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Total documents retrieved: 139 Results Generated From: Embase <1980 to 2026 Week 22> Embase Weekly Updates (updates since 2026-05-22) - (139 records) <1> [Use Link to view the full text] Accession Number 2044667704 Title Delay From First Symptoms in Patients Presenting With STEMI and Cardiogenic Shock: Insights From the DanGer Shock Trial. Source Circulation: Cardiovascular Interventions. 19(3) (no pagination), 2026. Article Number: e015718. Date of Publication: 01 Mar 2026. Author Jensen L.O.; Beske R.P.; Eiskjaer H.; Mangner N.; Polzin A.; Schulze P.C.; Skurk C.; Nordbeck P.; Clemmensen P.; Panoulas V.; Zimmer S.; Schafer A.; Werner N.; Holmvang L.; Wachtell K.; Engstom T.; Udesen N.L.J.; Schmidt H.; Junker A.; Terkelsen C.J.; Christensen S.; Linke A.; Moller J.E.; Hassager C. Institution (Jensen, Wachtell, Udesen, Junker) Department of Cardiology, Odense University Hospital, Denmark (Schmidt) Department of Anesthesiology and Intensive Care, Odense University Hospital, Denmark (Jensen) Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Beske, Holmvang, Engstom, Hassager) Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark (Eiskjaer, Terkelsen) Department of Cardiology, Aarhus University Hospital, Denmark (Christensen) Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Denmark (Mangner, Linke) Department of Internal Medicine and Cardiology, Heart Center Dresden, University Hospital, Technische Universitat Dresden, Germany (Polzin) Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Dusseldorf, Medical Faculty of the Heinrich Heine University Dusseldorf, Germany (Schulze) Department of Internal Medicine I, Cardiology, Angiology and Intensive Medical Care, University Hospital Jena, Germany (Skurk) Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin, Germany (Nordbeck) Department of Internal Medicine I, University Hospital Wurzburg, Germany (Clemmensen) Department of Cardiology, University Heart and Vascular Center (UHZ), University Clinic Hamburg - Eppendorf (UKE), Center for Population Health Research (POINT), Germany (Clemmensen) Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (Panoulas) Department of Cardiology, Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, Harefield Hospital, United Kingdom (Zimmer) Department of Cardiology, University Hospital Bonn, Germany (Schafer) Department of Cardiology and Angiology, Hannover Medical School, Germany (Werner) Department of Internal Medicine III, Heart Center Trier, Krankenhaus der Barmherzigen Bruder, Germany (Holmvang, Engstom, Moller, Hassager) Department of Clinical Medicine, University of Copenhagen, Denmark (Polzin) Cardiovascular Research Institute Dusseldorf (CARID), Germany (Skurk) Deutsches Zentrum fur Herz-Kreislauf-Forschung e.V., Berlin, Germany Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Microaxial flow pump (mAFP) use in selected patients with ST-segment-elevation myocardial infarction complicated by cardiogenic shock improves survival. The present study aimed to assess the influence of delay from first symptoms to randomization on the benefit of an mAFP in patients with ST-segment-elevation myocardial infarction complicated by cardiogenic shock. METHOD(S): - This was a secondary analysis of the international, multicenter, randomized, open-labeled DanGer Shock trial (Danish-German Cardiogenic Shock). A total of 345 of 355 patients with ST-segment-elevation myocardial infarction and cardiogenic shock were enrolled in this substudy. Patients were stratified into quartiles according to delay from first symptoms to randomization to either an mAFP or standard care alone. The end point was death from any cause at 180 days for treatment with an mAFP versus standard of care, according to time from onset of symptoms to randomization obtained by logistic regression analysis. RESULT(S): - Mortality at 180 days increased across quartiles of time from onset of symptoms to randomization: Q1 (0-140 minutes), 36%; Q2 (141-248 minutes), 53%; Q3 (249-650 minutes), 59%; and Q4 (> 651 minutes), 62%, respectively (log-rank P=0.002). However, those with longer delays were also older and more often women. Median age rose from 66 years (interquartile range, 57-73) in the earliest quartile to 71 years (interquartile range, 62-79) in the latest quartile (P=0.005), and the proportion of women increased from 15% to 34%, respectively. Combining the 3 lowest quartiles for the time from onset of symptoms to randomization, the mAFP treatment was associated with an odds ratio of 0.51 (95% CI, 0.31-0.84), whereas the odds ratio for the highest quartile was 0.92 (95% CI, 0.38-2.22; P for interaction = 0.26). CONCLUSION(S): - In patients with ST-segment-elevation myocardial infarction complicated with cardiogenic shock, treatment with an mAFP was associated with reduced all-cause mortality, but the treatment benefit appeared to weaken with prolonged time from the onset of symptoms to randomization. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT01633502. Copyright © 2026 American Heart Association, Inc. <2> Accession Number 2045263447 Title Posterior Left Ventricular Rupture Following Mitral Valve Surgery: A Literature Review of Successful Repair Strategies. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 1964538. Date of Publication: 2026. Author Atta S.; Khalaf Y.; Marigliano A.; Bashir A.; Lloyd C. Institution (Atta, Khalaf, Marigliano, Bashir, Lloyd) Cardiothoracic Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: Posterior ventricular rupture (PVR) is an uncommon but often fatal complication of mitral valve surgery, with reported incidence between 0.6% and 1.8% and mortality rates approaching 86%. Recognized risk factors include posterior mitral annular calcification, advanced age, female sex, extensive decalcification, and infective endocarditis. Despite advances in surgical techniques, this catastrophic complication continues to pose a major challenge. We reviewed published reports of successful repair strategies to outline practical approaches and propose a management framework. Method(s): A PubMed search identified 25 reports describing 34 successful repairs of posterior LV rupture. Only cases in which patients survived were included for analysis. Result(s): Most patients (21 of 34) presented with mitral stenosis, usually associated with posterior annular calcification. The circumstances of rupture varied, occurring intraoperatively, during attempts to wean from cardiopulmonary bypass (CPB), or in the intensive care unit. Thirty cases required reinitiation of CPB to enable definitive repair. External repair methods, such as Teflon patch reinforcement and surgical sealants, were reported in 13 patients. Internal approaches most often used pericardial patch reinforcement secured with Teflon-buttressed sutures, both to restore ventricular integrity and to support the prosthetic valve. In six situations, repair was undertaken using autotransplant techniques on an explanted heart. Mechanical circulatory support was frequently required: 14 patients received intra-aortic balloon pump therapy, and one patient was supported with an Impella device, both aiming to reduce LV workload during recovery. Conclusion(s): Posterior LV rupture following mitral valve surgery demands immediate recognition and rapid reinstitution of CPB. The choice of repair-internal or external-should be guided by rupture timing, location, and patient stability. Adjunctive mechanical circulatory support can be life-saving by unloading the injured ventricle. While experience remains limited to isolated reports, systematic accumulation of cases is needed to refine treatment strategies for this highly lethal complication. Copyright © 2026 Sameh Atta et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <3> Accession Number 2044479354 Title Comparative Study Between Intravenous Ketamine and Propofol as Induction Agents on Postoperative Recovery Scores in Neonates Undergoing Tracheoesophageal Fistula (TEF) Repair Surgery. Source Anestezi Dergisi. 95(1) (pp 46-52), 2026. Date of Publication: 20 Jan 2026. Author Prajapati J.; Rath A.; Reena; Anand N.; Sharma K. Institution (Prajapati) All India Institute of Medical Sciences, Department of Anesthesiology and Reanimation, Raipur, India (Rath, Reena) Banaras Hindu University, IMS, Department of Anesthesiology and Reanimation, Varanasi, India (Anand) AGRIM Hospital, Clinic of Anesthesiology and Critical Care, Varanasi, India (Sharma) Banaras Hindu University, IMS, Department of Pediatric Surgery, Varanasi, India Publisher Anestezi Dergisi Abstract Objective: Tracheoesophageal fistula (TEF) is a congenital anomaly necessitating early surgical intervention. Enhanced recovery after surgery - ERAS principles are increasingly applied in neonatal surgical care to improve outcomes. The choice of anesthetic induction agent plays a pivotal role in determining recovery quality and duration. Method(s): This was a randomized, double-blind, prospective clinical trial involving 60 neonates under 10 days old undergoing TEF repair. Subjects were assigned to receive either propofol (1.5 mg kg-1) or ketamine (1 mg kg-1) as induction agents, with standard maintenance anesthesia and postoperative care. The primary outcome was recovery score at extubation using the Modified Steward Score. Secondary outcomes included duration of mechanical ventilation, postoperative pain using the neonatal pain agitation and sedation scale, and hemodynamic stability. Result(s): Recovery scores were significantly higher in the propofol group (mean 4.86 +/- 0.89) compared to the ketamine group (mean 3.09 +/- 1.01) (p<0.001). The mean duration of mechanical ventilation was shorter in the propofol group (18.00 +/- 3.70 h) than in the ketamine group (21.45 +/- 2.55 h), (p=0.001). Postoperative pain scores were consistently lower in the ketamine group at all time intervals, with significant differences (p<0.05). Hemodynamic parameters were more stable and elevated in the ketamine group post-induction. Conclusion(s): Propofol is associated with faster recovery and reduced ventilation time, whereas ketamine offers superior postoperative analgesia and hemodynamic stability. Anesthetic choice should be individualized based on surgical and patient-specific needs. Copyright © (2026), (Anestezi Dergisi). All rights reserved. <4> Accession Number 2045195292 Title Clinical and echocardiographic predictors of reintervention after percutaneous or surgical treatment of rheumatic mitral stenosis: A systematic review. Source Current Problems in Cardiology. 51(9) (no pagination), 2026. Article Number: 103358. Date of Publication: 01 Sep 2026. Author Gomez-Gualdron S.A.; Macias-Martinez J.S.; Pulido-Parra A.M.; Higuera-Leal S.A.; Vesga-Angarita B.E. Institution (Gomez-Gualdron) Universidad Pedagogica y Tecnologica de Colombia (UPTC), Boyaca, Colombia (Gomez-Gualdron, Higuera-Leal, Vesga-Angarita) Departamento de Medicina Interna, Universidad Industrial de Santander, Santander, Bucaramanga, Colombia (Macias-Martinez, Pulido-Parra) Universidad de Santander (UDES), Santander, Colombia (Gomez-Gualdron, Higuera-Leal, Vesga-Angarita) Grupo de Investigacion para la Renovacion Educativa de la Medicina Interna (GERMINA), Santander, UIS, Colombia (Macias-Martinez, Pulido-Parra, Higuera-Leal, Vesga-Angarita) Departamento de Cardiologia, Instituto del Corazon de Bucaramanga, Santander, Bucaramanga, Colombia Publisher Elsevier Inc. Abstract Background Rheumatic mitral stenosis remains an important cause of valvular heart disease worldwide. Although percutaneous and surgical interventions improve symptoms and hemodynamics, some patients develop restenosis, adverse events, or require repeat interventions during follow-up. Identifying clinical and echocardiographic factors associated with these outcomes is important for risk stratification. Methods A systematic review was conducted following PRISMA guidelines to identify predictors of clinical outcomes after percutaneous or surgical treatment of rheumatic mitral stenosis. A search was performed in PubMed, PMC, Ovid MEDLINE, ScienceDirect, and Scopus without language or date restrictions. Studies evaluating clinical or echocardiographic predictors and reporting OR, HR, or RR were included. Study selection, data extraction, and risk of bias assessment were performed using the Newcastle-Ottawa Scale. Due to heterogeneity among studies, a qualitative synthesis was conducted. Results Fourteen studies were included. The evaluated predictors mainly corresponded to clinical, echocardiographic, hemodynamic, and procedural variables. Some studies identified pulmonary hypertension, unfavorable valvular anatomy, and suboptimal hemodynamic results as factors associated with adverse events or reintervention. In contrast, achieving a post-procedural mitral valve area >=2 cm2 was associated with a lower risk of restenosis and cardiovascular events. Conclusions Clinical and echocardiographic characteristics influence outcomes after intervention for rheumatic mitral stenosis. Baseline valvular morphology and the immediate hemodynamic result of the procedure appear to be key determinants of prognosis and risk of reintervention. Copyright © 2026 Elsevier Inc. <5> Accession Number 2045178136 Title Transcutaneous electrical nerve stimulation (TENS) for ischemia-reperfusion injury and secondary prevention post-PCI in STEMI: study protocol for a randomized controlled trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 338. Date of Publication: 01 Dec 2026. Author Zhang Z.; Wang Y.; Zhang X.; Gou R.; Rao C.; Li T.; Li M.; Li X.; Wang J.; Chen N.; Sun H.; Li Z.; Wang H. Institution (Zhang, Li) Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Jilin, Changchun, China (Wang) Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China (Li, Zhang, Gou, Rao, Li, Li) College of Acupuncture and Massage, Changchun University of Chinese Medicine, Jilin, Changchun, China (Wang) Department of Cardiovascular Medicine, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Jilin, Changchun, China (Wang, Chen) Department of Cardiovascular Medicine, The Second Hospital of Jilin University, Jilin, Changchun, China (Sun) Department of Cardiovascular Medicine, China-Japan Union Hospital of Jilin University, Jilin, Changchun, China (Li) Shandong University of Traditional Chinese Medicine, Shandong, Jinan, China Publisher BioMed Central Ltd Abstract Background: Effective strategies for managing ischemia-reperfusion injury in acute myocardial infarction remain limited, despite advances in reperfusion therapy. Transcutaneous electrical nerve stimulation (TENS), a safe and non-invasive intervention with good patient compliance, modulates pain perception and autonomic activity via specific neural pathways. These properties make it a promising candidate for integration into secondary prevention following percutaneous coronary intervention (PCI). Therefore, this randomized controlled trial investigates the potential of TENS as an innovative therapeutic approach in patients with ST-segment elevation myocardial infarction (STEMI). Method(s): This study was a multicenter randomized controlled trial designed to assess the effect of TENS in STEMI patients undergoing reperfusion. Using a randomization of district groups, 200 eligible patients will be randomized to either the treatment group or the control group (1:1 ratio), with all patients receiving standard PCI. The intervention will be administered for 3 days. The primary endpoint is myocardial infarct size (assessed by serial cardiac biomarker measurements), and secondary endpoints include inflammatory markers, myocardial injury markers, left ventricular function, heart rate variability, and major cardiovascular events. All patients will be followed for 12 weeks. Discussion(s): This trial aims to explore TENS as a novel, non-invasive strategy for mitigating reperfusion injury and enhancing secondary prevention in STEMI patients, addressing a critical gap in current post-PCI management. Trial registration: www.chictr.org.cn, Registration No. ChiCTR2400082515. Registered on 30 March 2024. Copyright © The Author(s) 2026. <6> Accession Number 2044514902 Title Post-PCI Global QFR and Long-Term Outcomes in ACS. Source JACC: Cardiovascular Interventions. 19(7) (pp 889-901), 2026. Date of Publication: 13 Apr 2026. Author Shen X.; Zhang H.; Li Z.; Guan C.; Jin C.; Jin Z.; Yu B.; Zhou Y.; Wang J.; Chen Y.; Pu J.; Chen L.; Qu X.; Yang J.; Liu X.; Zhang Q.; Ye F.; Wu Y.; Qiao S.; Stone G.W.; Fu G.; Song L.; Qiu F. Institution (Shen, Li, Jin, Fu, Qiu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Zhang, Guan, Wu, Qiao, Song) Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wang) Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Chen) Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (Pu) Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Chen) Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China (Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China (Yang) Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Liu) Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China (Zhang) Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (Ye) Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Elsevier Inc. Abstract Background The prognostic utility of residual pressure wire-based physiological assessment after percutaneous coronary intervention (PCI) has been demonstrated. Objectives The aim of this study was to investigate the prognostic value of the residual global Murray law-based angiographic quantitative flow ratio (muQFR) in an acute coronary syndrome (ACS) population. Methods In this post hoc analysis from the FAVOR III China (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients With Coronary Artery Disease) trial, off-line muQFR was computed for 3 major coronary arteries. Residual global muQFR was calculated as the sum of postprocedural muQFR values for treated vessels and preprocedural values for nontreated vessels. ACS patients (including those with ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, and unstable angina) were categorized into high-risk (less than or equal to the cutoff value) and low-risk (greater than the cutoff value) groups according to residual global muQFR. The primary endpoint was 3-year major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, or ischemia-driven revascularization. Results Among 2,428 ACS patients, 2,241 (92.3%) had analyzable muQFR, with a cutoff value of 2.71. High-risk patients (n = 407 [18.2%]) had a greater incidence of 3-year MACE (21.2% vs 10.4%; adjusted HR [aHR]: 1.53; 95% CI: 1.10-2.13; P = 0.01) and MACE excluding periprocedural myocardial infarction (16.2% vs 7.8%; aHR: 1.72; 95% CI: 1.17-2.53; P = 0.006) compared with the low-risk group. The prognostic effect of residual global muQFR was consistent across QFR- and angiography-guided subgroups ( P for interaction = 0.35). Patients with low residual ischemia derived the best outcomes after QFR-guided PCI (MACE 8.8% vs 11.9% for angiography-guided PCI; HR: 0.73; 95% CI: 0.55-0.97). Conclusions Residual global muQFR is a robust angiographic index for post-PCI ischemia burden and long-term risk stratification. In patients with ACS, QFR-guided PCI achieving low residual global ischemia was associated with the most favorable 3-year prognosis. Copyright © 2026 American College of Cardiology Foundation. <7> Accession Number 2045820512 Title Efficacy of intraoperative use of 20% albumin in combination with Ringer's lactate versus Ringer's lactate during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: protocol for a randomised controlled, open-label clinical trial (ALBUCHIP trial). Source BMJ Open. 16(4) (no pagination), 2026. Article Number: e109391. Date of Publication: 01 Apr 2026. Author Deniau B.; Moreau A.; Monsel A.; Faitot V.; Pottecher J.; Zoric L.; Suria S.; Bankole E.; Michelet D.; Poirier N.; Plaud B.; Chaix C.; Biard L.; Depret F. Institution (Deniau, Moreau, Poirier, Plaud, Depret) Department of Anesthesiology, Critical Care and Burn Unit, University Hospital Saint-Louis-Lariboisiere, Paris, France (Deniau) INSERM UMR 970, Paris Transplant Group, Paris, France (Deniau, Moreau, Plaud, Depret) Universite Paris Cite, Paris, France (Deniau, Depret) INI CRCT Network, Vandoeuvre-les-Nancy, France (Deniau, Moreau, Plaud, Depret) FHU PROMICE, Paris, France (Monsel) Sorbonne University, Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitie-Salpetriere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France (Monsel) INSERM UMRS_959, Immunology-Immunopathology-Immunotherapy, Sorbonne Universite, Paris, France (Monsel) Biotherapy (CIC-BTi), Pitie-Salpetriere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France (Faitot, Pottecher) Department of Anaesthesiology, Critical Care and Perioperative Medicine, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France (Pottecher) UR 3072, Stress Oxydant et Protection Musculaire, FMTS, FHU Omicare, Midwifery and Health Sciences, University of Strasbourg Faculty of Medicine, Strasbourg, France (Zoric) Department of Anaesthesiology and Intensive care, Montpellier Cancer Institute, Montpellier, France (Suria) Departement d'Anesthesie, Chirurgie et Interventionnel, Institut Gustave-Roussy, Villejuif, France (Bankole, Michelet) Department of Anaesthesiology, Criticial Care Medicine and Perioperative Medicine, Reims University Hospital, Reims, France (Michelet) C2S Laboratory, Reims Champagne Ardenne University, Reims, France (Plaud) UMR 942 MASCOT, Paris, France (Chaix, Biard) Publisher BMJ Publishing Group Abstract Introduction: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is considered the standard of care for the treatment of peritoneal metastases from gastrointestinal and gynaecological cancers. Characterised by substantial intraoperative fluid shifts and increased endothelial permeability, this procedure is associated with adverse perioperative outcomes. Human albumin has been extensively studied in critically ill patients as an intravenous fluid, but its efficacy during major non-cardiac surgery involving substantial fluid requirements remains insufficiently evaluated. The aim of this trial is to evaluate the efficacy of 20% albumin in combination with Ringer's lactate versus Ringer's lactate alone for fluid therapy during CRS with HIPEC in relation to postoperative outcomes. Methods and analysis: The study protocol was designed and written in accordance with the Prospective Randomised Open, Blinded Endpoint design and followed the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) recommendations. This is a randomised controlled, open-label parallel-group multicentre clinical trial. Participants will be patients admitted for CRS with HIPEC. Eligible patients will be randomly assigned to either the control group (Ringer's lactate) or the intervention group (20% albumin+Ringer's lactate) in a 1:1 ratio, with stratification by centre. The primary outcome is the Comprehensive Complication Index (CCI) score at day 28 following CRS with HIPEC. Secondary endpoints include mortality at day 28, CCI score at day 7, volume of intraoperative and postoperative (48 hours) fluid therapy, cumulative incidence of surgical and medical postoperative complications, and number of days alive and out of the hospital by day 28. To ensure 90% power, a total of 140 patients (70 per group) are required to detect a 13.6-point reduction in the CCI score on day 28 in the intervention group, assuming a SD of 24. Ethics and dissemination: The study has been authorised by the Clinical Trials Information System and approved by the European Ethical Committee (EU CT number 2024-5 10 943-76-00). Clinicians will explain the details of the study to all eligible participants. Written informed consent will be obtained from all participants prior to randomisation. The results of the study will be communicated to healthcare professionals and the public through presentations at international scientific conferences and publication in peer-reviewed medical journals. Trial registration number: The trial has been registered on ClinicalTrials.gov (NCT06351475). Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <8> Accession Number 2035919668 Title Perioperative respiratory muscle exercise in patients undergoing cardiac surgery: An evidence-based review. Source Heart and Lung. 70 (pp 73-81), 2025. Date of Publication: 01 Mar 2025. Author Wang Q.; Peng Y.; Xu S.; Guo H.; Chen Y.; Lin L.; Chen L.; Lin Y. Institution (Wang, Peng, Lin, Chen, Lin) Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fujian, Fuzhou, China (Wang, Peng, Lin, Lin) Department of Nursing, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fujian, Fuzhou, China (Xu, Guo, Chen) The school of Nursing, Fujian Medical University, No. 1, Xuefu North Road, Fujian, Fuzhou, China Publisher Elsevier Inc. Abstract Background: Enhanced respiratory muscle management is imperative in cardiac surgery patients due to their universal risk of decreased perioperative respiratory muscle strength. Objective(s): Most existing articles primarily examine respiratory muscle exercise during either the preoperative, postoperative, or at-home phases. Consequently, there is a crucial need to consolidate the evidence for respiratory muscle exercise throughout the perioperative period of cardiac surgery. Method(s): A literature search was performed, encompassing guideline networks and databases up until July 2023. The literature was classified into seven thematic categories: preoperative assessment, patient education, trainers, training plans, quality control, safety monitoring, and outcome assessment. The quality of the included literature was assessed using the GRAGE evidence grading system to ascertain the level of recommendation associated with each piece of evidence. Result(s): Nineteen papers were reviewed, encompassing 24 suggestions. These consisted of two suggestions on preoperative assessment, four on patient education, two on trainers, six on training programs, seven on quality control, two on safety monitoring, and one on outcome assessment. All 24 suggestions were categorized as strong recommendations, with 14 classified as high-quality evidence and ten as moderate-quality evidence. Conclusion(s): Our study presents a succinct synthesis of the most robust evidence available on perioperative respiratory muscle exercise in cardiac surgery patients. We identified ten high-quality suggestions while an additional 14 moderate-quality suggestions. In the context of perioperative exercise, we recommend that moderate-intensity inspiratory muscle exercises be provided during the preoperative and postoperative phases upon transfer to the ward. We advocate for the implementation of low-intensity inspiratory muscle exercises during the postoperative phase while patients are in the intensive care unit. Copyright © 2024 <9> Accession Number 2042276617 Title Tricuspid valve disease: updates on diagnostic imaging and intervention. Source Nature Reviews Cardiology. 23(6) (pp 420-432), 2026. Date of Publication: 01 Jun 2026. Author Grapsa J.; Zancanaro E.; Rommel K.P.; Weber L.; Coisne A.; Estevez-Loureiro R.; Delgado V.; Sitges M.; Enriquez-Sarano M.; Praz F.; Fam N.; Cristell N.; Latib A.; Piazza N.; Lurz P.; Modine T.; Hausleiter J.; Hahn R.T.; Leon M.B.; Granada J.F. Institution (Grapsa, Zancanaro) Heart and Vascular Institute, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, United States (Zancanaro, Rommel) Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, Mainz, Germany (Zancanaro) Department of Cardiac Surgery, San Raffaele Hospital, Milan, Italy (Weber, Modine) Hopital Cardiologique du Haut-Leveque, CHU de Bordeaux, Bordeaux, France (Weber) Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland (Coisne) University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France (Estevez-Loureiro) Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo, Spain (Delgado) Heart Institute, Department of Cardiology, Germans Trias i Pujol University Hospital, Barcelona, Spain (Sitges) Cardiovascular Institute, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain (Enriquez-Sarano) Minneapolis Heart Institute, Minneapolis, MN, United States (Praz) Universitatsklinik Fur Kardiologie, Inselspital Bern, Bern, Switzerland (Fam) St. Micheal's Hospital, Toronto, ON, Canada (Cristell, Hahn, Granada) Cardiovascular Research Foundation, New York, NY, United States (Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States (Piazza) McGill University Health Centre, Montreal, QC, Canada (Lurz) Department of Cardiology, University Medical Center Mainz, Mainz, Germany (Hausleiter) Medizinische Klinik und Poliklinik I, LMU Klinikum, LMU Munchen, Munich, Germany (Hausleiter) German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany (Hahn, Leon) NewYork-Presbyterian/Columbia University Medical Center, New York, NY, United States Publisher Nature Research Abstract Tricuspid regurgitation is associated with an increased risk of hospitalization and death. Many patients with severe tricuspid regurgitation are unable to undergo surgical intervention owing to prohibitive technical or clinical risk. The past two decades has seen an outburst of technological advances in the field of transcatheter tricuspid technologies, with numerous randomized, controlled trials assessing the safety and efficacy of various repair and replacement therapies for tricuspid regurgitation. However, crucial knowledge gaps persist, particularly in areas such as patient selection, anatomical eligibility and the haemodynamic effects of device implantation. In this Review, we outline the anatomical features of the tricuspid valve and the haemodynamic consequences of tricuspid regurgitation, and we summarize the imaging modalities used for diagnosis and management. Furthermore, we detail the current guideline-directed medical therapy for tricuspid regurgitation, as well as valve repair and replacement surgical procedures being tested in clinical trials. Finally, we highlight future technological innovations that promise to optimize diagnosis, patient selection and the device development process. Copyright © Springer Nature Limited 2026. <10> Accession Number 2038150714 Title Improved Cardiac Function and Glycemic Control in Elderly Diabetic Patients Through Structured Case Management After CABG. Source Medical Science Monitor. 