beth Israel Deaconess Medical Center, MA, United States (Batista) Universidade Federal da Paraiba, Paraiba, Brazil (Lucena) Federal University of Rio Grande Do Norte, Natal, RN, Brazil (Montenegro) University of Pernambuco, PE, Recife, Brazil (Santos Silva) Federal University of Ceara, Ceara, Fortaleza, Brazil (Fischer-Bacca) University Center for the Development of Alto Vale - UNIDAVI, Medical Sciences Research Center, Rio Do Sul, Brazil (Giorgi) Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil (Giorgi) Albert Einstein Hospital, Sao Paulo, Sao Paulo, Brazil (Strom) Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA, United States Publisher Elsevier B.V. Abstract Background Artificial intelligence-enabled quantitative coronary computed tomography angiography (AI-QCCTA) offers automated assessment of coronary plaque burden and morphology. Although AI-QCCTA has improved diagnostic consistency and downstream testing efficiency, its prognostic value for major adverse cardiovascular events (MACE) has not been comprehensively quantified. Methods We systematically searched PubMed, Embase, and Cochrane through October 2025 for studies evaluating AI-based plaque analysis in patients without prior MACE undergoing CCTA. Outcomes of interest were pooled using random-effects GLMM models, and prognostic associations were synthesized using inverse-variance random-effects meta-analysis of hazard ratios (HRs). The primary endpoint was MACE; secondary outcomes included myocardial infarction (MI), revascularization, angina, stroke, and mortality. Subgroup analysis was done to identify the association of different plaque characteristics in predicting MACE/MI/Death. Results Ten studies (n = 20,195) were included. Across six cohorts (n = 18,804), pooled rates were: all-cause mortality 1.20% (95% CI 0.38-3.77%), cardiovascular mortality 0.32% (0.21-0.48%), MACE 5.07% (1.25-18.46%), MI 1.30% (0.41-3.99%), and revascularization 13.09% (6.57-24.40%). AI-enabled plaque burden predicted MACE (HR 1.95, 95% CI 1.29-2.94; I2 = 99%), consistent in sensitivity analysis as per same AI platform use (HR 1.88, 95% CI 1.15-3.07). Low-attenuation plaque showed the strongest association (HR 2.95, 95% CI 1.95-4.45). Conclusions AI-QCCTA provides prognostic value beyond stenosis severity, with vulnerable plaque characteristics-particularly low-attenuation and non-calcified plaque most strongly predicting adverse cardiovascular outcomes. These findings support the integration of AI-enabled plaque analysis into contemporary risk stratification. Copyright © 2026 The Authors. <54> Accession Number 2045372855 Title Safety and efficacy of percutaneous patent foramen ovale closure compared with anti-thrombotic therapy for people with cryptogenic stroke: a systematic review and meta-analysis. Source Future Cardiology. 22(4) (pp 373-382), 2026. Date of Publication: 2026. Author Tewari J.; Agrawal H.; Dubey P.; Dwivedi A.; Neupane S.; Singh V.; Mallawaarachchi I.; Mukherjee D. Institution (Tewari) Department of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, TX, United States (Agrawal, Neupane) Division of Interventional/Structural Cardiology, Department of Internal Medicine, Washington Hospital and Medical Foundation, Fremont, CA, United States (Dubey) Department of Bioengineering, Santa Clara University, Santa Clara, CA, United States (Dwivedi) Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, University of Missouri School of Medicine, Columbia, MO, United States (Singh) Department of Internal Medicine, King George's Medical University, Lucknow, India (Mallawaarachchi) Division of Biostatistics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States (Mukherjee) Division of Cardiovascular Medicine, Department of Internal Medicine, Texas Tech University Paul L Foster School of Medicine, El Paso, TX, United States Publisher Taylor and Francis Ltd. Abstract Background: Stroke is a leading cause of death and disability. Patent foramen ovale (PFO) is more common in cryptogenic stroke, but the benefit of closure over antithrombotic therapy remains debated. We updated randomized evidence comparing PFO closure with antithrombotic therapy. Method(s): MEDLINE, Embase, and Cochrane Central were searched through September 2025. Primary outcomes were stroke, transient ischemic attack (TIA), and a composite of stroke, TIA, death, or systemic embolism. Serious adverse events and atrial fibrillation were assessed. Result(s): Six trials (n = 3,560; closure 1,889; therapy 1,671) were included. Composite events occurred in 84 (4.4%) vs 152 (9.1%). Closure reduced the composite endpoint (HR 0.46, 95% CI 0.28-0.75; p = 0.002) and recurrent stroke (37 [2.0%] vs 77 [4.6%]; HR 0.27, 95% CI 0.12-0.62; p = 0.002). Benefit was greatest in men, age <45 years, and those with large shunts. Serious adverse events and mortality were similar, but atrial fibrillation increased (HR 4.46, 95% CI 2.00-9.92; p < 0.001). Conclusion(s): In selected patients, PFO closure lowers recurrent stroke and composite events versus antithrombotic therapy, at the cost of higher atrial fibrillation. Protocol Registration: www.crd.york.ac.uk/prospero identifier is CRD420251167260. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <55> Accession Number 2045916671 Title Hypnosis on Perioperative Outcomes Among Patients Undergoing Non-Cardiovascular Surgeries: A Systematic Review of Randomized Trials. Source International Journal of Clinical and Experimental Hypnosis. 74(2) (pp 226-244), 2026. Date of Publication: 2026. Author El-Allam Y.; Hafiani Y.; Khalyfa M.; Bouzid J.; Mouhajir M.; Himmouche N. Institution (El-Allam, Khalyfa, Bouzid, Himmouche) Hassan First University, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco (Hafiani) Pedagogic Unit of Research in Anesthesia and Intensive Care, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco (Mouhajir) Higher Institute of Nursing Professions and Health Techniques of Rabat, Ministry of Health and Social Protection, Rabat, Morocco Publisher Routledge Abstract Surgery is a disturbing factor of perioperative outcomes in surgical patients. This study aims to explore the effects of clinical hypnosis in diverse perioperative disturbances among non-cardiovascular surgical patients. This is a systematic review according to PRISMA guidelines, using following databases: Cochrane trials, Scopus, Web of Science, Medline and Google Scholar with various keywords in English and French. Studies quality was assessed using Cochrane Rob 2 tool. Thirty randomized controlled trials published between 2012 and January 2025 were included in this review. Results showed that clinical hypnosis revealed a significant effect on decreasing pre and intraoperative anxiety, medication consumption especially opioids and hypnotics intra and postoperatively, risk of postoperative nausea and vomiting was also decreased in hypnosis group. A higher level of prolactin was also observed in women on post-cesarean section. Hypnosis is an interesting perioperative strategy, particularly in decreasing preoperative anxiety and medication consumption. Its impact on pain is uncertain and it can be related to techniques, patient hypnotic profile or type of surgery. Copyright © 2026 International Journal of Clinical and Experimental Hypnosis. <56> Accession Number 2045427103 Title Global Longitudinal Strain Improves After Revascularization of Chronic Total Occlusion: A Systematic Review and Meta-Analysis. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3186. Date of Publication: 01 May 2026. Author Kaya O.K.; Savcioglu A.S. Institution (Kaya, Savcioglu) Department of Cardiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: The clinical benefit of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains controversial, particularly regarding left ventricular (LV) functional recovery. Global longitudinal strain (GLS) has emerged as a more sensitive marker of myocardial function than left ventricular ejection fraction (LVEF). This study aimed to evaluate the effect of CTO revascularization on LV function using GLS. Method(s): This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. A comprehensive literature search was performed in the PubMed/MEDLINE database from inception through March 2026 using predefined search terms and Boolean operators. Reference lists of relevant articles were also screened to ensure completeness. Studies evaluating GLS before and after PCI for CTO and reporting quantitative strain data were included. Pooled effect estimates were calculated as mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model. Subgroup and sensitivity analyses were performed to explore heterogeneity and assess the robustness of the findings. Result(s): Six studies involving 376 patients were included. Successful CTO-PCI may be associated with an improvement in GLS (MD = 1.69; 95% CI: 1.09-2.29; p < 0.001), with substantial heterogeneity (I2 = 81%). Subgroup analysis demonstrated greater GLS improvement in studies with longer follow-up durations. Sensitivity analyses confirmed the robustness of the results. Conclusion(s): CTO revascularization may be associated with an improvement in LV myocardial function as assessed by GLS, even in the absence of marked changes in conventional parameters such as LVEF. These findings support the clinical utility of GLS as a sensitive imaging biomarker for detecting early myocardial recovery and for guiding risk stratification in patients undergoing CTO-PCI. Copyright © 2026 by the authors. <57> [Use Link to view the full text] Accession Number 650779070 Title Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation. Source The New England journal of medicine. 394(21) (pp 2083-2094), 2026. Date of Publication: 04 Jun 2026. Author Doshi S.K.; Kar S.; Nair D.G.; Waggoner T.; Agarwal H.; Moussavian M.; Kashani A.; Oza S.; Feldman L.; Sadhu A.; DeLurgio D.; Alli O.; Nielsen-Kudsk J.E.; Yamamoto M.; Alkhouli M.; Camm A.J.; Coylewright M.; Gibson C.M.; Granger C.B.; Gurol M.E.; Huber K.C.; Mansour M.; Natale A.; Pocock S.J.; Reddy V.Y.; Saliba W.I.; Asch F.M.; Wehrenberg S.; Frost K.; Christen T.; Sutton B.S.; Stein K.M.; Leon M.B.; Ellenbogen K.A. Institution (Doshi) Los AngelesMexico (Doshi) Pacific Heart Institute, Santa Monica, CA, United States (Kar) Los Robles Hospital and Medical Center, Thousand Oaks, CA, United States (Nair) Arrhythmia Research Group, Jonesboro, AR, United States (Waggoner) U.S. Heart and Vascular, Tucson, AZ, United States (Agarwal) Bergan Cardiology, Omaha, NE, United States (Moussavian) Cardiovascular Institute of San Diego, Chula Vista, CA, United States (Kashani) Memorial Hermann Memorial City Medical Center, Houston, United States (Oza) Ascension St. Vincent's, Jacksonville, FL, Puerto Rico (Feldman) Eisenhower Medical Center, Rancho Mirage, CA, United States (Sadhu) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States (DeLurgio) Emory University Hospital, Atlanta, United States (Alli) Novant Health Presbyterian Medical Center, Charlotte, NC (Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark (Yamamoto) Toyohashi Heart Center, Toyohashi, Japan (Alkhouli) Mayo Clinic Foundation, Rochester, MN, United States (Camm) Cardiology Clinical Academic Group, Molecular and Clinical Sciences Institute, City St. George's University of London, London, United Kingdom (Coylewright) Heart and Vascular Center, Essentia Health-St. Mary's Medical Center, Duluth, MN, United States (Gibson) Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States (Granger) Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States (Gurol, Mansour) Massachusetts General Hospital, Boston, United States (Huber) Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO, United States (Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, United States (Natale) Department of Biomedicine and Prevention, Division of Cardiology, University of Tor Vergata, Rome, United States (Pocock) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Reddy) Helmsley Trust Electrophysiology Center, Icahn School of Medicine at Mount Sinai, NY, United States (Saliba) Cleveland Clinic Foundation, Cleveland, United States (Asch) MedStar Health Research Institute, MedStar Washington Hospital Center, WA, United States (Wehrenberg, Frost, Christen, Sutton, Stein) Boston Scientific, Marlborough, MA (Leon) Columbia University Medical Center, NY, United States (Ellenbogen) Division of Cardiology, Virginia Commonwealth University School of Medicine, Richmond, United Kingdom Abstract BACKGROUND: For patients with atrial fibrillation, the use of oral anticoagulant therapy to prevent stroke is limited by the risk of bleeding. Left atrial appendage closure is considered for patients who are unsuitable candidates for long-term anticoagulation, but its role in patients who are eligible for anticoagulants has not been established. METHOD(S): In this ongoing, prospective, international, randomized trial involving patients with atrial fibrillation who were suitable candidates for anticoagulation, we randomly assigned patients in a 1:1 ratio to receive either device-based left atrial appendage closure (device group) or non-vitamin K antagonist oral anticoagulant (NOAC) therapy (anticoagulation group). The primary efficacy end point - a composite of death from cardiovascular causes, stroke, or systemic embolism - was tested for noninferiority (noninferiority margin, 4.8 percentage points) after 3 years of follow-up. The primary safety end point, non-procedure-related bleeding, was tested for superiority. RESULT(S): Of the 3000 patients who underwent randomization, 1499 were assigned to the device group and 1501 to the anticoagulation group. The mean (+/-SD) age of the patients was 71.7+/-7.5 years, 31.9% of the patients were women, and the mean CHA2DS2-VASc score was 3.5+/-1.3. At 3 years, a primary efficacy end-point event had occurred in 81 patients (Kaplan-Meier estimate, 5.7%) in the device group and in 65 patients (Kaplan-Meier estimate, 4.8%) in the anticoagulation group (difference, 0.9 percentage points; 95% confidence interval [CI], -0.8 to 2.6; P<0.001 for noninferiority). Non-procedure-related bleeding occurred in 154 patients (Kaplan-Meier estimate, 10.9%) in the device group and in 260 patients (Kaplan-Meier estimate, 19.0%) in the anticoagulation group (hazard ratio, 0.55; 95% CI, 0.45 to 0.67; P<0.001 for superiority). CONCLUSION(S): Among patients with atrial fibrillation who were candidates for anticoagulation, device-based left atrial appendage closure was noninferior to NOAC therapy with respect to a composite of death from cardiovascular causes, stroke, or systemic embolism and was superior to NOAC therapy for non-procedure-related bleeding at 3 years. (Funded by Boston Scientific; CHAMPION-AF ClinicalTrials.gov number, NCT04394546.). Copyright © 2026 Massachusetts Medical Society. <58> Accession Number 2046550893 Title Machine learning vs. traditional methods for predicting postoperative cardiac complications after non-cardiac surgery: a systematic review and Bayesian network meta-analysis. Source Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Dhaliwal S.; Chen S.; Papas C.; Hughes I.; Cavalucci D.; O'Rourke N. Institution (Dhaliwal, Hughes) Gold Coast Hospital and Health Service, Southport, QLD, Australia (Chen, Papas) Goulburn Valley Health, Shepparton, VIC, Australia (Cavalucci, O'Rourke) The Wesley Hospital, Auchenflower, QLD, Australia Publisher John Wiley and Sons Inc Abstract Introduction: Accurate prediction of peri-operative cardiac complications is critical to optimise pre-operative decision-making. Traditional risk prediction scores, such as the Revised Cardiac Risk Index, show only modest discrimination. Machine learning can model complex, non-linear relationships but their predictive performance compared with traditional scores remains unclear. Method(s): We performed a systematic review and Bayesian network meta-analysis. The primary outcome was postoperative adverse cardiac events following non-cardiac surgery. Prediction models were assessed relative to the Revised Cardiac Risk Index. As many studies evaluated multiple versions of each model type, the highest performing ('best version') and lowest performing ('worst version') results were analysed. Models were ranked using the surface under the cumulative ranking curve (SUCRA). Result(s): Thirteen studies evaluating 54 models and 927,113 patients were included. Machine learning approaches generally outperformed traditional risk scores. Automated machine learning ranked highest (SUCRA 96.6) showed the greatest improvement in the best version analysis (mean difference (MD) 0.28 (95%CrI 0.16-0.40)) and remained superior in the sensitivity analysis (MD 0.30 (95%CrI 0.14-0.45)). Gradient boosting models showed superior performance over the Revised Cardiac Risk Index across analysis (best version: MD 0.20 (95%CrI 0.14-0.26), worst version: MD 0.18 (95%CrI 0.12-0.25), SUCRA 82.4). The Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest score outperformed the Revised Cardiac Risk Index in the best version analysis (MD 0.16 (95%CrI 0.01-0.32)). Between-study heterogeneity was low. None of the included studies externally validated their machine learning models and only six were judged to be at low risk of bias. Discussion(s): Most machine learning models showed better discrimination than traditional risk scores, with automated machine learning and gradient boosting models ranking highest. However, study quality, calibration reporting and absence of external validation limit immediate clinical adoption. Prospective, multicentre evaluation is required before integration of these models into peri-operative practice. Copyright © 2026 Association of Anaesthetists. <59> Accession Number 651480682 Title Perioperative continuous vs. interrupted oral anticoagulation in TAVR: a systematic review and meta-analysis. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 11 Jun 2026. Author Gan X.; Lang Z.; Meng X.; Su Y.; Zhu Y.; Zhao J.; Bai M. Institution (Gan) Office of Graduate Education, First Hospital of Lanzhou University, Lanzhou, Gansu, China (Lang, Meng, Su, Zhu, Zhao, Bai) First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China (Lang, Meng, Su, Zhu, Zhao, Bai) Department of Cardiology, First Hospital of Lanzhou University, Lanzhou, Gansu, China (Lang, Meng, Su, Zhu, Zhao, Bai) Gansu Province Clinical Research Center for Cardiovascular Diseases, Lanzhou, Gansu, China Abstract OBJECTIVES: To evaluate the clinical outcomes associated with continuous versus interrupted oral anticoagulation strategies during the perioperative period of transcatheter aortic valve replacement, with a focus on balancing thromboembolic and bleeding risks. METHOD(S): We searched PubMed, Web of Science, Cochrane Library, Scopus, Ovid and Embase up to February 2026. All studies compared continuous oral anticoagulation versus interruption of oral anticoagulation for TAVI. The primary outcomes were major bleeding, major vascular complications, and stroke. Data synthesis was performed by calculating risk ratios (RRs) or standardized mean differences (SMDs), each accompanied by 95% confidence intervals (CIs). The study was prospectively registered with PROSPERO (CRD420251070176). RESULT(S): A total of five studies comprising 3,316 patients were included. Compared with interrupted anticoagulation, continued OAC was not associated with a statistically significant increase in major bleeding or major vascular complications. Continued OAC showed a borderline association with a lower risk of stroke, together with lower red blood cell transfusion and higher device success rates. However, given the limited number of studies, the predominance of retrospective evidence, and the trial sequential analysis findings, these results should be interpreted cautiously. CONCLUSION(S): Continuation of OAC during TAVR appears feasible and was not associated with an increased risk of major bleeding or major vascular complications in the currently available evidence. Although continued OAC showed a possible association with lower stroke and transfusion risks, the evidence remains limited and statistically fragile. Larger randomized trials are needed before definitive clinical recommendations can be made. Copyright © 2026. The Author(s). <60> Accession Number 2046518209 Title TAVR vs. SAVR in Patients With Severe Aortic Stenosis and Chronic Kidney Disease Undergoing Dialysis: A Comprehensive Meta-Analysis. Source Cardiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 9451268. Date of Publication: 2026. Author Mylavarapu M.; Kiyani M.; Tanwar N.; Reddy M.; Garcia I.; Karnan N.; Rao N.L.; Kodali L.S.M.; Borra N. Institution (Mylavarapu) Department of Cardiology, Endeavor Health Cardiovascular Institute, Endeavor Health Glenbrook Hospital, Glenview, IL, United States (Mylavarapu) Division of Cardiology, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL, United States (Kiyani) Department of Internal Medicine, MedStar Health, Georgetown University, Washington, DC, United States (Tanwar) Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States (Reddy) Department of Internal Medicine, Mysore Medical College & Research Institute, Karnataka, Mysuru, India (Garcia) Department of Family Medicine, University of Southern California School of Medicine, Los Angeles, CA, United States (Karnan) Department of Internal Medicine, MercyOne North Iowa Medical Center, Mason City, IA, United States (Rao) Department of Internal Medicine, Adventist Health Bakersfield, Bakersfield, CA, United States (Kodali) Department of Public Health & Health Sciences, University of Michigan - Flint, Flint, MI, United States (Borra) Department of Internal Medicine, Kamineni Academy of Medical Sciences & Research Center, Telangana, Hyderabad, India Publisher John Wiley and Sons Ltd Abstract Background: Patients with chronic kidney disease (CKD) undergoing dialysis who also suffer from severe aortic stenosis (AS) present a complex management challenge. Both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are treatment options, but comparative outcomes in this specific, high-risk population continue to remain unclear. Aim(s): This study aims to compare TAVR and SAVR postoperative clinical outcomes in patients with severe AS and CKD undergoing dialysis. Method(s): According to PRISMA guidelines, a comprehensive search was conducted across various databases such as PubMed, EMBASE, Scopus, and Google Scholar. Original studies that compared the clinical outcomes between TAVR and SAVR in patients with severe AS and CKD undergoing dialysis were included in the study. Result(s): Ten studies, all retrospective, involving 28,625 (14,625 TAVR and 14,000 SAVR) patients with severe AS and CKD undergoing dialysis who underwent TAVR or SAVR were included in this study. Patients who underwent TAVR had significantly lower odds of in-hospital mortality (OR 0.49; 0.29, 0.84; p = 0.01) and shorter length of stay (LOS) (SMD -2.59; 95% CI -5.04, -0.14; p <= 0.04). However, the TAVR group had significantly higher odds of permanent pacemaker implantation (OR 2.25; 95% CI 1.71-2.94; p < 0.00001). Conclusion(s): In patients with severe AS and CKD undergoing dialysis, TAVR is associated with lower in-hospital mortality and shorter LOS, suggesting a favorable early safety profile and recovery in this population. Copyright © 2026 Maneeth Mylavarapu et al. Cardiology Research and Practice published by John Wiley & Sons Ltd. <61> Accession Number 2046557585 Title Partner valves: role of a prospective device selection strategy using ACURATE and SAPIEN 3 as complementary devices in transcatheter aortic valve implantation. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1710186. Date of Publication: 2026. Author Michel J.M.; Chen M.; Winkler N.E.; Theil P.; Kleeberger J.A.; Schweiger V.; Candreva A.; Gotschy A.; Stehli J.; Haubner B.; Donati T.G.; Kowalik J.; Savic D.; Templin C.; Stahli B.E.; Tanner F.C.; Gilhofer T.; Kasel A.M. Institution (Michel, Chen, Winkler, Theil, Kleeberger, Candreva, Gotschy, Stehli, Haubner, Donati, Savic, Stahli, Tanner, Kasel) Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland (Winkler, Stahli, Tanner) Faculty of Medicine, University of Zurich, Zurich, Switzerland (Schweiger) Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany (Kowalik) Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland (Templin) Department of Cardiology, Greifswald University Hospital, Greifswald, Germany (Gilhofer) Department of Cardiology, Winterthur Hospital, Winterthur, Switzerland Publisher Frontiers Media SA Abstract Background - Transcatheter aortic valve implantation (TAVI) outcomes using balloon-expandable valves (BEV) and self-expanding valves (SEV) differ owing to device-specific technical features and anatomical factors. Objectives - This study aimed to evaluate prospective TAVI device selection based on anatomic features to optimise outcomes compared with published randomised data using two newer-generation devices. Methods - A total of 607 consecutive patients with severe aortic stenosis treated at a single centre from 2020 to 2023 underwent TAVI using a prospective device selection strategy. Heavy and/or asymmetric valve calcification and bicuspid anatomy were preferentially treated with SAPIEN 3/SAPIEN 3 ULTRA BEV, whereas small annulus dimensions and less calcified valves were preferentially treated with ACURATE neo/ACURATE neo2 SEV. In-hospital Valve Academic Research Consortium-3 endpoints and 1-year mortality were evaluated. Results - ACURATE was used in 182 (30%) patients and SAPIEN 3 in 425 (70%) patients. The proportion of women was higher in the ACURATE group (65% vs. 31%, p < 0.001), and patients were older (84 vs. 80 years, p < 0.001). Technical success (97% vs. 97%, p > 0.99) and new permanent pacemaker implantation during index hospitalisation (10% vs. 10%, p > 0.99) did not differ between the ACURATE and SAPIEN 3 groups. Intended performance was higher in the ACURATE group than in the SAPIEN 3 group (98% vs. 91%, p = 0.005), with aortic regurgitation >=moderate (2% vs. <1%, p = 0.32), and mean transvalvular gradient >=20 mmHg (<1% vs. 4%, p = 0.043). The estimated mortality at 1 year was 14% versus 12% (log-rank p = 0.60) in the ACURATE and SAPIEN 3 groups, respectively. Conclusions - A prospective device selection strategy using two complementary TAVI valves resulted in comparable outcomes between the SEV and BEV devices. In-hospital intended performance was higher in the ACURATE group. Despite baseline group differences, there was no difference in 1-year mortality. Copyright © 2026 Michel, Chen, Winkler, Theil, Kleeberger, Schweiger, Candreva, Gotschy, Stehli, Haubner, Donati, Kowalik, Savic, Templin, Stahli, Tanner, Gilhofer and Kasel. <62> Accession Number 2046518195 Title Glucagon-Like Peptide-1 Agonist vs. Placebo and Pulmonary Decline After Open-Heart Surgery: A Substudy of the GLORIOUS Randomised Clinical Trial. Source Acta Anaesthesiologica Scandinavica. 70(6) (no pagination), 2026. Article Number: e70282. Date of Publication: 01 Jul 2026. Author Mikkelsen A.D.; Wiberg S.; Schultz H.H.L.; Moller-Sorensen P.H.; Hofsten D.; Nilsson J.C.; Moller C.H.; Kober L.; Hassager C.; Kjaergaard J. Institution (Mikkelsen, Hofsten, Kober, Hassager, Kjaergaard) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic Anaesthesiology and Intensive Care, Copenhagen University Hospital, Copenhagen, Denmark (Wiberg, Hassager, Kjaergaard) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Schultz) Department of Cardiology, Section for Heart-and Lung Transplant, Copenhagen University Hospital, Copenhagen, Denmark (Moller) Department of Cardiac Surgery, Copenhagen University Hospital, Copenhagen, Denmark Publisher John Wiley and Sons Inc Abstract Background: Postoperative pulmonary decline is an established complication of open-heart surgery extending beyond the immediate postoperative phase. Inflammation-mediated lung damage and ischaemia-reperfusion injury secondary to extracorporeal circulation is a proposed pathophysiological driver. GLP-1 receptor agonists (GLP-1RA) have emerged as promising protective agents in this setting. Aim(s): Investigate whether infusion of the GLP-1RA, exenatide during cardiopulmonary bypass and weaning thereof, can mitigate the decline in diffusing capacity and ventilatory performance 3 months postoperative, compared to placebo. Method(s): In this predefined explorative substudy of the randomised, clinical GLORIOUS trial, 878 adult patients undergoing non-emergent coronary artery bypass grafting (CABG) and/or surgical aortic valve replacement (SAVR) were randomised to a continuous infusion of the GLP-1RA, exenatide or placebo during cardiopulmonary bypass, extending into the early postoperative period. Diffusing capacity of the lung for carbon monoxide (DLCO) and ventilatory performance (FEV<inf>1</inf>/FVC) were measured preoperatively and 3 months postoperatively. Result(s): Median DLCO (% predicted corrected) declined from 80% preoperative to 72% 3 months postoperative, corresponding to a -7.7 percentage point (pp) difference (95% CI 6.2 to 9.1; p < 0.001). FEV<inf>1</inf>/FVC declined from 0.75 preoperative to 0.73 postoperative, corresponding to a -1.6 difference (95% CI 1.0 to 2.1; p < 0.001). However, there were no significant differences in decline between the exenatide and placebo groups (all p > 0.3). Findings were consistent across subgroup analyses. Conclusion(s): While both diffusing capacity and ventilatory performance exhibited a mild-to-moderate decline 3 months after open-heart surgery, the GLP-1RA exenatide did not mitigate this decline compared with placebo. Editorial Comment: Pulmonary dysfunction is one of the most common complications to open-heart surgery. The present study confirms a decline in diffusing capacity of the lung for carbon monoxide (DLCO) and in ventilatory performance measured as FEV<inf>1</inf>/FVC at 3 months postoperatively compared to preoperative measurements. Infusion of GLP-1 receptor antagonist during cardiopulmonary bypass and weaning did not mitigate the pulmonary decline compared to placebo. Copyright © 2026 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. <63> Accession Number 2046698022 Title 2026 American Association for Thoracic Surgery Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in patients who undergo cardiac surgery. Source Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Chatterjee S.; Girardi N.I.; Crow J.; Wieruszewski P.M.; Grant M.C.; Cuker A.; Warkentin T.E.; Mims M.P.; Arora R.C.; Martin M.; Moon M.R.; Cangut B.; Sultan I.S.; Parker A.; Holler J.F.; Balsam L.B.; Engelman D.T. Institution (Chatterjee, Moon) Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex, United States (Chatterjee, Moon) Department of Cardiovascular Surgery, The Texas Heart Institute, Baylor College of Medicine, Houston, Tex, United States (Girardi) Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States (Crow) Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Md, United States (Wieruszewski) Department of Pharmacy, Department of Anesthesiology, Mayo Clinic, Rochester, Minn, United States (Grant) Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Md, United States (Cuker) Department of Medicine and Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa, United States (Warkentin) Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada (Mims) Department of Medicine, Baylor College of Medicine, Houston, Tex, United States (Arora) Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Ill, United States (Martin) Redline Perfusion & Consulting, LLC, Gainesville, Fla, United States (Cangut) Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Sultan) Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Parker) Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada (Holler) Department of Congenital Perfusion, Atrium Health Levine Children's Hospital, Charlotte, NC, United States (Balsam) Department of Surgery, UMass Chan Medical School, Worcester, Mass, United States (Engelman) Department of Surgery, Baystate Medical Center, University of Massachusetts Chan Medical School-Baystate, Springfield, Mass, United States Publisher Elsevier Inc. Abstract Background: Heparin-induced thrombocytopenia (HIT) in patients who undergo cardiac surgery presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence of critical illness in this population. Current guidelines do not fully address these cardiac surgery-specific features, leading to practice variation in screening, diagnosis, anticoagulation management, and perioperative planning. Consolidated, practical, and evidence-based recommendations are needed that are tailored to cardiac surgery and to temporary mechanical circulatory support after cardiac surgery. Method(s): The American Association for Thoracic Surgery Clinical Practice Standards Committee convened a multidisciplinary panel of 16 experts in cardiac surgery, hematology, critical care, anesthesiology, perfusion, and pharmacology. A comprehensive literature review was performed with medical librarian support. Using a modified Delphi methodology, the panel evaluated the evidence, developed clinical statements, and assigned a class of recommendation and a level of evidence to each recommendation. Result(s): Consensus was achieved for 32 recommendations across 5 domains: epidemiology and natural history of HIT after cardiac surgery; diagnostic evaluation, including appropriate Thrombocytopenia, Timing, Thrombosis, oTher cause (4Ts) score use, time-dependent platelet count patterns, and integration of immunoassay and functional testing; therapeutic management with nonheparin anticoagulants, including the selection of direct thrombin inhibitors, factor Xa inhibitors, and adjunctive therapies; perioperative management of patients with HIT who require cardiac surgery, including the timing of surgery, intraoperative anticoagulation strategy, and adjunctive therapies; and screening, testing, and anticoagulation strategies for patients supported by extracorporeal membrane oxygenation or temporary mechanical circulatory support after cardiac surgery. Additional best practices are included for cardiopulmonary bypass circuit management for patients with HIT. Conclusion(s): This American Association for Thoracic Surgery Expert Consensus Document provides practical, cardiac surgery-specific guidance for the diagnosis and management of HIT across the continuum of cardiac surgical care. By addressing the complexities unique to cardiac surgery, high-risk anticoagulation environments, and extracorporeal and temporary mechanical circulatory support, these recommendations aim to improve diagnostic accuracy, standardize care, reduce complications, and support safe heparin re-exposure or alternative anticoagulation strategies when surgery is required. Copyright © 2026 The American Association for Thoracic Surgery <64> Accession Number 2046547376 Title Does Anatomy Dictate Outcome?: Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve Replacement in Small and Extra-Small Annuli. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Abdelrahman A.K.; Elkholy M.; Arce J.E.; Al-Muhaisen R.; Ahmed K.; Omara G.; Altujjar M.; Leon M.B.; Beohar N. Institution (Abdelrahman, Arce, Al-Muhaisen, Altujjar, Beohar) Department of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, United States (Elkholy) Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, United States (Ahmed, Omara) Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt (Leon) Department of Cardiology, Columbia University Irving Medical Center, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract The optimal transcatheter aortic valve replacement strategy in patients with a small aortic annulus (SAA) remains unclear. We performed a systematic review and meta-analysis comparing self-expanding valves (SEVs) to balloon-expandable valves (BEVs) in SAA patients. We searched PubMed, Embase, Web of Science, and Scopus for studies comparing SEVs and BEVs in patients with SAA defined by computed tomography. A random-effects model using the Der Simonian and Laird estimator was used to pool odds ratios (ORs) and mean differences (MDs). We identified 25 studies encompassing 13, 846 patients (5633 BEV; 8213 SEV). SEVs demonstrated superior hemodynamics, including a larger indexed effective orifice area (MD: 0.20 cm2/m2; P < 0.00001), a lower mean transvalvular gradient (MD: -4.11 mm Hg; P < 0.00001), and a lower risk of severe patient-prosthesis mismatch (OR: 0.37; P < 0.00001). However, SEVs were associated with a higher risk of permanent pacemaker implantation (PPI) (OR: 1.63; P = 0.0008) and moderate or severe paravalvular leak (PVL) (OR: 2.26; P < 0.00001). There was no significant difference in all-cause mortality at 1 year (OR: 0.96; P = 0.55) or stroke at 30 days (OR: 1.34; P = 0.18). Notably, in a subgroup analysis restricted to patients with extra-small annuli (area <400 mm2 or diameter <23 mm), the hemodynamic advantages of SEVs persisted while the elevated risks of PPI and PVL were no longer statistically significant. In patients with SAA, SEVs provide better hemodynamics but carry safety concerns including higher risks of PVL and PPI in the overall population. These risks were not observed in the extra-small annulus subgroup. Valve selection should be individualized based on patient anatomy and procedural risk profile. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <65> Accession Number 2046809202 Title Haemodynamic Stability During Anaesthesia Induction and Sternotomy in Patients with Ischaemic Heart Disease: A Comparison of Various Anaesthetic Techniques. Source International Journal of Drug Delivery Technology. 16(61 Supplement) (pp 58-64), 2026. Date of Publication: 2026. Author Ranjith Veeramani T.; Saravanan M.; Imran J.M.; Vellingiri M.; Senthilkumar V.; Veeravijayan A. Institution (Ranjith Veeramani) Department of Anaesthesiology, Institute of Child Health - Madras Medical College (Saravanan) Department of Anaesthesiology, Chengalpattu Medical College (Imran, Vellingiri, Senthilkumar) Institute of Anaesthesiology and Critical Care, Madras Medical College (Veeravijayan) Department of Forensic Medicine, Chettinad Hospital and Research Institute Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background and Aims Haemodynamic stability during anaesthesia induction is critical in patients with ischaemic heart disease undergoing coronary artery bypass grafting. This study aimed to compare haemodynamic stability between thiopentone 3 mg/kg and 6 mg/kg and etomidate 0.4 mg/kg during anaesthesia induction and sternotomy. Methods A prospective randomised controlled trial was conducted on 60 patients with good left ventricular function undergoing elective coronary artery bypass grafting. Patients were randomly allocated into three equal groups (n=20 each): thiopentone 3 mg/kg (THIO3), thiopentone 6 mg/kg (THIO6), and etomidate 0.4 mg/kg (ETO). Haemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, and pressure rate quotient were recorded at eight standardised time points. Results Significant haemodynamic variations were observed among the three groups (p<0.001). The THIO3 group demonstrated the highest haemodynamic fluctuations with peak heart rate elevation at T4 (103.2+/-22.5 beats per minute, p<0.001) compared to THIO6 (68.9+/-11.2 beats per minute) and etomidate (73.7+/-6.1 beats per minute). Systolic blood pressure changes were significantly higher in thiopentone groups, with a mean difference of 16.18 mmHg between THIO3 and etomidate (p<0.001). Etomidate maintained superior haemodynamic stability across all parameters with minimal fluctuations in heart rate, blood pressure, and arterial pressure indices. Conclusion Etomidate provides superior haemodynamic stability during anaesthesia induction and sternotomy in patients with ischaemic heart disease. In resource-limited settings, thiopentone 6 mg/kg can be used with strict haemodynamic monitoring as a comparable alternative to etomidate. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <66> Accession Number 2046551784 Title Mitral annular disjunction and high-risk profiles: a conceptual approach to risk stratification and surgical implications. Source General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Furukawa K.; Ishii H.; Sakaguchi S.; Mori K.; Iwasaki A.; Meiri R. Institution (Furukawa, Ishii, Sakaguchi, Mori, Iwasaki, Meiri) Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kiyotakecho Kihara, Miyazaki, Miyazaki-City, Japan Publisher Springer Abstract Objective: Mitral annular disjunction (MAD), frequently associated with Barlow's disease, links degenerative mitral regurgitation to postoperative ventricular arrhythmias and sudden cardiac death, even after technically successful valve repair. However, despite advances in mitral repair, the arrhythmic substrate associated with MAD remains insufficiently addressed in current surgical paradigms. Method(s): A systematic search of PubMed and Google Scholar (2000-2025) was conducted using keywords including "mitral annular disjunction," "mitral regurgitation," "arrhythmic mitral valve prolapse," and "mitral valve surgery." Of 264 records screened, 41 peer-reviewed articles, prioritizing high-impact registries and surgical cohorts, were selected for synthesis. Result(s): MAD is associated with paradoxical annular curling and traction-related myocardial remodeling, which may contribute to fibrosis through pathological stretch. Observational studies suggest that higher-risk features-such as extensive MAD (>= 5 mm, particularly >= 8.5 mm), late gadolinium enhancement, or syncope-are linked to increased arrhythmic vulnerability. Although modern repair techniques can eliminate anatomical MAD, pre-existing substrate abnormalities may persist, and ventricular arrhythmias can still occur after technically successful repair. Conclusion(s): The extent of disjunction and the presence of associated substrate abnormalities appear to influence long-term rhythm stability. A conceptual, hypothesis-generating framework that integrates structural, electrical, imaging, and clinical information may help inform risk stratification. Prospective studies are needed to determine whether a risk-stratified approach or optimized intervention timing can modify arrhythmic risk or potentially affect long-term outcomes. Copyright © The Author(s) 2026. <67> Accession Number 2046706371 Title Measuring Value in Surgery: A Scoping Review of Economic Indices Across Specialties. Source Journal of Surgical Research. 325 (pp 32-63), 2026. Date of Publication: 01 Sep 2026. Author Nguyen K.; Lala E.; Yamanouchi K.; Pattison S.; Bansal A.; Balu A.; Ali M.A.; Louie P.K. Institution (Nguyen) School of Medicine, Tulane University, New Orleans, Louisiana, United States (Nguyen, Yamanouchi, Bansal, Ali, Louie) Department of Neurosurgery, Center for Neuroscience and Spine, Virginia Mason Franciscan Health, Seattle, WA, United States (Lala, Pattison) School of Medicine, University of Washington, Seattle, WA, United States (Yamanouchi) Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan (Balu) Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States Publisher Academic Press Inc. Abstract Introduction: Escalating health-care costs and increasing patient complexity underscore the need for standardized, comparable measures of surgical value. Despite numerous proposed indices, methodological heterogeneity limits cross-specialty comparison. This scoping review aims to (1) characterize trends in value index utilization, (2) assess variability in index components, (3) identify specialty-specific and bibliometric patterns, and (4) propose a preliminary conceptual model to guide index selection. Method(s): A Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews-guided scoping review of PubMed, Embase, and Google Scholar (July 2025) identified 2015-2025 studies evaluating surgical value. Eligible English-language, peer-reviewed studies applied quantitative value indices, while reviews, case reports, and nonoperative studies were excluded. Two reviewers screened independently, and data on specialty, index type, and components were extracted. Bibliometric analysis mapped keyword clusters and citation trends. Result(s): Of 342 included studies, 11 distinct indices were identified. The most frequently reported indices were incremental cost-effectiveness ratio (n = 189, 55.3%), time-driven activity-based costing (n = 93, 27.2%), and net monetary benefit (n = 27, 7.9%), followed by return on investment (n = 23, 6.7%) and operative value index (n = 6, 1.8%); net health benefit, net present value, and procedure value index each accounted for under 1% of studies (n <= 6). General, orthopedic, and cardiothoracic surgery were the most represented specialties. Bibliometric analysis identified orthopedic-predominant keyword clusters and citation bursts in replacement and quality of life. Substantial heterogeneity in index selection across specialties motivated development of a preliminary conceptual model for index selection. Conclusion(s): This first scoping review of surgical value metrics reveals pervasive heterogeneity and introduces a preliminary conceptual model intended to organize index selection and motivate future validation efforts toward comparable, evidence-based value assessment. Copyright © 2026 Elsevier Inc. <68> Accession Number 2046535268 Title A comparative study of ultrapulse CO2 fractional laser combined with pulsed dye laser versus pulsed dye laser alone for hypertrophic chest scars following pediatric congenital heart surgery. Source Archives of Dermatological Research. 318(1) (no pagination), 2026. Article Number: 206. Date of Publication: 01 Dec 2026. Author Liu Z.; Li X.; Xue L.; Liu Q.; Li F.; Gao Y. Institution (Liu, Li, Xue, Liu, Li, Gao) Plastic Surgery Department, Hebei Children's Health and Disease Clinical Medical Research Center, Hebei Children's Hospital, Hebei, Shijiazhuang, China (Gao) General Surgery Department, Hebei Children's Health and Disease Clinical Medical Research Center, Hebei Children's Hospital, Hebei, Shijiazhuang, China Publisher Springer Nature Abstract Hypertrophic sternotomy scars in children after congenital heart disease (CHD) surgery pose a significant burden. Evidence for combining pulsed dye laser (PDL) with ablative fractional lasers (AFLs) in this population is scarce. This study aimed to compare the efficacy and safety of combined ultrapulse fractional CO2 laser and PDL versus PDL alone for treating these scars. This retrospective study reviewed 36 children treated with either combined laser (n = 18) or PDL alone (n = 18) as part of routine clinical care, without randomization.Both groups received four treatment sessions. Scar improvement was assessed using the Vancouver Scar Scale (VSS) at baseline, 3 months, and 6 months post-treatment. Baseline characteristics were comparable. VSS scores improved significantly in both groups over time. At 3 months, there was no significant difference in median VSS scores between groups (control: 2.0, observation: 2.0, p = 0.072). At 6 months, the observation group showed a non-significant trend toward higher (worse) median scores (control: 4.0, observation: 3.5, p = 0.883). Adverse events (blisters, pigmentation) were similar between groups. However, scar re-growth occurred in 3 patients in the observation group versus none in the control group. Combined ultrapulse fractional CO2 laser and PDL therapy did not demonstrate superior efficacy over PDL monotherapy for pediatric post-sternotomy hypertrophic scars and was associated with a potential risk of rebound scar proliferation. PDL alone appears to be a safer and effective first-line treatment in this specific population. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <69> Accession Number 2046543150 Title Topical use of tranexamic acid for antifibrinolysis in cardiac surgery with cardiopulmonary bypass: a randomized clinical study. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 376. Date of Publication: 01 Dec 2026. Author Tuerhong D.; Li C.; Yan L. Institution (Tuerhong, Yan) Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (Li) The First Affiliated Hospital of Xinjiang Medical University, National Clinical Medical Research Institute, Urumqi, China (Li) Cancer Research Institute, Xinjiang Key Laboratory of Translational Biomedical Engineering, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China (Li) The First People's Hospital of Kashi & Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China Publisher BioMed Central Ltd Abstract Objective: To assess the non-inferiority of topical intrapericardial tranexamic acid (TXA) versus intravenous TXA for efficacy and safety in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): In this single-center randomized trial, 492 patients were assigned 1:1 to topical TXA (2.5 g in 50 mL saline via pericardial drain, clamp 30 min) or standard intravenous TXA. Primary endpoints: allogeneic red blood cell (RBC) transfusion rate (postoperative to discharge); 30-day composite adverse events (mortality, renal dysfunction, stroke, myocardial infarction, thromboembolism, seizures). Secondary endpoints included drainage volume, coagulation, and thromboelastography (TEG). The non-inferiority threshold was established at 10% for sensitivity. Result(s): RBC transfusion rate was 35.0% (topical) vs. 27.6% (intravenous; 95%CI - 1.2% to 16.0%, P = 0.080). Composite adverse events were 9.8% vs. 15.4% (95%CI - 11.2% to 0.0%, P = 0.057). Topical TXA showed delayed coagulation initiation, lower fibrinogen, and higher 24-hour drainage (all P < 0.05). At 10% margin, efficacy non-inferiority was not confirmed, but safety non-inferiority was verified for all endpoints. Conclusion(s): Topical intrapericardial TXA is non-inferior to intravenous TXA in safety but fails strict efficacy non-inferiority. Intravenous TXA remains first-line; topical TXA is a reasonable alternative for patients intolerant to systemic administration. Dose and timing optimization is needed to improve hemostasis. Trial registration: http://www.chictr.org.cn, ChiCTR2500113718, Registration date: 2 December 2025. Retrospectively registratered. Copyright © The Author(s) 2026. <70> Accession Number 651471769 Title Outcomes of mechanical and bioprosthetic surgical valve replacements in egypt: evidence from a narrative review and experts' survey. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 10 Jun 2026. Author El Fiky M.; Ahmed A.; Sarawy E.; Ghanam M.E.; Sanad M.; Mansour T.; Elezbawy B.; Fasseeh A.; Essam S.; Mowafy A.; Abaza S.; Salem A.; Gamil E. Institution (El Fiky, Ahmed, Ghanam) Department of Cardiothoracic surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt (El Fiky) Department of Cardiology, Nasser Health Institute, Cairo, Egypt (Sarawy) Department of Cardiac Surgery, National Heart Institute, Giza, Egypt (Ghanam) Cardiothoracic and vascular surgery Academy, Cairo, Egypt (Sanad) Cardiothoracic and Vascular Surgery Center (CVSC), Mansoura University Hospitals, Mansoura, Egypt (Mansour) Military Medical Academy, Cairo, Egypt (Mansour) CairoEgypt (Elezbawy) Doctoral School of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary (Elezbawy, Fasseeh, Essam, Mowafy, Abaza) Syreon Middle East, Alexandria, Egypt (Fasseeh) Faculty of Pharmacy, Alexandria University, Alexandria, Egypt (Salem) Edwards Lifesciences, Dubai, United Arab Emirates (Gamil) Department of Cardiothoracic surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt Abstract BACKGROUND: Selecting between mechanical and bioprosthetic valves depends on multiple clinical and patient-specific criteria. This study aims to compare mechanical and bioprosthetic valve replacement outcomes in Egypt to support evidence-informed decision-making. METHOD(S): We conducted a narrative literature review to identify studies reporting outcomes of mechanical and bioprosthetic valve replacements in Egypt. Findings were validated through an expert meeting with cardiothoracic surgeons. To capture real-world practice, an online survey was administered to cardiothoracic surgeons across Egypt. The narrative review and survey results were compared to global data to formulate recommendations on optimizing valve selection in Egypt. We extracted data from 41 eligible studies identified from the literature. RESULT(S): Findings showed that unlike global data, reoperation rate in Egypt is lower with bioprosthetic valves compared to mechanical valves. Mechanical valves are associated with higher bleeding rates globally and locally. Survival and stroke incidence do not differ significantly between mechanical and bioprosthetic valves. The expert survey was responded to by 128 cardiothoracic surgeons. Experts predominantly used mechanical valves, highlighted age, and anticoagulation eligibility as the main factors influencing valve choice, and showed that longer clinical experience is associated with more tendency to use bioprosthetic valves. CONCLUSION(S): Valve type selection in Egypt should be individualized and made on a case-by-case basis due to the multiple factors influencing choice and outcomes. To support evidence-based decision-making, more local studies should be conducted, especially for bioprosthetic valves. These factors should be considered in selection to choose the most suitable valve for each patient. Copyright © 2026. The Author(s). <71> Accession Number 651471635 Title Effect of driving pressure-guided individualized PEEP in children undergoing right lateral thoracotomy cardiac surgery with cardiopulmonary bypass on postoperative atelectasis and oxygenation: a randomized controlled trial. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 11 Jun 2026. Author Chen X.; Song H.; Zang M.; Zhou J.; Liu Y.; Ren Y. Institution (Chen, Zang) Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, China (Song, Zhou, Liu) Department of Anesthesiology, Affiliated Women and Children's Hospital of Qingdao University, Qingdao, China (Ren) Department of Anesthesiology, Affiliated Women and Children's Hospital of Qingdao University, Qingdao, China Abstract BACKGROUND: Right lateral thoracotomy cardiac surgery induces postoperative atelectasis due to cardiopulmonary bypass (CPB), patient positioning, and mechanical ventilation. Fixed positive end-expiratory pressure (PEEP) may fail to meet pediatric ventilation requirements. This study aims to investigate the effects of driving pressure-guided individualised PEEP on postoperative atelectasis and oxygenation. METHOD(S): Children aged 6 months to 5 years undergoing right lateral thoracotomy cardiac surgery with CPB were randomly assigned to two groups. Group C received conventional protective ventilation with fixed PEEP of 5 cmH2O in the lateral decubitus position until the end of ventilation. Group D had driving pressure-guided individualized PEEP titration following both the lateral decubitus position and the CPB, with ventilation maintained at the titrated PEEP. Both groups received lung recruitment maneuvers. Observations were conducted at the following time points: after intubation (T0), after lateral positioning (T1), before CPB (T2), after CPB (T3), at the end of surgery (T4), before leaving the operating room (T5), after admission to the ICU (T6), and 1 h after extubation (T7). Lung ultrasonography was performed for each patient at T0 and T5. The primary outcomes were the incidence of postoperative atelectasis and lung ultrasound scores (LUS). Secondary outcomes included PaO2/FiO2 ratio (P: F ratio), incidence of post-CPB hypoxemia and postoperative pulmonary complications (PPCs) within 3 days, peak airway pressure (Ppeak), dynamic pulmonary compliance (Cdyn), PEEP, driving pressure, extubation time, length of ICU stay, length of hospital stay, heart rate and mean arterial pressure. RESULT(S): At T5, the incidence of atelectasis and LUS were lower in Group D than in Group C (P < 0.05). P: F ratio in Group D was higher than in Group C at T2, T4, and T6 (P < 0.05). The incidence of post-CPB hypoxemia and extubation time were lower in Group D (P < 0.05). Group D showed superior intraoperative respiratory mechanics parameters. However, there were no significant differences in the incidence of PPCs within 3 days, intraoperative hemodynamics, ICU length of stay, or hospital length of stay between the two groups (P > 0.05). CONCLUSION(S): Driving pressure-guided individualized PEEP ventilation reduces the incidence of postoperative atelectasis in children undergoing right lateral thoracotomy cardiac surgery with CPB. It also improves oxygenation and intraoperative respiratory mechanics. However, there was no significant difference in the incidence of PPCs within 3 days. TRIAL REGISTRATION: ChiCTR, ChiCTR2500098036. Registered on February 28, 2025, www.chictr.org.cn. Copyright © 2026. The Author(s). <72> Accession Number 2046499311 Title Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Source Journal of the Society for Cardiovascular Angiography and Interventions. (no pagination), 2026. Article Number: 105446. Date of Publication: 2026. Author Gajula K.S.; Lingamsetty S.S.P.; Pamreddy H.R.; Banga A.; Jitta S.R.; Doma M.; Cherukuri K.; Vahdat K.; Ramsaran E.; Goldsweig A.M. Institution (Gajula, Cherukuri, Vahdat, Ramsaran) Department of Cardiovascular Medicine, Saint Vincent Hospital, UMass Chan Medical School, Worcester, MA, United States (Lingamsetty) Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Pamreddy) Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, United States (Banga) Department of Internal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States (Jitta) Department of Internal Medicine, Mercy Health St. Louis, St. Louis, MO, United States (Doma) Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center, and Division of Cardiology, University of Massachusetts-Baystate, Springfield, MA, United States Publisher Elsevier B.V. Abstract Background Atrial fibrillation (AF) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR) and increases risks of thromboembolism and bleeding with chronic anticoagulation. Concomitant left atrial appendage occlusion (LAAO) during TAVR may reduce long-term stroke and bleeding risks. Methods PubMed, Embase, and Cochrane databases were searched through May 2025 for studies comparing TAVR + LAAO versus TAVR + standard medical therapy in patients with atrial fibrillation. Random-effects models were used to pool risk ratios (RRs) or mean differences with 95% CIs. Results Four studies (2 randomized controlled trials, 2 observational; n = 563, mean age 82 years) were included; 279 patients (49.5%) underwent TAVR + LAAO. Thirty-day outcomes showed no differences in mortality (RR 0.91; 95% CI, 0.28-3.01), stroke/transient ischemic attack (RR 0.27; 95% CI, 0.04-1.66), or major bleeding (RR 0.27; 95% CI, 0.04-1.66). Over a 9.8-month to 2-year follow-up, all-cause mortality (RR 0.95; 95% CI, 0.68-1.32), cardiac death (RR 0.95; 95% CI, 0.60-1.50), stroke/transient ischemic attack (RR 1.33; 95% CI, 0.30-5.83), and major bleeding (RR 1.06; 95% CI, 0.71-1.59) remained similar. Contrast use and hospital length of stay were comparable. Conclusions Concomitant TAVR plus LAAO appears feasible, with no statistically significant differences in short-term outcomes versus TAVR plus standard medical therapy; however, certainty is low, and findings are hypothesis-generating, warranting larger randomized trials and prospective registries. Copyright © 2026 The Author(s). <73> Accession Number 2046489444 Title Hemodynamic Response to Laryngoscopy and Endotracheal Intubation With Conventional Macintosh Laryngoscope Versus C-MAC Video Laryngoscope in Patients Undergoing Elective Coronary Artery Bypass Grafting: A Randomized Controlled Trial. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 2771364. Date of Publication: 2026. Author Khan S.; Hameed M.; Khan W.R.; Yousuf M.S.; Samad K. Institution (Khan, Hameed, Khan, Yousuf, Samad) Department of Anesthesiology, Aga Khan University, Karachi, Pakistan Publisher John Wiley and Sons Ltd Abstract Background: Laryngoscopy and endotracheal intubation evoke significant hemodynamic responses, particularly in patients undergoing coronary artery bypass grafting (CABG) who have compromised cardiac reserves. This study aimed to compare the hemodynamic effects of the C-MAC video laryngoscope (VL) with those of the conventional Macintosh laryngoscope (MC) in patients undergoing elective CABG. Method(s): This randomized controlled trial included 86 patients scheduled for elective CABG, who were randomly assigned to intubation with either the MC group or the C-MAC VL group. Hemodynamic parameters, including heart rate, systolic, diastolic, and mean arterial pressures, were recorded at five time points (prelaryngoscopy baseline to 10 min postintubation). Secondary outcomes included the intubation success rate, duration of laryngoscopy and intubation, glottic visualization, and complications. Result(s): Two-way repeated measures ANOVA revealed no significant group effect or group-by-time interaction for any hemodynamic variable (all p > 0.05), confirming equivalent hemodynamic profiles across all time points. A significant time effect was observed for all variables (all p < 0.001). First-attempt intubation success was 88.4% (VL) versus 74.4% (MC) (p = 0.166). The C-MAC provided significantly better glottic visualization (modified CL grade, p < 0.001). No major complications occurred in either group. Conclusion(s): In patients undergoing CABG, C-MAC VL and conventional MC result in similar hemodynamic responses. The choice of laryngoscope may be guided by airway considerations and operator experience rather than anticipated cardiovascular effects. Trial Registration: Clinicaltrials.gov_identifier: NCT04433884. Copyright © 2026 Sehrish Khan et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <74> Accession Number 2038269612 Title The effect of diabetes mellitus on aortic valve stenosis and its treatment outcome: A meta-analysis review. Source ARYA Atherosclerosis. 22(2) (pp 55-56), 2026. Date of Publication: 01 Mar 2026. Author Hosseini A.; Maghami-Mehr A.; Khesali H. Institution (Hosseini, Khesali) Department of Cardiovascular Surgery, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Maghami-Mehr) Department of Statistics, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of Publisher Isfahan University of Medical Sciences(IUMS) Abstract BACKGROUND: Given the importance of diabetes mellitus (DM) and its role in the development of aortic valve stenosis (AVS), as well as its association with adverse outcomes after aortic valve replacement (AVR), the present meta analysis aimed to provide a comprehensive review of previous studies in this field. METHOD(S): To achieve this objective, a thorough literature search was conducted in PUBMED/MEDLINE, ScienceDirect, CINAHL, EMBASE/SCOPUS, PsycINFO, ClinicalKey, the Cochrane Central Register of Controlled Trials (CENTRAL), ProQuest, Web of Science, and Persian databases such as SID and Magiran. The number of patients, gender ratio, mean age, prevalence of T2DM, AVS, and treatment outcomes after TAVI, TAVR, and SAVR (stroke, early and late mortality) were recorded. RESULT(S): This meta-analysis comprised 22 studies involving a total of 760,287 patients with AVS. The pooled prevalence of DM was approximately 31% (95% CI: 26-36%). DM was associated with a significantly higher risk of early mortality, including both in-hospital mortality (OR: 2.399) and 30-day mortality (OR: 1.45), compared with non-DM patients (p<0.05). However, the increase in late mortality (one year or longer) among DM patients was not statistically significant. Additionally, DM patients showed a significantly elevated risk of stroke compared with non-DM patients (OR: 1.15; 95% CI: 1.03-1.28; p=0.009). CONCLUSION(S): Overall, DM appears to play a significant role in the development of AVS and is associated with adverse outcomes including mortality and stroke after AVR. Copyright © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved. <75> Accession Number 2046521966 Title Preoperative and intraoperative localization of small pulmonary nodules for thoracoscopic surgery: a contemporary narrative review. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 602. Date of Publication: 01 Dec 2026. Author Yan J.; Wang Y.; Shen C. Institution (Yan, Wang) West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China (Shen) Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China Publisher Springer Nature Abstract For thoracoscopic resection to be successful, accurate preoperative and intraoperative localization is necessary due to the growing detection of small, non-palpable lung nodules using low-dose CT scanning. Accurate localization is required rather than optional in robot-assisted thoracic surgery (RATS) since the total lack of tactile feedback makes it extremely difficult to identify deep, tiny, and subsolid nodules. With a focus on RATS-specific criteria, this study offers a modern, clinically focused framework for technique selection. This is a narrative review of the current literature. A structured literature search was conducted in PubMed, Embase, and Web of Science from January 2015 to May 2026, and 116 relevant articles were included for qualitative synthesis. We summarized the principles, clinical efficacy, complications, and RATS-specific adaptability of CT-guided percutaneous, bronchoscopy-assisted, and intraoperative localization techniques. No quantitative meta-analysis or bias risk assessment was performed in this study. Nodule traits, patient considerations, and institutional resources should all be taken into consideration when choosing a technique. Although percutaneous techniques have a high success rate (88-100%), there is a risk of bleeding and pneumothorax (up to 40%). First-line options for RATS are indocyanine green (ICG) fluorescence marking and microcoil localization. ICG uses robotic near-infrared channels to achieve 100% intraoperative identification and R0 resection rates, while microcoils allow sublobar resection in 90.6% of patients with 100% R0 resection. Transbronchial approaches (virtual bronchoscopic navigation [VBN], electromagnetic navigation bronchoscopy [ENB]) eliminate external marker interference and greatly lower the incidence of pneumothorax (88% reduction, 3.3% vs. 28.3% for CT-guided transthoracic aspiration, P < 0.001). Electromagnetic interference is completely avoided in next-generation shape-sensing robotic bronchoscopy. Single-stage hybrid operating room methods are favored by workflow integration. Resource-stratified approaches are suggested: low-resource settings may employ VBN/VAL-MAP or percutaneous methylene blue; mid-resource centers benefit from ENB/VBN with ICG; high-resource centers may use single-stage cone-beam CT or robotic bronchoscopy. The best RATS-compatible selection is guided by the "three-zero" approach (zero external indicators, zero transport danger, and zero electromagnetic interference). Nodule traits, patient considerations, and institutional resources must all be considered when choosing a localization technique. Precise localization is required in RATS in order to maintain negative margins, lower conversion rates, and make up for tactile deficiencies. The best balance is frequently achieved using multimodal techniques. Further increases in pulmonary nodule localization accuracy, safety, and workflow efficiency are anticipated due to ongoing advancements in robotic bronchoscopy, hybrid operating rooms, and artificial intelligence. Copyright © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2026. <76> Accession Number 2046534417 Title Robot-Assisted Thoracic Surgery Versus Video-Assisted Thoracic Surgery for Lung Resection: A Systematic Review and Meta-Analysis. Source International Journal of Medical Robotics and Computer Assisted Surgery. 22(3) (no pagination), 2026. Article Number: e70191. Date of Publication: 01 Jun 2026. Author Maghrabi A.; Altoukhi S.M.; Alghamidi F.A.S.; Alshammari M.M.; Alharbi W.M.; Hanbazazah M.A.; Almasoudi M.M.; Jamjoum G. Institution (Maghrabi) Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Maghrabi) Thoracic Surgery Division, Department of Surgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia (Altoukhi, Alharbi) College of Medicine, University of Jeddah, Jeddah, Saudi Arabia (Alghamidi) College of Medicine, King Khalid University, Abha, Saudi Arabia (Alshammari) College of Medicine, University of Hail, Hail, Saudi Arabia (Hanbazazah) College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia (Almasoudi) College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia (Jamjoum) Department of Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia (Jamjoum) Gastrointestinal Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia Publisher John Wiley and Sons Ltd Abstract Background: Lung resection is a standard treatment for lung cancer. Video-assisted thoracoscopic surgery (VATS) is widely used as a minimally invasive approach. Recent advancements in robotic technology enhances the safety and efficacy of robot-assisted thoracic surgery (RATS). This systematic review and meta-analysis compared the clinical outcomes of RATS and VATS in lung resection. Method(s): PubMed, ClinicalTrials.gov, and the Cochrane Library were searched from inception to June 2025. Primary outcomes were lymph node yield and operative time. Secondary outcomes included R0 resection, postoperative complications, and recurrence. Data were analysed using Review Manager v5.4.1 with random-effects models. Result(s): Twenty-nine studies involving 66,406 patients were included. RATS significantly improved lymph node yield (MD 4.54; 95% CI 2.91-6.17) and showed shorter operative time (MD -6.09; 95% CI -13.20-1.03). RATS was associated with higher R0 resection rates, fewer complications, and lower recurrence. Conclusion(s): The findings support the safety and oncologic effectiveness of RATS. Copyright © 2026 John Wiley & Sons Ltd. <77> Accession Number 2046588993 Title Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial. Source JAMA Cardiology. 11(6) (pp 544-552), 2026. Date of Publication: 10 Jun 2026. Author Nissen S.E.; Wolski K.; D'Alessio D.; Weerakkody G.; Kiljanski J.; Wiese R.J.; Pavo I.; Cariou B.; Nicholls S.J. Institution (Nissen, Wolski) Cleveland Clinic Coordinating Center for Clinical Research (C5 Research), Cleveland Clinic, Cleveland, OH, United States (Nissen, Wolski) Department of Medicine, Cleveland Clinic, Cleveland, OH, United States (D'Alessio) Duke University Medical Center, Durham, NC, United States (Weerakkody, Kiljanski, Wiese, Pavo) Eli Lilly and Company, Indianapolis, IN, United States (Cariou) l'Institut du Thorax, Nantes Universite, CHU Nantes, CNRS, INSERM, Nantes, France (Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC, Australia Publisher American Medical Association Abstract Importance The dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide was noninferior to a GLP-1 agonist, dulaglutide, for effects on the composite outcome of cardiovascular death, myocardial infarction (MI), or stroke. However, comparison for a comprehensive range of major adverse cardiovascular and kidney outcomes has not been reported. Objective To perform a post hoc analysis for an expanded range of adverse outcomes in a completed randomized clinical trial comparing the effects of tirzepatide and dulaglutide in patients with type 2 diabetes and cardiovascular disease. Design, Setting, and Participants This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania. Data were analyzed from July 2025 to February 2026. Interventions Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly. Main Outcomes and Measures The primary efficacy measure was time from randomization to first occurrence of a 6-component composite of cardiorenal adverse outcomes, including all-cause mortality, MI, stroke, coronary revascularization, hospitalization for heart failure, and a composite of adverse kidney outcomes. Results Among the 13 165 patients enrolled, the mean (SD) age was 64 (8.8) years; 9348 patients (71.0%) were male and 3817 were female (29.0%). The mean (SD) hemoglobin A<inf>1c</inf> was 8.4% (0.93). After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P <.001). Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93). Gastrointestinal adverse events were more common with tirzepatide (2827 patients [42.5%]) than dulaglutide (2387 patients [35.9%]) treatment. Other adverse events were similar. Conclusions In this post hoc analysis, the dual GLP-1 and GIP agonist tirzepatide, compared with the GLP-1 agonist dulaglutide, was associated with a lower incidence of a broad 6-component composite cardiovascular and kidney end point in patients with diabetes and established cardiovascular disease. Copyright © 2026 Nissen SE et al. <78> Accession Number 2046487703 Title Percutaneous left atrial appendage closure in non-valvular atrial fibrillation with concomitant heart failure: a systematic review and meta-analysis of periprocedural and long-term outcomes. Source Current Medical Research and Opinion. (no pagination), 2026. Date of Publication: 2026. Author Yusuf M.; Milla C.; Chandra L.A.; Ievan Hakim D.; Subali A.D.; Aditya M.R.; Mulia R.H.; Kizzandy K.; Susilo H.; Kencono Wungu C.D.; Papageorgiou P. Institution (Yusuf, Chandra, Ievan Hakim, Subali, Aditya, Mulia, Kizzandy) Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Milla) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Susilo) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Kencono Wungu) Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Kencono Wungu) Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia (Papageorgiou) Department of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece Publisher Taylor and Francis Ltd. Abstract Objective: Heart failure (HF) frequently coexists with non-valvular atrial fibrillation (NVAF) and may adversely affect outcomes after percutaneous left atrial appendage closure (LAAC). However, data on the safety and efficacy of LAAC in this high-risk subgroup remain inconsistent. Method(s): A comprehensive search of PubMed, Cochrane Library, ScienceDirect, Epistemonikos, and MedRxiv was conducted from inception to August 2025 for studies comparing outcomes of LAAC in NVAF patients with versus without HF. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) for periprocedural outcomes, and hazard ratios (HRs) or ORs for long-term outcomes, with 95% confidence intervals (CIs). Result(s): Forty studies comprising 351,266 patients were included, with thirty-three contributing to quantitative synthesis. Compared with patients without HF, those with HF had higher odds of periprocedural major adverse events (OR 1.17, 95% CI 1.03-1.32), periprocedural mortality (OR 2.41, 95% CI 1.84-3.16), and major bleeding (OR 1.26, 95% CI 1.08-1.45). No significant differences were observed for periprocedural stroke or pericardial effusion. During long-term follow-up, HF was associated with increased all-cause mortality (HR 1.83, 95% CI 1.50-2.22), major adverse events (HR 1.21, 95% CI 1.00-1.46), and device-related thrombus (OR 1.45, 95% CI 1.17-1.79). Rates of long-term stroke, major bleeding, and peri-device leak were similar between groups. Conclusion(s): In NVAF patients undergoing LAAC, HF confers higher procedural risk and worse long-term survival, while protection against thromboembolism and major bleeding appears comparable. These findings underscore the need for careful patient selection, optimized procedural care, and individualized post-implant antithrombotic strategies. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <79> Accession Number 2046658058 Title Acute brain injury in adult post-cardiotomy cardiogenic shock patients receiving central vs. peripheral VA-ECMO: A single-center experience and systematic review with meta-analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Ryu J.; Lin Y.; Woo H.Y.(.; Hamid A.; Malfitano M.; Sutariya P.; Lu J.; Crasta M.; Mahmood A.; Ahmed Y.B.; Spann M.; Whitman G.J.R.; Cho S.-M. Institution (Ryu) Soonchunhyang University College of Medicine, Cheonan, South Korea (Lin, Woo, Malfitano, Ahmed, Whitman, Cho) Division of Neurosciences Critical Care and Cardiac Surgery, Departments of Neurology, Surgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Hamid, Sutariya, Lu, Mahmood) College of Medicine, Drexel University, Philadelphia, PA, United States (Crasta) Lake Erie College of Osteopathic Medicine, Erie, PA, United States (Spann) Informationist Services, Johns Hopkins School of Medicine, Baltimore, MD, United States Publisher SAGE Publications Ltd Abstract Background: Postcardiotomy cardiogenic shock (PCS) is a life-threatening complication after adult cardiac surgery that frequently necessitates venoarterial extracorporeal membrane oxygenation (VA-ECMO). Central and peripheral VA-ECMO cannulation strategies generate distinct hemodynamic and perfusion profiles; however, whether these differences translate into varying risks of acute brain injury (ABI) remains uncertain. We therefore compared ABI risk according to cannulation strategy in adults with PCS requiring VA-ECMO, with secondary objectives to determine the overall prevalence of ABI and characterize its major subtypes. Method(s): We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus through April 15, 2025, for studies reporting ABI in adult PCS patients receiving VA-ECMO. ABI outcome was defined as ischemic stroke, intracranial hemorrhage, hypoxic-ischemic brain injury, seizures, unspecified stroke, and brain death. Random-effects meta-analysis was performed, incorporating a contemporary single-center cohort from Johns Hopkins Hospital (2020-2025). Result(s): The primary meta-analysis included seven cohorts (six published studies plus Johns Hopkins cohort; n = 2536), while secondary analyses included 17 cohorts (16 published studies plus Johns Hopkins cohort). Included patients (mean age = 65 years, BMI = 28 kg/m2, 61% male) underwent central VA-ECMO cannulation in 32% and peripheral cannulation in 68%. The pooled risk of ABI did not differ by cannulation strategy (risk ratio [RR], 1.01; 95% CI, 0.85-1.21; I2 = 0%), with similar ABI prevalence across groups (p = 0.99). Ischemic stroke and unspecified stroke were the most reported subtypes. Conclusion(s): In adults with PCS supported by VA-ECMO, the risk of ABI was not significantly associated with cannulation strategy. These findings suggest that cannulation approach alone is unlikely to be the primary determinant of neurological risk in this population, underscoring the need for systematic neuroprotective strategies regardless of cannulation configuration. Copyright © The Author(s) 2026 <80> Accession Number 2046716260 Title Negative Pressure Wound Therapy for Prevention and Treatment of Poststernotomy Complications in Adult Cardiac Surgery: A Systematic Review With Quantitative Synthesis. Source American Journal of Cardiology. 272 (pp 160-166), 2026. Date of Publication: 01 Aug 2026. Author Pollanen S.; Lee A.D.; McGuinty J.; Jeong S.; Chronis N.; Mukovozov I. Institution (Pollanen, Lee, McGuinty, Jeong, Chronis) Faculty of Medicine, University of Toronto Temerty, Toronto, ON, Canada (Mukovozov) Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada (Mukovozov) Toronto Dermatology Centre, Toronto, ON, Canada (Mukovozov) Division of Dermatology, Women's College Hospital, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Sternal wound complications following cardiac surgery increase reoperation risk, prolong hospitalization, and complicate postoperative cardiovascular recovery, yet optimal prevention strategies remain poorly defined. We performed a systematic review with quantitative synthesis of 31 studies enrolling 6,420 adult cardiac surgery patients to evaluate the usefulness of negative pressure wound therapy (NPWT) compared with conventional dressings for preventing and managing poststernotomy wound complications. The pre-specified primary analysis focused on prophylactic NPWT applied over closed sternotomy incisions, since open and closed-incision applications represent fundamentally distinct populations with non-comparable outcomes. Within this primary analysis, prophylactic foam-based closed-incision NPWT (ciNPT) in high-risk sternotomy patients showed the most consistent reduction in surgical site infection, with relative risk estimates of 0.25 to 0.94 across 7 studies enrolling 2,178 patients. Evidence for therapeutic NPWT in established sternal wound infections was directionally favorable but derived exclusively from observational studies. Interstudy heterogeneity precluded robust aggregate pooled conclusions. In conclusion, prophylactic ciNPT may be reasonable to consider in selected high-risk patients pending randomized trial confirmation. Crown Copyright © 2026 Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <81> Accession Number 2046762209 Title CPR-induced vertebral fractures: a case report and systematic review of literature. Source Journal of Forensic and Legal Medicine. 