32 (no pagination), 2026. Article Number: e952109. Date of Publication: 2026. Author Zhai W.; Yu H.; Li Y.; Zhang L.; Li Q. Institution (Zhai, Yu, Li, Zhang, Li) Department of Cardiovascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China Publisher International Scientific Information, Inc. Abstract Background: Elderly patients with both coronary heart disease (CHD) and diabetes mellitus (DM) undergoing off-pump coronary artery bypass grafting (CABG) face high risks of perioperative glucose fluctuations and impaired recovery. We evaluated the impact of a structured, multidisciplinary case management model on cardiac function and glycemic control in this population. Material/Methods: This single-center, randomized controlled trial enrolled 168 elderly (365 years) patients with CHD and type 2 DM scheduled for off-pump CABG. Patients were randomized (1: 1) to a control group (CG, n=84; routine care) or an observation group (OG, n=84). The OG received routine care plus a 6-month multidisciplinary intervention including individualized cardiac rehabilitation, modified Mediterranean diet, psychological support, and intensified follow-up. The primary endpoint was 6-month left ventricular ejection fraction (LVEF); HbA1c was a key secondary endpoint. Result(s): All 168 randomized patients were analyzed. At 6 months, the observation group demonstrated significantly superior primary outcomes. LVEF was significantly higher in the OG (mean difference: 6.2%, P<0.001), and HbA1c was significantly lower (mean difference: 1.3%, P<0.001). The intervention group also showed significant improvements in secondary endpoints, including reduced left ventricular diameters (LVESD, LVEDD), an improved lipid profile (P<0.05), longer 6-minute walk test distance, and higher Diabetes-Specific Quality of Life (DSQL) and Activity of Daily Living (ADL) scores (P<0.0001). Conclusion(s): Structured, multidisciplinary case management significantly improved cardiac function, metabolic control, and functional capacity in elderly diabetic patients after off-pump CABG, validating its efficacy for this high-risk group. Copyright © Med Sci Monit, 2026; 32. <11> Accession Number 2045284651 Title Efficacy of Cotton Candy Flavoured Edible Oil and Audio-Visual Therapy on Pain Perception and Anxiety among Children aged 6-9 years on Administration of Inferior Alveolar Nerve Block: A Randomized Clinical Trial. Source International Journal of Drug Delivery Technology. 16(35 Supplement) (pp 334-338), 2026. Date of Publication: 2026. Author Deorukhkar S.; Patil L.; Rathi N.; Chaudhari V. Institution (Deorukhkar, Patil, Rathi, Chaudhari) Department of Pediatric and Preventive Dentistry, Dr. D.Y Patil Dental College and Hospital, Pimpri, Pune, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Aim and Background: To compare efficacy of cotton candy flavoured edible oil and audio-visual therapy on pain perception and dental anxiety in children on administration of local anesthesia. Material(s) and Method(s): 40 children aged 6-9 years were included in the study and were divided into two groups. Group I was Lorr Ann Cotton candy flavour and group II was Audio-visual therapy. Pain perception and anxiety was assessed pre-operatively. The vitals (Heart Rate and Oxygen Saturation) of the child were recorded pre-operatively using pulse oximeter. Following this inferior alveolar nerve block was administered. Pain perception and anxiety was assessed after administration of the block. The vitals (Heart rate and Oxygen Saturation) were recorded post administration of inferior alveolar nerve block. Result(s): Statically significant decrease was seen in the anxiety levels and pain perception in both the groups. However, children were less anxious in Group I when compared to Group II. Conclusion(s): Both the methods were effective in reducing the anxiety of the child out of which cotton candy flavour being the most effective one. Clinical Significance: Both the techniques were effective in reducing dental anxiety of the children, allowing dental procedures to be performed more efficiently and with minimal behavioral disruption. Overall both the techniques contribute to a positive early dental experience, benefiting both the child and the clinician Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <12> Accession Number 2045758571 Title Methods and Criteria for Evaluating the Success of Surgical Left Atrial Appendage Closure: A Systematic Review. Source European Journal of Cardio-thoracic Surgery. 68(5) (no pagination), 2026. Article Number: ezag146. Date of Publication: 01 May 2026. Author Vad R.; Gosvig K.; Beetham R.; Hansson N.H.; Whitlock R.; Riber L.P.S. Institution (Vad) Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark (Gosvig) Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark (Gosvig) Department of Clinical Research, Research Unit for Cardiac Surgery, University of Southern Denmark, Odense, Denmark (Beetham) Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (Hansson) Department of Cardiology, Odense University Hospital, Odense, Denmark (Whitlock) Department of Surgery, McMaster University, Hamilton, ON, Canada (Whitlock) Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (Riber) Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark (Riber) Department of Clinical Research, Research Unit for Cardiac Surgery, University of Southern Denmark, Odense, Denmark Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: Surgical left atrial appendage closure (LAAC) is recommended as a concomitant procedure during cardiac surgery in patients with atrial fibrillation to reduce stroke risk, but the methods and criteria used to evaluate procedural success remain poorly standardized. This systematic review aims to identify and describe the imaging modalities, evaluation criteria, and validation methods used to assess the success of surgical LAAC. Method(s): A systematic literature search was conducted in Embase, MEDLINE, and the Cochrane Library. Clinical studies reporting intraoperative or postoperative evaluation of surgical LAAC were included. Data were extracted on imaging modality, timing of assessment, criteria for procedural success, measurement techniques, validation efforts, and reported success rates. Result(s): Eighty studies comprising 7517 patients and 10 375 imaging examinations were included. Transesophageal echocardiography was the most frequently used imaging modality (83%), primarily for intraoperative assessment, while cardiac computed tomography was used in 44% of studies for postoperative evaluation. Seventeen different definitions of procedural success were identified. The most commonly applied definitions were absence of persistent flow between the left atrium and LAA and a residual stump length <10 mm. The overall procedural success rate across all modalities, timings, and criteria was 92.8%. Success rates were highest intraoperatively (96.8%) and declined with increasing postoperative time. Conclusion(s): There is substantial heterogeneity in the evaluation of procedural success following surgical LAAC. The lack of standardized imaging protocols and success definitions limits comparability across studies and interpretation of reported clinical outcomes. Establishing uniform evaluation criteria is essential to improve reproducibility and to clarify the relationship between technical success and clinical benefit. PROSPERO Registration Number: Prospective Register of Systematic Reviews in Health and Social Care (PROSPERO) registration number: CRD42024617540. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. <13> Accession Number 2045819235 Title Right internal thoracic artery versus radial artery as the second-best arterial conduit in multi-arterial coronary artery bypass grafting. Source Asian Cardiovascular and Thoracic Annals. (no pagination), 2026. Date of Publication: 2026. Author Asai T. Institution (Asai) Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa Prefecture, Japan Publisher SAGE Publications Inc. Abstract Background: Multi-arterial coronary artery bypass grafting (maCABG) improves long-term outcomes compared to single internal thoracic artery grafting. Choosing the second arterial conduit-the right internal thoracic artery (RITA) or the radial artery (RA)-is critical. RITA offers superior biological integrity but raises deep sternal wound infection (DSWI) concerns; RA provides ease of harvest but is susceptible to vasospasm and patency issues. Method(s): This narrative review synthesizes recent high-quality clinical investigations, including propensity-matched cohort studies and meta-analyses, comparing RITA and RA as the second conduit in left internal thoracic artery-based CABG. We analyzed comparative long-term survival, graft patency, and complication rates. Finding(s): Multiple propensity score-matched studies demonstrate the superiority of RITA/bilateral internal thoracic artery (BITA) use, reporting significantly improved long-term survival and major adverse cardiac event-free survival compared to RA. BITA use was associated with a 35% reduction in the long-term hazard of death. Conversely, recent large-scale registries and randomized trials increasingly support the use of RA. The risk of DSWI with BITA use can be mitigated through skeletonized harvesting; however, this technique requires significant expertise to ensure graft patency. Conclusion(s): The second arterial graft selection must be individualized, balancing patient-specific risks-such as diabetes and obesity-against the surgeon's proficiency in multi-arterial revascularization. Copyright © The Author(s) 2026 <14> Accession Number 2044786149 Title Summary of Best Evidence for Pain Management after Open-heart Surgery in Children with Congenital Heart Disease. Source Chinese General Practice. 29(11) (pp 1473-1480), 2026. Date of Publication: 01 Jan 2026. Author Jingran Y.; Fang M.; Yu W.; Yimei Z.; Min Z. Institution (Jingran) School of Nursing, Kunming Medical University, Kunming, China (Jingran, Fang, Yu, Yimei, Min) Department of Nursing, the First Affiliated Hospital of Kunming Medical University, Kunming, China Publisher Chinese General Practice Abstract Background The standardized management of pain after open-heart surgery in children with congenital heart disease is very important, and there is no systematic best evidence for pain management after open-heart surgery in children with congenital heart disease. Objective To summarize the best evidence for pain management after open-heart surgery in children with congenital heart disease, and provide an evidence-based basis for clinical practice. Methods We systematically searched UpToDate Clinical Advisor, BMJ Best Clinical Practice, International Guideline Collaboration Network, National Guidelines Clearinghouse, National Institute for Health and Care Excellence, Yimaitong Guideline Network, Cochrane Library, PubMed, Web of Science, Embase, CINAHL, Wanfang Data, VIP Database, CNKI, Sinomed, American Heart Association, American College of Cardiology, European Society of Cardiology, American Pain Society, and Registered Nurses' Association of Ontario for clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials on pain management in children with congenital heart disease after open - chest surgery. The search period was from the establishment of the database to January 1, 2025. After methodological quality evaluation, the evidence was extracted and summarized according to the themes. Results A total of 15 papers were included, including 1 guideline, 1 expert consensus, 3 systematic evaluations, and 10 randomized controlled trials, and 26 pieces of evidence in 4 areas of pain management principles, pain assessment, pharmacological pain management strategies, and nonpharmacological pain management strategies were finally summarized through reading, extraction, and summarization. Conclusion Forming the best evidence regarding pain management principles, pain assessment, drug-based pain relief strategies, and non-drug-based pain relief strategies for children with congenital heart disease after undergoing thoracotomy surgery, can provide clinical medical workers with evidence support and improve the quality of clinical care. Copyright © (2026), (Chinese General Practice). All right reserved. <15> Accession Number 2042216650 Title Obesity-Associated Cardiovascular Risk and Benefit From PCSK9 Inhibition. Source Journal of the American College of Cardiology. 87(21) (pp 3016-3025), 2026. Date of Publication: 02 Jun 2026. Author Kang Y.M.; Giugliano R.P.; Keech A.C.; Lopez J.A.G.; Monsalvo M.L.; Ohman E.M.; Ran X.; Murphy S.A.; Sabatine M.S.; O'Donoghue M.L. Institution (Kang, Giugliano, Ran, Murphy, Sabatine, O'Donoghue) TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States (Kang) Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Keech) NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia (Lopez, Monsalvo, Ohman) Global Development, Amgen Inc, Thousand Oaks, CA, United States Publisher Elsevier Inc. Abstract Background: The PCSK9 inhibitor evolocumab decreases the risk of major adverse cardiovascular events (MACE). The relationship between body mass index (BMI) and benefit of evolocumab remains unknown. Objective(s): This study sought to investigate the association between BMI, risk of MACE, and the clinical benefit of evolocumab. Method(s): The FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) trial randomized 27,564 stable atherosclerotic cardiovascular disease patients to evolocumab or placebo (median follow-up 2.2 years). The primary endpoint was cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The association between BMI and cardiovascular risk was examined in the placebo arm adjusting for clinical predictors. Effect modification by treatment arm was assessed using an interaction term in the Cox model. Kaplan-Meier rates are at 3 years. Result(s): A total of 10,942 (40%) participants had a BMI >=30 kg/m2; 3,446 (13%) had a BMI >=35 kg/m2. In the placebo arm, for every 5-unit-higher BMI above 30 kg/m2, there was an 11% higher risk of the primary endpoint (adjusted HR: 1.11; 95% CI: 1.02-1.21). The relative risk reduction for the primary endpoint with evolocumab was progressively greater in those with BMI >=30 kg/m2 modeled on a continuous basis (P for interaction = 0.025). Evolocumab reduced the risk of the primary endpoint by 11% in those with a BMI <30 kg/m2 (HR: 0.89; 95% CI: 0.81-0.98), by 14% in those with BMI of 30 to <35 kg/m2 (HR: 0.86; 95% CI: 0.75-0.98), and by 29% in those with BMI >=35 kg/m2 (HR: 0.71; 95% CI: 0.59-0.86). The corresponding absolute risk reductions were 1.4%, 1.8%, and 5.7%, respectively. Conclusion(s): Individuals with obesity and atherosclerotic cardiovascular disease face an elevated risk of MACE compared with those without obesity, and evolocumab helps to attenuate this risk. 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/ <16> Accession Number 2045301653 Title Vasopressor requirements and hemodynamic stability during anesthesia using remimazolam and sevoflurane in patients undergoing minimally invasive aortic valve replacement surgery: a prospective randomized controlled study. Source Journal of Thoracic Disease. 18(4) (no pagination), 2026. Article Number: 342. Date of Publication: 30 Apr 2026. Author Lee J.; Shin S.-W.; Yoon J.-U.; Kim H.-J.; Yoon J.-P.; Shon H.-S.; Lee D.E.; Kim H.Y. Institution (Lee, Yoon, Kim, Yoon, Shon, Lee) Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea (Lee, Yoon, Kim, Yoon, Shon, Lee) Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea (Lee, Yoon, Kim, Yoon, Shon) Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, South Korea (Shin) Department of Anesthesia and Pain Medicine, Haeundae Bumin Hospital, Busan, South Korea (Kim) Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Beomeo-ri, Mulgeumeup, Yangsan, South Korea (Kim) Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Beomeo-ri, Mulgeumeup, Yangsan, South Korea (Kim) Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea, 20 Geumo-ro, Beomeo-ri, Mulgeumeup, Yangsan, South Korea Publisher AME Publishing Company Abstract Background: Anesthetic agents can cause hypotension, and patients with severe aortic stenosis (AS) require special attention. This study compared the effects of remimazolam versus sevoflurane anesthesia on hemodynamics in patients with severe AS undergoing minimally invasive aortic valve replacement (AVR). Method(s): Patients were assigned to the remimazolam (R) or sevoflurane (S) group. Group R received remimazolam 6 mg/kg/h for induction and 1-2 mg/kg/h for maintenance with remifentanil. Group S received 1% propofol at 1-2 mg/kg for induction and sevoflurane with remifentanil for maintenance. Vasopressor requirement and hypotensive events were compared. Result(s): Sixty-four patients were enrolled, and one patient was excluded from the study. The infusion rate of norepinephrine was lower in group R during post-cardiopulmonary bypass (CPB) (0.040+/-0.051 vs. 0.085+/-0.080 mcg/kg/min, P=0.03). The proportion of hypotension was lower in group R during post-CPB (80.2%+/-21.5% vs. 91.9%+/-25.2%, P=0.04), and the entire duration of anesthesia (66.5%+/-16.9% vs. 76.0%+/-16.2%, P=0.03). Conclusion(s): Compared to conventional sevoflurane anesthesia, remimazolam-based total intravenous anesthesia was associated with more stable hemodynamics and reduced vasopressor requirement during pre-CPB, and post-CPB in patients with severe AS undergoing minimally invasive AVR. Trial Registration: The clinical research was registered at ClinicalTrials.gov (Ref: NCT05864625). Copyright © AME Publishing Company. <17> Accession Number 2043958550 Title Assessing preoperative bleeding risk using international normalized ratio and activated partial thromboplastin time: a systematic review. Source Journal of Thrombosis and Haemostasis. 24(5) (pp 1627-1642), 2026. Date of Publication: 01 May 2026. Author Rahhal H.; Sampat R.; Tse B.; Liontos L.; Hicks L.K.; Tang G.H.; Sholzberg M. Institution (Rahhal) Departamento de Clinica Medica, Instituto Central, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil (Rahhal) Faculdade de Medicina, Universidade de Sao Caetano do Sul, Sao Paulo, Brazil (Sampat, Tse, Tang) Hematology-Oncology Clinical Research Group, St. Michael's Hospital, Toronto, ON, Canada (Tse, Sholzberg) Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Liontos) Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Hicks, Sholzberg) Department of Medicine, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada Publisher Elsevier B.V. Abstract Background The prothrombin time (PT) and activated partial thromboplastin time (APTT) are often considered routine tests in the assessment of perioperative bleeding risk. Physicians continue to order these tests, and major medical societies guidelines exhibit significant heterogeneity regarding the utility of coagulation tests as a general screening tool, despite many advocating for a risk-stratified approach over routine testing. Objectives This study aimed to assess for association between preoperative coagulation tests and bleeding events around elective surgery. Methods We conducted a systematic review of the literature. Three electronic databases were consulted MEDLINE, EMBASE, and EBM Reviews. Randomized trials and observational studies that assessed the predictive accuracy of preprocedural PT and APTT test results for perioperative bleeding were deemed eligible for inclusion. Outcomes included any bleeding events in the postoperative period. Results In total, 100 studies were included in our qualitative synthesis: otolaryngology ( n = 15), minor surgeries and procedures ( n = 15), neurosurgery ( n = 17), orthopedic surgeries ( n = 6), cardiac surgeries ( n = 16), liver transplantation or hepatectomy ( n = 20), general surgery, and other types of major surgery ( n = 11). Qualitative synthesis demonstrated a weak or inconsistent association between PT or APTT and bleeding events. Associations were more frequently reported in studies involving patients with cirrhosis and/or neoplastic disease of the liver undergoing liver resection, transplantation, or major abdominal cancer debulking surgery. Conclusion Our findings confirm that coagulation testing results are not consistently associated with bleeding in minor surgeries and nearly all major elective surgeries. However, PT results might be associated with bleeding outcomes in patients with advanced liver disease undergoing major abdominal surgeries. Copyright © 2026 International Society on Thrombosis and Haemostasis. <18> Accession Number 2045306867 Title Surgical, perventricular, and transcatheter closure for ventricular septal defects: a network meta-analysis of randomized controlled trials. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 399. Date of Publication: 01 Dec 2026. Author Rivera-Torrejon O.; Coronel-Chucos L.G.; Chambergo-Michilot D.; Diaz-Barrera M.E.; Paredes-Angeles R.; Taype-Rondan A. Institution (Rivera-Torrejon) Universidad de Piura, Lima, Peru (Coronel-Chucos) Facultad de Ciencias de la Salud, Universidad Continental, Lima, Peru (Chambergo-Michilot, Paredes-Angeles) Universidad Cientifica del Sur, Lima, Peru (Diaz-Barrera) Nova Evidence Research Group, Trujillo, Peru (Taype-Rondan) Unidad de Investigacion para la Generacion y Sintesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru Publisher BioMed Central Ltd Abstract Background: Ventricular septal defect is a common congenital heart defect. While surgical repair has been the standard, transcatheter and perventricular closures have emerged as minimally invasive alternatives. Method(s): We conducted a systematic review and network meta-analysis of randomized controlled trials. We searched PubMed, Embase, Cochrane Library, clinicaltrials.gov, and Google Scholar up to February 2026. Risk of bias was assessed using the Cochrane tool, and the certainty of evidence was evaluated with GRADE. We conducted pairwise random-effects meta-analyses for direct comparisons, followed by a frequentist random-effects network meta-analysis to indirectly compare transcatheter and perventricular closure. Result(s): Seven randomized controlled trials involving 2,126 participants were included. Studies were conducted in China, Egypt, or Russia. No deaths were reported. Transcatheter and perventricular closures may reduce blood transfusion needs compared to surgical repair, but the evidence is very uncertain. Perventricular closure may reduce hospital stay and operative time but may increase tricuspid regurgitation risk, compared to surgical repair. No significant differences were observed in indirect comparisons of transcatheter and perventricular approaches. Certainty of the evidence was low to very low. Conclusion(s): Current evidence suggests that transcatheter and perventricular approaches may be associated with a lower need for blood transfusion compared with surgical repair, while perventricular closure may also reduce length of hospital stay but may increase tricuspid regurgitation. However, the evidence is uncertain, precluding firm conclusions and highlighting the need for well-designed, adequately powered randomized controlled trials. PROSPERO I Registration: CRD42024595282 Copyright © The Author(s) 2026. <19> Accession Number 2045321621 Title Comparison of three point-of-care ultrasound techniques to confirm endotracheal tube placement: A randomized clinical trial. Source American Journal of Emergency Medicine. 106 (pp 55-61), 2026. Date of Publication: 01 Aug 2026. Author Kudu E.; Korgan M.B.; Altun M.; Yakin F.; Karacabey S.; Sanri E.; Akoglu H.; Denizbasi A. Institution (Kudu, Korgan, Altun, Yakin, Karacabey, Sanri, Akoglu, Denizbasi) Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, Turkey (Korgan) Department of Emergency Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey Publisher W.B. Saunders Abstract Background: Rapid confirmation of the endotracheal tube (ETT) position following emergency intubation is crucial, but traditional methods have limitations in this setting. Although ultrasonographic techniques are highly accurate, studies comparing them are limited. In this study, we aimed to compare the diagnostic performance and speed of three different point-of-care ultrasound (POCUS) techniques for confirming ETT position. Method(s): We conducted a single-center, prospective, randomized clinical trial in the emergency department of a university hospital. Adults undergoing rapid sequence intubation were randomly assigned to transtracheal ultrasound (TUS), lung-sliding ultrasound (LUS), or diaphragm ultrasound (DUS) with 1:1:1 allocation ratio. The primary outcome was ETT location (tracheal or esophageal), determined by waveform capnography and auscultation. We also measured intubation time and the time needed for each confirmation method. Result(s): Of 217 patients screened, 200 were randomized to TUS (n = 66), LUS (n = 67), or DUS (n = 67), and all were included in the primary analysis. The median age was 75 years (IQR 63-84), and 54.5% were male. Esophageal intubation occurred in 14% (n = 28) of patients. For tracheal placement detection, sensitivity and specificity were 98.2% (95% CI, 90.4% to 100.0%) and 100.0% (95% CI, 69.2% to 100.0%) for TUS, 98.2% (95% CI, 90.6% to 100.0%) and 100.0% (95% CI, 69.2% to 100.0%) for LUS, and 96.6% (95% CI, 88.3% to 99.6%) and 87.5% (95% CI, 47.3% to 99.7%) for DUS, with no between-group difference in accuracy (p = 0.44). Confirmation times were 4.6 s (IQR, 3.3-6.0) for TUS, 9.4 s (IQR, 7.3-12.2) for LUS, and 13.4 s (IQR, 11.8-15.1) for DUS (p < 0.001). Auscultation took a median of 11.5 s (IQR 9.4-13.9), and obtaining five capnography waveforms took 17.0 s (IQR 14.2-20.6). Conclusion(s): All three ultrasound techniques demonstrated high diagnostic performance for confirming ETT location after rapid sequence intubation, with TUS providing the shortest confirmation time. Trial registration: ClinicalTrials.gov Identifier: NCT06656546 Copyright © 2026 Elsevier Inc. <20> Accession Number 2045678836 Title Effectiveness of hypotension prediction index in reducing postoperative organ hypoperfusion-related complications in non-cardiac surgery: a meta-analysis of randomized controlled trials. Source Minerva Anestesiologica. 92(4) (pp 340-349), 2026. Date of Publication: 01 Apr 2026. Author Ding Y.; Jia H.; Xu J.-S.; Liao Q.-G.; Dai J.-Y.; Wei X.; Pan C.; Fu H.-L. Institution (Ding, Jia, Xu, Liao, Dai, Wei, Pan, Fu) Department of Anesthesiology, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China Publisher Edizioni Minerva Medica Abstract BacKgroUnD: intraoperative hypotension during non-cardiac surgery is associated with postoperative complications such as acute kidney injury (aKi), myocardial injury, and stroke, which may increase mortality and severe adverse outcomes. although the Hypotension Prediction index (HPi) may help reduce intraoperative hypotension, its clinical value in lowering the incidence of these complications remains uncertain. this meta-analysis evaluates whether HPi-guided hemodynamic management reduces major postoperative complications (including aKi, cardiorenal, and cerebrovascular events) in adult patients undergoing non-cardiac surgery. MetHoDs: a systematic search was conducted in PubMed, eMBase, cochrane library, and Web of science, to identify rcts assessing HPi in non-cardiac surgery. the outcomes encompassed the incidence of postoperative complications such as aKi, myocardial injury after non-cardiac surgery (Mins), stroke and 30-day mortality. Pooled effect estimates, including odds ratios (ORs) with 95% confidence intervals (95% CIs), were calculated using either fixed-effects or random-effects models based on heterogeneity assessments. sensitivity analyses were performed by excluding trials with a high or unclear risk of bias to evaluate the robustness of the findings. RESULT(S): A total of 10 RCTs involving 1746 participants were included. The results revealed no statistically significant difference in incidence of aKi (or: 0.85; 95%ci: 0.65 to 1.10; P=0.21), Mins(or: 0.62; 95%ci: 0.36 to 1.06; P=0.08), stroke (or: 0.63; 95%ci: 0.20 to 1.98; P=0.42), and 30-day mortality (or: 0.87; 95%ci: 0.32 to 2.34; P=0.78) between HPi group and control group. conclUsions: Hemodynamic management guided by the HPi in adults undergoing non-cardiac surgery does not significantly reduce the incidence of major postoperative complications compared to standard care. Copyright © 2025 EDIZIONI MINERVA MEDICA. <21> Accession Number 2041100083 Title Association Between Perioperative Sleep Disorders and Post-Operative Delirium in Cardiac Surgeries: A Systematic Review and Meta-Analysis. Source Journal of Sleep Research. 35(3) (no pagination), 2026. Article Number: e70241. Date of Publication: 01 Jun 2026. Author Varpaei H.; Deka P.; Robbins L.B.; Farhadi K.; Reeves M.; Mowbray F.; Quan S.F. Institution (Varpaei, Deka, Robbins, Mowbray) College of Nursing, Michigan State University, East Lansing, MI, United States (Deka) College of Nursing, Wayne State University, Detroit, MI, United States (Farhadi) Anesthesia, Critical Care, and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Reeves) Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States (Quan) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Publisher John Wiley and Sons Inc Abstract Post-operative delirium (POD) is an acute deterioration in cognitive function and highly prevalent after cardiac surgery (CS; up to 55%). Perioperative sleep disorders (PSD) are also commonly noted in surgical patients (up to 60%). The primary aim of our systematic review is to determine the association between PSD and POD in CS patients during their hospital stay. We searched five databases (PubMed, CINAHL, Web of Science, Scopus, and EMBASE) to identify studies evaluating the association between PSD and POD amongst CS (any open-heart CS) patients, without time and geographic restriction. Original articles that focused on adults undergoing cardiac surgeries and assessed sleep and POD were included. We conducted a meta-analysis using a random effects model to determine the effect of sleep quality on POD. Thirty-three studies were included (63% observational designs); most studies originated from China (33%). The most frequently used subjective and objective sleep assessment tools were the Pittsburgh Sleep Quality Index (PSQI) (33%) and polysomnography (18%). After pooling observational data, we identified an incidence of POD ranging from 3.6% to 73%. Increased PSQI scores (standard threshold > 5) were associated with a greater likelihood of POD occurrence (standardised mean difference [SMD] = 0.73, p > 0.05). Lower total sleep time (SMD = -0.68, p < 0.05) was associated with an increased risk of POD. Poor sleep quality, insomnia, and sleep-disordered breathing are prevalent forms of PSD and are major risk factors for POD following CS. Additional research is warranted to clarify when sleep quality normalises after cardiac surgery and how targeted interventions can accelerate this recovery. Copyright © 2025 The Author(s). Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society. <22> Accession Number 651202844 Title Residual Angina Following Complete Revascularization in the ISCHEMIA Trial: Frequency, Clinical Characteristics, Health Status, and Cardiovascular Outcomes. Source Journal of the American Heart Association. 15(10) (pp e047355), 2026. Date of Publication: 19 May 2026. Author Singh A.; Brown D.L.; Jones P.G.; Fu Z.; Reynolds H.R.; Boden W.E.; O'Brien S.M.; Mavromatis K.; Poh K.K.; Ali Z.; Stone G.W.; Bangalore S.; Spertus J.A.; Maron D.J.; Hochman J.S. Institution (Singh, Brown) Division of Cardiovascular Medicine Keck School of Medicine, University of Southern California Los Angeles CA USA (Jones, Fu, Spertus) University of Missouri-Kansas City's Healthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute Kansas City MO USA, United States (Reynolds, Bangalore, Hochman) Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine NYU Grossman School of Medicine New York NY USA (Boden) VA New England Healthcare System Boston MA USA, United Kingdom (O'Brien) Duke Clinical Research Institute Durham NC USA (Mavromatis) Atlanta VA Healthcare System Atlanta GA USA (Mavromatis) Emory University School of Medicine Atlanta GA USA (Poh) National University Heart Center Singapore and the Yong Loo Lin School of Medicine National University of Singapore Singapore, Singapore (Ali) Department of Cardiology St Francis Hospital and Heart Center Roslyn NY USA (Ali) Cardiovascular Research Foundation New York NY USA (Stone) Icahn School of Medicine at Mount Sinai New York NY USA (Maron) Department of Medicine Stanford University School of Medicine Stanford CA USA Abstract BACKGROUND: The frequency of residual angina and its impact on health status and death following anatomic complete revascularization in symptomatic patients with chronic coronary disease are unknown. METHOD(S): Data were analyzed from ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial participants randomized to invasive management with baseline angina (Seattle Angina Questionnaire Angina Frequency score <100), no prior coronary artery bypass graft surgery, and anatomic complete revascularization within 90 days of randomization. The primary outcome was frequency of residual angina after revascularization, defined as a Seattle Angina Questionnaire Angina Frequency score <100 within 6 months of randomization. Secondary outcomes included 6-month health status and medication use and 5-year all-cause and cardiovascular death. RESULT(S): Among 2588 participants randomized to invasive management, 1442 (56%) had baseline angina and no prior coronary artery bypass graft surgery; 1034 underwent revascularization within 90 days, and 436 achieved anatomic complete revascularization. Of these, 184 (42.2%) had residual angina within 6 months. Baseline characteristics were similar between those with and without residual angina. Percutaneous coronary intervention was more common than coronary artery bypass graft surgery in those with residual angina (88% versus 80%, P=0.03). At 6 months, residual angina participants reported lower quality of life (Seattle Angina Questionnaire Quality of Life: 70+/-20 versus 83+/-20, P<0.001), greater physical limitation (Seattle Angina Questionnaire Physical Limitation: 84+/-20 versus 95+/-11, P<0.001), more dyspnea (Rose Dyspnea Scale score: 1+/-1.3 versus 0.4+/-0.8, P<0.001), and more antianginal medication use (P=0.006). Five-year all-cause and cardiovascular death did not differ significantly between groups. CONCLUSION(S): Residual angina is common (>40%) following anatomic complete revascularization for chronic coronary disease and is associated with reduced quality of life and greater antianginal medication use but no increase in death. REGISTRATION: Unique Identifier: NCT01471522. <23> Accession Number 2044973785 Title Effectiveness of machine learning for diagnosis and prognostic prediction of congenital heart disease: a systematic review and meta-analysis. Source BMC Pediatrics. 26(1) (no pagination), 2026. Article Number: 367. Date of Publication: 01 Dec 2026. Author Wan W.; Luo T.; Zhang X.; Guo C.; Wang X. Institution (Wan, Luo, Zhang, Guo, Wang) The Pediatric Heart Disease Center, Sichuan Provincial Women's and Children's Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Sichuan, Chengdu, China (Wang) Sichuan Maternal and Child Health Hospital, No. 290 Shayan West Second Street, Wuhou District, Sichuan, Chengdu, China Publisher BioMed Central Ltd Abstract Purpose: This study aims to synthesize the effectiveness of machine learning (ML) in the diagnosis and prediction of congenital heart disease (CHD), providing evidence for the subsequent development of ML models for CHD. Method(s): PubMed, EMBASE, Web of Science, and Cochrane were searched for studies on the application of ML in CHD up to April 8, 2024. The risk of bias was assessed using the prediction model risk of bias assessment tool (PROBAST). Subgroup analyses by task types (diagnosis and prediction) and different populations were performed. Result(s): Fifty-two papers covering 850,866 subjects were included. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and summary receiver operating characteristic (SROC) curves of ML in the diagnosis of CHD were 0.90 (95%CI: 0.86-0.93), 0.90 (95%CI: 0.85-0.93), 8.6 (95%CI: 5.8-12.6), 0.11 (95%CI: 0.08-0.16), and 0.95 (95%CI: 0.82-0.99), respectively. The sensitivity and specificity of the ML model for predicting whether the fetus would develop CHD based on the clinical characteristics of pregnant women were 0.749 (95% CI: 0.69-0.81) and 0.876 (95% CI: 0.83-0.92), respectively. A mortality risk prediction model based on clinical characteristics had a sensitivity of 0.82 (95% CI: 0.71-0.90) and a specificity of 0.83 (95% CI: 0.77-0.88). The model for predicting coagulation status after CHD surgery had a sensitivity of 0.84 and a specificity of 0.70; the model for predicting malnutrition 1 year after CHD surgery had a sensitivity of 0.85 and a specificity of 0.88. Conclusion(s): ML, especially image-based ML, appears to be an effective tool for the diagnosis and prediction of CHD. Nonetheless, this conclusion is drawn based on limited evidence. More and larger open datasets should be covered in future studies. Copyright © The Author(s) 2026. <24> Accession Number 2045317975 Title Left Main Revascularization in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Source Current Cardiology Reviews. 22(4) (no pagination), 2026. Date of Publication: 2026. Author Gialamas I.; Kalogeras K.; Pantelidis P.; Zakynthinos G.E.; Lysandrou A.; Katsianos E.; Goliopoulou A.; Gounaridi M.I.; Vythoulkas-Biotis N.; Katsarou O.; Oikonomou E.; Siasos G.; Vavuranakis M. Institution (Gialamas, Kalogeras, Pantelidis, Zakynthinos, Lysandrou, Katsianos, Goliopoulou, Gounaridi, Vythoulkas-Biotis, Katsarou, Oikonomou, Siasos, Vavuranakis) 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Siasos) Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, United States Publisher Bentham Science Publishers Abstract Introduction/Objective: This systematic review and meta-analysis compares percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) as revascularization strategies for patients with left main coronary artery disease (LMCAD) and chronic kidney disease (CKD). Method(s): A comprehensive search of PubMed, Embase, and CENTRAL was conducted, with a pre-registered study protocol registered on PROSPERO (ID: CRD42024496529). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction (MI), stroke, or ischemia-driven revascularization. Secondary endpoints included each component of MACCE and 30-day all-cause mortality. Result(s): Seven studies were analyzed, including five cohort studies and two subanalyses of randomized clinical trials, encompassing 3,376 patients. PCI was associated with a higher incidence of MACCE (hazard ratio [HR]: 1.50; 95% confidence interval [CI] 1.26-1.78), driven by all-cause mortality (HR: 1.38; 95% CI 1.07-1.79), MI (HR: 1.76; 95% CI 1.15-2.71), and ischemia-driven revascularization (HR: 3.66; 95% CI 1.84-7.30). There were no differences in stroke rates (HR: 0.70; 95% CI 0.40-1.22) or 30-day all-cause mortality (odds ratio [OR]: 1.28; 95% CI 0.85-1.94). Discussion(s): While previous studies have reported conflicting evidence regarding the non-inferiority of PCI to CABG in patients with LMCAD, our pooled analysis demonstrates an increased incidence of MACCE in the PCI group, primarily driven by higher rates of all-cause mortality, MI, and ischemia-driven revascularization. The findings suggest that CKD may play a role in clinical outcomes comparable to diabetes in multivessel disease and should be a key factor in revascularization decisions. Conclusion(s): CABG is associated with superior long-term outcomes compared to PCI in patients with LMCAD and CKD. However, dedicated randomized controlled trials stratified by CKD stage are essential to guide optimal treatment strategies in this high-risk population. Copyright 2026, Bentham Science Publishers <25> Accession Number 2045819204 Title Minimal invasive extracorporeal circulation represents a dominant technique in coronary artery bypass grafting; insights from a cost-utility economic analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Maniadakis N.; Antonitsis P.; Mylonas C.; Anastasiadis K. Institution (Maniadakis, Mylonas) Department of Health Services Organization & Management, National School of Public Health, Athens, Greece (Antonitsis, Anastasiadis) Cardiothoracic Department, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece Publisher SAGE Publications Ltd Abstract Introduction: To evaluate the cost-utility of minimal invasive extracorporeal circulation (MiECC) versus conventional cardiopulmonary bypass (cCPB) in coronary artery bypass grafting (CABG) over a 7-years horizon. Method(s): A cohort-based, deterministic cost-utility model was constructed from the Greek NHS perspective over a 7-year period. Clinical inputs were derived from a meta-analysis including 4849 patients. Direct medical costs for intensive care unit (ICU) and ward stay, blood transfusions, intra-aortic balloon pump (IABP) use, and perfusion circuits were applied to estimate the cost of care. Quality of life was quantified in terms of quality-adjusted life years (QALYs) by mapping SF-36 data to EQ-5D utilities. Deterministic sensitivity analyses were used to test key assumptions and a probabilistic sensitivity analysis assessed overall result robustness. Result(s): MiECC was associated with improved clinical outcomes, including lower perioperative mortality and complication rates, shorter mechanical ventilation duration, and reduced lengths of ICU and ward stay. Over 7 years, patients operated on MiECC accrued 2.21 QALYs versus 2.18 QALYs for cCPB. MiECC dominated cCPB, yielding both cost savings (DELTACost = -1369) and a QALY gain (DELTAQALY = +0.03). Sensitivity analysis confirmed the robustness of the default results under all tested scenarios. Conclusion(s): In an era focused on value-based care, cardiac centers and healthcare authorities should consider the integration of MiECC as a standard perfusion strategy in coronary surgery, given the supportive evidence of improved morbidity and mortality outcomes without financial impact concerns. Copyright © The Author(s) 2026 <26> Accession Number 2045730895 Title Comparison of the effectiveness and safety of dronedarone and amiodarone for preventing recurrence after catheter ablation of atrial fibrillation: an open-label randomized controlled trial. Source Europace. 28(5) (no pagination), 2026. Article Number: euag095. Date of Publication: 01 May 2026. Author Zhang X.; Jiang R.; Chen Y.; Lou L.; Liu S.; Sok T.; Han J.; Zhou D.; Zhang B.; Li Z.; Shi W.; Dai Z.; Hu X.; Guo X.; Yang J. Institution (Zhang, Jiang, Chen, Lou, Liu, Sok, Han, Zhou, Zhang, Li, Shi, Dai, Hu, Guo, Yang) Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing-Chun Road, Hangzhou, China Publisher Oxford University Press Abstract Aims: The high recurrence rate after catheter ablation for atrial fibrillation (AF) remains a challenge. Short-term antiarrhythmic drugs are commonly used during the 3-month blanking period, but the choice between amiodarone and dronedarone is unclear. Objective(s): This trial directly compared the effectiveness and safety of dronedarone vs. amiodarone administered during the blanking period post-ablation in AF. Methods and Results: In this open-label, randomized controlled trial, 280 patients undergoing AF ablation were assigned to receive 12 weeks of treatment with either dronedarone or amiodarone, which was discontinued upon completion of this treatment phase as per protocol. The primary endpoint was atrial tachyarrhythmia recurrence (>30 s) after the blanking period. A total of 280 participants were enrolled, of whom 273 were included in the modified intention-to-treat (mITT) analysis. In the mITT analysis, recurrence rates were not significantly different between the dronedarone and amiodarone groups (23.4% vs. 16.9%, P = 0.184). Secondary efficacy endpoints also showed no significant differences. However, the dronedarone group had a significantly lower incidence of side effects (40.9% vs. 64.0%, P < 0.001), primarily due to fewer cases of QTc-interval prolongation (5.8% vs. 15.4%, P = 0.01) and hypothyroidism (8.8% vs. 26.5%, P < 0.001). The intention-to-treat analysis, which included all enrolled participants, yielded results consistent with those of the mITT analysis. Conclusion(s): Therapy with dronedarone during the blanking period after AF ablation was associated with a similar recurrence rate but a superior safety profile compared to amiodarone. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. <27> Accession Number 2045799359 Title Impact of cardiopulmonary bypass on cefuroxime plasma and interstitial tissue concentrations in patients undergoing cardiac bypass surgery-a prospective controlled clinical trial. Source Journal of Antimicrobial Chemotherapy. 81(6) (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Nothofer S.; Dumps C.; Dorn C.; Lier C.; Weiss M.; Zeitlinger M.; Stock S.; Girdauskas E.; Heller A.R.; Simon P. Institution (Nothofer) Anaesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Dumps) Anaesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Dorn) Institute of Pharmacy, University of Regensburg, Regensburg, Germany (Lier) Institute of Pharmacy, University of Regensburg, Regensburg, Germany (Weiss) Anaesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Zeitlinger) Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria (Stock) Cardiothoracic Surgery, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Stock) Department of Cardiovascular Surgery, Faculty of Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany (Girdauskas) Cardiothoracic Surgery, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Girdauskas) Department of Cardiovascular Surgery, Faculty of Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany (Heller) Anaesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany (Simon) Anaesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany Publisher Oxford University Press Abstract Objective: Cardiopulmonary bypass (CPB) alters the pharmacokinetics (PK) of antibiotics administered as surgical prophylaxis (SAP) due to haemodilution, circuit interactions, protein binding and inflammation. This study investigated plasma and interstitial fluid (ISF) concentrations of cefuroxime in patients undergoing on- versus off-pump coronary artery bypass graft (CABG) surgery. Method(s): Patients undergoing on- or off-pump CABG received SAP with cefuroxime, consisting of a bolus of 3 g before skin incision and a second dose of 1.5 g at CPB weaning or at sternal closure, respectively. ISF concentrations were measured by two microdialysis catheters in the subcutaneous tissue of both upper arms. Plasma and ISF concentrations were determined up to 8 hours after the first dose. Pharmacokinetic analysis was performed by non-compartmental analysis. Result(s): Fifteen patients were enrolled per group. Baseline characteristics and cardiovascular risk profile were comparable between groups. Median [minimum; maximum] surgical duration was 4.3 h [3.1 h; 6.1 h] in the on-pump and 3.4 h [1.8 h; 4.0 h] in the off-pump group, with a median bypass time of 1.7 h [0.8 h; 2.5 h]. The fAUC<inf>0-8h</inf> in plasma (on-pump versus off-pump group; mean +/- SD: 417 +/- 124 versus 542 +/- 238 h.mg/L, P = 0.081) and in ISF (488 +/- 212 versus 508 +/- 209 h.mg/L, P = 0.835) did not differ significantly. Based on an extrapolation of the first dose, plasma concentrations remained above a minimum inhibitory concentration of 8 mg/L for up to 4.5 h in the on-pump and 4.8 h in the off-pump group. Conclusion(s): For a median bypass time of 1.7 h and considering all factors cumulatively, no significant impact of CPB on cefuroxime plasma and ISF concentrations was observed. A dose of 3 g cefuroxime administered intravenously 30-60 min before skin incision with a second repetitive dose of 1.5 g administered after CPB weaning in the on-pump group or after sternal closure in the off-pump group, resulted in adequate plasma and ISF concentrations in patients undergoing cardiac bypass surgery. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. 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) <28> Accession Number 2042958871 Title Prevention and treatment of thrombosis in patients with decompensated cirrhosis. Source Journal of Thrombosis and Haemostasis. 24(5) (pp 1609-1619), 2026. Date of Publication: 01 May 2026. Author Bell C.; Afzal A.; Carlin S.; Roberts L.N. Institution (Bell, Carlin) Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, ON, Canada (Afzal) Division of Hematology, Department of Medicine, Washington University in St Louis, St. Louis, MO, United States (Roberts) King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom (Roberts) Institute of Pharmaceutical Sciences, King's College London, London, United Kingdom Publisher Elsevier B.V. Abstract Patients with decompensated cirrhosis commonly have indications for anticoagulation, including stroke prevention in atrial fibrillation and the prevention and treatment of venous thromboembolism, particularly portal vein thrombosis. While the rates of anticoagulation in those with indications for therapy have improved over time, the concern for bleeding due to altered hepatic elimination of anticoagulants and exclusion of patients with cirrhosis from pivotal randomized trials of direct oral anticoagulants and warfarin continue to create challenges in defining best practices for anticoagulation in patients with cirrhosis, especially in decompensated disease. In this review, we present 3 commonly encountered clinical scenarios in patients with decompensated cirrhosis requiring consideration of anticoagulation: a patient with atrial fibrillation and elevated baseline international normalized ratio, a patient with atrial fibrillation and recurrent bleeding while on anticoagulation, and a patient with portal vein thrombosis and thrombocytopenia. For each scenario, we discuss the available literature and propose a management approach. Copyright © 2026 The Authors. <29> Accession Number 2045678825 Title Efficacy and safety of dexmedetomidine infusion without induction dose on postoperative delirium in geriatric patients undergoing major noncardiac surgeries: a randomized controlled clinical trial. Source Minerva Anestesiologica. 92(4) (pp 286-297), 2026. Date of Publication: 01 Apr 2026. Author Youssef M.M.; Jaccoub V.F.; Atalla M.G.; Alkonaiesy R.M.; Abdelhalim M.A. Institution (Youssef, Jaccoub, Atalla, Alkonaiesy, Abdelhalim) ICU & Pain Management, Department of Anesthesia, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt Publisher Edizioni Minerva Medica Abstract BACKGROUND: The impact of dexmedetomidine on postoperative delirium (POD) remains a subject of debate in elderly patients undergoing noncardiac surgeries. This study aimed to assess the efficacy and safety of dexmedetomidine infusion without an induction dose in reducing the incidence of POD while maintaining hemodynamic stability in geriatric patients undergoing major surgeries. The loading dose was omitted based on the hypothesis that continuous dexmedetomidine infusion without a loading dose would lower the incidence of POD while preserving cardiovascular safety. METHOD(S): This randomized, double-blind clinical trial was conducted on 122 elderly patients, belonging to the American Society of Anesthesiologists I or II physical status, who were scheduled for major noncardiac surgeries. Patients were randomly allocated into two equal groups. Patients in Group I received 0.5 mug/kg/h of dexmedetomidine, diluted in 50 mL of isotonic normal saline, while patients in Group II received 50 mL of isotonic normal saline as a placebo. The primary outcome was the incidence of POD. Secondary outcomes included intraoperative and postoperative hemodynamics. RESULT(S): Postoperative delirium was observed in only one (1.64%) patient in Group I on the first postoperative day, whereas 21 (34.4%) patients in Group II experienced POD with a statistically significant difference (P<0.001). Furthermore, patients in group I exhibited a significant reduction in intraoperative mean arterial pressure and heart rate, along with a notably high incidence of intraoperative hypotension but without bradycardia. Postoperatively, the mean heart rates, the incidence of hypotension, and bradycardia were comparable between groups without the need for rescue hypotensive medications (all P>0.05). CONCLUSION(S): In elderly patients undergoing non-cardiac surgery, dexmedetomidine infusion without an induction dose effectively and safely reduces the incidence of POD. Dexmedetomidine significantly preserves postoperative hemodynamics. Copyright © 2025 EDIZIONI MINERVA MEDICA. <30> Accession Number 2045329071 Title Effectiveness of non-pharmacological and pharmacological interventions in preventing delirium in older adults: a systematic review and meta-analysis of randomised controlled trials. Source Age and Ageing. 55(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Sanchez A.; Sawant-Uttekar P.; Heinen D.; Pribadi A.N.; Thomas C.; von Arnim C.; Kuhnle J.; Kreisel S.H.; Hewer W.; Fath B.; Sadlonova M.; Rapp M.; Deeken F. Institution (Sanchez) Department of Social and Preventive Medicine, University of Potsdam, Brandenburg, Potsdam, Germany (Sawant-Uttekar) Klinik fur Geriatrie, Marien Hospital Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Heinen) Department of Social and Preventive Medicine, University of Potsdam, Brandenburg, Potsdam, Germany (Pribadi) Department of Social and Preventive Medicine, University of Potsdam, Brandenburg, Potsdam, Germany (Thomas) Department of Old Age Psychiatry and Psychotherapy, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Thomas) Department of Neurology and Neurophysiology, Medical Center, University of Freiburg, Baden-Wurttemberg, Freiburg, Germany (Thomas) Department of Anaesthesiology, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (von Arnim) Department of Geriatrics, University Medical Center Gottingen, Lower Saxony, Gottingen, Germany (Kuhnle) Department of Geriatrics, University Medical Center Gottingen, Lower Saxony, Gottingen, Germany (Kuhnle) Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Kuhnle) German Center for Cardiovascular Research (DZHK), Lower Saxony, Gottingen, Germany (Kreisel) Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy Bethel, Evangelisches Krankenhaus Bielefeld, North Rhine-Westphalia, Bielefeld, Germany (Hewer) Clinic for Geriatric Psychiatry, Klinikum Christophsbad, Baden-Wurttemberg, Goppingen, Germany (Fath) Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Fath) Clinic for Geriatric Psychiatry, Klinikum Christophsbad, Baden-Wurttemberg, Goppingen, Germany (Sadlonova) Department of Geriatrics, University Medical Center Gottingen, Lower Saxony, Gottingen, Germany (Sadlonova) German Center for Cardiovascular Research (DZHK), Lower Saxony, Gottingen, Germany (Sadlonova) Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen, Lower Saxony, Goettingen, Germany (Sadlonova) Department of Cardiac, University Medical Center Goettingen, Lower Saxony, Germany (Sadlonova) Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States (Rapp) Department of Social and Preventive Medicine, University of Potsdam, Brandenburg, Potsdam, Germany (Rapp) German Center for Mental Health (DZPG), Brandenburg, Potsdam, Germany (Deeken) Department of Social and Preventive Medicine, University of Potsdam, Brandenburg, Potsdam, Germany Publisher Oxford University Press Abstract Background: Delirium is a serious neuropsychiatric condition common among older adults, associated with prolonged hospital stays, increased morbidity and mortality. Although guidelines emphasise prevention, identifying most effective measures is crucial. Objective(s): To evaluate the efficacy of non-pharmacological and pharmacological interventions in preventing delirium in older adults (>=65 years). Method(s): We conducted a systematic review and meta-analysis of randomised controlled trials across settings, excluding ICU-only studies. MEDLINE, Cochrane, Web of Science and PsycINFO were searched through October 2024. Comparators included standard care, placebo, or other drugs. Random-effects models estimated pooled risk ratios. Risk of bias was assessed using RoB 2.0. Subgroup analyses were performed by setting and drug type. PROSPERO: CRD42024500387. Result(s): Eighty-seven trials (19,289 randomised patients) were included. Non-pharmacological multicomponent interventions (k = 17) significantly reduced delirium occurrence (risk ratio [RR] = 0.56, 95% CI 0.45-0.72; I2 = 63%) versus usual care, although certainty of evidence was very low. Effects were significant in non-cardiovascular surgical and medical patients. Single-component non-pharmacological interventions (k = 9) showed mixed or inconclusive findings. Among pharmacological trials (k = 53), dexmedetomidine reduced delirium risk (RR = 0.49; 95% CI 0.43-0.57; low-certainty) in non-cardiovascular surgical patients. Corticosteroids and intranasal insulin showed significant effects (high-certainty), based on a small number of trials. Mixed strategies, such as haemodynamic or cerebral oxygen-guided approaches, suggested potential benefit but were heterogeneous. Conclusion(s): Non-pharmacological multicomponent interventions reduce delirium occurrence and should be prioritised. Dexmedetomidine showed benefit in non-cardiac surgical populations, while evidence for other drugs remains inconclusive. Overall, certainty was low to very low, highlighting the need for further high-quality randomised trials to ensure generalisability. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the British Geriatrics Society. 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. <31> Accession Number 2045344833 Title Effect of colchicine for secondary prevention of cardiovascular diseases in individuals with diabetes: A meta-analysis of randomized trials. Source Diabetes and Vascular Disease Research. 23(2) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Yasaratna N.R.; Wijekoon D.; Tardif J.-C.; Reid C. Institution (Yasaratna, Reid) Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, VIC, Australia (Yasaratna, Wijekoon) Community Medicine, Post Graduate Institute of Medicine, Colombo, Sri Lanka (Wijekoon) Research Unit, Melbourne Sexual Health Center, Carlton, VIC, Australia (Tardif) Department of Medicine, Montreal Heart Institute, Montreal, Canada Publisher SAGE Publications Ltd Abstract Aims: Colchicine is effective for secondary prevention of major adverse cardiovascular events (MACE), yet its benefit in individuals with diabetes remains uncertain despite their elevated cardiovascular risk. This systematic review and meta-analysis assessed the impact of colchicine on cardiovascular outcomes in individuals with diabetes. Method(s): Databases were searched from inception to November 2024 for randomized controlled trials assessing colchicine for reducing MACE. A meta-analysis was performed using RevMan 5.4 with a fixed-effects inverse-variance model to generate pooled risk ratios (RR, HR). PROSPERO registration: CRD42024575366. Result(s): Five RCTs were included, comprising 2977 participants with diabetes (1492 (50%) colchicine; 1485 (50%) placebo/usual care). Most were males over 60 years. Colchicine significantly reduced MACE, HR 0.79 (95% CI 0.67-0.94, p = 0.006). Subgroup analysis of diabetic versus non-diabetic participants yielded a similar effect, HR 0.75 (95% CI 0.67-0.83, p < 0.001). Colchicine did not increase adverse events: composite events RR 0.81 (95% CI 0.68-0.96; p = 0.02), gastrointestinal events RR 1.09 (95% CI 0.98-1.20, p = 0.12), or musculoskeletal events RR 0.77 (95% CI 0.43-1.38, p = 0.39). Benefits were observed with 0.5 mg daily over a median 28.6 months. Conclusion(s): Colchicine is associated with a reduction in major cardiovascular events in individuals with diabetes, with consistent long-term benefit at low doses without an increase in adverse effects. Copyright © The Author(s) 2026. 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). <32> Accession Number 2043868344 Title Fibrinolysis vs urgent surgery in obstructive prosthetic valve thrombosis: updated evidence from a systematic review and meta-analysis. Source Journal of Thrombosis and Haemostasis. 24(5) (pp 1827-1839), 2026. Date of Publication: 01 May 2026. Author Resende B.; Mata E.; Castro M.; Pinto A.M.; Ribeiro S.; Gameiro J.; Lourenco A.; Ferraz-Costa G.; Goncalves L. Institution (Resende, Gameiro, Ferraz-Costa, Goncalves) Department of Cardiology, Coimbra Local Health Unit, Coimbra, Portugal (Mata, Castro, Pinto, Ribeiro, Lourenco) Department of Cardiology, Alto Ave Local Health Unit, Guimaraes, Portugal (Ferraz-Costa, Goncalves) Faculty of Medicine, University of Coimbra, Coimbra, Portugal (Goncalves) Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal Publisher Elsevier B.V. Abstract Background Obstructive prosthetic valve thrombosis (PVT) is a life-threatening complication. The first-line therapy remains uncertain. While surgery has historically been preferred, advances in low-dose, slow-infusion fibrinolysis protocols have improved outcomes. Objectives To evaluate the efficacy and safety of fibrinolytic therapy versus urgent valve surgery in PVT. Methods Following a systematic search of 5 databases, a meta-analysis compared fibrinolysis with urgent valve surgery for obstructive PVT. The primary outcomes were in-hospital all-cause mortality and complete restoration of valve function. Secondary outcomes included stroke, systemic embolism, major bleeding, recurrent PVT, and all-cause mortality during follow-up. Data were pooled as risk ratio (RR) using random-effects models, with sensitivity and meta-regression analyses. Results Across 12 observational studies and 1 randomized controlled trial, 1300 patients (fibrinolysis/surgery: 714/586) were included. No significant difference was observed in in-hospital mortality (RR: 0.59 [0.27-1.30]; I 2=57.1%). However, fibrinolysis was associated with lower complete restoration of valve function (RR: 0.82 [0.70-0.96]; I 2=71.6%) and higher risks of stroke (RR: 3.19 [1.30-7.85]; I 2=0%), systemic embolism (RR: 3.88 [1.44-10.4]; I 2=0%), and recurrent PVT (RR: 2.44 [1.18-5.05]; I 2=58.3%). No differences were found in major bleeding or all-cause mortality during follow-up. Sensitivity analyses restricted to alteplase-based regimens favored fibrinolysis, showing lower in-hospital mortality (RR: 0.12 [0.05-0.29]; I 2=0%), consistent with meta-regression findings, and efficacy comparable to surgery. Conclusion Our study suggests that surgery offers higher immediate success with fewer embolic or recurrent events. However, contemporary alteplase protocols may be associated with improved safety outcomes relative to surgery, with no apparent loss of efficacy. Given the low certainty of available evidence, treatment should be individualized according to patient risk profile, and institutional resources. Copyright © 2026 International Society on Thrombosis and Haemostasis. <33> Accession Number 2044685844 Title Transcatheter Tricuspid Valve Intervention Plus Optimized Medical Therapy Versus Optimized Medical Therapy Alone in Tricuspid Regurgitation: A Systematic Review and Meta-Analysis. Source Cardiovascular Innovations and Applications. 