121 (no pagination), 2026. Article Number: 103192. Date of Publication: 01 Jul 2026. Author Gozzelino C.; Pigaiani N.; Sanna J.; Chighine A. Institution (Gozzelino, Sanna, Chighine) Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cagliari, Italy (Pigaiani) Department of Diagnostics and Public Health, Section of Legal Medicine, University of Verona, Verona, Italy Publisher Churchill Livingstone Abstract Background: Cardiopulmonary resuscitation is a critical intervention for cardiac arrest, but its forceful chest compressions can lead to skeletal injuries, including rare vertebral fractures Case presentation: This case report details a 78-year-old woman with a history of cardiac surgery and obesity who suffered a fatal cardiac arrest due to a DeBakey type II aortic dissection. Despite 30 minutes of advanced manual CPR, she succumbed to cardiogenic shock. Autopsy revealed an incidental transvertebral fracture of the 8th thoracic vertebra alongside multiple bilateral rib fractures, with no evidence of pre-existing trauma Literature review: A systematic literature search was conducted in three major scientific databases and reported according to PRISMA 2020, with structured eligibility criteria and methodological quality appraisal of included reports. Results were evaluated by two independent reviewers. Data on demographics, anatomy, bone comorbidities, and CPR were extracted independently and reviewed collectively Conclusion(s): A systematic literature review of 16 studies identified 23 cases of CPR-related vertebral fractures, predominantly in the mid-to-lower thoracic spine, with Th10 being the most affected level. Pre-existing conditions such as osteopenia, osteoporosis, and kyphosis increase susceptibility to these injuries by compromising spinal integrity. The biomechanical forces of CPR, combined with structural vulnerabilities, contribute to this rare complication. This case underscores the importance of post-mortem examinations in distinguishing CPR-related injuries from traumatic causes, aiding forensic investigations. Clinicians and forensic pathologists should remain vigilant for vertebral fractures as a potential CPR complication, particularly in elderly patients with predisposing bone conditions, to ensure accurate diagnosis and avoid medico-legal issues. Copyright © 2026 Published by Elsevier Ltd. <82> Accession Number 2046780537 Title Individualised positive end-expiratory pressure to minimise driving pressure and postoperative pulmonary complications in minimally invasive thoracic and abdominal surgery a systematic review and meta-analysis. Source British Journal of Anaesthesia. 137(1) (pp 231-243), 2026. Date of Publication: 01 Jul 2026. Author Abbott M.; Ma R.; Chakera H.; Kishibe T.; Girard M.; Turgeon A.F.; Serpa Neto A.; Sklar M.C.; Sankar A. Institution (Abbott) Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Abbott, Sklar, Sankar) Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (Ma) Michael G. Degroote School of Medicine, McMaster University, Hamilton, ON, Canada (Chakera) Schulich School of Medicine and Dentistry, Western University, London, ON, Canada (Kishibe) Library Services, St. Michael's Hospital, Toronto, ON, Canada (Girard) Department of Anesthesiology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada (Girard) Division of Critical Care Medicine, Department of Medicine, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada (Girard) Imaging and engineering, CHUM Research Center, Montreal, QC, Canada (Turgeon) Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Faculty of Medicine, Universite Laval, Quebec City, QC, Canada (Turgeon) CHU de Quebec - Universite Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Universite Laval, Quebec City, QC, Canada (Serpa Neto) Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Serpa Neto) Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Sklar) Interdepartmental Division of Critical Care Medicine, St. Michael's Hospital, Toronto, ON, Canada (Sklar, Sankar) Department of Anesthesia, Unity Health Toronto - St. Michael's Hospital and Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada Publisher Elsevier Ltd Abstract Background: Mechanical ventilation during minimally invasive surgery is associated with postoperative pulmonary complications. Limiting driving pressure appears to reduce pulmonary complications with lung-protective ventilation strategies. Whether individualising PEEP minimises driving pressure to reduce pulmonary complications is unknown. In this systematic review, we assessed whether individualised PEEP strategies during minimally invasive surgery reduce postoperative pulmonary outcomes and driving pressures or both. Method(s): We searched Medline, Central, LILACS, Embase, and Scopus for studies comparing individualised PEEP to lung-protective ventilation in minimally invasive thoracic and abdominal surgery (PROSPERO CRD42023495377). The primary outcome was postoperative pulmonary complication. Random-effects models generated risk ratios (RRs) with 95% confidence intervals (95% CIs) for binary outcomes. We conducted prespecified subgroup analyses by surgery type and post hoc subgroup analyses by individualised PEEP strategy and patient factors. We compared driving pressure differences between individualised PEEP and lung-protective strategies. Statistical heterogeneity was assessed using the I2 index and the risk of bias with Cochrane (RoB2) and ROBINS-I. Result(s): Thirty studies were included (n=3295 participants). Individualised PEEP was associated with reduced risk of postoperative pulmonary complications, compared with lung-protective ventilation (RR=0.67, 95% CI=0.56-0.79, I2=0.4%). This association was consistent in abdominal and thoracic surgery, and in subgroup analyses. Individualised PEEP was associated with lower driving pressures (mean difference= -3.17, 95% CI= -3.84 to -2.50); I2=86.6%). The certainty of evidence for PPCs was moderate, with a low risk of bias. Conclusion(s): Individualised PEEP was associated with fewer postoperative pulmonary complications and lower driving pressures during minimally invasive surgery; showing causality requires further research. Copyright © 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <83> Accession Number 2046515544 Title Echocardiography before non-cardiac surgery: current knowledge, guideline recommendations, and clinical evidence - a narrative review. Source Journal of Clinical Monitoring and Computing. (no pagination), 2026. Date of Publication: 2026. Author Mertin V.; Stroda A.; Bruns T.; Lurati Buse G. Institution (Mertin, Stroda, Bruns, Lurati Buse) Department of Anesthesiology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany Publisher Springer Science and Business Media B.V. Abstract This narrative review provides an overview of the evidence on transthoracic echocardiography (TTE) at rest in patients undergoing non-cardiac surgery with regard to detection of new diagnoses, TTE-driven management changes, and outcome impact of preoperative TTE. It summarizes the evidence on preoperative TTE and reviews the current recommendations by professional societies from both Europe and Northern America. TTE is a very important non-invasive diagnostic tool to obtain information on cardiac function before surgery. While studies on the effectiveness of preoperative TTE are limited, there is evidence that TTE before non-cardiac surgeries can detect new diagnoses in a relevant proportion of patients. Also, data on changes in management based on TTE findings is scarce. Both the American Heart Association and the American College of Cardiologists and the European Society of Cardiology have recently published updated recommendations regarding the use of TTE before non-cardiac surgery. While both societies are in favour of TTE in symptomatic patients and do not recommend TTE to be performed routinely, several differences remain. Information on outcome benefits in patients having received TTE prior to surgery is not conclusive. In this review we could detect several knowledge gaps concerning the yield and impact on management and outcome of preoperative TTE in non-cardiac surgery patients. Copyright © The Author(s) 2026. <84> Accession Number 2038257111 Title Radiology: Cardiothoracic Imaging Highlights 2025. Source Radiology: Cardiothoracic Imaging. 8(3) (no pagination), 2026. Article Number: e260065. Date of Publication: 01 Jun 2026. Author Pinos D.; de Farias L.P.G.; Onnis C.; Sucha D.; Escalon J.G.; Hanneman K.; Abbara S.; Litt H.I.; Gulsin G.S.; Mastrodicasa D. Institution (Pinos) Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States (Pinos) Department of Radiology, University of New Mexico, Albuquerque, NM, United States (de Farias) Department of Radiology, Hospital Sirio-Libanes, Sao Paulo, Brazil (de Farias) Allianca Saude, Sao Paulo, Brazil (Onnis) Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States (Sucha) Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands (Escalon) Department of Radiology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, NY, United States (Hanneman) Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Hanneman) Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, ON, Canada (Abbara) Department of Radiology, Mayo Clinic, Jacksonville, FL, United States (Litt) Department of Radiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States (Litt) Diagnostics Institute, Cleveland Clinic Florida, Weston, FL, United States (Gulsin) Department of Cardiovascular Sciences, BHF Centre of Research Excellence and NIHR, Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester, United Kingdom (Mastrodicasa) Department of Radiology, University of Washington School of Medicine, UW Medical Center, Montlake, 1959 NE Pacific St, Seattle, WA, United States Publisher Radiological Society of North America Inc. Abstract Radiology: Cardiothoracic Imaging publishes novel research and technical developments in cardiac, thoracic, and vascular imaging. This review article, led by the Radiology: Cardiothoracic Imaging Early Career Editorial Board, highlights selected articles published in the journal between November 2024 and October 2025. Featured articles span the breadth of cardiothoracic and vascular imaging, including cardiac CT assessment of prosthetic heart valves, photon-counting CT for improved coronary stent evaluation, and streamlined multiparametric cardiac MRI acquisition techniques. Additional topics include imaging of mitral annular disjunction; cardiac MRI markers of diastolic dysfunction, myocardial heterogeneity, and myocarditis prognosis; and cardiac MRI-based assessment of sarcopenia as a novel prognostic marker. Ongoing research and future directions include accelerated cardiac MRI, opportunistic cardiovascular risk assessment from incidental findings at routine imaging, and expanding applications of quantitative and artificial intelligence-driven techniques across cardiac, thoracic, oncologic, and vascular imaging. Copyright © RSNA, 2026. <85> Accession Number 651470566 Title Perioperative hyperoxia versus normoxia during cardiopulmonary bypass in adult cardiac surgery: a systematic review and meta-analysis of randomized controlled trials. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 10 Jun 2026. Author AlSejari N.Y.; Aljaber B.H.; Alyahya S.A.; Alharran A.M.; Abdul-Hafez H.A.; Alsubaiei A.A. Institution (AlSejari, Aljaber, Alyahya, Alsubaiei) Kuwait CityKuwait (Alharran) College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain (Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine Abstract BACKGROUND: While hyperoxia has conventionally been the standard during cardiopulmonary bypass (CPB) to prevent hypoxemia, recent concerns regarding oxygen-induced oxidative stress have sparked debate over whether a normoxic strategy provides a safer clinical alternative. METHOD(S): A comprehensive search of PubMed, Web of Science, CENTRAL, and Scopus was conducted to identify randomized controlled trials (RCTs) through December 2025. Primary outcomes included short-term and long-term mortality, and acute kidney injury (AKI). Secondary outcomes included assessment of clinical complications and healthcare resource utilization. Risk ratios (RR) and mean differences (MD) were pooled using a random-effects model. RESULT(S): Twelve RCTs involving 2,732 patients were included. The analysis found no significant difference between hyperoxia and normoxia in short-term mortality (RR: 1.23, 95% CI [0.60, 2.54]; p = 0.57), long-term mortality (RR: 1.10, 95% CI [0.84, 1.43]; p = 0.48), or the incidence of AKI (RR: 0.94, 95% CI [0.82, 1.07]; p = 0.32). Similarly, no significant differences were observed in secondary clinical outcomes, including myocardial infarction, stroke, arrhythmia, or surgical site infections. Hospital resource utilization was comparable, with no significant differences in mechanical ventilation duration (p = 0.06), ICU stay (p = 0.32), or length of hospital stay (p = 0.08). CONCLUSION(S): This meta-analysis detected no statistically significant differences between hyperoxic and normoxic strategies during CPB regarding mortality, clinical outcomes, or hospital resource utilization. Still, the current evidence remains uncertain, warranting further research. Copyright © 2026. The Author(s). <86> Accession Number 2046520452 Title A Systematic Review of Modeling Platforms for Atrioventricular Valves in Atrioventricular Septal Defects. Source Journal of Cardiovascular Translational Research. 19(1) (no pagination), 2026. Article Number: 73. Date of Publication: 01 Dec 2026. Author Wang C.C.; Marx M.; Barth E.; D'Amore A.; Luo H.; Coyan G. Institution (Wang, Marx, Coyan) Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, United States (Barth, Luo) Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States (D'Amore) Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States (D'Amore) Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Coyan) Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States (Coyan) Division of Pediatric Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, United States Publisher Springer Abstract Given the high rate of re-intervention in patients with atrioventricular septal defects (AVSD), there is a continuing need to accurately model the complex valve anatomy and surgical repair strategies. This systematic review examined the current scientific landscape for modeling platforms designed to study abnormal congenital heart valves that are used or could be used for AVSD investigation. Of 1,050 sources screened, 47 were included (14 in silico; 26 in vitro; 7 in vivo). In silico models studying valve pathologies have advanced in recent years, but few targeted AVSD valves. In vitro platforms allow comparisons of repair techniques, but have yet to be applied for AVSD valve repair. In vivo studies could offer physiologically accurate platforms, but face challenges such as replicating AVSD pathologies. Multidisciplinary approaches to creating high-fidelity, reproducible, physiologically accurate AVSD valve models can transform the understanding of AVSD valve properties and repair strategies. Copyright © The Author(s) 2026. <87> Accession Number 2046649048 Title From legacy to future: A global bibliometric analysis of the Ross procedure over 60 years. Source Asian Cardiovascular and Thoracic Annals. (no pagination), 2026. Article Number: 02184923261458925. Date of Publication: 2026. Author Cubas W.S.; Alfabeto A.; Kawaguchi Y.; Guo L.-R.; Chu M.W.A. Institution (Cubas, Alfabeto, Kawaguchi, Guo, Chu) Division of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada Publisher SAGE Publications Inc. Abstract Background: The Ross procedure, introduced in 1967, transformed cardiac surgery. This study presents one of the first global bibliometric analyses, to the best of our knowledge, mapping research trends, collaborations, and authorship to identify future directions in this field. Method(s): A global bibliometric analysis of Ross procedure publications (1967-2025) was performed using Scopus and PubMed. Data processed in R (bibliometrix, biblioshiny) explored productivity, collaborations, authorship, and thematic evolution. Future publication trends to 2050 were forecast using a linear extrapolation model with 95% confidence intervals. Result(s): A total of 2370 Ross procedure publications were identified (1967-2025), showing an 8.1% average annual growth rate. Original articles dominated (65%), followed by reviews/meta-analyses (13.9%) and case reports (13.5%). Among 6228 authors (69.5% male), collaboration averaged 4.9 coauthors/document, with 12.6% international partnerships. The USA (32.3%), the Netherlands (19.3%), and Germany (14.5%) led in productivity. Top institutions were Erasmus University Medical Center (4.3%), Mount Sinai Health System (3.0%), and University Heart Center Lubeck (2.2%). Major journals included Annals of Thoracic Surgery (13.5%), Journal of Thoracic and Cardiovascular Surgery (12.2%), and European Journal of Cardio-Thoracic Surgery (7.6%). Faculty surgeons authored 66% of first-author papers. Main research themes involved allograft reintervention, durability, suture technique, failure, and postoperative complications. Linear regression predicted 164 annual publications by 2050. Conclusion(s): This analysis reveals an exponentially increasing and sustained global interest in the Ross procedure, which continues to shape cardiac surgery worldwide. The findings highlight growing research output, robust international collaboration, and a focus on clinical innovation, ensuring ongoing advancements in surgical techniques, patient outcomes, and global cardiovascular surgical excellence. Copyright © The Author(s) 2026 <88> Accession Number 651452542 Title Postoperative outcomes of combined interpectoral-pectoserratus versus combined deep-superficial serratus anterior plane blocks in minimally invasive coronary artery bypass surgery: A prospective randomized study. Source Scientific reports. (no pagination), 2026. Date of Publication: 08 Jun 2026. Author Yildirim A.K.; Ensarioglu M.; Demirdas E.; Karabacak K. Institution (Yildirim) Department of Cardiovascular Surgery, Gulhane Training and Research Hospital, Ankara, Turkey (Ensarioglu) Department of Anesthesiology and Reanimation, Gulhane Training and Research Hospital, Ankara, Turkey (Demirdas, Karabacak) Department of Cardiovascular Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey Abstract Minimally invasive coronary artery bypass grafting (MICS-CABG) and minimally invasive direct coronary artery bypass (MIDCAB) reduce surgical trauma compared with sternotomy but remain associated with significant postoperative pain that may delay recovery and contribute to complications. Although regional analgesic techniques are increasingly used to reduce opioid requirements, comparative data on different block strategies are limited. This study evaluated the effects of combined interpectoral-pectoserratus and combined deep-superficial serratus anterior plane blocks on postoperative pain, analgesic consumption, recovery quality, and clinical outcomes. In this prospective randomized single-center clinical study, 180 patients undergoing MICS-CABG or MIDCAB were randomized into three groups: combined interpectoral-pectoserratus plane block (Group P, n = 60), combined deep-superficial serratus anterior plane block (Group S, n = 60), and control (n = 60). All blocks were ultrasound guided and performed by experienced anesthesiologists. Pain intensity was assessed using the visual analog scale (VAS) at 6, 12, 24, and 48 h after extubation. Quality of recovery was evaluated using the QoR-40 questionnaire preoperatively and on postoperative days 1 and 2. Secondary outcomes included time to first rescue analgesia, total analgesic consumption, extubation time, ICU and hospital length of stay, and postoperative complications. VAS scores were