11(1) (no pagination), 2026. Article Number: 15. Date of Publication: 2026. Author Elmozugi T.; Al Swayah M.B.; Elmesherghi A.F.; Ali O.M.; El Sayed M.; Ziada A.; Ali M.; Abdelfattah M.A.; Otmani Z.; Alassiri A.K. Institution (Elmozugi) Faculty of Medicine, Benghazi University, Benghazi, Libyan Arab Jamahiriya (Elmozugi) National Cardiac Centre, Benghazi, Libyan Arab Jamahiriya (Al Swayah, Elmesherghi) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab Jamahiriya (Ali, Ali, Abdelfattah) Faculty of Medicine, Ain Shams University, Cairo, Egypt (El Sayed) Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt (Ziada) Faculty of Medicine, Tanta University, Tanta, Egypt (Otmani) Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou, Algeria (Alassiri) Cardiac Surgery Unit, Department of Surgery, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Publisher Compuscript Ltd Abstract Tricuspid regurgitation (TR) is common and associated with substantial morbidity and mortality. Although optimized medical therapy (OMT) can alleviate symptoms, it may be insufficient in severe cases, and surgical interventions carry considerable procedural risk, limiting their use; consequently, tricuspid transcatheter valve interventions (TTVIs) have emerged as a less invasive alternative. We conducted a systematic search of PubMed, Scopus, and Web of Science to identify randomized clinical trials and observational studies comparing TTVI plus OMT versus OMT alone. The primary outcome was all-cause mortality, and secondary outcomes included heart failure (HF) hospitalization and a combined outcome of all-cause mortality and HF hospitalization. Eight studies (five observational and three randomized trials) comprising 4836 patients were included. Compared with OMT alone, TTVI plus OMT was associated with a significant reduction in all-cause mortality (HR = 0.59, 95% CI: 0.44-0.78, P < 0.001) and HF hospitalization (HR = 0.69, 95% CI: 0.49-0.96, P = 0.03), and it significantly reduced the combined outcome (HR = 0.59, 95% CI: 0.47-0.74, P < 0.001). However, subgroup analysis showed that the mortality benefit was driven primarily by observational studies (HR = 0.48, 95% CI: 0.37-0.61), whereas randomized trials demonstrated no significant difference (HR = 0.88, 95% CI: 0.75-1.03). Overall, TTVI combined with OMT may be associated with lower mortality and HF hospitalization compared with OMT alone, although the apparent benefit is largely derived from non-randomized evidence. Copyright © 2026 The Authors. Creative Commons Attribution 4.0 International License <34> Accession Number 2043717395 Title Evaluation of the Effect of Intravenous Lidocaine on the Systemic Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(6) (pp 1668-1677), 2026. Date of Publication: 01 Jun 2026. Author Fernandez-Martinez A.; Lopez Picado A.; Gonzalez-Garcia J.; Aguado Sevilla M.; Lobato Solores F.; Castroviejo Ibanez B.; de Miguel Fernandez P.; Benito Martinez P.; Valero Gonzalez S.; Galve Marques A.I.; Mainar Gil I.; Boukichou Abdelkader N.; Iniguez Martinez M.; Bermejo Bravo A.; Apinaniz Apinaniz R.; Corral Cardenas E.; Ferreira Laso L. Institution (Fernandez-Martinez) Faculty of Medicine, University of the Basque Country, Bizkaia, Leioa, Spain (Fernandez-Martinez, Aguado Sevilla, Lobato Solores, Castroviejo Ibanez, de Miguel Fernandez, Benito Martinez, Valero Gonzalez, Galve Marques, Ferreira Laso) Anaesthesiology, Resuscitation and Pain Management, Hospital Universitario San Pedro, Logrono, Spain (Lopez Picado) Department of Public Health and Preventive Medicine, University of the Basque Country, Bilbao, Spain (Gonzalez-Garcia) Department of Surgery, Radiology and Physical Medicine, University of the Basque Country, Bilbao, Spain (Gonzalez-Garcia) Anaesthesiology, Resuscitation and Pain Management, Hospital Universitario de Basurto, Bilbao, Spain (Mainar Gil) Intensive Care Medicine, Hospital Universitario San Pedro, Logrono, Spain (Boukichou Abdelkader) Department of Statistics, Data Science Unit, La Rioja Biomedical Research Center (CIBIR), Logrono, Spain (Iniguez Martinez) Department of Infectious Diseases, La Rioja Biomedical Research Center (CIBIR), Logrono, Spain (Bermejo Bravo, Apinaniz Apinaniz) Hospital Pharmacy, Hospital Universitario San Pedro, Logrono, Spain (Corral Cardenas) Hospital Universitario San Pedro, Logrono, Spain Publisher W.B. Saunders Abstract Objectives: To assess whether intravenous lidocaine reduces the systemic inflammatory response associated with cardiopulmonary bypass (CPB) and improves clinical outcomes in adult patients undergoing elective valvular and/or coronary cardiac surgery. Design(s): Single-center, parallel-group, double-blind, randomized clinical trial. Setting(s): San Pedro University Hospital, Logrono, Spain. Participant(s): Ninety adult patients (>=18 years) scheduled for elective valvular and/or coronary surgery with CPB who provide informed consent. Intervention(s): Patients will be randomly assigned to receive either intravenous lidocaine (1.5-mg/kg bolus followed by 1.5-mg/kg/h infusion until sternal closure) or an equivalent volume of saline solution as placebo. For patients with a body mass index greater than 30 kg/m2, the infusion dose will be adjusted according to ideal body weight, calculated as height (in centimeters) - 100 for men and height (in centimeters) - 110 for women. Measurements and Main Results: The primary outcome is the interleukin 6 level at 6 hours postoperatively. Secondary outcomes include trajectories of inflammatory and myocardial injury biomarkers (C-reactive protein, high-sensitivity troponin T, and tumor necrosis factor alpha), postoperative complications related to the systemic inflammatory response (acute kidney injury, transfusion requirements, vasoplegia, respiratory dysfunction, delirium, infection, and multiorgan dysfunction), postoperative pain, intensive care unit length of stay, 30-day mortality, and incidence of post-CPB atrial fibrillation. The analysis will be conducted on an intention-to-treat basis. Conclusion(s): This trial will determine whether intravenous lidocaine attenuates the systemic inflammatory response induced by CPB and improves clinical outcomes in adult patients undergoing elective cardiac surgery. Copyright © 2026 The Author(s) <35> Accession Number 2045752727 Title Efficacy Intravascular Lithotripsy Compared with Rotational/Orbital Atherectomy in Stent Restenosis: A Systematic Review. Source Annals of Clinical Cardiology. 8(1) (pp 42-50), 2026. Date of Publication: 01 Jan 2026. Author Laksono S.; Nurbaeti P.; Rahmawati U.D. Institution (Laksono) Division of Interventional Cardiology and Structural Heart Disease, Siloam Heart Center, Cinere, Indonesia (Laksono) Department of Medical Education, Faculty of Medicine, Universitas Muhammadiyah Prof. Dr. Hamka, Tangerang, Indonesia (Laksono, Nurbaeti, Rahmawati) Department of Medical Education, Medical Education Program, Faculty of Medicine, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia Publisher Wolters Kluwer Medknow Publications Abstract Background: Severe coronary artery calcification poses a major challenge during percutaneous coronary intervention (PCI) and increases the likelihood of in-stent restenosis (ISR). Rotational atherectomy (RA) and intravascular lithotripsy (IVL) are widely used plaque-modifying strategies, yet clear guidance on selecting between them remains limited. Objective(s): This systematic review compares the efficacy of RA and IVL in the management of ISR, focusing on patient characteristics, lesion morphology, procedural performance, and clinical outcomes. Method(s): A systematic search was conducted in PubMed, the Cochrane Library, and Google Scholar for studies published from January 2020 to April 2025. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The inclusion criteria comprised angiographically confirmed coronary ISR treated with RA or IVL and reported angiographic or clinical outcomes. Both randomized and observational studies were eligible. Data extraction encompassed study characteristics, procedural parameters, complications, and short-to mid-term outcomes. A qualitative synthesis was performed due to heterogeneity in study design and reported endpoints. Result(s): Nine studies involving 1250 patients met the eligibility criteria. Procedural success was consistently high (95%-100%) for both modalities. IVL demonstrated numerically fewer procedural complications in several reports, particularly vessel perforation and slow/no-reflow (RA 3%-13% vs. IVL 0%-3%), although pooled results did not reach statistical significance. Rates of major adverse cardiac events (MACE) during the follow-up were comparable between the groups (RA 6%-18% vs. IVL 5-17%). RA was more frequently employed in densely calcified lesions requiring substantial plaque debulking, whereas IVL tended to be favored in cases prioritizing procedural safety. Conclusion(s): RA and IVL are the effective strategies for treating calcified ISR after PCI. Selection should be individualized based on lesion complexity, plaque morphology, and procedural risk. Additional high-quality studies are needed to refine modality-specific indications and establish the long-term comparative outcomes. Copyright © 2026 Annals of Clinical Cardiology. <36> Accession Number 2042560529 Title Intraoperative Hemoadsorption and Acute Kidney Injury in Cardiac Surgery: Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(6) (pp 1869-1878), 2026. Date of Publication: 01 Jun 2026. Author Salles M.M.M.; Massoud R.O.; de Carvalho P.L.; Correia J.S.; Melo R.H. Institution (Salles) Department of Medicine, University of Oeste Paulista, Jau, Brazil (Massoud) Department of Medicine, State University of Para, Belem, Brazil (de Carvalho) Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil (Correia) Department of Arts and Science, University of South Florida, Tampa, FL, United States (Melo) Hospital Municipal Gilson de Cassia Marques de Carvalho, Sao Paulo, Brazil (Melo) Hospital Israelita Albert Einstein, Sao Paulo, Brazil Publisher W.B. Saunders Abstract Cardiovascular surgery with cardiopulmonary bypass (CPB) is associated with several potential complications, including the activation of inflammatory and coagulation pathways, which may lead to acute kidney injury (AKI). In this context, the intraoperative use of extracorporeal cytokine adsorbers has been studied for their potential benefits; however, their association with renal outcomes remains unclear. The authors aimed to perform a systematic review and meta-analysis comparing the AKI incidence and the need for renal replacement therapy in patients undergoing cardiovascular surgery with and without intraoperative hemoadsorption (HA). A comprehensive search of the PubMed, Embase, and Cochrane Library databases was conducted to identify observational studies and randomized controlled trials (RCTs) comparing the use of cytokine adsorbers incorporated into the CPB circuit (eg, CytoSorb and Jafron HA series) with standard surgical treatment during cardiac surgery. Statistical analysis was performed using Review Manager, version 5.4. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. The authors included 17 studies-7 of which were RCTs-comprising a total of 1,797 patients, 826 of whom underwent HA during CPB. The incidence of AKI was lower with HA in the overall analysis, driven by observational data, whereas RCTs did not show a statistically significant reduction (overall RR, 0.66; 95% CI, 0.49-0.87; p = 0.008). The need for renal replacement therapy did not differ significantly between groups (RR, 0.83; 95% CI, 0.63-1.11; p = 0.19). Intraoperative HA may be associated with a lower AKI incidence in observational studies, but randomized data do not confirm a causal benefit. Larger, standardized trials are required to determine the effect on renal outcomes. Copyright © 2025 Elsevier Inc. <37> Accession Number 2045321623 Title Alcoholic cardiomyopathy presenting with severe circulatory failure requiring mechanical circulatory support: A systematic review. Source American Journal of Emergency Medicine. 106 (pp 49-54), 2026. Date of Publication: 01 Aug 2026. Author Itagaki H.; Endo T. Institution (Itagaki, Endo) Division of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, Sendai, Japan Publisher W.B. Saunders Abstract Background: Alcoholic cardiomyopathy (ACM) is a potentially reversible form of dilated cardiomyopathy associated with chronic excessive alcohol consumption. Although recovery of left ventricular function after alcohol abstinence has been reported, the clinical course of patients presenting with cardiogenic shock or cardiac arrest requiring mechanical circulatory support (MCS) remains poorly characterized. This study aimed to evaluate survival outcomes and myocardial recovery in patients with ACM presenting with severe circulatory failure. Method(s): A systematic literature search was conducted in PubMed, Web of Science, Google Scholar, and Ichushi-Web from database inception to February 28, 2026. Studies describing patients with ACM presenting with cardiogenic shock or severe circulatory failure requiring temporary MCS (including ECMO, Impella, intra-aortic balloon pump, or LVAD) were included. Extracted data included patient characteristics, type of circulatory support, survival outcomes, and recovery of left ventricular function. Result(s): Five studies (three case reports and two case series), including 10 patients, were identified. The median age was 43 years (IQR, 38-46), and 9 of 10 patients (90%) were male. The median baseline LVEF was 15% (IQR, 15-20%). Cardiac arrest occurred in 3 patients (30%). Veno-arterial extracorporeal support, including VA-ECMO/PCPS, was used in 9 patients (90%), Impella in 1 patient (10%), and LVAD support in 3 patients (30%). One patient ultimately underwent heart transplantation. All published cases survived. Among patients with available follow-up data, the median LVEF improved to 55% (IQR, 45-60%), representing a median absolute increase of approximately 40 percentage points. Conclusion(s): Published case-based evidence suggests that alcoholic cardiomyopathy may retain clinically meaningful reversibility even in selected patients with severe circulatory failure requiring mechanical circulatory support. Although favorable outcomes may be overrepresented in published reports, awareness of this potentially reversible phenotype may support timely recognition and appropriate management of severe circulatory failure. Copyright © 2026 Elsevier Inc. <38> Accession Number 2045301531 Title Preoperative statin use and postoperative mortality in cardiac surgery patients: a retrospective cohort study of the MIMIC-IV database. Source Journal of Thoracic Disease. 18(4) (no pagination), 2026. Article Number: 285. Date of Publication: 30 Apr 2026. Author Zou X.; Zheng J.; Zhou J.; Qiu H.; Wu X. Institution (Zou, Zheng, Qiu, Wu) Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China (Zhou) Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China (Zhou) Department of Pharmacy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China Publisher AME Publishing Company Abstract Background: The impact of preoperative statin use on postoperative survival in cardiac surgery (CS) patients remains controversial. While some randomized controlled trials (RCTs) have reported neutral or harmful effects, real-world evidence from large, granular databases like Medical Information Mart for Intensive Care IV (MIMIC-IV) can provide complementary insights into long-term outcomes and dose-response relationships. This study aimed to investigate the association between preoperative statin use and short- to medium-term postoperative mortality in cardiac surgery patients using a large, real-world database and to explore potential dose-response effects. Method(s): This retrospective cohort study utilized the MIMIC-IV database [2008-2019]. We included adult patients (>=18 years) with an intensive care unit (ICU) stay of >24 hours undergoing their first CS. Patients were divided into preoperative statin users and non-users. The primary outcome was in-hospital mortality, while secondary outcomes were 30-, 90-, and 360-day mortality. Multivariable Cox proportional hazards models were constructed, adjusting for demographics, vital signs, laboratory results, and comorbidities (e.g., hypertension, diabetes, heart failure). Follow-up data were derived from hospital records and related death registry information. Result(s): A total of 17,172 CS patients were finally included in the study. Among 17,172 CS patients, 3,647 (21.2%) received preoperative statins. Statin users were older and had a higher burden of comorbidities such as hypertension and diabetes compared to non-users. In the fully adjusted model, preoperative statin use was associated with significantly lower in-hospital mortality rates [hazard ratio (HR) =0.708, 95% confidence interval (CI): 0.622-0.807, P<0.001]. Similar associations were observed for 30-day (HR =0.826, P=0.001), 90-day (HR =0.829, P<0.001), and 360-day mortality rates (HR =0.884, P=0.002). Dose-response analysis revealed a more significant reduction in mortality rates with high-dose (>40 mg) atorvastatin. Conclusion(s): In this large, real-world cohort, preoperative statin use was associated with reduced short- and medium-term mortality rates after CS, with a potential dose-dependent effect. However, given the conflicting evidence from RCTs, these findings should be interpreted cautiously. Perioperative management should be individualized, and further research is necessary to identify patient subgroups most likely to benefit from statin therapy. Copyright © AME Publishing Company. <39> Accession Number 2045614060 Title Efficacy of Dexmedetomidine in Preventing Postoperative Delirium in Patients Undergoing Brain Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Neurocritical Care. (no pagination), 2026. Date of Publication: 2026. Author dos Reis M.A.O.M.; de Assis E.B.T.; Swamy H.K.; Matos B.C.M.; Ferreira M.Y.; Ben-Shalom N.; Polverini J.E.R.; Polverini A.D. Institution (dos Reis, Matos) Faculty of Medicine, Universidad Nacional de Rosario, Santa Fe, Rosario, Argentina (de Assis, Swamy) Faculty of Medicine, Baltic Federal University, Kaliningrad Oblast, Kaliningrad, Russian Federation (Ferreira, Ben-Shalom) Department of Neurosurgery, Northwell Health Hospital, New York, NY, United States (Polverini) Department of Anaesthesiology, Barretos Cancer Hospital, SP, Barretos, Brazil (Polverini) Neurosurgical Oncology Division, Barretos Cancer Hospital, SP, Barretos, Brazil Publisher Springer Abstract Background: Dexmedetomidine (DEX), a selective alpha-2 adrenergic receptor agonist, is widely used in various surgical settings, including cardiac and general surgeries, for its sedative, analgesic, and neuroprotective properties. Patients undergoing brain surgery are particularly susceptible to postoperative delirium (POD). Given the established benefits of dexmedetomidine in other surgical fields, its potential to mitigate delirium in neurosurgery warrants investigation. Method(s): A systematic search of PubMed, Embase, Scopus, and Cochrane databases was conducted from inception to January 2025 and updated in April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed, and a meta-analysis was performed using Review Manager 5.4.1. Five randomized controlled trials were included, evaluating the efficacy of DEX in preventing POD in adult patients undergoing brain surgery. Result(s): A total of 646 patients were enrolled, with DEX administered with a loading dose ranging from 0.5 to 1 mug/kg over 10 min, followed by a maintenance infusion rate of 0.1 to 0.5 mug/kg/h during the surgical procedure. The pooled risk ratio (RR) for POD with DEX was 0.47 (95% confidence interval (CI): 0.35-0.63; p < 0.00001); reflecting a 53% reduction in the risk of postoperative delirium, with no statistical heterogeneity detected (chi2 = 2.09, degrees of freedom (df) = 4, p = 0.72; I2 = 0%). Subgroup analyses showed similar effect estimates across brain tumor and other cranial procedures. Adverse events were comparable between groups and generally mild. Conclusion(s): This meta-analysis found that perioperative dexmedetomidine was associated with a significant reduction in postoperative delirium risk in neurosurgical patients. Further multicenter trials are needed to confirm these findings and to refine optimal administration strategies. Copyright © Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2026. <40> Accession Number 2044602920 Title Effect of preoperative oral iron supplementation on postoperative outcomes in children with acyanotic congenital heart disease undergoing cardiac surgery: A pragmatic randomised clinical trial. Source Cardiology in the Young. 36(3) (pp 538-544), 2026. Date of Publication: 01 Mar 2026. Author Murugaiyan A.; Jha A.K.; Parida S.; Rajeswari Thangaswamy C.; Munuswamy H. Institution (Murugaiyan, Jha, Parida, Rajeswari Thangaswamy) Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India (Munuswamy) Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Publisher Cambridge University Press Abstract Background: Studies assessing the effect of preoperative iron supplementation in paediatric cardiac surgery are limited and yield conflicting data. Objective(s): The study aimed to evaluate the effect of preoperative oral iron supplementation on allogeneic blood transfusion after cardiac surgery for acyanotic CHD. Method(s): This was a prospective, open-label, outcome assessor-blinded, randomised clinical trial performed in a large tertiary care centre in India. Children (haemoglobin <13 gm/dl) with acyanotic CHD were recruited for the study. Children in the intervention arm received colloidal iron (3 mg/kg), folic acid, and cyanocobalamin according to body weight for at least 7 days before cardiac surgery. The primary outcome was the amount of allogeneic blood transfusion, while secondary outcome measures were the duration of mechanical ventilation and ICU stay. Result(s): A total of eighty-six children (43 in each arm) completed the trials. A total of 43 children received iron supplementation for a minimum of 1 month. The haemoglobin level improved by 1.3 gm/dl immediately before the cardiac surgery in the intervention arm. The allogeneic blood transfusions (ml/kg) median (IQR) were significantly lower in the intervention group (5 (0-8) vs 10 (8-12); p < 0.01). Furthermore, total cumulative allogeneic blood transfusion was also significantly lower in the intervention arm (60 ml; (0-100) vs 100 ml; (70-140); p < 0.001). The duration of mechanical ventilation, ICU stay, and hospital stay was significantly lower in the intervention arm. Conclusion(s): Preoperative oral iron supplementation significantly reduces the need for allogeneic blood transfusion in children undergoing cardiac surgery for acyanotic heart disease. Copyright © The Author(s), 2026. <41> Accession Number 2040599962 Title Revascularisation strategies for non-acute myocardial ischaemic syndromes. Source Heart. 112(10) (pp 530-538), 2026. Date of Publication: 01 May 2026. Author Kawczynski M.J.; Barili F.; Brophy J.M.; De Caterina R.; Biondi Zoccai G.; Boden W.E.; Albuquerque A.; Almeida R.; Anselmi A.; Beurtheret S.; Biondi-Zoccai G.; Boden W.; Borger M.; Brophy J.; Buttiglione G.; Dayan V.; Caterina R.D.; Cuesta M.D.L.; Firstenberg M.; Garcia-Villareal O.; Gomes W.; Heuts S.; Kaul S.; Kawczynski M.; Mandrola J.; Cuartas M.M.; Misfield M.; Musumeci F.; Parolari A.; Quintana E.; Redberg R.; Riad R.; Stuart J.R.-R.; Ronco D.; Uva M.S.; Tomasi J.; Verhoye J.-P.; Zenati M.; Dib N. Institution (Kawczynski, Heuts) Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, Netherlands (Kawczynski, Heuts) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands (Barili, Parolari) Universita Degli Studi Di Milano, Milan, Italy (Barili) IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy (Barili) Harvard T.H. Chan School of Public Health, Boston, MA, United States (Brophy) McGill University, Montreal, QC, Canada (De Caterina) Cardiology Division, Pisa University Hospital, Pisa, Italy (Biondi Zoccai) Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy (Biondi Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Anselmi) Department of Thoracic and Cardiovascular Surgery, University Hospital Centre Rennes, Rennes, France (Boden) VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, United States Publisher BMJ Publishing Group Abstract Background: Contemporary guidelines by the European Society for Cardiology and American College of Cardiology/American Heart Association for the treatment of non-acute myocardial ischaemic syndromes dispute the value of revascularisation and differ in their recommendation to perform revascularisation. A Bayesian network meta-analysis was performed, evaluating the strength of evidence for the comparative incremental effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) over medical therapy on long-term outcomes. Method(s): A hierarchical Bayesian network meta-analysis was designed (PROSPERO CRD42024541215, date 20 May 2024), including randomised controlled trials (RCTs) published between 2005 and 10 June 2025, which consisted of three initial treatment modalities: optimal medical therapy (OMT), PCI+OMT and CABG+OMT. The primary outcome was all-cause mortality at maximum follow-up; secondary outcomes were trates of the rates of myocardial infarction, stroke and re-revascularisation at maximum follow-up, expressed in HRs and 95% credible intervals (CrIs), accompanied by surface under the cumulative ranking curve (SUCRA) scores. Result(s): 10 RCTs, comprising 10 742 patients, were included. For all-cause mortality, the estimated median HR of CABG+OMT versus OMT was 0.84 (95% CrI 0.68-1.07); the HR of PCI+OMT versus OMT was 0.93 (0.79-1.16); and the HR of CABG+OMT versus PCI+OMT was 0.91 (0.71-1.13). The SUCRAs of a CABG+OMT strategy ranking as the optimal revascularisation treatment regarding mortality, myocardial infarction, stroke and re-revascularisation were 88.1%, 99.7%, 17.5% and 99.5%, respectively. Results were consistent across sensitivity analyses, including in the node-splitting models. Conclusion(s): This Bayesian network meta-analysis found that an initial CABG (+OMT) revascularisation strategy was associated with higher probabilities of optimal outcomes, with the exception of stroke, compared with an initial PCI (+OMT) revascularisation strategy, although CrIs overlapped, suggesting that some uncertainty remains. PROSPERO registration number: CRD42024541215. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <42> Accession Number 2045735534 Title Microcirculatory effects of cardiopulmonary bypass primings in coronary artery bypass graft surgery the prime randomised clinical trial for a physiological proof-of-principle. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Beukers A.M.; Seegers J.C.; van Haasteren N.; Brouwers M.; Bosch R.J.; Tuip-de Boer A.M.; van den Brom C.E.; Eberl S.; Mansvelder F.J.; Kunst G.; van Meenen D.M.P.; Bulte C.S.E.; Loer S.A.; Vonk A. Institution (Beukers, Seegers, van Haasteren, Brouwers, van den Brom, Eberl, Mansvelder, van Meenen, Bulte, Loer) Department of Anaesthesiology, Amsterdam University Medical Centre, Amsterdam, Netherlands (Seegers, Tuip-de Boer, van den Brom, van Meenen) Department of Intensive Care Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands (Seegers, Vonk) Department of Cardiothoracic Surgery, Amsterdam University Medical Centre, Amsterdam, Netherlands (Bosch) Department of Clinical Perfusion, St. Antonius Hospital, Nieuwegein, Netherlands (Tuip-de Boer, van den Brom) Laboratory for Experimental Intensive Care and Anaesthesiology (LEICA), Amsterdam University Medical Centre, Amsterdam, Netherlands (Kunst) Department of Anaesthesiology, King's College Hospital, The United Kingdom, London Publisher SAGE Publications Ltd Abstract Objectives: Cardiopulmonary bypass (CPB) impairs endothelial function, causing oedema and disturbed microcirculatory perfusion, that contribute to organ dysfunction following cardiac surgery. We hypothesised that the composition of CPB prime fluids with either albumin or gelofusine preserves sublingual microcirculatory perfusion in patients undergoing coronary artery bypass graft surgery. Method(s): Thirty-four patients were subjected to CPB primed with 1500 ml of either albumin/ringers (n = 8, gelofusine/ringers (n = 11), or solely ringers plus retrograde autologous priming (RAP) (n = 15). All solutions included 100 ml of mannitol. The primary outcome was perfused vessel density (PVD) assessed after anaesthesia induction, aortic cross-clamping, weaning from CPB, upon intensive care unit (ICU) arrival and 24 h after ICU arrival. Result(s): CPB immediately impaired PVD across all groups, persisting until ICU arrival. The decrease in PVD was most profound with albumin/ringers (estimated mean difference between baseline and ICU arrival -7.56 [95% CI -11.53 to -3.59] mm.mm-2), compared to gelofusine/ringers (-4.10 [-7.53 to -0.67] mm.mm-2), and ringers/RAP (-3.77 [-6.64 to -0.90] mm.mm-2), without differences between groups (p = 0.41). In patients receiving gelofusine/ringers COP was preserved after aortic cross clamping. Concentration of inflammatory (interleukin-6) and endothelial damage markers (angiopoietin-2) were increased with albumin/ringers compared with gelofusine/ringers and ringers plus RAP. Conclusion(s): In this exploratory physiological study, all of the three CPB priming strategies, albumin/ringers, gelofusine/ringers or ringers plus RAP, similarly induced perioperative microcirculatory dysfunction in patients undergoing CABG surgery. 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). <43> Accession Number 2044968972 Title Ultrasound-Guided Superficial Versus Deep Continuous Serratus Anterior Plane Block in Patients Undergoing Thoracotomy for Lung Surgery: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 180-185), 2026. Date of Publication: 01 Apr 2026. Author Raghupathy R.; Negi S.L.; Biswas I.; Singh H.; Mandal B.; Gourav K.P.; Sharma A. Institution (Raghupathy) Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Negi, Biswas, Mandal, Gourav) Department of Cardiac Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Singh) Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Sharma) Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Publisher Wolters Kluwer Medknow Publications Abstract Background: Thoracic surgery is considered to be one of the most painful surgical procedures; therefore, providing adequate analgesia in the perioperative period is crucial. Inadequate pain control impedes deep breathing, which further leads to atelectasis and pneumonia. The optimal analgesic protocol that allows adequate postoperative pain control and facilitates fast recovery of this population has yet to be determined. The serratus anterior plane (SAP) block is a new procedure that is relatively easier to perform and safer, compared with other modalities. Material(s) and Method(s): Patients undergoing lung resection surgery via thoracotomy at a single center were randomized to undergo either superficial or deep SAP block with 0.4 mL/kg of bupivacaine 0.25%, following which 20-gauge peripheral nerve block catheter was placed above or below the serratus anterior muscle plane and continuous bupivacaine 0.125% infusion at the rate of 5-7 mL/h was initiated up to 24 hours in intensive care unit (ICU). The primary outcome was the total opioid consumption during the first 24 h in the ICU. Secondary outcomes were the severity of pain in the visual analog scale (VAS) score, patient satisfaction score, ICU stay duration, and the incidence of postoperative nausea and vomiting (PONV). Result(s): A total of 36 participants were randomized to each group, and the baseline characteristics were comparable between the groups. The total postoperative opioid consumption during the first 24 h in ICU was lower in deep SAP block (60.00 +/- 68.22) compared to superficial SAP block (85.31 +/- 68.40), but it was not statistically significant (P > 0.303). The VAS score, time to first rescue analgesia, patient satisfaction score, incidence of PONV, and the length of ICU stay were comparable between the two groups (P > 0.05). Conclusion(s): There was lower opioid consumption in the continuous deep SAP block compared to the superficial SAP block at 24 hours; however, the difference was not statistically significant. Continuous analgesia through an indwelling catheter is safe and an effective method for the management of postoperative pain in lung resection surgery. Copyright © 2026 Annals of Cardiac Anaesthesia. <44> Accession Number 2045714273 Title Effect of intensive blood pressure control in patients with resistant hypertension: insights from the STEP trial. Source European Journal of Preventive Cardiology. 33(7) (pp 1218-1226), 2026. Date of Publication: 01 May 2026. Author Dong X.; Bai J.; Ling Q.; Zhao X.; Cai J. Institution (Dong) Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Bai) Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Chinese Institutes for Medical Research, Beijing, China (Ling) Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Zhao) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Cai) Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Chinese Institutes for Medical Research, Beijing, China Publisher Oxford University Press Abstract Aims: Resistant hypertension is defined as uncontrolled blood pressure (BP) despite the use of >=3 antihypertensive drugs or controlled BP with >=4 antihypertensive drugs. Whether intensive BP control is beneficial for the management of resistant hypertension is unknown. Methods and Results: Intensive (<130 mmHg) BP control in patients is compared with standard (130-150 mmHg) BP control in patients with resistant hypertension, using the Strategy of Blood Pressure Intervention in Older Hypertensive Patients (STEP) trial data. Patients were divided into those with and without resistant hypertension. The primary outcome was a composite of cardiovascular events. Hazard ratios (HRs) were calculated using the Fine-Gray sub-distribution hazard model for primary and secondary events and the Cox regression model for all-cause death. In patients with resistant hypertension, intensive BP control was associated with a lower risk of primary outcomes (HR, 0.36; 95% CI, 0.14-0.93; P = 0.035). Results were consistent across different BP thresholds used to define resistant hypertension and in patients with true resistant hypertension. The benefit of intensive BP control was consistent across resistant hypertension status. Intensive BP control was not associated with an increased risk of adverse events in patients with resistant hypertension. Patients with resistant hypertension had increased cardiovascular risk compared with those without (HR, 1.78; 95% CI, 1.13-2.81; P = 0.012). Conclusion(s): Intensive BP control is associated with reduced risk of cardiovascular events in patients with resistant hypertension without increased risk of adverse events. Registration: https://www.clinicaltrials.gov/ct2/show/NCT03015311 Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <45> Accession Number 2045769958 Title Transcatheter aortic valve replacement in low-to-medium surgical risk patients: time for a reappraisal?. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Flather M.; Shibata M.C. Institution (Flather) Norwich Medical School, University of East Anglia, Norwich Research Park Campus, Norwich, United Kingdom (Flather) Cardiology, Norfolk and Norwich University Hospital NHS Trust, Norwich, United Kingdom (Shibata) Division of Cardiology, University of Alberta Department of Medicine, Edmonton, AB, Canada (Shibata) Cardiology Covenant Health Group, Misericordia Community Hospital, Edmonton, AB, Canada Publisher BMJ Publishing Group <46> Accession Number 2045764236 Title Safety of Carbon Dioxide-Facilitated vs Conventional Epicardial Access: Systematic Review and Meta-Analysis. Source JACC: Clinical Electrophysiology. 12(5) (pp 997-1011), 2026. Date of Publication: 01 May 2026. Author Castello-Branco B.; Wilnes B.; Sroubek J.; Higuchi K.; Lee J.; Hussein A.; Saliba W.; Kanj M.; Taigen T.; Younis A.; Bhargava M.; Wazni O.; Carmo A.A.L.; Santangeli P. Institution (Castello-Branco, Wilnes, Carmo) Electrophysiology Section, Advanced Arrhythmia Treatment Center, Belo Horizonte, Brazil (Sroubek, Higuchi, Lee, Hussein, Saliba, Kanj, Taigen, Younis, Bhargava, Wazni, Santangeli) Section of Cardiac Pacing and Electrophysiology, Division of Cardiology, Cleveland Clinic, Cleveland, OH, United States (Carmo) Unit of Cardiology and Cardiovascular Surgery, Clinics Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Publisher Elsevier Inc. Abstract Background: Percutaneous epicardial access has been increasingly adopted in clinical practice, particularly for ventricular tachycardia ablation. "Dry" epicardial puncture (Dry-EPI) carries a considerable risk of access-related complications, even with modified techniques. Pericardial carbon dioxide insufflation (EpiCO<inf>2</inf>) has emerged as a promising alternative, potentially enhancing safety by increasing anatomical clearance between pericardial layers. Objective(s): This study compared the safety and efficacy of EpiCO<inf>2</inf> vs traditional Dry-EPI techniques through systematic review, meta-analysis, and meta-regression. Method(s): PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane databases were searched using medical subject heading terms "epicardial access," "carbon dioxide insufflation," "complications," and similar key words. Random-effects meta-analyses of proportions and means, subgroup analyses, and meta-regressions were conducted. Result(s): A total of 119 studies (8,784 procedures) were included; most (95.0%) were of moderate or high quality. Ventricular tachycardia ablation was the main access indication (n = 7,178). EpiCO<inf>2</inf> was used in 493 procedures (5.6%) and Dry-EPI in 8,291 (94.4%). Among 5,786 Dry-EPI cases with specified needle type, 5,184 (89.6%) used a large-bore needle and 602 (10.4%) a micropuncture needle. EpiCO<inf>2</inf> was associated with significantly fewer complications requiring surgery compared with Dry-EPI (0.24% [95% CI: 0.00-0.93] vs 1.55% [95% CI: 1.27-1.86], P < 0.010), large-bore needle (0.24% [95% CI: 0.00%-0.93%] vs 1.58% [95% CI: 1.23-1.97], P < 0.010), and micropuncture (0.24 [95% CI: 0.00-0.93] vs 1.66% [95% CI: 0.60-3.17], P = 0.020). Inadvertent ventricular puncture was also lower with EpiCO<inf>2</inf> compared with Dry-EPI (0.28% [95% CI: 0.00-1.00] vs 3.17% [95% CI: 2.36-4.10], P < 0.010). Conclusion(s): Compared with Dry-EPI, EpiCO<inf>2</inf> was associated with significantly lower risk of inadvertent ventricular puncture and complications requiring surgery, supporting broader clinical adoption. Copyright © 2026 American College of Cardiology Foundation <47> Accession Number 2043813869 Title Wedge Resection for Early-Stage Non-Small Cell Lung Cancer: Are We There Yet?. Source Annals of Thoracic Surgery. 121(6) (pp 1299-1308), 2026. Date of Publication: 01 Jun 2026. Author Baiu I.; Altorki N.K.; Kneuertz P.J. Institution (Baiu, Kneuertz) Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States (Altorki) Department of Cardiothoracic Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States Publisher Elsevier Inc. Abstract The optimal extent of resection for early-stage non-small cell lung cancer (NSCLC) remains one of the most debated questions in thoracic surgery. Although lobectomy has traditionally represented the standard of care, contemporary randomized trials have redefined the role of sublobar resection. For appropriately selected patients with small, peripherally located tumors, segmentectomy has shown oncologic equivalence to lobectomy, whereas the evidence supporting wedge resection remains less definitive. This review synthesizes the available evidence comparing wedge resection and segmentectomy, contextualized against lobectomy as the historical benchmark. A comprehensive literature review was performed, focusing on studies published over the last 30 years reporting outcomes of anatomic and non-anatomic, lobar and sublobar lung resections in patients with stage I NSCLC. Wedge resection offers a less-invasive option for early-stage NSCLC, with potential benefits in pulmonary preservation and perioperative safety. However, current evidence remains mixed, and although wedge resection may be appropriate in carefully selected standard-risk patients, its routine use awaits further high-level validation. Careful patient selection, attention to margins, appropriate lymph node evaluation, and consideration of tumor biology are critical in determining patients for whom a wedge resection can be oncologically adequate. Copyright © 2026 The Authors. <48> Accession Number 2034538863 Title Ischemic outcomes after left atrial appendage closure following intracerebral hemorrhage: a retrospective inverse probability weighting analysis from the HANSE-LAAC registry. Source Clinical Research in Cardiology. 115(6) (pp 946-954), 2026. Date of Publication: 01 Jun 2026. Author Jurczyk D.; Mezger M.; Lemmer F.; Fatum C.; Gradaus R.; Drochner-Brocks N.-K.; Saraei R.; Frerker C.; Stiermaier T.; Paitazoglou C.; Eitel I. Institution (Jurczyk, Mezger, Lemmer, Fatum, Gradaus, Drochner-Brocks, Saraei, Frerker, Stiermaier, Paitazoglou, Eitel) Medical Clinic II (Cardiology, Angiology, Intensive Care Medicine), University Hospital Schleswig-Holstein, University Heart Center Lubeck, University Schleswig-Holstein (UKSH), Ratzeburger Allee 160, Luebeck, Germany (Jurczyk, Mezger, Lemmer, Fatum, Saraei, Frerker, Stiermaier, Paitazoglou, Eitel) German Center for Cardiovascular Research, Hamburg/Kiel/Lubeck/Greifswald, Partner Site Lubeck, Luebeck, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Intracerebral hemorrhage (ICH) is associated with worse outcomes and subsequent high risk for acute arterial ischemic events. Percutaneous left atrial appendage closure (LAAC) is an established procedure in case of atrial fibrillation and adverse events, such as severe bleeding. Clinical benefits of LAAC in patients with ICH are currently unclear. Method(s): The single-center registry HANSE-LAAC included consecutively treated patients from 2014 to 2022. Index-procedure and standardized follow-ups at 3 and 12 months were analyzed regarding safety and efficacy retrospectively. Mortality, major adverse cardiovascular, and bleeding events were compared between patients with or without ICH. We used Cox proportional hazard models and inverse probability weights to adjust confounders. Result(s): 401 patients received percutaneous LAAC (ICH 15.2%, n = 61 and non-ICH 84.8%, n = 340). The composite endpoint of death, MACE, and bleeding was significantly lower in the ICH group (HR 0.35, confidence interval [CI] 0.05-4.62, p = 0.0044). This clinical benefit was mainly driven by a significant reduction in bleeding events (HR 0.27; CI 0.06-1.15, p = 0.04). Re-hospitalization was significantly lower as well (HR 0.36; CI 0.20-0.64, p < 0.0001). Adjustment for confounders and inverse probability weighting for the probability of ICH showed no statistically significant difference in mortality (HR 0.53, CI 0.15-1.92, p = 0.33), stroke (HR 0.32 CI 0.03-3.13, p = 0.33), bleeding (HR 0.26; CI 0.05-1.29, p = 0.02), and MACE (HR 0.29; CI 0.04-2.36, p = 0.002). Conclusion(s): LAAC in ICH was safe and associated with less MACE, bleeding, and re-hospitalization. Randomized-controlled trials are needed to confirm these first positive signs. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2025. <49> Accession Number 2043534722 Title Superficial Parasternal Intercostal Plane Block for Analgesia After Cardiac Surgery: An Updated Meta-analysis of Randomized Controlled Trials With Meta-regression and Trial Sequential Analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(6) (pp 1879-1890), 2026. Date of Publication: 01 Jun 2026. Author Dost B.; Karapinar Y.E.; Turunc E.; Beldagli M.; Turan E.I.; 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 (Beldagli) Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey (Turan) Department of Anesthesiology and Reanimation, Health Science University, Istanbul Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, 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 W.B. Saunders Abstract Background: Effective postoperative pain control is essential for enhanced recovery after cardiac surgery, yet optimal multimodal strategies continue to evolve. The superficial parasternal intercostal plane (S-PIP) block has been proposed as a simple and safe technique for median sternotomy analgesia; however, current evidence remains fragmented, and its clinical impact is unclear. Method(s): We conducted a systematic review and meta-analysis of randomized controlled trials assessing the analgesic efficacy and safety of the S-PIP block in adult cardiac surgery. PubMed, Embase, CENTRAL, Web of Science, Scopus, ClinicalTrials.gov, and gray literature were searched through September 2025. Trials comparing S-PIP with standard or placebo analgesia were pooled using a random-effects model. The primary outcome was 24-hour opioid use (morphine milligram equivalents). Trial sequential analysis, meta-regression, and Grades of Recommendation, Assessment, Development, and Evaluation were applied to evaluate the robustness and certainty of evidence. Result(s): Twenty-seven randomized controlled trials (1,760 patients) met the inclusion criteria. S-PIP block significantly reduced 24-hour opioid use compared with control (mean difference, -8.53 mg; 95% CI, -14.39 to -2.68), although the reduction was below the minimal clinically important difference and demonstrated substantial heterogeneity (I2 = 98.1%). Trial sequential analysis confirmed statistical significance, but the required sample size was not achieved. The block also lowered early pain scores, reduced rescue analgesic use, and shortened extubation time and intensive care unit stay. No meaningful differences were observed in hospital stay, postoperative nausea and vomiting, or chronic postsurgical pain. The certainty of the evidence ranged from moderate to very low. Conclusion(s): S-PIP provides modest early analgesic benefits after cardiac surgery. Further high-quality multicenter trials are required to clarify its overall clinical value. Copyright © 2026 Elsevier Inc. <50> Accession Number 2044968974 Title The Effect of Dexmedetomidine on Hemodynamic Response during Double-Lumen Tube Insertion: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 191-198), 2026. Date of Publication: 01 Apr 2026. Author Govind M.R.H.; George G.; Vithayathil R.; Gowri M.; Rao V.M.; Sahajanadanan R.; Kuppuswamy B. Institution (Govind) Department of Anaesthesia, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (George) Department of Anaesthesia, Bangalore Baptist Hospital, Karnataka, Bengaluru, India (Vithayathil) Department of Anaesthesia, Bedford Hospital South Wing, Bedford, United Kingdom (Gowri) Department of Biostatistics, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (Rao) Department of Cardiothoracic Surgery, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (Sahajanadanan) Department of Anaesthesia, Sultan Qaboos Cancer Centre and Research Centre and University, Seeb, Oman (Kuppuswamy) Department of Cardiac Anaesthesia, Christian Medical College and Hospital, Tamil Nadu, Vellore, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aim: Double-lumen tube (DLT) insertion, which is often necessary to isolate the lung in thoracic surgeries, causes a significant and prolonged stress response. This study aims to evaluate the effect of a single preinduction bolus of dexmedetomidine 0.5 mcg/kg on hemodynamic responses to DLT insertion and fiberoptic confirmation. Material(s) and Method(s): In this prospective randomized control trial, 60 patients coming for thoracic surgery requiring DLT insertion were recruited. Thirty were assigned to the dexmedetomidine group (A) and 30 to the placebo group (B). Group A received 0.5 mcg/kg dexmedetomidine, and Group B received normal saline over 10 min. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded at baseline, after study drug administration, just before intubation, at intubation, and thereafter at regular intervals up to 30 min. Usage of supplementary anesthetics and rescue medications was noted. Result(s): Patients in Group A had lower HR after study drug administration (P < 0.001), before intubation (P < 0.001), at intubation (P < 0.001), and at various other time points. Group A had lower SBP (P = 0.049) and DBP (P = 0.005) after study drug administration. Fewer patients in Group A required additional propofol (14 vs. 27) (P < 0.001) and lesser doses (21.3 vs. 41.0 mg) (P = 0.008). Lesser Group A patients required additional fentanyl (15 vs. 21) (P = 0.114). More patients in Group A required ephedrine (P = 0.038). Use of phenylephrine and atropine was comparable in both groups. Conclusion(s): Dexmedetomidine worked as an excellent adjuvant to anesthesia, providing good HR control and hemodynamic stability during DLT insertion and fiberoptic bronchoscopy confirmation. It decreases the overall anesthetic requirements and causes minimal side effects. Copyright © 2026 Annals of Cardiac Anaesthesia. <51> Accession Number 2042689151 Title Right Ventricular Function After Mitral Valve Surgery: Insights From the United Kingdom Mini Mitral Study. Source Annals of Thoracic Surgery. 121(6) (pp 1404-1412), 2026. Date of Publication: 01 Jun 2026. Author Bayliss C.; Wagnild J.; Maier R.; Ogundimu E.; Graham R.; Zacharias J.; Deshpande R.; Akowuah E. Institution (Bayliss, Graham, Akowuah) Department of Cardiac Surgery, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom (Wagnild) Department of Anthropology, Durham University, Durham, United Kingdom (Maier, Akowuah) Academic Cardiovascular Unit, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom (Ogundimu) Department of Mathematical Sciences, Durham University, Durham, United Kingdom (Zacharias) The Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom (Deshpande) The Cardiac Care Group, King's College Hospital, London, United Kingdom (Akowuah) Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom Publisher Elsevier Inc. Abstract Background Right ventricular (RV) function is frequently reduced after cardiac surgery, with persistent impairment associated with increased mortality. This study aimed to compare RV function after mitral valve repair through right minithoracotomy vs sternotomy. Methods In the UK Mini Mitral trial, patients were randomized to mitral valve repair through right minithoracotomy (small lateral pericardial incision) or sternotomy. Prespecified secondary outcomes included assessment of cardiac function by blinded echocardiography preoperatively and at early (12 weeks) and late (52 weeks) time points. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE). RV to pulmonary artery coupling was determined by the TAPSE to systolic pulmonary artery pressure ratio. Results Of 330 patients randomized, 224 had suitable echocardiographic data for analysis. Baseline demographic, clinical, and echocardiographic data were comparable between groups. Cross-clamp and bypass times were significantly longer in the minithoracotomy group. At 12 weeks, there was a significant reduction in TAPSE from baseline in both groups (TAPSE minithoracotomy, -7.52 mm [95% CI, -8.52 to -6.53; P < .001], vs sternotomy, -8.75 mm [95% CI, -9.80 to -7.71; P < .001]), which recovered, but not to preoperative levels, by 52 weeks. The degree of RV impairment was significantly less in the minithoracotomy group at both early (between-group difference in TAPSE at 12 weeks, 1.47 mm [95% CI, 0.37-2.56; P = .009]) and late time points (between-group difference in TAPSE at 52 weeks, 1.37 mm [95% CI, 0.29-2.45; P = .013]). Conclusions Despite longer cross-clamp and bypass times, mitral valve repair through minithoracotomy was superior to sternotomy at preserving RV function (measured by TAPSE) at 12 weeks and 1 year. Copyright © 2026 The Society of Thoracic Surgeons. <52> Accession Number 2045747094 Title Two-Lung Ventilation Attenuates Systemic Inflammatory and Oxidative Stress Responses During Thoracic Surgery: A Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Ballester E.; Frandoloso M.; Mendes R.A.; Helene M.K.; Ballester M.E.; Effting P.S.; Dominguini D.; Ritter C.; Rocco P.R.M.; Dal-Pizzol F. Institution (Ballester, Effting, Dominguini, Ritter, Dal-Pizzol) Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciuma, Brazil (Ballester, Frandoloso, Mendes, Ballester) Department of Thoracic Surgery, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Helene) Department of Anesthesiology, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Rocco) Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Ritter, Rocco, Dal-Pizzol) National Science and Technology Institute for Precision Critical Care Medicine - INCT PCCM, Criciuma, Brazil Publisher W.B. Saunders Abstract Objective: To evaluate whether two-lung ventilation (TLV) attenuates perioperative inflammatory and oxidative responses compared with one-lung ventilation (OLV). Design(s): A randomized, open-label clinical trial. Setting(s): Thoracic Surgery Department of a general hospital in Southern Brazil. Participant(s): Forty adults (age >=18 years) undergoing thoracic surgery between July and November 2023 were enrolled. Exclusion criteria included pregnancy, preoperative mechanical ventilation, American Society of Anesthesiologists class IV status, inability to place a double-lumen tube, and prior lung resection. Intervention(s): Patients were randomized to receive OLV or TLV during surgery. Measurements & Main Results: Bronchoalveolar lavage (BAL) fluid from the operated and nonoperated lungs and plasma samples were collected preoperatively and postoperatively. Cytokines (interleukin [IL]-6, IL-1beta, IL-8, IL-4, IL-10, and tumor necrosis factor alpha) and oxidative stress markers (thiobarbituric acid reactive substances, protein carbonyls, and DCFH-DA [2',7'-dichlorodihydrofluorescein diacetate]) were quantified. Group-by-time effects were analyzed using generalized mixed-effects models adjusted for age, sex, and surgical duration. BAL fluid cytokine levels, including the primary outcome, IL-6 (p = 0.57), did not differ between groups. However, TLV was associated with reduced postoperative IL-1beta (p = 0.04) and oxidative damage (p = 0.02) in the operated lung. Systemically, TLV markedly attenuated inflammatory and oxidative responses, with lower circulating cytokines and oxidative stress markers and significant group-by-time interactions for multiple mediators. Conclusion(s): Although TLV did not modify local IL-6 concentrations, it consistently dampened systemic inflammatory and oxidative activation induced by thoracic surgery, supporting its potential as a protective perioperative ventilatory strategy. Copyright © 2026 The Author(s) <53> Accession Number 2045585148 Title Practical Recommendations for Anticoagulation in Patients With Atrial Fibrillation. Source European Journal of Clinical Investigation. 56(5) (no pagination), 2026. Article Number: e70224. Date of Publication: 01 May 2026. Author Johner N.; Gencer B. Institution (Johner, Gencer) Cardiology Division, Geneva University Hospitals, Geneva, Switzerland (Johner) Hopital Cardiologique du Haut-Leveque, CHU de Bordeaux, Pessac, France (Gencer) Cardiology Division, Lausanne University Hospital, Lausanne, Switzerland (Gencer) Institute of Primary Healthcare (BIHAM), University of Bern, Bern, Switzerland Publisher John Wiley and Sons Inc Abstract Background: The lifetime risk of stroke among non-anticoagulated patients with atrial fibrillation (AF) approximates 1 in 3. Oral anticoagulation (OAC) reduces stroke and systemic embolism by at least two thirds and mortality by one fourth. Method(s): The present narrative review summarizes current evidence and practical recommendations on OAC in AF and highlights recent advances and remaining gaps in knowledge. Result(s): The threshold for net clinical benefit of OAC is met when stroke risk exceeds 1%-2% per year, typically corresponding to >= 1 traditional stroke risk factor (CHA<inf>2</inf>DS<inf>2</inf>-VA >= 1), with increasing risk per additional risk factor. OAC also appears beneficial in device-detected (subclinical) AF, possibly at higher CHA<inf>2</inf>DS<inf>2</inf>-VA scores. Direct oral anticoagulants (DOACs) reduce intracranial haemorrhage compared to vitamin K antagonists (VKAs), and meta-analyses of randomized trials showed further reduction in stroke and mortality with DOACs, including in the elderly and chronic kidney disease. VKAs are preferred in patients with mechanical heart valves, mitral stenosis, antiphospholipid syndrome and Child-Turcotte-Pugh C cirrhosis. Modifiable bleeding risk factors should be assessed periodically and mitigated. These include anti-inflammatory drugs, antiplatelet therapy, drug interactions, excessive alcohol consumption, uncontrolled hypertension, diabetes, risk factors for gastrointestinal bleeding, major organ dysfunction and frailty. There are very few contraindications to OAC and most are relative or temporary conditions. Follow-up involves reassessing adherence, thrombotic and bleeding risk, co-medication and dosing. Integrated patient-centred AF management additionally involves risk factor management, symptom control and dynamic reassessment. Lifelong OAC is currently recommended, but recent data suggested that discontinuing OAC after successful catheter ablation of AF and/or left atrial appendage closure could be safe. OAC in specific settings is discussed, including cardioversion, catheter ablation, surgery, post-operative AF, elderly patients, pregnancy and bleeding. Conclusion(s): OAC is the cornerstone of thromboembolism prevention in AF, but knowledge gaps remain, including on risk stratification, device-detected AF, trigger-induced AF, cardioversion, OAC resumption after major bleeding, and potential safety of OAC discontinuation after successful catheter ablation or left atrial appendage occlusion. Copyright © 2026 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation. <54> Accession Number 2045292597 Title Implementation of quality of care in heart failure and in predisposing conditions. Source European Heart Journal - Quality of Care and Clinical Outcomes. 12(3) (pp 285-286), 2026. Date of Publication: 01 May 2026. Author Mascolo C.; Pasotti B.; Piepoli M. Institution (Mascolo) Cardiology University Department, IRCCS Policlinico San Donato, Via Morandi, Milan, Italy (Pasotti) Cardiology University Department, IRCCS Policlinico San Donato, Via Morandi, Milan, Italy (Piepoli) Cardiology University Department, IRCCS Policlinico San Donato, Via Morandi, Milan, Italy (Piepoli) Department of Cardiovascular Prevention, University of Wroclaw, Wroclaw, Poland Publisher Oxford University Press <55> Accession Number 2044968856 Title The Effect of Preoperative Oral Carbohydrate Loading on Insulin Resistance in Adult Patients Undergoing On-Pump Cardiac Surgery: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 228-236), 2026. Date of Publication: 01 Apr 2026. Author Nur R.F.; Synthana M.R.; Kurnia Y.; Rudiarto K.M.; Alicia R.J.; Kurniawaty J.; Pratomo B.Y.; Deviatika F.E. Institution (Nur, Synthana, Kurniawaty, Pratomo) Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (Kurnia) Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (Rudiarto) Nutrition Installation, Dr. Sardjito Hospital, Yogyakarta, Indonesia (Alicia, Deviatika) Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia Publisher Wolters Kluwer Medknow Publications Abstract Background: Preoperative oral carbohydrate loading has been shown to reduce insulin resistance in various surgical fields, but its effect in cardiac surgery remains uncertain. This study aimed to evaluate whether preoperative carbohydrate loading can reduce insulin resistance in adults undergoing on-pump cardiac surgery. Method(s): A randomized controlled trial was conducted at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Fifty adults scheduled for elective cardiac surgery (January-May 2024) were randomized to receive either 400 mL of a 12.5% maltodextrin-based carbohydrate drink (CL group) or 400 mL of water 2 h before surgery (PL group). Blood glucose and insulin were measured at postinduction, 0 h, and 24 h postoperatively to calculate HOMA-IR, analyzed at a significance level of 0.05. Result(s): Blood glucose and HOMA-IR did not differ significantly between groups at any time point (all P > 0.05). Insulin was higher in the CL group than in the PL group at postinduction ((95%CI = -6.07 to - 0.42; P = 0.022)). In the PL group, insulin rose progressively (P < 0.05), while changes in the CL group were nonsignificant (P > 0.05). HOMA-IR increased from postinduction to 0 h in both groups (P < 0.05) but remained stable thereafter (P > 0.05). Conclusion(s): Preoperative oral carbohydrate loading did not significantly affect perioperative glucose or HOMA-IR in cardiac surgery. While insufficient to counteract the magnitude of CPB-induced insulin resistance, carbohydrate loading may modestly stabilize metabolic responses, as reflected by a flatter insulin trajectory. Copyright © 2026 Annals of Cardiac Anaesthesia. <56> Accession Number 2045678854 Title Perioperative oxygen therapy, oxidative stress, and cardiac outcomes. Source Minerva Anestesiologica. 