significantly lower at all postoperative time points in both block groups compared with the control group, with no difference between block techniques. Time to first rescue analgesia was longer and total postoperative analgesic consumption was lower in both block groups. ICU and hospital stays were significantly shorter in patients receiving combined blocks. QoR-40 scores were better preserved throughout follow-up in both block groups. The incidence of atelectasis was lower in block groups, whereas other postoperative complications were infrequent and did not differ significantly between groups. Combined interpectoral-pectoserratus and combined deep-superficial serratus anterior plane blocks provide effective postoperative analgesia, reduce opioid requirements, enhance early recovery, and shorten ICU and hospital stays after minimally invasive CABG. Both techniques may represent practical opioid-sparing options for perioperative pain management in this setting. This study was also registered with the ISRCTN registry (ISRCTN32677289; first posted 16/02/2026). Copyright © 2026. The Author(s). <89> Accession Number 651452123 Title Efficacy of a small-volume blood culture diversion device across three wards: a 6-month retrospective review. Source Microbiology spectrum. (pp e0059326), 2026. Date of Publication: 09 Jun 2026. Author Dolin H.H.; Krupp A.M.; John A.R.; Cherian S.S.; Lewin G.R.; Saade E.A.; Ransom E.M. Institution (Dolin, Cherian, Ransom) Department of Pathology, University Hospitals Cleveland Health, Cleveland, OH, United States (Krupp, John, Saade) Department of Internal Medicine, University Hospitals Cleveland Health, Cleveland, OH, United States (Cherian, Lewin, Ransom) Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, United States (Lewin) Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, United States (Lewin) Case Western Reserve University-Cleveland VA Medical Center for Antimicrobial Resistance and Epidemiology, Cleveland, OH, United States Abstract Blood culture contamination (BCC) is a challenging issue that can negatively impact patients and healthcare costs. The Clinical and Laboratory Standards Institute (CLSI) historically encouraged a BCC rate of <3%, although recent evidence suggests <1% is achievable. One approach to reducing BCC is initial specimen blood diversion devices (ISDDs). ISDDs prevent the initial blood, which may contain contaminating microorganisms, from inoculating the blood bottles. The ISDD literature remains limited, particularly for evaluating performance across different wards. Here, the Kurin Lock ISDD was evaluated in an emergency department (ED), cardiothoracic intensive care unit (CTICU), and medical intensive care unit (MICU). A comparison of 6 months pre- and post-implementation revealed a 35.3% BCC reduction overall (P = 0.016), with variation across wards: ED 41.0% (P = 0.043), CTICU 38.7% (P = 0.20), and MICU 20.3% (P = 0.61). Device compliance rates varied by ward: ED (62.5%), CTICU (32.2%), and MICU (35.4%). When post-implementation cultures were segregated by ISDD usage, the MICU BCC rate was 0.39% versus 3.02% without ISDD usage (P = 0.025). The ED and MICU also had multiple months below 1%. The CTICU did not have a month below 1% nor a significant BCC rate difference post-implementation with or without ISDD usage (2.52% and 3.19%, P > 0.99). Furthermore, an estimated $170,378 of contamination costs were avoided using a cost per contamination of $6,553 from a prior meta-analysis. Given our low ISDD compliance, contamination rates and financial savings can still be improved. Taken together, ISDDs are a promising approach to lower BCC rates and costs, although impact may vary by ward.IMPORTANCEHealthcare systems continue to strive toward a <1% blood culture contamination rate. Initial specimen blood diversion devices (ISDDs) are a promising approach to achieve this goal; however, data remain limited on small-volume ISDDs, especially in different hospital ward settings. Here, we found the small-volume Kurin Lock ISDD reduced blood culture contamination rates and theoretically avoided contamination costs, despite low ISDD compliance. Importantly, performance varied considerably across an emergency department and two intensive care units. While the presented findings support ISDD usage, health systems must be mindful of variable ward performance and manage expectations accordingly. <90> Accession Number 2038271832 Title Technological evolution of uniportal video-assisted thoracoscopic surgery in lung cancer: a comprehensive review. Source Current Thoracic Surgery. 11(1) (pp 82-88), 2026. Date of Publication: 2026. Author Elkhayat H.; Sezen C.B. Institution (Elkhayat) Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt (Sezen) University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Thoracic Surgery, Istanbul, Turkey Publisher Turkish Society of Thoracic Surgery Abstract In this review, we will examine how uniportal video-assisted thoracoscopic surgery (U-VATS) compares in the management of non-small cell lung cancer (NSCLC) in terms of effectiveness, safety, and advancements in technology, as supported by recent literature. The change from multiportal techniques to uniportal techniques has expanded the limits of minimal invasiveness in thoracic surgery. In all aspects evaluated in the literature included in this review, U-VATS is comparable to multiportal techniques in postoperative pain, drainage time, and oncologic outcomes. The learning curve criteria set by the ESTS consensus for the safe adoption of U-VATS provides a sound basis for promoting this technique. In essence, Uniportal VATS is an evolving technique that is equally minimally invasive and has great oncologic potential, given advancements in technology. Copyright © 2026, Turkish Society of Thoracic Surgery. All rights reserved. <91> Accession Number 2038271828 Title Global patterns of surgical research production: a bibliometric analysis of thoracic surgery literature. Source Current Thoracic Surgery. 11(1) (pp 23-36), 2026. Date of Publication: 2026. Author Yavuz O.; Iscan M.; Erdogdu E.; Ertan R.; Kertmen M.; Dubus T.; Yeginsu A. Institution (Yavuz, Iscan, Erdogdu, Ertan, Kertmen, Dubus, Yeginsu) Department of Thoracic Surgery, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey Publisher Turkish Society of Thoracic Surgery Abstract Background: Scientific studies with comparable methodological quality may not achieve similar levels of publication visibility. This study aimed to assess whether publication visibility in the thoracic surgery literature varies across institutional and geographic contexts, using primary spontaneous pneumothorax (PSP) as a homogeneous clinical framework. Material(s) and Method(s): This descriptive bibliometric analysis included PSP-related publications indexed in the Web of Science Core Collection between January 1, 2000, and October 15, 2025. In total, 972 publications were analyzed. Author name origin and gender were inferred using the NamSor API (version 2). Author and institutional country income levels were classified according to World Bank definitions as high-income (HIC) or low-and middle-income (LMIC). Journal impact factor and quartile (Q1-Q4) rankings were obtained from the most recent Journal Citation Reports. Result(s): Based on name origin, 73.9% of first authors were from high-income countries (HICs), while 26.1% were from low-and middle-income countries (LMICs). According to institutional affiliation, 83.4% of publications originated from HIC institutions and 16.6% from LMIC institutions. Overall, 95.2% of publications were published in journals based in HICs. Studies led by authors from highincome countries were associated with publication in higher-impact and higher-quartile journals (p < 0.001). Gender distribution was comparable across groups, and variations in impact factor were more strongly associated with institutional income level than with gender. Conclusion(s): Despite comparable methodological characteristics, publications led by authors and institutions from high-income countries demonstrated greater publication visibility in the PSP literature. Greater transparency in editorial processes may help improve equity in research dissemination. Copyright © 2026, Turkish Society of Thoracic Surgery. All rights reserved. <92> [Use Link to view the full text] Accession Number 651453027 Title Comparison of Intensive Versus Conventional Glycemic Control Targets: An Updated Systematic Review and Meta-Analysis of the 2024 Society of Critical Care Medicine Guidelines on Glycemic Control for Critically Ill Adults. Source Critical care medicine. (no pagination), 2026. Date of Publication: 09 Jun 2026. Author Sirimaturos M.; Honarmand K.; Long M.T.; Preiser J.-C.; Nagpal A.D.; Agus M.S.D.; Aldouhan J.; Bircher N.G.; Carpenter D.L.; Dearness K.; Farrington E.A.; Freire A.X.; Hirshberg E.L.; Irving S.Y.; Krinsley J.S.; Lanspa M.J.; Prager R.; Srinivasan V.; Umpierrez G.E.; Wax S.P.; Jacobi J. Institution (Sirimaturos) System Critical Care Pharmacy Services Leader, Houston Methodist Hospital, Houston, TX, United States (Honarmand) Division of Critical Care, Department of Medicine, Mackenzie Health, Vaughan, ON, Canada (Honarmand) GUIDE Canada, McMaster University, Hamilton, ON, Canada (Long) Department of Anesthesiology, Division of Critical Care, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States (Preiser) Department of Internal Medicine, Erasme University Hospital, Brussels, Belgium (Nagpal) London Health Sciences Centre, Division of Cardiac Surgery and Critical Care Western, London, ON, Canada (Agus) Harvard Medical School and Division Chief, Boston Children's Hospital, Boston, MA, United States (Aldouhan) King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia (Bircher) Department of Nurse Anesthesia, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States (Carpenter) Emory Critical Care Center, Atlanta, GA, United States (Dearness) Hamilton, ON, Canada (Farrington) Pediatric Critical Care Pharmacist, New Hanover Regional Medical Center, Wilmington, NC, United States (Freire) Pulmonary Critical Care and Sleep Medicine at the University of Tennessee Health Science Center, Memphis, TN, United States (Hirshberg) Adult and Pediatric Critical Care Specialist, University of Utah School of Medicine, Salt Lake City, UT, United States (Irving) Department of Nursing and Clinical Care Services-Critical Care, University of Pennsylvania School of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Krinsley) Emeritus, Vagelos Columbia University College of Physicians and Surgeons, Stamford Hospital, Stamford, CT, United States (Lanspa) Division of Critical Care, Intermountain Medical Center, Salt Lake City, UT, United States (Prager) Division of Critical Care, Western University, London, Canada (Srinivasan) Departments of Anesthesiology, Critical Care and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States (Srinivasan) Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Umpierrez) School of Medicine, Emory University, Atlanta, GA, United States (Wax) Queen's University, Kingston, ON, Canada (Jacobi) INLebanon Abstract OBJECTIVES: To perform an updated systematic review and meta-analysis of the efficacy and safety of intensive (INT) vs. conventional (CONV) blood glucose (BG) targets for critically ill adults on insulin infusions. DATA SOURCES: We conducted a comprehensive search of Embase and OVID Medline databases from inception to October 16, 2023. We manually excluded studies published before 2000 due to potential lack of relevance as glycemic control in the ICU was not routinely practiced before 2000. STUDY SELECTION: We included randomized controlled trials (RCTs) evaluating adult, critically ill patients on insulin infusions comparing INT vs. CONV targets for efficacy and safety outcomes. DATA EXTRACTION: Data were screened and extracted with accuracy confirmed by a second reviewer. Study methodological characteristics, patient population, interventions, and outcome data were recorded. Studies without numerical outcomes were summarized as text statements. DATA SYNTHESIS: Forty-five RCTs were included involving 32,215 patients. No differences were seen between INT and CONV targets for hospital mortality or ICU mortality. INT targets were associated with lower ICU length of stay (LOS), infections, and critical illness polyneuropathy (CIP); however, INT targets demonstrated a 3.6-fold higher risk of severe hypoglycemia. Most of the studies with significant differences contained serious inconsistencies or risk of bias. In the subgroup analyses, INT targets demonstrated favorable neurologic outcomes in neurologic ICU patients, lower ICU LOS in mixed ICU patients, and lower ICU mortality in the cardiac surgery subgroup. CONCLUSION(S): INT BG targets demonstrated mild to moderate improvements in several important morbidity secondary outcomes, including LOS, infections, and CIP, but were associated with a 3.6-fold higher risk of severe hypoglycemia. No differences were seen in ICU or hospital mortality. INT targets should not be routinely used over CONV targets when trying to minimize hypoglycemia as a marker of patient safety. However, as stated in the Society of Critical Care Medicine guidelines, a lower target within the INT range (110-140 mg/dL; 6.1-7.8 mmol/L) may be considered acceptable in select centers where the risk of hypoglycemia is documented to be negligible based on routine assessment and with the use of optimized glycemic management protocols. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. <93> Accession Number 2046450930 Title Impact of Gender on Outcomes Following Surgery for Infective Endocarditis: A Systematic Review and Meta-Analysis. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 7256304. Date of Publication: 2026. Author Kukreja N.S.; Singh R.; Fareed F.F.I.; Joshi S.; Awad W.I. Institution (Kukreja, Singh, Joshi) National Medical Research Association, London, United Kingdom (Kukreja) SHTAC, University of Southampton, Southampton Science Park, Southampton, United Kingdom (Fareed) University of Buckingham Medical School, Hunter Street, Buckingham, United Kingdom (Joshi) School of Medicine, Queen's University Belfast, Belfast, United Kingdom (Awad) Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom (Awad) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Awad) University of South Wales, Cardiff, United Kingdom Publisher John Wiley and Sons Inc Abstract Objective: Outcomes after surgical management of infective endocarditis (IE) for male and female patients is controversial, with some studies suggesting worse outcomes for female patients. The aim of this systematic review was to assess postoperative outcomes after surgery for IE in all studies reporting by patient gender. Method(s): A systematic review and meta-analysis was conducted in accordance with Preferred Reporting in Systematic Review and Meta-Analysis (PRISMA) guidelines. A comprehensive search of MEDLINE, Embase and Scopus databases was conducted from inception until 15th September 2025. Two authors independently conducted study screening and data extraction. Outcomes included mortality (< 30 day and > 1 year), postoperative (< 30 day) stroke, sepsis, acute kidney injury (AKI) and length of stay (LOS). Result(s): Database search yielded 3102 results, and 13 studies were included with 20,824 patients (14,479 male and 6345 female). Women had increased risk of 30-day mortality compared with men (odds ratio (OR): 1.36, 95% confidence interval (CI): 1.15-1.61 and p < 0.01), increased risk of > 1-year mortality (OR: 1.34, 95% CI: 1.04-1.73 and p = 0.02) and of developing postoperative (< 30 day) AKI (OR: 1.20, 95% CI: 1.03-1.41 and p = 0.02). No significant differences were found in postoperative stroke (OR: 1.12, 95% CI: 0.95-1.30 and p = 0.17), sepsis (OR: 1.03, 95% CI: 0.62-1.71 and p = 0.92) or LOS (standardised mean difference: -0.06 days, 95% CI: -0.71-0.59 and p = 0.78). Conclusion(s): Female patients had significantly worse short- and long-term mortality and increased risk of developing AKI than men; however, stroke, sepsis and LOS outcomes were comparable. Further research is needed to determine the reasons for worse mortality outcomes in females. Copyright © 2026 Niraj S. Kukreja et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <94> Accession Number 651453690 Title Effects of remote ischemic preconditioning on postoperative gastrointestinal function in patients undergoing off-pump coronary artery bypass grafting: a randomized controlled trial. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 10 Jun 2026. Author Yang W.; Liu Q.; Wang X.; Han W.; Li H.; Wang T. Institution (Yang, Liu, Wang) Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China (Han) Beijing Municipal Geriatric Medical Research Center, Beijing Geriatric Healthcare Center, Beijing, China (Han) Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China (Li) Department of Cardiac Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China (Wang) Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China Abstract BACKGROUND: Postoperative gastrointestinal function is one of the important factors influencing the prognosis of off-pump coronary artery bypass grafting (OPCAB) patients. Remote ischemic preconditioning (RIPC) is a noninvasive intervention that may offer multiorgan protection. This study aimed to evaluate the impact of preoperative RIPC on postoperative gastrointestinal function and clinical outcomes in OPCAB patients. METHOD(S): This prospective, assessor- and statistician-blinded, sham-controlled, randomized clinical trial included 106 patients scheduled to undergo elective OPCAB. They were randomly assigned to the RIPC (n = 53) or sham-RIPC (n = 53) group. The RIPC group received bilateral upper limb ischemia/reperfusion cycles (200 mmHg, 5-min ischemia/5-min reperfusion, repeated for 5 cycles) twice daily for 3 consecutive preoperative days. The primary outcome was the incidence of postoperative gastrointestinal intolerance (POGI), defined as an I-FEED score of 3-5 within 7 days postoperatively. The secondary outcomes included markers of intestinal injury (intestinal fatty acid-binding protein (I-FABP)), systemic inflammation (interleukin-6 (IL-6), C-reactive protein (CRP)), and S-100 protein beta subunit (S-100beta). The exploratory outcomes comprised gut microbiota analysis and other clinical parameters. RESULT(S): The incidence of POGI was lower in the RIPC than in the sham-RIPC group (35.4% vs. 56.5%, P = 0.040). The postoperative serum levels of I-FABP, IL-6, CRP, and S-100beta were also lower in the RIPC group. Moreover, the relative abundance of Gemella and Dorea decreased in the RIPC group postoperatively. Notably, the abundance of Gemella showed a positive correlation with the postoperative levels of I-FABP and IL-6, whereas that of Dorea exhibited a positive correlation with the postoperative I-FABP levels. CONCLUSION(S): The preoperative application of RIPC was associated with a lower risk of POGI, with no observed safety concerns. This effect of RIPC may be related to attenuated intestinal mucosal injury, reduced systemic inflammation, and potential modulation of the gut microbiota. TRIAL REGISTRATION: This study was registered on May 30, 2024 (ChiCTR2400085044). Copyright © 2026. The Author(s). <95> Accession Number 651457904 Title Applying the fear-avoidance model to exercise rehabilitation after coronary artery bypass grafting a nurse-led intervention study. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 09 Jun 2026. Author Xia L.; Hua J.; Xuan L. Institution (Xia) Department of cardiac surgery, Anhui Chest Hospital, Hefei, Anhui, China (Hua, Xuan) Department of cardiac surgery, Anhui Chest Hospital, Hefei, Anhui, China Abstract OBJECTIVE: To examine whether a nurse-led intervention grounded in the Fear-Avoidance Model (FAM) reduces postoperative kinesiophobia indirectly by improving patients' perceived physical capability. METHOD(S): We conducted a single-center, parallel-group randomized controlled trial. A total of 122 patients who underwent coronary artery bypass grafting (CABG) were randomized 1:1 to an intervention group or a usual-care control group (n = 61 each). The intervention included graded activity, functional feedback, goal setting, structured education, and post-discharge follow-up. Perceived physical capability and kinesiophobia were assessed 30 days after discharge. Mediation analysis was used to test whether perceived physical capability mediated the effect of the intervention on kinesiophobia. RESULT(S): The intervention was associated with higher perceived physical capability (a = 2.43, p = 0.031). Perceived physical capability was inversely associated with kinesiophobia (b = - 0.775, p < 0.001). The indirect effect of the intervention on kinesiophobia through perceived physical capability was significant (ab = - 1.879; bootstrapped 95% CI [- 3.702, - 0.288]). In contrast, the total effect (c = - 1.557, p = 0.433) and the direct effect (c'=0.322, p = 0.860) were not statistically significant. CONCLUSION(S): These findings suggest a rehabilitation-relevant pathway in which strengthening perceived capability may help reduce avoidance-oriented responses after CABG. A nurse-led approach that combines graded mobilization, performance feedback, and goal-based progression may support engagement in early recovery activities and may offer a practical framework for transitional rehabilitation support. Copyright © 2026. The Author(s). <96> Accession Number 2046436285 Title The Society of Thoracic Surgeons 2026 Clinical Practice Guidelines for the Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation After Cardiac Surgery. Source Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication: 2026. Author Chatterjee S.; Grant M.C.; Hui D.S.; Schwann T.A.; Alexander J.H.; Gaudino M.F.L.; Mack C.A.; Malaisrie S.C.; Merritt H.; Sood P.; Wyler von Ballmoos M.; Schena S. Institution (Chatterjee) Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States (Chatterjee) The Texas Heart Institute at Baylor College of Medicine, Houston, TX, United States (Grant) Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Hui) Department of Cardiothoracic Surgery, Joe and Teresa R. Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, United States (Schwann) Division of Cardiac Surgery, Department of Surgery, Corewell Health East, Royal Oak, MI, United States (Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke Health, Durham, NC, United States (Gaudino, Mack) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Malaisrie) Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, IL, United States (Merritt) Cardiothoracic Surgery, Nebraska Methodist Hospital, Omaha, NE, United States (Sood) The Society of Thoracic Surgeons, Chicago, IL, United States (Wyler von Ballmoos) Department of Cardiovascular and Thoracic Surgery, Texas Health Fort Worth, Fort Worth, TX, United States (Schena) Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States Publisher Elsevier Inc. Abstract Background Postoperative atrial fibrillation (POAF) is the most frequent complication after cardiac surgery and is associated with greater morbidity, mortality, length of stay, and cost. Multiple pharmacologic and procedural strategies exist for POAF prevention and treatment, yet practice variation persists. The Society of Thoracic Surgeons (STS) Workforce on Evidence-Based Surgery convened a multidisciplinary writing group to synthesize contemporary evidence and develop guideline recommendations for preventing and treating new-onset POAF after cardiac surgery. Methods In 2025, the group used the Population, Intervention, Comparison, Outcome framework to formulate clinical questions spanning preoperative, intraoperative, and postoperative domains. Following standardized STS methodology, evidence from randomized controlled trials and observational studies was reviewed, and recommendations were graded by Class of Recommendation and Level of Evidence. Results The group developed 15 recommendations: 8 addressing preventive strategies, 3 intraoperative techniques, and 4 postoperative treatments. Two Class I recommendations addressed perioperative oral amiodarone and rhythm cardioversion for hemodynamically unstable POAF. Two Class IIa recommendations supported posterior pericardiotomy and perioperative beta-blockers. Eight Class IIb recommendations reflected areas of uncertainty and limited data. Three Class III recommendations addressed therapies without demonstrated benefit. Conclusions Levels of Evidence vary across interventions, and high-quality data remain limited for POAF after cardiac surgery. Pharmacologic studies often lack granularity in dose and timing, and intraoperative maneuvers continue to evolve. Individualized risk assessment remains essential given therapy-related adverse effects. The 2026 STS guidelines provide the most comprehensive recommendations focused on POAF after cardiac surgery, offering a framework to standardize care and highlight future investigational priorities. Copyright © 2026 The Society of Thoracic Surgeons. <97> Accession Number 2046443191 Title A Systematic Review of the Clinical Impact of GLP-1 Receptor Agonists in Hidradenitis Suppurativa. Source American Journal of Clinical Dermatology. (no pagination), 2026. Date of Publication: 2026. Author Visan M.-A.; Carroll E.; Ryan S.-L.; Pender E.; Costache D.-O.; Caruntu C.; Hughes R.; Kirby B. Institution (Visan, Carroll, Ryan, Pender, Hughes, Kirby) Dermatology Department, St. Vincent's University Hospital, Dublin, Ireland (Visan, Caruntu) Physiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Visan, Costache) Dermatology Department, Carol Davila Central Military Emergency University Hospital, Bucharest, Romania (Carroll, Pender, Hughes, Kirby) School of Medicine, Charles Institute of Dermatology, University College Dublin, Dublin, Ireland (Costache) Dermatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Caruntu) Prof. Dr. N. Paulescu National Institute of Diabetes, Nutrition, Metabolic Diseases, Bucharest, Romania Publisher Adis Abstract Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease which imposes a significant burden in terms of pain, disability, and comorbidities. Obesity and metabolic dysfunction are highly prevalent in HS, contributing to disease severity. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used in type 2 diabetes and obesity, have shown additional anti-inflammatory properties that may be relevant in HS.However, data on their clinical benefit remain limited. Method(s): We performed a systematic review of PubMed/MEDLINE, Scopus, Web of Science, and Embase through June 2025, following PRISMA guidelines. Studies reporting outcomes in HS patients treated with GLP-1RAs were included. Information on clinical severity, quality of life, metabolism, inflammatory markers, and healthcare use were extracted. Findings were critically assessed and summarized descriptively, with pooled analysis applied where outcomes were consistently reported. This review was registered with PROSPERO (CRD420251110220). Result(s): Nineteen studies including 67,568 patients were identified. Pooled analysis showed that 60% of patients achieved clinical improvement in Hurley stage (95% CI 52-67). Dermatology Life Quality Index (DLQI) improved by a mean of -3.83 points (95% CI -5.14 to -2.51). Clinical benefit was observed despite modest weight reduction (mean BMI change -2.64 kg/m2). Inflammatory and metabolic markers improved, with significant reductions in mean C-reactive protein (-1.35 mg/L, 95% CI -2.33 to -0.36) and HbA1c (-0.39%, 95% CI -0.59 to -0.18). Large real-world cohorts showed decreased antibiotic and corticosteroid use and lower hospitalization rates, though results for biologic use, surgical procedures, and cardiovascular outcomes were mixed. Two studies reported reduced risk of major adverse cardiovascular events, while one HS-diabetes cohort suggested persistent excess cardiovascular risk compared with diabetes-only controls. Conclusion(s): This systematic review suggests that GLP-1RAs are associated with improvements in HS severity, quality of life, metabolic and inflammatory parameters, and may additionally reduce healthcare utilization and cardiometabolic risk, observed alongside weight loss. However, current evidence remains limited and heterogeneous, and the relative contribution of weight-dependent and weight-independent effects cannot be determined. Prospective studies and controlled trials are needed to clarify the role of GLP-1RAs in HS management. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <98> Accession Number 2045325312 Title Addition of Cilostazol to Aspirin and a Thienopyridine for Prevention of Restenosis After Coronary Artery Stenting: A Meta-Analysis. Source Journal of Clinical Pharmacology. 50(4) (pp 415-421), 2010. Date of Publication: 01 Apr 2010. Author Jennings D.L.; Kalus J.S. Institution (Jennings, Kalus) Department of Pharmacy, Henry Ford Hospital, Detroit, MI, United States Publisher John Wiley and Sons Inc Abstract The purpose of this study is to evaluate the effect of adding cilostazol to dual antiplatelet therapy (aspirin and thienopyridine) on rates of restenosis after coronary artery stenting. A meta-analysis is conducted of randomized, controlled trials comparing 3 drug regimens (cilostazol, thienopyridine, aspirin [triple therapy]) with dual antiplatelet therapy to reduce restenosis after coronary stenting. A total of 5 studies are included for analysis. The analysis reveals that triple therapy is used in 796 patients, whereas dual therapy is used in 801 patients. Approximately 56% of patients receive a drug-eluting stent. The 6-month restenosis rates are significantly lower with triple versus dual antiplatelet therapy (12.7% vs 21.9%; odds ratio 0.5; 95% confidence interval, 0.38-0.66; P <.001). This benefit is seen regardless of whether a bare-metal or drug-eluting stent is used. Rates of major adverse cardiac events and bleeding are reported for 3 of the 5 studies (n = 1426); analysis of these outcomes shows no difference between treatment groups (P =.21 and.48, respectively). The addition of cilostazol to standard dual antiplatelet therapy reduces angiographic restenosis and increases MLD at 6 months without significantly affecting rates of major adverse cardiac events or bleeding. Copyright 2010 American College of Clinical Pharmacology. <99> Accession Number 2046442388 Title Outcomes in provisional one-stent versus dedicated two-stent coronary bifurcation stenting techniques: a systematic review and meta-analysis. Source Egyptian Heart Journal. 78(1) (no pagination), 2026. Article Number: 45. Date of Publication: 01 Dec 2026. Author Agrawal H.; Dubey P.; Tewari J.; Neupane S.; Singh V.; Shunk K.; Perera M.; Dwivedi A.K.; Mukherjee D. Institution (Agrawal, Neupane) Washington Hospital Healthcare System, Fremont, United States (Dubey) Santa Clara University, Santa Clara, United States (Tewari) Department of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, United States (Singh) King George's Medical University, Lucknow, India (Shunk) San Francisco VA Medical Center, San Francisco, United States (Perera, Dwivedi) University of Missouri, Columbia, United States (Mukherjee) Texas Tech University Health Sciences Center El Paso, El Paso, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: The optimal long-term strategy for coronary bifurcation PCI remains debated. Earlier meta-analyses limited to long-term data suggested better outcomes with a provisional approach versus routine two-stent techniques. Method(s): We conducted an updated, comprehensive meta-analysis of randomized controlled trials comparing provisional versus two-stent strategies. MEDLINE, Embase, and the Cochrane Library were searched through September 2025. Fifteen RCTs (n = 6978) met inclusion criteria. Using Stata 16.1, random-effects (DerSimonian-Laird) risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for prespecified outcomes. Result(s): Relative risks (95% CIs) for provisional vs two-stent were: all-cause mortality 0.97 (0.72-1.30); cardiovascular mortality 0.98 (0.68-1.40); myocardial infarction 0.86 (0.62-1.19); target lesion revascularization 1.07 (0.80-1.44); stent thrombosis 1.36 (0.81-2.29); and MACE 1.27 (0.81-1.99). Across endpoints, pooled estimates did not show statistically significant differences between strategies. Conclusion(s): In this updated synthesis of randomized trials, the available evidence did not demonstrate clear superiority of either provisional or two-stent strategies for major clinical outcomes. Unlike prior long-term-only analyses, we did not observe higher mortality or myocardial infarction with two-stent approaches. Technique selection should remain individualized according to lesion anatomy, procedural complexity, and operator expertise. These findings should not be interpreted as proof of equivalence or non-inferiority. Trial registration CRD420251167534. Copyright © The Author(s) 2026. <100> Accession Number 2046464261 Title Colchicine Prevents Postoperative Atrial Fibrillation in Cardiac and Thoracic Surgery Patients: Contemporary Evidence From a Meta-Analysis of Randomized Controlled Trials. Source Cardiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 1851955. Date of Publication: 2026. Author Saeed M.H.; Haider S.Z.; Lohana K.C.; Kashish F.; Zaheer M.A.; Abbasi T.N.; Mazhar S.; Rahman J. Institution (Saeed, Lohana, Kashish) Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, Pakistan (Haider) Department of Forensic Medicine, Al-Tibri Medical College, Isra University, Karachi, Pakistan (Zaheer, Abbasi, Mazhar) Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Rahman) Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh Publisher John Wiley and Sons Ltd Abstract Background: Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac and thoracic surgery. Stems from atrial oxidative stress and pericardial inflammation, POAF is associated with adverse clinical outcomes such as heart failure, stroke, and increased mortality. As an anti-inflammatory agent, colchicine has shown effective POAF risk reduction. Method(s): A systematic review and meta-analysis were conducted including randomized controlled trials (RCTs) evaluating colchicine for POAF prevention till september 2025. Data were pooled using random-effects models with restricted maximum likelihood (REML). Subgroup analyses examined treatment duration (< 2 weeks vs. > 2 weeks) and surgery type. Heterogeneity was assessed with I2, and stability of outcomes was assessed using leave-one-out (LOO) analyses. Result(s): Twelve RCTs encompassing 5637 participants were included. Colchicine significantly reduced POAF incidence compared with control (RR = 0.73; 95% CI = 0.64-0.84; p < 0.0001; I2 = 0%). Both short-course (< 2 weeks) and long-course (> 2 weeks) regimens were effective without any significant subgroup difference (p = 0.57). Colchicine increased gastrointestinal adverse events (OR = 2.25; 95% CI = 1.86-2.73) and diarrhea (RR = 3.16; 95% CI = 2.25-4.42) but showed no excess bleeding (RR = 0.89; 95% CI = 0.61-1.28), sepsis (RR = 1.32; 95% CI = 0.48-3.59), or in-hospital mortality (RR = 0.90; 95% CI = 0.43-1.86). Funnel plots and Egger's tests revealed no publication bias. Conclusion(s): Colchicine achieved significant POAF risk reduction without serious adverse events. Both short- and long-course regimens were effective, with the short-course approach offering optimal tolerability. These findings support colchicine as a safe, inexpensive adjunct for POAF prevention. Copyright © 2026 Muhammad Hassan Saeed et al. Cardiology Research and Practice published by John Wiley & Sons Ltd. <101> Accession Number 2046467375 Title Clinical spectrum, cardiac phenotypes, and outcomes of FHL1-related cardiomyopathies: a systematic review. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 518. Date of Publication: 01 Dec 2026. Author Bobbio E.; Caiazza M.; Pisacane F.; Viscovo I.; Gentile A.; Monda E.; De Falco C.; Esposito D.; Borrelli F.; Losi M.; Bossone E.; Chen S.N.; Frisso G.; Calabro P.; Esposito G.; Lombardi R.; Limongelli G. Institution (Bobbio, Caiazza, Pisacane, Viscovo, Monda, Limongelli) Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, via Leonardo Bianchi 1, Naples, Italy (Pisacane) UOC Patologia Clinica, AORN dei Colli, via Leonardo Bianchi 1, Naples, Italy (Gentile, De Falco, Borrelli, Losi, Esposito, Lombardi) Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy (Gentile, Chen, Lombardi) Division of Cardiology, University of Colorado School of Medicine, 12505 E. 16th Avenue, Anschutz Inpatient Pavilion 2, Aurora, CO, United States (Esposito) Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden (Esposito) Department of Endocrinology at Sahlgrenska University Hospital, University of Gothenburg, Bla Straket 8, Gothenburg, Sweden (Bossone) Department of Public Health, University of Naples Federico II, Via Pansini 5, Naples, Italy (Bossone) Heart Centre of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia (Frisso) Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Pansini 5, Naples, Italy (Calabro, Limongelli) Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Caserta, Italy (Limongelli) Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom (Bobbio) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Bobbio) Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Publisher BioMed Central Ltd Abstract Background: Mutations in the Four-and-a-Half LIM Domains 1 (FHL1) gene are increasingly recognized as a rare cause of inherited cardiomyopathies, often associated with skeletal myopathy and adverse cardiac outcomes. The phenotypic spectrum and clinical implications of FHL1 variants remain poorly defined. Objective(s): To systematically review published cases of FHL1-related cardiomyopathy and characterize the clinical, genetic, and pathological features. Method(s): We conducted a systematic literature search in PubMed and EMBASE up to July 2025 using predefined criteria to identify studies reporting clinical cases of patients with FHL1 mutations and cardiac involvement. Data on genotype, phenotype, cardiac and neuromuscular features, and clinical outcomes were extracted and synthesized. Result(s): Twenty-two studies were included, comprising 114 patients with pathogenic or likely pathogenic FHL1 mutations. Most patients were male (69%), with a median age of onset of 18 (IQR 10-26) years. Cardiac involvement consisted in left ventricular hypertrophy (56%), followed by arrhythmias (51%), and conduction abnormalities (8%). The incidence of sudden cardiac death was 7%, and heart transplantation was reported in 5% of patients. Skeletal muscle involvement was present in 75%, ranging from mild contractures to more severe myopathic phenotypes with functional impairment. Creatine kinase levels were variably elevated. Truncating variants were reported in several severe cardiac presentations in young males, while isolated cardiac disease occurred with selected variants. Conclusion(s): FHL1-related cardiomyopathy is a rare but important diagnosis. Genetic testing should be considered in patients with cardiac hypertrophy and neuromuscular features. Further research is needed to define prognostic markers and guide management. Copyright © The Author(s) 2026. <102> Accession Number 2046605961 Title Comparison Between Artificial Intelligence-Based Models and Traditional Risk Scores for Predicting Risks in Adult Cardiothoracic Surgery: A Systematic Review. Source Journal of Surgical Research. 325 (pp 64-72), 2026. Date of Publication: 01 Sep 2026. Author Fuchs T.K.; Jones C.; Breiner M. Institution (Fuchs, Jones) Edward Via College of Osteopathic Medicine (VCOM), Clinical Sciences, Blacksburg, VA, United States (Breiner) Department of Surgery, Edward Via College of Osteopathic Medicine (VCOM), Blacksburg, VA, United States Publisher Academic Press Inc. Abstract Introduction: Conventional risk scores like EuroSCORE II and Society of Thoracic Surgeons models, derived from logistic regression, may not fully represent complex interactions within cardiac surgery cohorts. Using nonlinear modeling, machine learning (ML) may improve risk prediction by capturing complex relationships. Objective(s): To conduct a systematic review of studies (2020-2026) that compare ML models with traditional risk scores for predicting perioperative mortality or significant adverse events in adult cardiac surgery. Method(s): Following the PRISMA 2020 guidelines, PubMed, Google Scholar, and Cochrane were searched from January 2020 to January 2026. The protocol was registered in PROSPERO (CRD420261295268; registered January 28, 2026). Inclusion necessitated direct comparisons between ML and traditional scoring methodologies with reported performance metrics, such as the area under the curve (AUC). Prediction model Risk Of Bias ASsessment Tool+ artificial intelligence was utilized for bias risk assessment. Result(s): Thirteen studies were included (N = 308-647,726). Studies originated from China (n = 5), United States (n = 3), United Kingdom (n = 2), Colombia, Saudi Arabia, and Turkey (n = 1 each). Algorithms included extreme gradient boosting, random forest, and ensembles. ML models showed improved or comparable performance, with AUC differences of 0.006-0.42, improved calibration, and reclassification (net reclassification improvement 0.550). Extreme gradient boosting AUC was 0.96 for postoperative infection, and random forest AUC was 0.975 for major adverse events in type A dissection. Prediction model Risk Of Bias ASsessment Tool+ artificial intelligence indicated low risk of bias; external validation was limited, and some analyses raised concerns regarding overfitting. Key methodological limitations included data leakage, overfitting risk, and limited temporal and external validation. Conclusion(s): ML models may improve risk prediction in cardiac surgery relative to traditional scores, especially through ensembles and advanced validation techniques. Prospective multicenter validation and evaluation of clinical integration and algorithmic fairness are needed before widespread implementation, with attention to data leakage prevention, overfitting mitigation, temporal drift, and calibration on independent validation sets. Copyright © 2026 Elsevier Inc. <103> Accession Number 2046586929 Title Should targeted nipple reinnervation be routinely offered in gender-affirming chest surgery? A narrative review. Source Journal of Sexual Medicine. 23(7) (no pagination), 2026. Article Number: qdag181. Date of Publication: 01 Jul 2026. Author Cripps C.; Zhou S.Y. Institution (Cripps) Division of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago, Chicago, IL, United States (Zhou) University of Minnesota Medical School, Minneapolis, MN, United States (Zhou) University of California San Francisco, San Francisco, CA, United States Publisher Oxford University Press Abstract Introduction: Chest masculinization, or top surgery, is a commonly sought procedure for transgender men and gender-diverse individuals. This surgery typically involves the removal of breast tissue with reconstruction of the nipple-areola complex (NAC). However, sensory loss following surgery is common and may negatively impact postoperative satisfaction, intimacy, and sexual function. As a result, techniques for targeted nipple reinnervation (TNR) have gained increasing attention. Objective(s): To provide coverage of the current literature on TNR in gender-affirming chest surgery, including surgical approaches, sensory outcomes, and implications for access and patient satisfaction. Method(s): This narrative review summarizes the current literature on techniques, outcomes, and considerations regarding TNR in gender-affirming chest surgery. PubMed and Embase were queried using keywords. Studies were included if they discussed operative approach in the context of gender-affirming mastectomy. Articles were also reviewed for sensory outcomes, including return of erogenous function. Result(s): Various techniques for TNR have been explored, aiming to restore sensation and improve esthetic outcomes. These techniques involve direct coaptation, autografting, or allografting to enhance sensory recovery. Studies revealed mixed outcomes, with some patients reporting sensory return and others experiencing delayed or partial recovery. Although TNR has demonstrated potential benefits, including improved nipple and areola sensation, its results remain inconsistent, and it requires additional operative time, leading to increased costs. This may present financial barriers, especially when insurance coverage is limited. Conclusion(s): Targeted nipple reinnervation is a promising adjunct to gender-affirming chest surgery, offering potential benefits in sensation and patient satisfaction. However, evidence remains limited and inconsistent. Until more robust standardized data are available, TNR should be offered as an optional component of care to informed patients who are aware of the risks and uncertainties, but it should not yet be considered a standard component of gender-affirming chest surgery. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <104> Accession Number 2046360710 Title Prevalence of healthcare-associated infections in developing and developed countries: a systematic review. Source BMC Infectious Diseases. 26(1) (no pagination), 2026. Article Number: 1135. Date of Publication: 01 Dec 2026. Author Nappi F.; Avtaar Singh S.S. Institution (Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord, Saint-Denis, France (Avtaar Singh) Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom Publisher BioMed Central Ltd Abstract Introduction: In the global context, healthcare-associated infections (HCAIs) are the most prevalent outcome of substandard patient care. There is a lack of data from developing regions, except for developing countries such as China and India, where reports from the World Health Organization (WHO) demonstrate a more substantial presence. This systematic review aims to investigate geographical disparities in HCAI occurrence in developing and developed countries. It also focuses on healthcare-associated infections, especially infectious endocarditis (IE) from implantable cardiac devices in high-income countries. Method(s): A literature review was conducted according to a pre-designed protocol. A search was performed in Embase, Ovid Medline, and PubMed for reports published between 2000 and 2024. No language restrictions were applied, and older, highly cited studies were retained. The search process retrieved 6,928 abstracts, of which 263 met eligibility criteria. The primary endpoint was to ascertain extant empirical research on the epidemiology of HCAIs in developing countries, with a focus on bacterial infections. The secondary endpoint investigated infections associated with transcatheter aortic valve replacement (TAVR) and cardiac implantable electronic devices (CIED) in developed countries. Result(s): The primary endpoint revealed a HCAI rate in adult ICUs that is at least three times the USA rate. Surgical site infections were the most prevalent type of infection, with rates significantly higher than in developed countries. Gram-negative bacilli caused the most hospital infections. Methicillin-resistant Staphylococcus aureus was detected in many cases. The secondary endpoint demonstrated that Staphylococcus aureus is responsible for approximately one-third of healthcare-associated IE cases. In the United States, the percentage increased from 24% to 32%. Healthcare-associated IE carries a higher in-hospital mortality rate than community-acquired IE (31.1% vs. 20.3%; p < 0.01). Comparisons between TAVR and surgical aortic valve replacement are few and mixed. Large national registries and pooled PARTNER-trial data show comparable IE rates for both procedures. CIEDs-IE have a lower three-year survival rate (53.8% vs. 33% for pacemakers, 47.7% vs. 31.6% for implantable cardioverter-defibrillators, and 50.8% vs. 36.5% for cardiac resynchronization therapy). Conclusion(s): Surveillance HCAIs is essential for tracking disease and evaluating interventions. Focusing on key procedural steps can improve adherence and intervention impact. IE after TAVR and CIED is rare but severe, with high in-hospital mortality. Copyright © The Author(s) 2026. <105> Accession Number 2046383762 Title Comparative outcomes of prophylactic cranial irradiation and brain surveillance in limited-stage small cell lung cancer: A systematic review and meta-analysis. Source Journal of Clinical Oncology. Conference: ASCO Gastrointestinal Cancers Symposium. San Francisco United States. 44(16 Supplement) (pp e20142-e20142), 2026. Date of Publication: 01 Jun 2026. Author Shin K.; Simran; Olabode K.; Martinka L.B.; Puri S.; Saltos A.N.; Gray J.E.; Creelen B.; Rosenberg S.; Dilling T.J.; Jabbour S.K.; Kim J. Institution (Shin) Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States (Kim) Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States (Simran) Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, United States (Simran) All India Institute of Medical Sciences (AIIMS) Raipur, Raipur, India (Olabode, Martinka) Morsani College of Medicine, University of South Florida, Tampa, FL, United States (Puri, Saltos, Gray, Creelen) Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, United States (Rosenberg, Dilling) Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, United States (Jabbour) Department of Radiation Oncology, Rutgers Cancer Institute, New Brunswick, NJ, United States (Kim) Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute and Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States Publisher Lippincott Williams and Wilkins Abstract Background: Prophylactic cranial irradiation (PCI) improves survival outcomes versus no PCI in limited-stage small-cell lung cancer (LS-SCLC), but prior trials predated routine brain MRI; the benefit over modern MRI/CT surveillance is unclear as the phase 3 MAVERICK trial is ongoing. We performed a meta-analysis to compare PCI with routine imaging surveillance and inform practice in the modern imaging era. Method(s): We systematically searched PubMed, Embase, and the Cochrane Library for studies published from 2023 to November 18, 2025. We included patients with LS-SCLC in complete or partial remission without brain metastases confirmed by brain MRI or CT. The intervention was PCI; the comparator was routine brain MRI or CT surveillance. The primary outcome was overall survival (OS); secondary outcomes were brain metastasis-free survival (BMFS) and progression-free survival (PFS). Outcomes were summarized as hazard ratios (HRs). When HRs were not reported, they were estimated from Kaplan-Meier curves. Random-effects models were used, and heterogeneity was summarized with I2. Analyses were performed in R (version 4.4.2). For studies with propensity score matching (PSM), matched cohorts were used for meta-analysis. Result(s): A total of 714 patients receiving PCI and 709 patients managed without PCI were included across eight studies. The meta-analysis used propensity score-matched (PSM) cohorts when available (six studies) and full cohorts from two non-PSM studies. Across included cohorts, first-line therapy was radiotherapy with or without concurrent or sequential chemotherapy in 1, 327 (92.2%) patients and thoracic surgery in 112 (7.8%) patients. None of the included studies reported whether immunotherapy was used as first-line therapy. The timing of surveillance brain imaging varied across studies, ranging from every 3-4 months during the first 1-2 years, every 3-6 months during years 2-3, and every 3-12 months thereafter. Additionally, the timing and regimens of salvage treatments differed among studies. For OS (8 studies), PCI was associated with better survival (pooled HR 0.74, 95% CI 0.57-0.96; I2 = 56.5%, Q = 16.11). For PFS (3 studies), PCI was related to improved outcomes (pooled HR 0.77, 95% CI 0.65- 0.90; I2 = 0.0%, Q = 0.44). For BMFS (4 studies), PCI was linked to superior BMFS (pooled HR 0.37, 95% CI 0.25- 0.54; I2 = 0.0%, Q = 2.67). Conclusion(s): Compared with imaging surveillance, PCI was associated with improved OS, PFS, and BMFS in LS-SCLC patients. Heterogeneity among comparator follow-up strategies underscores the need for randomized trials reporting survival outcomes and long-term neurocognitive effects. These findings may help inform clinical decision-making while awaiting results from the ongoing MAVERICK randomized trial. Copyright © 2026 by American Society of Clinical Oncology <106> Accession Number 2046585406 Title A comparative study of operative & postoperative parameters in coronary artery bypass grafting patients: Insights from a tertiary care experience. Source International Journal of Drug Delivery Technology. 16(58 supplement) (pp 1151-1158), 2026. Date of Publication: 2026. Author Rahman K.M.A.; Barua S.; Aziz A.K.M.S.; Mahbub K.; Nahar A. Institution (Rahman, Barua) Department of Cardiac Surgery, Bangladesh Medical University (BMU), Dhaka, Bangladesh (Aziz) Department of Cardiac Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh (Mahbub) Department of Cardiac Surgery, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh (Nahar) Department of Paediatric Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Coronary artery bypass grafting (CABG) remains the standard surgical treatment for multivessel coronary artery disease. Off-pump and on-pump techniques differ in intraoperative management and postoperative outcomes. This study aimed to compare operative and postoperative parameters between off-pump and on-pump CABG patients. Method(s): This comparative cross-sectional study was conducted in a cardiac surgery department. A total of 60 patients undergoing CABG were divided into two groups: off-pump CABG (n=30) and on-pump CABG (n=30). Baseline characteristics, operative variables, postoperative clinical outcomes and myocardial injury markers including CK-MB and cardiac troponin I (cTnI) were analyzed. Statistical comparisons were performed using appropriate tests, with p<=0.05 considered significant. Result(s): Baseline demographic characteristics, risk factors and preoperative cardiac function were comparable between groups. Operative time was significantly shorter in the off-pump group compared to the on-pump group (254.00 +/- 28.75 vs. 334.50 +/- 23.72 minutes; p<0.001). Postoperative inotropic support requirement was significantly higher in the on-pump group (76.7% vs. 10.0%; p<0.00001). CK-MB and cTnI levels were significantly elevated in the on-pump group at 6, 12 and 24 hours postoperatively, indicating greater myocardial injury. However, mechanical ventilation time, blood loss, transfusion requirement and postoperative complications showed no significant differences between groups. Conclusion(s): Both on-pump and off-pump CABG are safe and effective techniques with comparable early clinical outcomes. Off-pump CABG is associated with shorter operative time and reduced perioperative myocardial injury, while on-pump CABG requires greater postoperative inotropic support. Copyright © 2026, Dr. Yashwant Research Labs Pvt Ltd. All rights reserved. <107> Accession Number 2046429243 Title A HEART-WISE: Allogeneic Wharton's Jelly-derived Mesenchymal Stromal Cells' Intracoronary Transplantation in Pediatric Patients with Dilated Cardiomyopathy: The First Case Reports. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 509. Date of Publication: 01 Dec 2026. Author Madani H.; Pahlavan S.; Vosough M.; Barekat M.; Rezaei-kalantari K.; Aghdami N.; Zeinaloo A.A. Institution (Madani) Department of Applied Cell Sciences, Faculty of Basic Sciences and Advanced Technologies in Medicine, Royan Institute, ACECR, Tehran, Iran, Islamic Republic of (Madani, Vosough, Barekat, Aghdami) Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran, Islamic Republic of (Pahlavan) Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran, Islamic Republic of (Rezaei-kalantari) Department of Radiology, Medical and Research Center, Cardio-Oncology Research Center, Rajaie Cardiovascular, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Zeinaloo) Department of Pediatrics, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Zeinaloo) Fetal & Pediatric Cardiovascular Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Pediatric dilated cardiomyopathy (PDCM) is a severe cardiovascular disorder characterized by ventricular systolic dysfunction, with heart transplantation as the gold standard therapy. Mesenchymal stromal cells (MSCs) have demonstrated promise for treating cardiomyopathy, but previous studies in pediatric patients have focused exclusively on autologous cells such as MSCs, while allogeneic MSCs with better results were studied only in adults. Objective(s): The study "A HEART-WISE" is the first case reports to evaluate the safety and feasibility of intracoronary transplantation of allogeneic GMP-complierant Wharton's jelly-derived MSCs (WJ-MSCs) in PDCM patients. Method(s): Two pediatric patients with PDCM received a single intracoronary infusion of 1.5 x 106 cells/kg WJ-MSCs. Clinical evaluations included NYHA functional class, six-minute walk test (6MWT), N Terminal pro-brain natriuretic peptide (NT-proBNP), and cardiac imaging over a 12-month follow-up period. Result(s): Both patients tolerated intracoronary WJ-MSC administration without serious adverse events related to the procedure. Patient 1 demonstrated marked improvements by 3 months (NYHA III to II, LVEF 33% to 48%, 6MWT 300 to 373 m, NT-proBNP 3502 to 1734 pg/mL) but passed away at 6 months follow-up due to a viral infection. Patient 2 had a persistently reduced LVEF in the 43-46% range for more than three years prior to therapy but achieved sustained improvement by 12 months (NYHA III to II, LVEF 43% to 64%, 6MWT 265 to 380 m). Conclusion(s): Our preliminary findings suggest the safety and feasibility of intracoronary transplantation of allogeneic WJ-MSCs in PDCM, with potential off-the-shelf therapeutic benefit. Validation of these observations in larger randomized controlled trials is needed to better evaluate long-term safety and efficacy. Copyright © The Author(s) 2026. <108> Accession Number 2046437396 Title Routine Versus Selective Temporary Epicardial Pacing Wire Placement: A Scoping Review. Source Surgery Today. (no pagination), 2026. Date of Publication: 2026. Author Akele O.; Osuji E.; Patel V.; Kamal M.; Kiernan P.; Dhakal R.; Khoury M.E.; Shahani R. Institution (Akele, Patel, Kamal, Kiernan) Department of Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, United States (Osuji) Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States (Dhakal) Department of Medicine, Staten Island University Hospital, Staten Island, NY, United States (Khoury) Department of Cardiology, Staten Island University Hospital, Staten Island, NY, United States (Shahani) Department of Cardiothoracic Surgery, Staten Island University Hospital Heart Institute, Staten Island, NY, United States Publisher Springer Abstract Temporary epicardial pacing wires (TEPWs) are used widely for rhythm management in cardiac surgery. However, their routine placement is being debated increasingly because of low utilization and potential procedural risks. We compared routine versus selective TEPW placement practices and assessed the utilization, complications, and predictors of pacing need. A scoping review was conducted in accordance with the PRISMA-ScR guidelines. We searched PubMed, Embase, Scopus, and Cochrane Library until June 2025. Studies were included if they examined TEPW strategies in adult or pediatric cardiac surgery and reported outcomes related to wire use, complications, or predictors of pacing need. Eleven studies involving 16,874 patients (14,957 adults, 1,917 children) were included. Routine placement rates ranged from 73.5% to 89.9%, but utilization was low at 2.9%-29.6%. Selective strategies showed higher utilization of 30%-100% with fewer unused wires. Predictors of the need for TEPW included intraoperative arrhythmias, prolonged CPB, and complex procedures. Complications were rare. Thus, routine TEPW placement often leads to unnecessary wire use. Selective strategies based on intraoperative and clinical predictors may optimize patient care. Developing a risk-based tool could enhance decision-making and reduce procedural burden. Copyright © The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2026. �

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