92(4) (pp 316-327), 2026. Date of Publication: 01 Apr 2026. Author Dai Z.; Wang D.; Li J.; Li T.; Sui W. Institution (Dai, Li, Li) Department of Anesthesiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, Yantai, China (Wang) Department of Infectious Disease Prevention and Control, Laishan District Center for Disease Control and Prevention, Shandong, Yantai, China (Sui) Department of Anesthesiology, Weifang Traditional Chinese Medicine Hospital, Shandong, Weifang, China Publisher Edizioni Minerva Medica Abstract BACKGROUND: The optimal perioperative oxygen regimen remains clinically debated. As preclinical studies implicate oxidative pathways in cardiovascular pathophysiology, an evaluation of the oxygen, oxidative stress and cardiac outcome triad is therefore crucial for perioperative oxygen treatment. METHOD(S): A meta-analysis based on RCTs was conducted to reveal the impact of hyperoxia on oxidative stress indicators and cardiac complications compared with normoxia. Two-sample mendelian randomization (MR) analysis was conducted to investigate the influence of oxidative stress on cardiac complications. Trial sequential analysis (TSA) was performed to ascertain the necessary sample size and evaluate the reliability for definitive conclusions. RESULT(S): The meta-analysis revealed no significant differences in cardiac complications between hyperoxia and normoxia groups, including atrial fibrillation (AF; RR 1.06, 95% CI 0.89-1.27), myocardial infarction (MI; RR 0.73, 95% CI 0.45-1.20), myocardial injury (RR 1.02, 95% CI 0.81-1.28), arrhythmia (RR 0.92, 95% CI 0.72-1.26), and low cardiac output syndrome (LCOS; RR 0.84, 95% CI 0.49-1.44). Perioperative hyperoxia significantly increased intraoperative plasma total oxidant status (TOS; SMD 0.86, 95% CI 0.42-1.30) and F2-isoprostane levels (SMD 0.71, 95% CI 0.05-1.38). MR analysis demonstrated that uric acid (UA) was positively associated with MI (OR 1.0021, 95% CI 1.0009-1.0033), cardiovascular disease (CVD; OR 1.0012, 95% CI 1.0005-1.0020), and ischemic heart disease (IHD; OR 1.001, 95% CI 1.000-1.002), while CAT and GST showed negative associations with CVD (OR 0.97, 95% CI 0.95-0.99) and AF (OR 0.96, 95% CI 0.96-0.99), respectively. False discovery rate (FDR) adjustment confirmed causal links for UA with MI and CVD, and TSA validated adequate sample size for AF and MI conclusions. No significant differences were found on other complications. CONCLUSION(S): Based on the comprehensive evidence presented, including the equivalent safety profile of perioperative normoxia across organ systems, the significant increase in systemic oxidative stress associated with hyperoxia, and the MR-confirmed causal links between oxidative stress biomarkers and cardiovascular risks, is recommend as the preferred oxygenation strategy in perioperative caredue to the safety and potential cardiovascular benefits. Copyright © 2026 EDIZIONI MINERVA MEDICA. <57> Accession Number 2044968983 Title Comparison of Analgesic Efficacy of Intrathecal Morphine and Ultrasound-Guided Bilateral Erector Spinae Plane Block in Patients Undergoing Open Heart Surgery with Midline Sternotomy: An Open Label Randomized Control Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 212-218), 2026. Date of Publication: 01 Apr 2026. Author Karuppiah V.; Kumar R.; Mohammed S.; Chouan A.; Kamal M.; Chhabra S.; Sharma A. Institution (Karuppiah) Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India (Kumar, Mohammed, Chouan, Kamal, Chhabra) Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India (Sharma) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Intrathecal morphine (ITM) and erector spinae plane block (ESPB) decrease postoperative pain in standard cardiac surgery. In this study, we compared the analgesic efficacy of ITM and B/L ESPB in patients undergoing open heart surgeries. Method(s): After approval from the institutional ethics committee and written informed consent from patients scheduled for open heart surgeries, they were randomized into two groups: Group ITM patients received ITM (5 mcg/kg), whereas Group ESPB patients received bilateral ESP block (0.3 mL/kg of 0.5% ropivacaine on either side). The primary outcome was to compare postoperative fentanyl consumption during the first 24 hours of ICU stay after extubation. Secondary outcomes were postoperative VAS at rest and on cough during the first 24 hours, pre- and postoperative pulmonary function, and number of rescue analgesics. Quantitative variables were presented as mean (SD) or median (IQR). Categorical variables were expressed as numbers or percentages. Spirometry variables were compared over time between the groups using Friedman test. Result(s): The ITM group had significantly less median fentanyl consumption compared to the ESPB group during the first 24 hours postoperative period [0 (0-75) mug vs. 234 (160-336) mug (95% CI, 171.65, 255.38); P < 0.001]. The VAS score at rest and during cough was significantly better in the ITM group. FEV1 and FVC reduced postoperatively in both groups with significantly better values in the ITM group. Conclusion(s): ITM administered prior to induction provides superior postoperative analgesia compared to bilateral ESPB in patients undergoing open-heart surgery. It significantly reduces opioid requirements, improves patient satisfaction, and enhances postoperative pulmonary function. Copyright © 2026 Annals of Cardiac Anaesthesia. <58> Accession Number 2045748442 Title Frailty Response in Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Implantation (FRAIL-AS Response Trial): Study Protocol for a Cluster Randomised Controlled Trial. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Straiton N.; Muller D.W.M.; Macdonald P.; Wilson K.; Arriagada A.; Roy D.; Mills N.; Frost S.A.; McInnes E.; Inglis S.C.; Lauck S.; Herrero M.; Dolja-Gore X.; McCreanor V.; Harrison S.; Holman T.; Ferguson C.; McDonagh J.; Wan C.S.; Dale S.; Fasugba O.; Middleton S. Institution (Straiton, McInnes, Holman, Dale, Fasugba, Middleton) Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, Sydney, NSW, Australia (Straiton, McInnes, Holman, Dale, Fasugba, Middleton) School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, NSW, Australia (Straiton, Muller, Macdonald, Roy, Mills, McInnes, Holman, Dale, Middleton) St Vincent's Hospital, Sydney, NSW, Australia (Muller, Macdonald, Arriagada, Roy, Mills) St Vincent's Private Hospital, Sydney, NSW, Australia (Muller, Macdonald, Mills) School of Medicine, University of New South Wales, Sydney, NSW, Australia (Macdonald) Victor Chang Cardiac Research Institute, Sydney, NSW, Australia (Wilson) St Thomas' Hospital London, London, United Kingdom (Roy) University of Notre Dame, Sydney, NSW, Australia (Frost, Ferguson, McDonagh) Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia (Inglis, Herrero) Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia (Lauck) School of Nursing, University of British Columbia, BC, Canada (Herrero) John Hunter Hospital, Newcastle, NSW, Australia (Dolja-Gore, McCreanor) Hunter Medical Research Institute, Newcastle, NSW, Australia (Dolja-Gore, McCreanor) School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia (Harrison) The George Institute for Global Health, Sydney, NSW, Australia (Ferguson, McDonagh) Centre for Chronic and Complex Care Research, Blacktown Hospital, Sydney, NSW, Australia (Wan) School of Translational Medicine, Monash University, Melbourne, VIC, Australia Publisher Elsevier Ltd Abstract Background & Aim: Aortic stenosis (AS) is a common valvular heart disease in older adults, affecting up to one in eight people over 65 years. Transcatheter aortic valve implantation (TAVI) offers a less invasive alternative surgical aortic valve replacement. However, approximately 30% of TAVI patients are frail, placing them at greater risk of complications and poorer outcomes post procedure. Despite this, evidence-based strategies to manage frailty in TAVI care remain limited. The FRAIL-AS Response Trial aims to implement and evaluate an evidence-based Frailty Response Program to improve care and outcomes for adults with AS and frailty undergoing TAVI. Method(s): We plan a multicentre, cluster-randomised controlled trial with embedded process evaluation being conducted in hospitals and their respective TAVI programs across Australia. Hospitals will be randomised 1:1 to the Frailty Response Program (intervention) or standard care (control). The intervention comprises: (1) a Frailty Response Clinical Protocol focusing on nutritional screening, patient frailty education, General Practitioner (GP) notification of patient's frailty classification, referrals for cardiac rehabilitation and geriatrician review; and (2) an Implementation Strategy informed by the Theoretical Domains Framework, incorporating meetings to determine local barriers and solutions, clinician education, local clinical champions, audit and feedback, action plans and remote facilitation. The primary outcome is the proportion of frail AS patients scheduled for TAVI receiving nutritional screening after frailty identification. Secondary outcomes are patient outcomes (as per the Valve Academic Research Consortium 3 endpoints), processes of care (frailty information provision, GP notifications, referrals for cardiac rehabilitation and geriatrician review) and implementation outcomes (intervention acceptability, feasibility and fidelity). Conclusion(s): The FRAIL-AS Response Trial will determine whether addressing frailty in older adults with AS undergoing TAVI enhances evidence-based care, reduces complications, and improves patient outcomes. If effective, the FRAIL-AS Response Program may provide a scalable, evidence-based model for managing patients with heart valve disease and frailty undergoing transcatheter procedures. Copyright © 2026 The Author(s) <59> Accession Number 648808410 Title Effectiveness of the Preschool Children eHealth Cardiac Rehabilitation Program After Congenital Heart Surgery: A Randomised Controlled Trial. Source Journal of advanced nursing. 82(6) (pp 6857-6871), 2026. Date of Publication: 01 Jun 2026. Author Luo W.; Chen L.; Cai X.; Yang Z.; Deng H.; Xu Y.; Hickey P.; Zhang Y. Institution (Luo, Yang, Deng) Department of Nursing, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Luo, Chen, Cai) Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Xu) Department of Rehabilitation, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Hickey) Cardiovascular, Boston Children's Hospital, Boston, MA, United States (Zhang) Editorial Department of Journal of Shanghai Jiao Tong University (Medical Science), Shanghai, China Abstract AIM(S): To develop the Preschool Children eHealth Cardiac Rehabilitation programme based on the Interaction Model of Client Health Behaviour, and to evaluate its effects on children after congenital heart surgery. DESIGN: A parallel two-arm randomised controlled trial was conducted. METHOD(S): A total of 84 participants were recruited from July 2022 to June 2023 and randomly assigned to either the intervention group (n = 40) or control group (n = 44). The intervention group participated in a 3-month eHealth Cardiac Rehabilitation programme, while the control group received routine care. Outcomes were measured at baseline, 3 months post baseline (intervention endpoint), and 6 months post baseline. Eighty participants completed the study. RESULT(S): Compared to the intervention group, the control group demonstrated significantly worse outcomes at both 3 and 6 months, including a higher risk of heart failure, lower left ventricular ejection fraction scores, and shorter 6-min walk distance tests. The intervention group engaged in significantly more vigorous physical activity. Significant between group differences were also observed in parental knowledge, attitudes, behaviours and trust levels. Additionally, the proportion of parents experiencing anxiety decreased significantly more in the intervention group by 6 months post baseline. CONCLUSION(S): This pioneering eHealth programme transforms home-based rehabilitation for preschool children with congenital heart disease, addressing a critical gap in accessible and long-term paediatric cardiac rehabilitation care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The use of eHealth programmes is valuable for improving paediatric cardiac rehabilitation by empowering parents, enhancing care continuity, and reducing barriers to accessing specialised services in paediatric care, especially in areas with limited medical resources. IMPACT: This study establishes the first validated eHealth framework for family-centred cardiac rehabilitation in preschool children following congenital heart surgery, addressing the critically low uptake of previously home-based rehabilitation. It also provides clinicians with a scalable solution for delivering care in underserved regions lacking access to specialised cardiac services. REPORTING METHOD: This study adhered to the CONSORT checklist guidelines for reporting randomised controlled trials. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting. TRIAL AND PROTOCOL REGISTRATION: This study was a randomised controlled clinical trial. The research protocol was registered with the China Clinical Trial Registration Center (registration number: ChiCTR2200062022; https://www.chictr.org.cn/showproj.html?proj=174261). Copyright © 2025 John Wiley & Sons Ltd. <60> Accession Number 2045634068 Title What factors are associated with work after cardiothoracic transplant? A systematic review. Source Transplantation Reviews. 40(3) (no pagination), 2026. Article Number: 101025. Date of Publication: 01 Jul 2026. Author Tomic D.; Khillan A.; Hopper I.; Mobarki Y.; O'Dwyer M.; MacFarlane E.; Paraskeva M.; Patel H.; Walker-Bone K.; Keegel T. Institution (Tomic, Mobarki, O'Dwyer, MacFarlane, Walker-Bone, Keegel) Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Khillan) Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, VIC, Australia (Hopper, Patel) Cardiology Department and General Medical Unit, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Hopper) School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Paraskeva) Department of Respiratory Medicine, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Paraskeva) Medicine Alfred Hospital, Monash University, Melbourne, VIC, Australia (Patel) Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, VIC, Australia (Keegel) Heart and Lung Transplant Trust, PO Box 25036, Melbourne, VIC, Australia Publisher Elsevier Inc. Abstract Cardiothoracic transplantation is a lifesaving intervention for end-stage cardiopulmonary disease, however true recovery requires comprehensive social reintegration, including the opportunity for work participation. This systematic review (PROSPERO CRD42025634363) reports rates of work and characterises factors associated with working post-cardiothoracic transplant. Research questions were informed through consultation with the cardiothoracic transplant community and guided by a work and health perspective. Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, Web of Science, PsycINFO) were searched for studies published 2000-2024. Quantitative and mixed-methods studies reporting post-transplant work outcomes were included. Screening, data extraction, and risk of bias assessment were conducted independently by two reviewers, with discrepancies resolved by consensus. Thirty-five manuscripts, representing 32 unique studies and 23,511 cardiothoracic transplant recipients (12,062 heart; 11,400 lung; 49 heart and lung), were included. Post-transplant employment rates at one year were 22-44% for heart and 28% for lung transplant recipients. At five years, 29.4-30% heart and 48% lung transplant recipients were employed. Return-to-work rates varied widely (heart 28-88%; lung 18-83%), with median time to return ranging from 5 to >31 months. Factors associated with higher work participation included pre-transplant employment, younger age, higher education, and male sex. Lower participation was associated with post-transplant complications, fatigue, and depression. Other work-related outcomes including work ability, absenteeism, and employer support were inconsistently reported. Methodological limitations were common, particularly reliance on self-reported, unvalidated work outcome measures and heterogeneous follow-up time points. Addressing modifiable determinants through targeted interventions is critical to improving work participation among cardiothoracic transplant recipients. Copyright © 2024 <61> Accession Number 2045495810 Title Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial. Source European Urology. (no pagination), 2026. Date of Publication: 2026. Author Brassetti A.; Tuderti G.; Anceschi U.; Bove A.M.; Bologna E.; Capecchi L.; Chiacchio G.; D'annunzio S.; Ferriero M.; Flammia R.S.; Guaglianone S.; Iuculano S.; Denaro C.; Luzio A.D.; Leonardo C.; Licari L.C.; Mastroianni R.; Misuraca L.; Proietti F.; Sperduti I.; Simone G. Institution (Brassetti, Tuderti, Anceschi, Bove, Bologna, Capecchi, Chiacchio, D'annunzio, Ferriero, Flammia, Guaglianone, Iuculano, Denaro, Luzio, Leonardo, Licari, Mastroianni, Misuraca, Proietti, Simone) Uro-Oncology Program, IRCCS Regina Elena National Cancer Institute, Rome, Italy (Sperduti) Clinical Trial Center-Biostatistics & Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy Publisher Elsevier B.V. Abstract Background and objective The sutureless (SL) purely off-clamp robotic partial nephrectomy (ocRPN) technique has been proposed to minimize postoperative functional damage. We assessed whether this approach is noninferior to renorrhaphy (RR) in terms of surgical quality. Methods Patients with cT1-2N0M0 renal tumors were randomly assigned to SL or RR-ocRPN within a single-center, single-surgeon randomized controlled trial (NCT06846112). A covariate-adaptive 1:1 randomization algorithm ensured balance between treatment arms for age, sex, baseline renal function, and tumor surgical complexity. The primary endpoint was Trifecta achievement at discharge. A prespecified noninferiority test (margin -10%) compared Trifecta rates using one-sided testing and confidence intervals. Secondary outcomes were descriptively analyzed and compared between study arms. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. Key findings and limitations Among 248 patients, baseline characteristics were balanced. Trifecta was achieved in 93% and 95% of cases (absolute difference -2.4%; 90% confidence interval [CI] -7.4%-2.6%), meeting the criterion for noninferiority (one-sided p = 0.006). Blood transfusions (2.4% vs 0%) and acute kidney injury (1.6% in both groups) were rare. Nine urinary fistulae occurred overall, all managed with temporary stenting; rates were higher in the SL group but not statistically significant ( p = 0.08). Renal function remained stable up to 12 mo, and 1-yr RFS was 99% in all cohorts. Limitations include single-center design, surgeon expertise, and short oncologic follow-up. Conclusions and clinical implications SL-ocRPN is safe and effective and represents a feasible alternative to RR-ocRPN in selected cT1-2N0M0 renal tumors. Copyright © 2026 The Author(s). <62> [Use Link to view the full text] Accession Number 2039721450 Title Donor Simvastatin Treatment in Heart Transplantation: 5-y Results of SIMVA Trial. Source Transplantation. 110(5) (pp e1158-e1160), 2026. Date of Publication: 01 May 2026. Author Holmstrom E.; Syrjala S.O.; Dhaygude K.; Krebs R.; Helantera I.; Lommi J.; Nykanen A.I.; Lemstrom K.B. Institution (Holmstrom, Syrjala, Dhaygude, Krebs, Nykanen, Lemstrom) Transplantation Laboratory, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Holmstrom, Syrjala, Nykanen, Lemstrom) Department of Cardiothoracic Surgery, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland (Helantera) Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland (Lommi) Department of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland Publisher Lippincott Williams and Wilkins <63> Accession Number 2045301602 Title Association of the prognostic nutritional index and geriatric nutritional risk index with clinical outcomes in patients undergoing coronary artery bypass surgery: a systematic review and meta-analysis. Source Journal of Thoracic Disease. 18(4) (no pagination), 2026. Article Number: 319. Date of Publication: 30 Apr 2026. Author Gao Y.; Hou W.; Ma Y.; Xu Z. Institution (Gao, Hou, Ma, Xu) Department of Cardiothoracic Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an, China Publisher AME Publishing Company Abstract Background: The association between preoperative prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) and clinical outcomes in patients receiving coronary artery bypass surgery (CABG) remains unclear now. This study aimed to clarify the associations of the PNI and the GNRI with clinical outcomes among patients who underwent CABG. Method(s): The PubMed, Embase, and Web of Science databases were searched up to July 11, 2025. Studies that investigated the relationships between the PNI and GNRI and clinical outcomes, such as long-term and short-term mortality and postoperative complications, were included. Odds ratios (ORs) with 95% confidence intervals (CIs) were combined. Result(s): Twenty-one observational cohort studies involving 14,523 patients undergoing CABG were included in this meta-analysis. Most studies were retrospective in design, and follow-up periods ranged from in-hospital outcomes to long-term mortality. For PNI, the pooled results demonstrated that a lower PNI was related to an increased risk of long-term mortality (OR =0.91, P<0.001), short-term mortality (OR =0.88, P=0.01), acute kidney injury (AKI) (OR =0.73, P=0.009), major adverse cardiac and cerebrovascular events (OR =0.774, P<0.001), atrial fibrillation (OR =0.92, P=0.02), neurologic complications (OR =0.61, P=0.041), hemorrhage (OR =0.123, P=0.025), hospital-acquired infection (OR =0.472, P<0.001), and intra-aortic balloon pump use (OR =0.372, P<0.001), but the PNI was not associated with the risk of postoperative overall complications (P=0.13) or pulmonary complications (P=0.663). Only three studies evaluated GNRI. The GNRI was only associated with the risk of short-term mortality (OR =0.91; P=0.03), and no significant relationship between the GNRI and AKI (P=0.42) or major adverse cardiac or cerebrovascular events (OR =0.195) was observed. Conclusion(s): Based on the current evidence, the PNI was associated with clinical outcomes in patients who underwent CABG, and lower PNI indicated increased risk of postoperative mortality and complications. Copyright © AME Publishing Company. <64> Accession Number 2045496576 Title Short-Term, Weight-Adjusted Colchicine to Prevent Post-CABG Arrhythmias: A Randomized, Double-Blind, Controlled Trial. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Farzaneh A.H.; Abbaspour H.; Habibi V.; Sadraei S.J.; Darayi M.; Moradi S.; Nataj A.H. Institution (Farzaneh, Abbaspour) Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Habibi, Sadraei, Darayi) Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Moradi) Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Nataj) Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Postoperative arrhythmias are common after coronary artery bypass graft (CABG) surgery and are linked to adverse outcomes. Colchicine, an anti-inflammatory agent, has shown inconsistent results in prior studies, possibly due to dosing and timing variations. Objective(s): To evaluate the efficacy and safety of short-term, weight-adjusted colchicine initiated preoperatively for preventing postoperative arrhythmias after CABG. Method(s): In this randomized, double-blind, placebo-controlled trial, 172 adults scheduled for on-pump CABG received colchicine or placebo. The regimen included a preoperative loading dose (1 mg twice daily) followed by a weight-based maintenance dose (0.5 mg daily if <70 kg; 1 mg daily if >=70 kg) for 14 days. The primary outcome was incidence of postoperative atrial fibrillation (POAF). Secondary outcomes included early (<=48 h) and late (>48 h) POAF, other arrhythmias, inflammatory markers (CRP, ESR), length of stay, and adverse events. Result(s): Of 163 analyzed patients (81 colchicine, 82 placebo), POAF incidence was significantly lower in the colchicine group (17.3% vs. 46.3%; RR 0.37, 95% CI 0.21-0.66; p < 0.001), with an absolute risk reduction of 29.0% and number needed to treat (NNT) of 4. Colchicine reduced both early and late POAF (p < 0.001 and p = 0.002). No significant reduction was seen in other arrhythmias. Gastrointestinal events, primarily diarrhea, were more common with colchicine (25.9% vs. 8.5%, p = 0.003), but were manageable and without serious adverse events. Conclusion(s): Short-term perioperative weight-adjusted colchicine is effective and safe for preventing POAF after CABG, with a low NNT and manageable side effects, though it did not significantly affect other arrhythmias. Trial Registration: Iranian Registry of Clinical Trials, IRCT20200328046886N6. Copyright © 2026 Wiley Periodicals LLC. <65> Accession Number 2045225025 Title Design and rational of the the PRACTICAL-HERO trial: A randomized trial of higher and lower doses of heparin vs placebo for elective diagnostic coronary angiography. Source American Heart Journal. 298 (no pagination), 2026. Article Number: 107441. Date of Publication: 01 Aug 2026. Author Lavi S.; Shadpour S.; Allen E.; Ogunsakin R.E.; Mehta S.R. Institution (Lavi, Shadpour, Allen) Division of Cardiology, London Health Sciences Centre, London, ON, Canada (Lavi, Ogunsakin) Department of Medicine, Western University, London, ON, Canada (Mehta) Department of Medicine, McMaster University and Hamilton Health Sciences, Population Health Research Institute, Hamilton, ON, Canada Publisher Elsevier Inc. Abstract Rationale Radial artery occlusion (RAO) and bleeding are the principal complications of transradial cardiac catheterization. Although unfractionated heparin (UFH) reduces RAO, it may increase bleeding risk; thus, the optimal balance between efficacy and safety remains uncertain. Primary hypothesis Among patients undergoing transradial coronary angiography, UFH (high-dose 50 U/kg or low-dose 25 U/kg) compared with placebo reduces RAO, assessed by Doppler ultrasound prior to discharge. Design Multicenter, randomized, controlled trial comparing high-dose UFH, low-dose UFH, and placebo. Patients undergo standardized radial hemostasis (30-minute compression followed by stepwise 20-minute release). Net clinical benefit defined as composite of RAO and hematoma >=5 cm. Clinical trial registration URL: www.clinicaltrials.gov ; Unique identifier: NCT04374799. Copyright © 2026 The Author(s). <66> Accession Number 2040069183 Title Half-Dose Anticoagulation versus Antiplatelet Therapy to Reduce Silent Cerebral Embolism after Left Atrial Appendage Occlusion (HALO-SCE Study): Rationale and Design of a Randomized Clinical Trial. Source Cerebrovascular Diseases. 55(3) (pp 394-399), 2025. Date of Publication: 15 Jul 2025. Author Wang K.; Shi L.; Ruan Z.; Jin C.; Li M.; Liu H.; Chen H.; Ju W.; Chen M. Institution (Wang, Jin, Li, Liu, Chen, Ju, Chen) Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China (Shi) Department of Cardiology, Affiliated Hospital of Nantong University, Nantong, China (Ruan) Department of Cardiology, Taizhou People's Hospital, Taizhou, China Publisher S. Karger AG Abstract Abstract - Introduction: Patients with atrial fibrillation (AF) continue to face thrombotic risks even after the left atrial appendages have been occluded, which may manifest as silent cerebral embolisms (SCEs). Half-dose anticoagulation (Hd-OAC) is a pathophysiologically more reasonable therapy in addressing this issue than antithrombotic therapy, but it still lacks strong evidence. Method(s): The trial (NCT05671276) is a multicenter, randomized controlled trial comparing the efficacy of two antithrombotic strategies (Hd-OAC therapy vs. standard antithrombotic therapy) in AF patients after left atrial appendage occlusion (LAAO). The primary endpoint is the incidence of newly detected SCEs on any magnetic resonance imaging conducted during the follow-up period. The secondary endpoints are: (1) more than two new SCEs during the follow-up, their size, and distribution; (2) cognitive function, and (3) a composite endpoint of all-cause mortality, clinical thromboembolic events, and major bleeding events. Follow-up is scheduled at 90 +/- 15 days, 180 +/- 15 days, and 365 +/- 15 days after LAAO. Conclusion(s): This trial aimed to determine whether Hd-OAC therapy can reduce the incidence of SCE and protect cognitive function in patients who have successfully undergone LAAO, compared to standard antithrombotic therapy. Copyright © 2025 S. Karger AG, Basel <67> Accession Number 2035000001 Title Comparison of left atrial appendage occlusion with medical treatment for non-valvular atrial fibrillation: systematic review, network and reconstructed individual patient data meta-analysis. Source Clinical Research in Cardiology. 115(6) (pp 955-964), 2026. Date of Publication: 01 Jun 2026. Author Lerman T.T.; Hershenson R.; Greenberg N.; Kheifets M.; Talmor-Barkan Y.; Codner P.; Perl L.; Witberg G.; Rotholz A.; Vons S.; Orvin K.; Eisen A.; Belkin D.; Fishman B.; Golovchiner G.; Kornowski R.; Levi A. Institution (Lerman, Hershenson, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Rotholz, Vons, Orvin, Eisen, Golovchiner, Kornowski, Levi) Department of Cardiology, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel (Lerman, Hershenson, Greenberg, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Rotholz, Vons, Orvin, Eisen, Belkin, Fishman, Golovchiner, Kornowski, Levi) The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Greenberg) Department of Internal Medicine F-Recanati, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel (Fishman) University of Pittsburgh Medical Center, Pittsburgh, PA, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Percutaneous left atrial appendage occlusion (LAAO) is a non-pharmacological strategy to prevent stroke and systemic emboli in patients with non-valvular atrial fibrillation (AF). However, data regarding its safety and efficacy profile compared to different oral anti-coagulant regimens remain limited. Method(s): A network meta-analysis compared LAAO, warfarin, and NOACs (standard dose [SD] and low-dose [LD]). Outcomes included all-cause mortality, stroke or systemic embolism, and bleeding risk. Bayesian models with surface under the cumulative ranking curve (SUCRA) and reconstructed individual patient data (IPD) were utilized. Result(s): Twelve studies, including eight randomized controlled trials, were analyzed (13,049 patients with LD NOAC, 29,513 with SD NOAC, 29,611 with warfarin, and 2811 with LAAO). Warfarin was inferior for all-cause mortality compared to LAAO (OR 1.44 [95% CrI; 1.07-1.89]), LD NOAC (OR 1.13 [95% CrI; 1.01-1.26]), and SD NOAC (OR 1.11 [95% CrI; 1.02-1.20]). SUCRA analysis ranked SD NOAC as the most effective for stroke or systemic emboli prevention, LD NOAC as the most effective in preventing major bleeding and LAAO in preventing hemorrhagic stroke. Conclusion(s): SD NOACs were the most effective for preventing stroke or systemic embolism, while LD NOACs were the safest in terms of major bleeding. LAAO was comparable to NOACs and superior to warfarin in both safety and efficacy. Further studies are needed to clarify LAAO's role in the management of atrial fibrillation. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2025. <68> Accession Number 2045227851 Title Acoramidis, Serum Transthyretin, and Cardiovascular Outcomes in Transthyretin Amyloid Cardiomyopathy: Insights From the ATTRibute-CM Trial. Source Journal of Cardiac Failure. 32(5) (pp 864-876), 2026. Date of Publication: 01 May 2026. Author Ambardekar A.V.; Sarswat N.; Wright R.; Berk J.; Davis M.K.; Garcia-Pavia P.; Gillmore J.D.; Grodin J.L.; Mitchell J.D.; Mooney D.; Nativi-Nicolau J.; Poulsen S.H.; Ruberg F.L.; Chen C.; Ji A.; Siddhanti S.; Tamby J.; Castano A.; Katz L.; Sinha U.; Fox J.C.; Maurer M.S.; Cheng R.K. Institution (Ambardekar) Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, United States (Sarswat) Division of Cardiovascular Medicine, University of Chicago Medicine, Chicago, IL, United States (Wright) Cedars' Sinai Pacific Heart Institute, Santa Monica, CA, United States (Berk) Boston University, Boston, MA, United States (Davis) Division of Cardiology, University of British Columbia, Vancouver, Canada (Garcia-Pavia) Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, CIBERCV, Madrid, Spain, and Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain (Gillmore) National Amyloidosis Centre, Division of Medicine, University College London, Royal Free Hospital, London, United Kingdom (Grodin) Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States (Mitchell) Cardiovascular Division, Washington University School of Medicine in St. Louis, St. Louis, MO, United States (Mooney) Providence Center for Advanced Heart Disease & Transplantation, Spokane, WA, United States (Nativi-Nicolau) Division of Advanced Heart Failure and Heart Transplantation, Mayo Clinic, Jacksonville, FL, United States (Poulsen) Department of Internal Medicine, Division of Cardiology, Haderslev Hospital, Haderslev, Denmark (Ruberg) Section of Cardiovascular Medicine, Department of Medicine, Amyloidosis Center, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, United States (Chen, Ji, Siddhanti, Tamby, CastaNO, Katz, Sinha, Fox) BridgeBio Pharma, Inc., San Francisco, CA, United States (Maurer) Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States (Cheng) University of Washington Medicine, Seattle, WA, United States Publisher Elsevier B.V. Abstract Background Transthyretin amyloid cardiomyopathy (ATTR-CM) causes heart failure, often leading to death, and it may be associated with low serum transthyretin (sTTR) levels. Acoramidis, a near-complete (>=90%) TTR stabilizer, increases sTTR levels and has demonstrated clinical efficacy in ATTR-CM. This report evaluates the association between the acoramidis-related early change from baseline in sTTR (DELTATTR) and cardiovascular-specific outcomes. Methods The 611 participants in the phase 3 (ATTRibute-CM) trial (NCT03860935; Efficacy and Safety of Acoramidis in Participants With Transthyretin Amyloid Cardiomyopathy) (acoramidis [409], placebo [202]) received oral acoramidis hydrochloride (800 mg) or placebo twice daily. Outcomes through month 30 included time to cardiovascular mortality (CVM) or first cardiovascular-related hospitalization (CVH), CVM alone, DELTATTR (day 28 until month 30), and the association between early DELTATTR (at day 28) and cardiovascular risk, including a mediation analysis. Results Acoramidis reduced the risk of CVM or first CVH vs placebo (33.3% vs 48.5%; hazard ratio [HR] 0.62; 95% confidence interval [CI] 0.48-0.80; P < .001). A trend toward lower CVM with acoramidis was observed (14.9% vs 21.3%; HR 0.71; 95% CI 0.47, 1.05; P = .09). Cardiovascular benefits appeared to be mediated by acoramidis-induced DELTATTR (mean [standard error], 9.2 [0.25] mg/dL). Each 1- and 5-mg/dL increase in acoramidis-mediated early DELTATTR was associated with a 5.5% and 24.5% reduction in CVM and a 4.1% and 19.0% reduction in first CVH, respectively, over 30 months. Conclusions In ATTRibute-CM trial, acoramidis led to early DELTATTR, which mediated, in part, reduced risks of CVM and first CVH over 30 months. This suggests that sTTR may serve as a clinically informative biomarker for ATTR-CM cardiovascular risk assessment following stabilizer initiation. Tweet #Acoramidis led to an early increase in serum TTR (sTTR) that reduced risk of cardiovascular (CV) #mortality and first #CV-hospitalization over 30 months, suggesting that #sTTR may be a clinically informative biomarker after stabilizer initiation. @BridgeBioPharma Copyright © 2026 The Authors. <69> Accession Number 2044461435 Title Safety and efficacy of ultralow-dose fluoroscopy in left atrial appendage occlusion. Source Heart Rhythm O2. 7(5) (pp 912-919), 2026. Date of Publication: 01 May 2026. Author Demian J.; Younis A.; El Hajjar A.H.; Kanj M.; Saliba W.I.; Santangeli P.; Tabaja C.; Baranowski B.; Taigen T.L.; Bhargava M.; Wazni O.M.; Hussein A.A. Institution (Demian, Younis, El Hajjar, Kanj, Saliba, Santangeli, Tabaja, Baranowski, Taigen, Bhargava, Wazni, Hussein) Cardiac Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier B.V. Abstract Background Minimizing radiation exposure has become a growing priority in electrophysiology, with increasing adoption of zero- or minimal-fluoroscopy techniques. Little is known about left atrial appendage occlusion (LAAO) using ultralow-dose fluoroscopy. Objective This study aimed to assess the safety and efficacy of an ultralow-dose fluoroscopy strategy for LAAO. Methods In a prospectively maintained registry at our center, 46 patients underwent LAAO with ultralow-dose fluoroscopy using Watchman FLX devices (Boston Scientific, Minneapolis, MN). The ultralow-dose strategy was a priori planned for these patients with the goal of minimizing radiation exposure (total radiation exposure <10 mGy), while relying on transesophageal echocardiography guidance for device placement. The ultralow-dose fluoroscopy group was compared using propensity score matching with patients treated with standard fluoroscopy guidance (1:3 matching; n = 46 vs 138). Baseline characteristics, procedural metrics, and clinical outcomes were compared between groups. Results Procedural success was 100% in both groups, with significantly shorter procedural duration in the ultralow-dose group (42 vs 60 minutes; P < .001). Periprocedural adverse events were infrequent and did not differ significantly (none in ultralow dose vs 3 cases [2.2%] in standard dose; P = .6). Closure success at 45 days was high in both groups (97.8% vs 100%; P = .3). Device-related thrombus occurred in 1 ultralow-dose patient (2.2%)-with none in the standard group ( P = .3)-and resolved without sequelae with anticoagulation. The 1-year rate of ischemic stroke or systemic embolism was similarly low between groups, with 2 (4.3%) vs 3 events (2.2%), respectively ( P = .4). Conclusion Ultralow-dose fluoroscopy is a safe and effective, radiation-sparing strategy for LAAO. Copyright © 2026 Heart Rhythm Society. <70> Accession Number 2043840292 Title Conduction system pacing vs right ventricular pacing after TAVR: A systematic review and meta-analysis. Source Heart Rhythm O2. 7(5) (pp 887-899), 2026. Date of Publication: 01 May 2026. Author Deaconu A.; Alexandru Bistriceanu M.I.; Deaconu S.; Makdah O.; Ursu C.G.; Calin I.; Moldovan H.; Vatasescu R.G. Institution (Deaconu, Alexandru Bistriceanu, Makdah, Ursu, Moldovan, Vatasescu) Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Deaconu, Moldovan, Vatasescu) Department of Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Deaconu, Moldovan, Vatasescu) Emergency Clinical Hospital, Bucharest, Romania (Deaconu, Calin) Monza Ares Hospital, Bucharest, Romania Publisher Elsevier B.V. Abstract Background Conduction system pacing (CSP), including His bundle pacing and left bundle branch pacing, has emerged as a physiological alternative to right ventricular pacing (RVP) for patients developing conduction disturbances after transcatheter aortic valve replacement. Objective We performed a systematic review and meta-analysis to compare CSP with RVP. Methods PubMed, Embase, and Cochrane databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A random-effects model was used for all outcomes, and heterogeneity was assessed using I2 statistics. The protocol was registered in PROSPERO (CRD420251125169). Results 8 studies, including 784 patients, were analyzed. At 15-month follow-up, all-cause mortality did not differ significantly between CSP (left bundle branch pacing in 74%) and RVP (odds ratio 0.76; 95% confidence interval [CI] 0.51-1.14; P = .15; I2 = 0%). CSP was associated with a shorter paced QRS duration after implant (mean difference -34.6 ms; 95% CI -40.2 to -29.1; P < .001) and higher left ventricular ejection fraction (mean difference +5.4%; 95% CI 3.5-7.3; P = .003) at 15-month follow-up. Heart failure hospitalization at 15 months was associated with a reduction in CSP (odds ratio 0.44; 95% CI 0.27-0.72; P = .006), whereas cardiovascular mortality, sensing, impedance, and lead dislodgement were similar between pacing strategies. Conclusion These findings suggest that CSP provides more physiological ventricular activation and may improve functional outcomes after transcatheter aortic valve replacement without affecting overall survival. Further randomized studies are warranted to confirm these observations. Copyright © 2026 Heart Rhythm Society. <71> Accession Number 2043319148 Title The Society of Thoracic Surgeons (2025) Expert Consensus Document on Interventions for Screen-Detected Lung Nodules. Source Annals of Thoracic Surgery. 121(6) (pp 1283-1297), 2026. Date of Publication: 01 Jun 2026. Author Servais E.L.; Hayanga J.W.A.; Linden P.; Sood P.; Raymond D.P.; Antonoff M.B.; Chudgar N.P.; Keshava H.B.; Velotta J.B.; Crabtree T.; Jeffrey Yang C.-F.; Raz D.; Tong B.; Cooke D.T.; Erkmen C.P.; Shaller B.; Kent M.S.; McKee A.; Phan C.T.; Daly M.E.; Onaitis M.W.; Edwards J.P.; Yang S.C.; Merritt R.E.; Shrager J. Institution (Servais) Department of Thoracic Surgery, Lahey Hospital and Medical Center, Burlington, MA, United States (Servais) Department of Surgery, UMass Chan Medical School, Worcester, MA, United States (Hayanga) Department of Cardiovascular and Thoracic Surgery, Heart and Vascular Institute, West Virginia University Medicine, Morgantown, WV, United States (Linden) Division of Thoracic and Esophageal Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Sood) The Society of Thoracic Surgeons, Chicago, IL, United States (Raymond) Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States (Antonoff) Division of Surgery, Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States (Chudgar) Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, United States (Keshava) Division of Thoracic Surgery, Department of Surgery, University of California, Irvine, Irvine, CA, United States (Velotta) Divison of Thoracic Surgery, Kaiser Permanente, Oakland, CA, United States (Velotta) Department of Surgery, University of California, San Francisco School of Medicine, San Francisco, CA, United States (Velotta) Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States (Crabtree) Division of Cardiothoracic Surgery, Southern Illinois University Medical Center, Springfield, IL, United States (Jeffrey Yang) Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States (Raz) Division of Thoracic Surgery, City of Hope, Duarte, CA, United States (Tong) Division of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, United States (Cooke) Division of General Thoracic Surgery, University of California, Davis Health, Sacramento, CA, United States (Erkmen) Division of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States (Shaller) Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, United States (Kent) Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (McKee) Department of Radiation Oncology, Lahey Hospital and Medical Center, Burlington, MA, United States (Phan) Division of Pulmonary, Critical Care and Sleep Medicine, University of California, Davis Health, Sacramento, CA, United States (Daly) Department of Radiation Oncology, University of California, Davis Comprehensive Cancer Center, Sacramento, CA, United States (Onaitis) Department of Surgery, University of California, San Diego, La Jolla, CA, United States (Edwards) Section of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada (Yang) Division of Thoracic Surgery, Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, United States (Merritt) Division of Thoracic Surgery, The Ohio State Wexner Medical Center, Columbus, OH, United States (Shrager) Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States (Shrager) Veterans Affairs Palo Alto Health Care Center, Palo Alto, CA, United States Publisher Elsevier Inc. Abstract Background Computed tomographic (CT) lung cancer screening (LCS) reduces lung cancer-specific mortality and improves survival. We reviewed contemporary literature to develop consensus recommendations on perioperative quality standards for LCS programs to optimize outcomes. Methods The Society of Thoracic Surgeons (STS) Task Force on Lung Cancer Screening and STS Workforce on Evidence Based Surgery convened a multidisciplinary panel of thoracic surgeons, radiation oncologists, and interventional pulmonologists. A comprehensive literature review was conducted using the PICO (Population, Intervention, Comparisons, Outcome) framework. Consensus statements were developed through a modified Delphi process addressing: (1) preoperative biopsy and diagnostic surgical procedures, (2) acceptable rates of complications from diagnostic and therapeutic procedures, and (3) timing of intervention after a suspicious LCS finding, and the role of the multidisciplinary team in patient management. Consensus required >=75% agreement. Results The panel developed 23 consensus statements after 3 Delphi rounds; 20 achieved consensus in the first round. Surgery without tissue diagnosis was acceptable for carefully selected patients, favoring minimally invasive, parenchymal-sparing approaches. Pneumonectomy without diagnosis was unanimously rejected. Programs should track benign resection rates. Acceptable complication benchmarks included pneumothorax <5%, hemoptysis <2%, and mortality <1% for bronchoscopic biopsy; and surgical morbidity <10% and 30-day mortality <1%, per STS database standards. Definitive resection should occur within 12 weeks of the inciting imaging study. Multidisciplinary teams should include thoracic surgery, oncology, pulmonology, and radiology. Preoperative pulmonary rehabilitation and smoking cessation were emphasized. Conclusions This STS consensus defines perioperative quality standards for CT LCS programs, supporting shared decision-making, multidisciplinary care, and quality improvement. Copyright © 2026 The Society of Thoracic Surgeons. <72> Accession Number 2041969597 Title Artificial Intelligence in Pediatric Surgery: From Diagnostics and Preoperative Planning to Risk Stratification: A Comprehensive Review of Current Applications. Source European Journal of Pediatric Surgery. 36(3) (pp 174-183), 2026. Date of Publication: 01 Jun 2026. Author Gnatzy R.; Feng X.; Graefe D.; Deffaa O.J.; Lacher M. Institution (Gnatzy, Feng, Deffaa, Lacher) Department of Pediatric Surgery, Leipzig University, Leipzig, Germany (Graefe) Department of Pediatric Radiology, Leipzig University, Leipzig, Germany Publisher Georg Thieme Verlag Abstract Objective Artificial intelligence (AI) is increasingly explored in pediatric surgical care, yet its translation into diagnostics and preoperative planning lags behind adult surgery. Unlike prior reviews, this study provides a comprehensive synthesis across four domains, diagnostics, preoperative planning, risk stratification, and surgical error prevention, highlighting recent advances and unmet challenges. Methods A narrative review of PubMed/MEDLINE (2020-2025) identified peer-reviewed studies on AI in pediatric surgery. Eligible articles addressed one of the four domains and were assessed for methodology, clinical applicability, and relevance to pediatric surgical patients. Results Diagnostic imaging is the most advanced field, with deep learning models for fracture detection and bone age assessment achieving accuracies up to 95% and near-expert agreement, though external validation is scarce. Preoperative planning benefits from AI-driven segmentation, 3D reconstruction, and virtual reality, with reports of altered surgical strategy in up to 8% of oncology cases, but evidence of outcome benefit is limited. Risk models for appendicitis and congenital heart surgery often surpass clinical scores, yet fewer than 10% have undergone external validation. Tools for error prevention, such as intelligent checklists and workflow monitoring, remain at the proof-of-concept stage. Across domains, most studies are retrospective, single-center, and methodologically heterogeneous. Conclusion AI demonstrates tangible potential to improve pediatric surgical diagnostics, planning, and safety. However, translation into clinical practice requires multicenter pediatric datasets, prospective validation, and transparent, interpretable models. By consolidating the most recent evidence across four domains, this review outlines both the opportunities and critical gaps that should be addressed for safe and effective adoption. Copyright © 2026 Georg Thieme Verlag. All rights reserved. <73> Accession Number 2045712229 Title CytoSorb haemoadsorption in high-risk cardiac surgery: A focused review with proposed tiered patient selection. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Ohri S.K. Institution (Ohri) Department of Cardiac Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom Publisher SAGE Publications Ltd Abstract Cardiopulmonary bypass (CPB) activates a well-characterised systemic inflammatory response that contributes substantially to postoperative morbidity and mortality, particularly in high-risk patient subgroups. CytoSorb (CytoSorbents Corporation, Princeton, NJ) is a polystyrene-divinylbenzene copolymer haemoadsorption device capable of removing hydrophobic molecules of up to 55 kDa, including pro-inflammatory cytokines, myoglobin, bilirubin, and direct oral anticoagulants (DOACs) from whole blood during CPB. Whilst aggregate meta-analyses have not demonstrated consistent benefit across unselected surgical populations, subgroup analyses and targeted clinical series consistently identify meaningful benefit in high-risk phenotypes: infective endocarditis (IE), complex aortic surgery under hypothermic circulatory arrest, heart transplantation, emergency surgery in patients on antiplatelet or anticoagulant therapy, and patients developing vasoplegia or septic shock. This focused narrative review critically appraises the current evidence base, examines the mechanistic rationale, and proposes a clinically applicable patient-selection framework to guide rational integration of CytoSorb into high-risk cardiac surgical practice. Regulatory considerations including the recent United States Food and Drug Administration (FDA) De Novo denial for the related DrugSorb-ATR device are discussed in context. Copyright © The Author(s) 2026 <74> Accession Number 2045265849 Title Comparison of Fentanyl Versus Morphine-Ketamine-Lidocaine Infusion for Postoperative Pain Following Coronary Artery Bypass Grafting (CABG): A Randomized Clinical Trial. Source Journal of Critical and Intensive Care. 17(1) (pp 1-10), 2026. Date of Publication: 2026. Author Kashani S.; Sayyadi Nia M.; Tarbebar M.V.; Asoodeh I.Z.; Mahmoudi M.; Jandaghi A.; Jarineshin H. Institution (Kashani, Sayyadi Nia, Tarbebar, Asoodeh, Jarineshin) Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of (Mahmoudi) Department of Research and Technology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of (Jandaghi) Hormozgan University of Medical Sciences, Student Research Committee, Bandar Abbas, Iran, Islamic Republic of Publisher Society of Turkish Intensivists Abstract Aim: This study aimed to compare the effectiveness and safety of fentanyl infusion with a combination of morphine, ketamine, and lidocaine (multimodal analgesia) for postoperative pain management in patients undergoing coronary artery bypass grafting (CABG). Study Design: This randomized clinical trial was conducted from 2024 to 2025 and included 74 patients undergoing elective CABG at the study hospital. Patients received either fentanyl (500 microg/100 mL) or a combination of morphine (20 mg), ketamine (20 mg), and lidocaine (200 mg) diluted to 100 mL, administered as an infusion at 4 mL/h for the first 24 postoperative hours. Pain was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, 16, 20, and 24 hours after surgery. Additional recorded parameters included hemodynamic variables, respiratory depression, and the need for rescue analgesia. Result(s): Patients receiving fentanyl infusion demonstrated a statistically significant greater reduction in pain scores at 4 and 8 hours postoperatively compared to those receiving the multimodal regimen. However, at the remaining assessment times (1, 12, 16, 20, and 24 hours), no significant differences in pain intensity were observed. Over the full 24-hour period, both regimens provided comparable analgesia. Additionally, no significant differences were found between the groups regarding adverse effects or the need for rescue analgesia. Conclusion(s): Fentanyl infusion demonstrated greater efficacy in early postoperative pain control compared to the multimodal regimen; however, this benefit was of short duration. Over the first 24 hours following surgery, both strategies showed comparable efficacy and safety; therefore, both may be considered viable options for post-CABG analgesia. Copyright © 2026 Journal of Critical and Intensive Care by Kare Media. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. <75> [Use Link to view the full text] Accession Number 2040338519 Title Open-lung ventilation and mechanical power in thoracic surgery. Source European Journal of Anaesthesiology. 43(5) (pp 395-404), 2026. Date of Publication: 01 May 2026. Author Zorrilla-Vaca A.; Barbeta E.; Librero J.; Ferrando C. Institution (Zorrilla-Vaca, Barbeta, Librero, Ferrando) From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA (AZV), Department of Anesthesiology, Hospital Universitario Evaristo Garcia, Universidad del Valle, Cali, Colombia (AZV), Department of Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona (EBCF), Red de Investigacion en Servicios de Salud, Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona Spain (JL), Institut D'investigacio August Pi I Sunyer, Barcelona (CF) and CIBER de Enfermedades Respiratorias CIBERES, Instituto de Salud Carlos III, Madrid, Spain Publisher Lippincott Williams and Wilkins Abstract BACKGROUND - Individualisation of positive-end expiratory pressure (PEEP) is an open-lung ventilation strategy associated with better respiratory mechanics. Mechanical power has been associated with lung injury in critical care settings, but the interaction between optimisation of PEEP and mechanical power during one-lung ventilation (OLV) remains poorly understood.OBJECTIVE - This study aimed to determine the effect of individualisation of PEEP on mechanical power during OLV as well as to establish the association between mechanical power and postoperative pulmonary complications after thoracic surgery.DESIGN - This is a post hoc analysis of a multicentre randomised trial.SETTING - Operating rooms.PATIENTS - Thoracic surgery cases requiring OLV.INTERVENTION - Open-lung ventilation strategy (i.e. individualised PEEP titration based on respiratory compliance) versus standard PEEP. Mechanical power and its components were compared between both groups at five different time-points: two-lung ventilation (T0), baseline OLV (T1), 20 min after OLV (T2), end of OLV (T3) and before extubation (T4).MAIN OUTCOME MEASURES - Our primary outcome included a composite of postoperative pulmonary complications within 30 days after surgery. Multivariable mixed-effects logistic regressions were performed to assess associations between various thresholds of mechanical power and postoperative pulmonary complications.RESULTS - A total 1253 patients were included in this analysis, of which 635 received open-lung ventilation, and 618 received conventional ventilation. The median difference in mechanical power was higher in the open-lung ventilation group during OLV than in the control group at T2, T3 and T4: 1.39 [95% confidence interval (CI), 0.91 to 1.86] J min-1, 1.27 (95% CI, 0.79 to 1.75) J min-1 and 2.12 (95% CI, 1.60 to 2.63) J min-1, respectively. While the resistive component of mechanical power was associated with postoperative pulmonary complications [odds ratio (OR), 1.07 (95% CI, 1.01 to 1.13) per J min-1], the static component was protective [OR, 0.91 (95% CI, 0.85 to 0.98) per J min-1].CONCLUSION - Individualisation of PEEP during OLV leads to nonclinically significant higher levels of mechanical power compared with standard PEEP. Each component of mechanical power seems to have different interactions with the occurrence of postoperative pulmonary complications.TRIAL REGISTRATION - NCT03182062 Copyright © 2025 American Heart Association, Inc. <76> Accession Number 2045659247 Title Methemoglobin Formation Reflects Systemic Nitric Oxide Uptake: The Critical Role of Delivery Method-Results from Secondary Analysis of a Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Cenci S.; Gaonkar M.; Villalobos R.; Medeiros K.J.; Shetty N.; Nardini R.; Carroll R.W.; Bittner E.A.; Winkler T.; Yu B.; Lewandrowski K.B.; Ichinose F.; Arora P.; Berra L. Institution (Cenci, Villalobos, Medeiros, Shetty, Bittner, Winkler, Ichinose, Berra) Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States (Cenci, Medeiros, Shetty, Nardini, Yu, Ichinose, Berra) Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States (Gaonkar, Arora) Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, United States (Carroll) Division of Pediatric Critical Care, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States (Carroll, Bittner, Winkler, Yu, Lewandrowski, Ichinose, Berra) Harvard Medical School, Boston, MA, United States (Lewandrowski) Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Arora) Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, United States (Berra) Respiratory Care Department, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States Publisher W.B. Saunders Abstract Objectives: Methemoglobin (metHb) is routinely monitored as a safety marker during inhaled nitric oxide (NO) therapy but may also reflect systemic NO uptake. This study aims to investigate how different NO delivery systems influence metHb formation rates and systemic NO uptake. Design(s): Retrospective analysis of a randomized controlled trial. Setting(s): Single-center study at an academic institution. Participant(s): Adults undergoing cardiac surgery with preoperative signs/symptoms suggestive of endothelial dysfunction. Intervention(s): Patients received 80 parts-per-million (ppm) of NO for 24 consecutive hours to prevent postoperative kidney injury. NO was subsequently administered via cardiopulmonary bypass (CPB), mechanical ventilation (MV), and nasal cannula (NC). Systemic metHb formation and NO uptake rates were assessed and compared across different NO delivery methods. Measurements and Main Results: Data on metHb from 105 patients were analyzed. Median metHb levels were 0.6% during CPB, 2.1% during ICU MV, and 0.8% during NC administration. Duration of NO exposure significantly affected metHb levels (p < 0.001). The slope of metHb increase was higher during MV than during CPB (beta = 8.354 * 10-3 v beta = 3.738 * 10-3, p < 0.001), whereas metHb levels declined during NC with a negative slope compared with CPB (beta = -5.352 * 10-3 v beta = 3.738 * 10-3, p < 0.001). Estimated NO delivery rates were greater with MV than with CPB (median 25.1 v 8.2 mumol/min, p < 0.001). Conclusion(s): NO delivery modalities significantly influence metHb formation and systemic NO uptake. Monitoring biomarkers of NO uptake, such as metHb, may help optimize NO therapy beyond delivered concentration, particularly when extrapulmonary effects are desired. Copyright © 2026 Elsevier Inc. <77> Accession Number 2045682996 Title Prevalence of dysglycemia following paediatric cardiac surgery: a systematic review and meta-analysis. Source BMJ Paediatrics Open. 10(1) (no pagination), 2026. Date of Publication: 2026. Author Abera E.G.; Sime H. Institution (Abera) Department of Public Health, Jimma University, Oromia, Jimma, Ethiopia (Abera) Clinical Trial Unit, Jimma University, Oromia, Jimma, Ethiopia (Sime) King Faisal Hospital Rwanda, Kigali, Rwanda (Sime) Africa Health Science University, Kigali, Rwanda Publisher BMJ Publishing Group Abstract Background: Postoperative dysglycemia is a common but under-recognised complication in paediatric cardiac surgery, driven by physiologic stress, hormonal changes and cardiopulmonary bypass. Reported prevalence varies widely, and no meta-analysis has synthesised the evidence. Therefore, this study aimed to estimate the pooled prevalence of postoperative dysglycaemia and describe associated postoperative outcomes, such as intensive care unit (ICU) stay and mechanical ventilation duration. Method(s): We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines and the Joanna Briggs Institute (JBI) methodology for prevalence studies. Eligible studies included paediatric patients (<=18 years) undergoing cardiac surgery reporting postoperative dysglycaemia (hyperglycaemia or hypoglycaemia). A random-effects model was used to calculate pooled prevalence and 95%CIs, with logit transformation applied to prevalence proportions and heterogeneity assessed using I2 statistics. Subgroup analyses were performed by region/continent, study design, age group and glycaemic threshold. All included studies were critically appraised using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias 2 tool for randomised trials. The protocol was registered with PROSPERO (CRD420251161893). Result(s): 22 studies involving 3864 patients were included. The pooled prevalence of postoperative dysglycemia was 68.6% (95% CI 52.8 to 81.0), with hyperglycaemia accounting for most cases (71.2%) and hypoglycaemia observed in 8.1%. Prevalence was higher in Asia and North America (~75%) than in Europe (45.2%), though not statistically significant. Studies using lower hyperglycaemia thresholds (126-139 mg/dL) reported significantly the highest prevalence (82.3%, p<0.032). The pooled mean ICU stay among dysglycemic patients was 180.3 hours (95% CI 82.3 to 279.3), and mean mechanical ventilation duration was 94.6 hours (95% CI 5.2 to 184.1). Sensitivity analyses showed that no single study disproportionately influenced the overall pooled estimates, and no publication bias was detected. The certainty of evidence assessed using the GRADE approach was moderate for overall dysglycemia prevalence. Conclusion(s): Dysglycaemia is highly prevalent following paediatric cardiac surgery, particularly hyperglycaemia, with prolonged ICU and mechanical ventilation times observed among affected patients. These findings underscore the need for vigilant perioperative glucose monitoring, standardised definitions of dysglycaemia, and evidence-based glycaemic management protocols. Future multicentre studies are warranted to establish optimal glycaemic thresholds and evaluate targeted interventions to improve postoperative outcomes in this vulnerable population. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <78> Accession Number 651198857 Title Minimally invasive versus full sternotomy for combined aortic valve and proximal aortic surgery: a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 13 May 2026. Author Awad A.K.; Badran A.S.; El-Nasr A.S.A.; Moawad W.M.; Ahmed A.K.; Elghadban M.T.; Almehandi A.; Tabrizi N.S. Institution (Awad, Badran) Department of Cardiothoracic Surgery, Ain-Shams University, Cairo, Egypt (El-Nasr) Faculty of Medicine, October 6 University, Giza, Egypt (Moawad) Faculty of Medicine, Fayoum University, Egypt (Ahmed) Faculty of Medicine, Alzeaim AlAzhari University, Sudan (Elghadban) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Almehandi) Institute of Cardiovascular Science, University College London, London, United Kingdom (Tabrizi) Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States Abstract BACKGROUND: While minimally invasive cardiac surgery has gained widespread popularity, full sternotomy (FS) remains the standard approach, particularly for multi-component cardiac surgery due to concerns over restricted exposure and technical challenges with minimally invasive surgical (MIS) approaches. We sought to compare clinical outcomes in patients undergoing MIS approaches to full FS for combined aortic valve and aortic surgeries. METHOD(S): PubMed, Web of Science, Scopus, and Cochrane CENTRAL were systematically searched to identify studies comparing MIS to FS in patients undergoing combined aortic valve and aortic surgery. The primary endpoints were cardiopulmonary bypass time, cross-clamp time, operative time, and postoperative mortality. RESULT(S): A total of 1,114 patients from nine studies were analyzed. Compared to FS, MIS approach for combined aortic valve and aortic surgery demonstrated comparable cardiopulmonary bypass time (MD = -3.2 min; 95% CI: [-10.10, 3.68]; P = 0.36), cross-clamp time (MD = -1.4 min; 95% CI: [-7.17, 4.34]; P = 0.63), operative time (MD = 6.6 min; 95% CI: [-10.2, 23.4]; P = 0.45), operative mortality (RR = 0.56; 95% CI: [0.20, 1.52]; P = 0.25), and overall mortality at follow up (RR = 0.46; 95% CI: [0.07, 3.21]; P = 0.43). MIS was associated with a significantly shorter mechanical ventilation duration (MD = -3.9 h; 95% CI: [-5.89, -2.06]; P < 0.0001), hospital stay (MD = -1.2 days; 95% CI: [-2.01, -0.47]; P = 0.002), risk of re-exploration for any cause (RR = 0.47; 95% CI: [0.23, 0.97]; P = 0.04). There was no significant difference for ICU stay, stroke, atrial fibrillation, permanent pacemaker implantation, acute kidney injury, and sternal dehiscence between the two groups. CONCLUSION(S): Our meta-analysis suggests that MIS is a feasible alternative to FS for combined aortic valve and aortic surgeries in carefully selected patients at experienced centers, offering shorter recovery times with comparable operative and long-term mortality. TRIAL REGISTRY NUMBER: This meta-analysis was registered on PROSPERO. REGISTRATION NUMBER: CRD42024597960. Copyright © 2026. The Author(s). <79> Accession Number 2045268729 Title Feasibility and Effectiveness of a Multicomponent Exercise Program in Rural Post-Coronary Artery Bypass Grafting Patients. Source International Journal of Drug Delivery Technology. 16(30 Supplement) (pp 964-969), 2026. Date of Publication: 2026. Author Patil C.B.; Patil V.C. Institution (Patil) Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to be University, Karad, India (Patil) Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Deemed to be University, Karad, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Participation in cardiac rehabilitation (CR) after coronary artery bypass grafting (CABG) is associated with reduced morbidity and mortality [1, 2]. However, uptake in rural populations remains low due to access barriers [10]. Pragmatic, low-cost, multicomponent exercise programs may improve reach and outcomes in these settings. Objective(s): To determine the feasibility and effectiveness of an 8-week multicomponent exercise program on physiological outcomes in rural post-CABG patients. Method(s): In this parallel-group randomized controlled trial, 40 clinically stable adults enrolled between postoperative day 3 to day 15 following CABG from rural communities were randomized (1:1) to a multicomponent exercise program (intervention) or conventional CR (control). Feasibility outcomes included recruitment, retention, adherence, and adverse events. Effectiveness outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and resting respiratory rate (RR). Analyses included paired t-tests (within-group), independent t-tests (between-group), and ANCOVA adjusting for baseline values. Effect sizes (Cohen's d) and 95% confidence intervals (CI) were reported. Significance was set at p < 0.05. Result(s): Recruitment was 83.3% (40/48), retention 95% (38/40), and adherence 88.5% +/- 5.2, with no major adverse events. After adjustment, the intervention produced greater reductions than control in SBP (adjusted mean difference -9.5 mmHg; 95% CI -14.2 to -4.8; p < 0.001; d = 0.85), DBP (-7.2 mmHg; 95% CI -10.5 to -3.9; p < 0.001; d = 0.78), and RR (-2.8 breaths/min; 95% CI -4.1 to -1.5; p = 0.002; d = 0.65). Conclusion(s): A multicomponent exercise program is feasible, safe, and clinically effective for improving physiological parameters in rural post-CABG patients, supporting its use as an accessible CR model. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <80> Accession Number 2045485220 Title A Systematic Review and Expert Evaluation of Perioperative SGLT2 Inhibitor-Associated Ketoacidosis Case Reports. Source Acta Anaesthesiologica Scandinavica. 70(6) (no pagination), 2026. Article Number: e70254. Date of Publication: 01 Jul 2026. Author Snel L.I.P.; Li X.; Jamaludin F.; Siegelaar S.E.; Holleman F.; Vriesendorp T.M.; DeVries J.H.; Hoekstra J.B.L.; Preckel B.; van Raalte D.H.; Hermanides J.; Hulst A.H. Institution (Snel, Li, Preckel, Hermanides, Hulst) Department of Anesthesiology, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Snel, Holleman, van Raalte) Department of Internal Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Snel, Li, Preckel, Hermanides) Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands (Snel, van Raalte, Hulst) Amsterdam Cardiovascular Sciences Research Institute, VU University, Amsterdam, Netherlands (Li) Center for Cell Lineage and Development, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China (Jamaludin) Amsterdam Medical Library, Amsterdam UMC, Amsterdam, Netherlands (Siegelaar, DeVries, Hoekstra) Department of Endocrinology and Metabolism, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Siegelaar, Hulst) Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam UMC, Amsterdam, Netherlands (Vriesendorp) Department of Internal Medicine, Isala Hospital, Zwolle, Netherlands Publisher John Wiley and Sons Inc Abstract Introduction: The use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in the perioperative setting may lead to SGLT2i-associated postoperative ketoacidosis (SAPKA) in patients with type 2 diabetes (T2D). Therefore, cessation of this drug is recommended before surgery. We aimed to study reported cases to assess the causality of SGLT2i, identify common characteristics, potential risk factors, treatment and outcomes of SAPKA. Method(s): We conducted a systematic literature search to identify case reports of patients with metabolic acidosis and the presence of ketones who used SGLT2i in the perioperative setting. Case reports were summarised for common characteristics, assessed for quality and distributed to a panel of diabetes experts, who evaluated the likelihood of SAPKA using a questionnaire. Result(s): Ninety-three papers containing 128 case reports fulfilled the inclusion criteria. The expert panel found SAPKA to be 'likely' in 53 (41%), 'possible' in 38 (30%) and 'unlikely' in 27 (21%) cases; 10 cases (8%) could not be validated due to insufficient data or implausible timing. SAPKA was therefore considered likely or possible in 71% (91/128) of cases. Common factors identified in the SAPKA reports included a diagnosis of T2D mellitus (n = 115), impaired perioperative intake (n = 30) and insufficient insulin supplementation (n = 10). Treatment with insulin was effective, and ketoacidosis resolved in all surviving patients, although significant morbidity, including ICU admission, was reported in a substantial proportion of cases. Discussion(s): Confirming a SAPKA diagnosis is challenging due to the variable reporting quality and numerous confounding factors present during the perioperative period. Clinicians should remain aware of SAPKA given the increasing prevalence of SGLT2i use. Focusing on early recognition and treatment represents a potential alternative strategy to routine preoperative SGLT2i discontinuation, though this requires further prospective evaluation. Editorial Comment: This systematic review presents an overview and discussion of the many, to date, case reports of ketoacidosis thought to be associated with perioperative SGLT2 inhibitor treatment. Copyright © 2026 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. <81> Accession Number 2045655104 Title Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial. Source BMJ. 393 (no pagination), 2026. Date of Publication: 31 Mar 2026. Author Yuan X.; Li J.; Lei L.; Chen K.; Chu Q.; Feng W.; Xu F.; Yang Y.; Wang X.; Wang H.; Dong A.; Cheng Z.; Guo H.; Zhou T.; Chen X.; Ge J.; Zhang L.; Liu S.; Shen Z.; Wang J.; Wang Y.; Li W.; Hu S. Institution (Yuan, Chen, Chu, Feng, Wang, Wang, Xu, Liu, Yang, Hu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Li, Lei, Zhang, Li, Hu) National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Wang) Yunnan Fuwai Cardiovascular Hospital, Yunnan Province, Kunming City, China (Wang) General Hospital of Northern Theatre Command, Liaoning Province, Shenyang City, China (Dong) The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China (Cheng) Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou City, China (Guo) Guangdong Provincial People's Hospital, Guangdong Province, Guangzhou City, China (Zhou) Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, Wuhan, China (Chen) Nanjing First Hospital, Nanjing Medical University, Jiangsu Province, Nanjing City, China (Ge) The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Anhui Province, Hefei City, China (Zhang) Anhui Provincial Chest Hospital, Anhui Province, Hefei City, China (Liu) The Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang City, China (Shen) The First Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou City, China (Wang) The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou City, China (Wang, Li) Medical Research and Biometrics Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China Publisher BMJ Publishing Group Abstract Objectives: To evaluate the efficacy of dual antiplatelet therapy (DAPT) for three months versus 12 months in saphenous vein graft occlusion while reducing bleeding risk. Design(s): Multicentre, non-inferiority, double blind, randomised controlled trial. Setting(s): 13 cardiac surgery centres in China, with enrolment between February 2023 and July 2024. Participant(s): 2300 participants aged 18 to 80 years who underwent elective primary coronary artery bypass grafting with >=1 saphenous vein graft. Intervention(s): Participants were randomly assigned (1:1) to receive DAPT (ticagrelor 90 mg twice daily plus aspirin 100 mg once daily) for 12 months or the same dual antiplatelet regimen for the first three months, followed by placebo plus aspirin for nine months. Main Outcome Measure(s): The primary outcomes were saphenous vein graft occlusion at one year (non-inferiority) and Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding (superiority). Secondary outcomes were major adverse cardiovascular events (MACCE), saphenous vein graft failure, venous or arterial graft stenosis, and venous or arterial graft occlusion. Result(s): 2290 patients (mean age 61.5 (standard deviation (SD) 8.4) years, 20.6% (n=472) women) were included in the modified intention-to-treat set. The mean number of saphenous vein graft segments was 2.5 (SD 0.8). 2070 patients (90.4%) with a total of 5125 saphenous vein graft segments were assessed at one year. Saphenous vein graft occlusion occurred in 280 of 2596 (10.8%) in the three month DAPT group and 283 of 2529 (11.2%) in the 12 month DAPT group (absolute difference -0.31%, 95% confidence interval (CI) -3.13% to 2.52%; P=0.008 for non-inferiority). During a median follow-up of 368 (interquartile range 358-382) days, BARC type 2, 3, or 5 bleeding occurred in 95 patients (8.3%) in the three month DAPT group and 149 patients (13.2%) in the 12 month DAPT group (absolute difference -4.67%, 95% CI -7.18% to -2.16%; P<0.001). The number needed to treat to prevent one bleeding event was 21 (95% CI 13 to 46). MACCE occurred in 26 (2.3%) patients in the three month DAPT group and 27 (2.7%) in the 12 month DAPT group (absolute difference -0.11%, 95% CI -1.48% to 1.26%). The findings for other secondary outcomes were also similar between the two groups. Conclusion(s): A three month DAPT strategy was non-inferior to the 12 month DAPT strategy in saphenous vein graft occlusion and was superior in reducing bleeding risk. Trial registration: ClinicalTrials.gov NCT05380063. Copyright © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. <82> Accession Number 2043948858 Title Low-dose direct oral anticoagulation vs dual antiplatelet therapy after left atrial appendage occlusion: 1-year results from the ADALA trial. Source Revista Espanola de Cardiologia. 79(6) (pp 522-533), 2026. Date of Publication: 01 Jun 2026. Author Flores-Umanzor E.; Cruz-Gonzalez I.; Cepas-Guillen P.; Millan X.; Antunez-Muinos P.; Asmarats L.; Laffond A.; Regueiro A.; Lopez-Tejero S.; Li C.-H.P.; Sanchis L.; Rodes-Cabau J.; Arzamendi D.; Freixa X. Institution (Flores-Umanzor, Cepas-Guillen, Antunez-Muinos, Regueiro, Sanchis, Rodes-Cabau, Freixa) Departamento de Cardiologia, Instituto Cardiovascular, Instituto de Investigaciones Biomedicas August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain (Cruz-Gonzalez, Laffond, Lopez-Tejero) Departamento de Cardiologia, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain (Cruz-Gonzalez, Laffond, Lopez-Tejero) Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Millan, Asmarats, Li, Arzamendi) Departamento de Cardiologia, Hospital Universitario de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain (Rodes-Cabau) Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada Publisher Ediciones Doyma, S.L. Abstract Introduction and objectives: The ADALA trial showed a more favorable efficacy-safety profile with low-dose direct oral anticoagulation (LD-DOAC) vs dual antiplatelet therapy (DAPT) at 3 months after left atrial appendage occlusion (LAAO). However, outcomes after switching both regimens to single antiplatelet therapy (SAPT) remain uncertain. This study reports the 1-year results, focusing on outcomes after the switch to SAPT. Method(s): The ADALA trial was a multicenter, randomized clinical trial that enrolled 91 patients with atrial fibrillation and contraindications to oral anticoagulation. After successful LAAO, participants were randomized to receive LD-DOAC or DAPT for 3 months, after which all patients transitioned to SAPT. The primary endpoint was a composite of thromboembolic events, device-related thrombus (DRT), or major bleeding at 1-year. Result(s): At 12 months, the primary endpoint was significantly lower in the LD-DOAC group compared with the DAPT group (9.1% vs 32.6%; HR, 0.25; 95%CI, 0.08-0.74; P = .013), mainly driven by a reduction in DRT (0% vs 11.6%; P = .023). Major bleeding was numerically lower with LD-DOAC (9.1% vs 19.6%; P = .167), and total bleeding events were significantly reduced (13.6% vs 37.0%; P = .013). Landmark analysis showed significant differences during the initial 3 months (P < .001) but not from 3 to 12 months (P = .195). All DRT cases treated with LD-DOAC (n = 4) resolved completely without bleeding. Conclusion(s): LD-DOAC reduced thromboembolic and bleeding events compared with DAPT during the first year after LAAO, driven by a marked reduction in early DRT. No DRT events occurred after LD-DOAC withdrawal, supporting a strategy of LD-DOAC for 3 months followed by SAPT in this high-risk population. Copyright © 2025 <83> 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. <84> Accession Number 2045752154 Title Gender Gaps in Cardiothoracic Surgery: Are Patient Outcomes Shaped by Workforce Inequity?. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of Publication: 2026. Author Al-Ebrahim K.E. Institution (Al-Ebrahim) Department of Surgery, Division of Cardiac Surgery, King Abdulaziz University, Jeddah, Saudi Arabia Publisher Georg Thieme Verlag Abstract Background Gender disparities persist across cardiac and thoracic surgical care, influencing access, procedural selection, perioperative risk, and long-Term outcomes. Despite major advances in operative technique and perioperative pathways, women continue to experience delayed diagnosis, lower procedural referral rates, and distinct complication profiles after high-risk procedures, including coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), and transcatheter edge-To-edge repair (TEER). These patient-level disparities parallel persistent inequities within the cardiothoracic surgery workforce, raising the possibility that structural workforce imbalances may influence clinical outcomes. Objective This study aimed to synthesize contemporary evidence (2020-2025) characterizing sex-and gender-based disparities across cardiac and thoracic surgery, identify interconnected root causes, and outline strategies and research priorities for reducing inequities. Methods A narrative review (2020-2025) combined structured database searches of trials and registries with synthesis of mechanistic and health-system literature to interpret heterogeneous evidence. Results Women undergoing cardiothoracic procedures often present at older age with greater frailty, smaller anatomical dimensions, and more atypical symptoms, increasing procedural complexity and perioperative risk. CABG and SAVR show higher early morbidity in women, while PCI disparities have narrowed but persist due to delayed recognition; TAVR demonstrates higher early complications yet better mid-and long-Term survival. In thoracic surgery, women generally have lower perioperative mortality, but experience delayed diagnosis, lower screening rates, and reduced use of minimally invasive approaches. These outcome differences occur alongside persistent workforce inequities, including the underrepresentation of women in surgical practice, leadership, and academia. Conclusion Gender disparities in cardiac and thoracic surgery are multifactorial and closely intertwined with systemic workforce inequities. Solutions require sex-Aware risk assessment, equitable referral pathways, inclusive device development, mandated sex-stratified reporting, and targeted workforce reforms. Addressing both patient-level and structural contributors is essential to achieve durable gender equity in cardiothoracic surgical care. Copyright © 2026 Georg Thieme Verlag. All rights reserved. <85> Accession Number 2044253736 Title Left Atrium and Mitral Valve Hemodynamics in Patients With Mitral Stenosis Pre and Post-Percutaneous Balloon Mitral Valvuloplasty: A Systematic Review and Meta-Analysis. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 2078-2097), 2026. Date of Publication: 01 May 2026. Author Zaied M.A.; Shahzaib M.; Mukhlis M.; Latif J.; Fatima N.; Brohi F.; Alam U.; Singh P. Institution (Zaied) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Shahzaib) King Edward Medical University, Lahore, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Pakistan (Latif) Allama Iqbal Medical College, Lahore, Pakistan (Fatima) Gomal Medical College, Dera Ismail Khan, Pakistan (Brohi) Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan (Alam) Khyber Medical College, Peshawar, Pakistan (Singh) Kirori Mal College, Delhi University, Delhi, India Publisher John Wiley and Sons Inc Abstract Mitral stenosis (MS) is still a significant cause of cardiovascular morbidity and mortality in low- and middle-income countries, despite being nearly eradicated in the developed world. Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice for appropriate patients with MS, but traditional predictors such as mitral valve area and regurgitation grade fail to fully reflect long-term prognosis. This review aims to analyze pre- and post-PBMV hemodynamic changes in the left atrium and determine their prognostic significance in predicting clinical outcomes in patients with MS. This meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251017356). PubMed, Scopus, and Web of Science were searched on March 23, 2025, for studies on adults >= 18 years with isolated MS undergoing PBMV. Eligible studies reported both pre- and post-procedure valve and hemodynamic parameters. Primary outcomes included mitral valve area, mean gradient, and left atrial indices. Pooled analyses were conducted in R (v 4.5.1). This meta-analysis included the outcomes of PBMV by comparing pre- and post-procedural data from 30 studies consisting of 2239 participants. Post-PBMV outcomes revealed a significant increase in mitral valve area (MD 0.8834, 95% CI: 0.80; 0.96, p < 0.0001), cardiac output (MD 0.70, 95% CI: 0.58; 0.81, p < 0.0001), and alongside significant reductions in left atrial diameter (MD -4.47; 95% CI: -6.23 to -2.71, p < 0.0001), left atrial pressure (MD -9.51, 95% CI: -11.19; -7.84, p < 0.0001), mitral valve pressure (MD -8.58, 95% CI: -9.41; -7.74, p < 0.0001), and systolic pulmonary pressure (MD -17.96, 95% CI: -21.48; -14.45, p < 0.0001). Out of 2239 patients, 71, 37, and 32 had valve replacement, PBMV repetition, and experienced death, respectively. PBMV showed promising effectiveness and safety in treating patients with MS with a significant increase in cardiac output and MV area and a significant decrease in LA diameter, LA pressure, MV pressure, and systolic pulmonary pressure post-PBMV, while observing low adverse events. Copyright © 2026 Wiley Periodicals LLC. <86> Accession Number 2044395055 Title Navigating Vascular Access Strategies for Transcatheter Aortic Valve Replacement in Patients With Peripheral Artery Disease: A Literature Review. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 2100-2109), 2026. Date of Publication: 01 May 2026. Author Aufazhafarin N.T.; Saputra P.B.T.; Widiarti W.; Putra R.M.; Luthfah N.; Budiarto R.M.; Putranto J.N.E.; Multazam C.E.C.Z.; Alkaff F.F. Institution (Aufazhafarin, Widiarti) Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Putra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia (Putra) Universitas Airlangga Hospital, East Java, Surabaya, Indonesia (Multazam) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Alkaff) Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands (Alkaff) Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia Publisher John Wiley and Sons Inc Abstract Transcatheter aortic valve replacement (TAVR) is the preferred treatment for severe aortic stenosis (AS) in high-risk surgical patients. The transfemoral (TF) access is the gold standard due to its minimally invasive nature and favorable outcomes. However, peripheral artery disease (PAD), common in TAVR candidates, can complicate TF access due to calcification, tortuosity, and vessel narrowing. This literature review evaluates vascular access strategies for TAVR in patients with PAD, highlighting recent advances that support expanded use of TF access. A narrative literature review was conducted in scientific databases up to 14 April 2025. Studies reporting on access strategies for TAVR in patients with PAD were included. The SANRA scale was utilized to ensure methodological quality. TF access remains the preferred route for TAVR, associated with lower mortality and complication rates compared to alternative approaches. Tools like the Hostile Score has further strengthened pre-procedural planning by quantifying iliofemoral complexity and helping clinicians determine the safest and most feasible access route. Advances in technology have enhanced TF feasibility in patients with PAD, enabling device delivery despite complex anatomy. When TF access is not viable, alternative routes remain feasible but are linked to increased risks, including stroke and vascular complications. Expanding the eligibility for TF access through vessel preparation and imaging-guided planning can improve safety and outcomes in PAD patients undergoing TAVR. A personalized approach based on anatomy feasibility, supported with risk stratification tools and multidisciplinary collaboration is essential to selecting the optimal vascular access strategy. Copyright © 2026 Wiley Periodicals LLC. <87> [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. <88> Accession Number 2045596612 Title Association of Platelet Count, Mean Platelet Volume, Platelet Distribution Width, Plateletcrit, and Platelet-Lymphocyte Ratio With Postoperative Cardiac Surgery-Associated Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 2799748. Date of Publication: 2026. Author Mao K.; Caruana C.B.; Frentiu A.; Raveendran D.; Perry L.A.; Penny-Dimri J.C.; Ramson D.M.; Segal R.; Bellomo R.; Smith J.A.; Plummer M.; Liu Z. Institution (Mao, Raveendran, Perry, Segal, Bellomo, Liu) Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia (Caruana, Penny-Dimri) Department of Anaesthesia, Austin Hospital, Melbourne, VIC, Australia (Frentiu, Ramson, Smith) Department of Surgery, Monash University, Melbourne, VIC, Australia (Perry, Segal) Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia (Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia (Bellomo) Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (Bellomo) School and Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Bellomo) Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital, Melbourne, VIC, Australia (Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne, VIC, Australia (Plummer) Department of Intensive Care, Royal Adelaide Hospital, Adelaide, SA, Australia Publisher John Wiley and Sons Inc Abstract Background: The predictive value of platelet indices, including the platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet-lymphocyte ratio (PLR) for postoperative atrial fibrillation (POAF) following cardiac surgery remains undetermined. Method(s): MEDLINE, Embase, and the Cochrane Library were searched from inception to October 2024. For each included study, median differences (MDs) and odds ratios (ORs) were tabulated with 95% confidence intervals (CIs). Pooled estimates were generated using random-effects inverse-variance modeling. Statistical analysis focused on cases of POAF. Result(s): Six thousand five hundred and seventeen unique studies were screened and included 23 studies involving 12,375 patients in the subsequent analysis. Compared with patients who did not develop POAF, patients with POAF had higher preoperative MPV (MD: 0.30 fL, 95% CI: 0.07-0.53, and p = 0.0112) and PLR (MD: 40.42, 95% CI: 7.49-73.33, and p = 0.0161). Preoperative PLT (MD: 3.32, 95% CI: -5.87-12.51, and p = 0.4785) was not significantly different between groups. Study numbers were insufficient to assess the association between PCT with POAF. Conclusion(s): Elevated preoperative MPV and PLR were associated with POAF after cardiac surgery. Further research is required to investigate the roles of these indices in the risk stratification of POAF in patients undergoing cardiac surgery. Copyright © 2026 Kevin Mao et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <89> Accession Number 2045727144 Title Determinants of Healthcare Costs in Individuals With Down Syndrome: A Systematic Review. Source Health Science Reports. 9(6) (no pagination), 2026. Article Number: e72297. Date of Publication: 01 Jun 2026. Author Rakhshan S.T.; Byford S.; Razimoghadam M.; Moradi F.; Soltani S. Institution (Rakhshan, Razimoghadam) Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Byford) King's Health Economics, King's College London, London, United Kingdom (Razimoghadam) National Center for Health Insurance Research, Tehran, Iran, Islamic Republic of (Moradi) Medical Education Department Center (EDC), Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic of (Soltani) Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Individuals with Down syndrome (DS) require specialized medical follow-up and services more frequently than the general population, resulting in substantial healthcare costs for families and health systems. This systematic review aimed to synthesize evidence on the magnitude and determinants of direct healthcare and indirect costs associated with DS. Method(s): We searched Web of Science, PubMed, and Scopus for observational and experimental studies published in English between January 1, 2000, and December 31, 2022 (updated June 15, 2024), that reported healthcare costs or cost determinants for individuals with DS. Reference lists were also screened. We excluded non-English papers, qualitative studies, reviews, protocols, editorials, and gray literature. Result(s): The search identified 625 unique citations, of which 14 matched the inclusion criteria. Half were conducted in the USA. Inpatient services constituted the largest share of direct healthcare costs in 58% of studies. Indirect costs, mainly productivity losses among families, were reported in 25% of studies. Healthcare costs were highest during infancy (driven primarily by congenital heart defects and early hospitalizations), decreased throughout childhood and adolescence, and increased again in adulthood, particularly after age 40, due to age-related comorbidities such as dementia and multimorbidity. Associated morbidities, greater functional limitations, and lower socioeconomic status were consistently associated with higher costs. Conclusion(s): Age, comorbidities, functional ability, and socioeconomic factors are key drivers of healthcare costs in DS. Long-term, comprehensive policies integrating medical, social, and educational support are needed. Priority should be given to early cardiac surgery coverage, multidisciplinary adult transition clinics, subsidized respite care, and financial assistance schemes to reduce both inpatient utilization and family productivity losses. Copyright © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC. <90> Accession Number 2045927962 Title Incidence and predictors of major arrhythmic events after myocarditis: a systematic review and meta-analysis. Source Europace. 28(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Morena A.; Giacobbe F.; Candido-Todesco L.; Moretti A.; Saglietto A.; Bocchino P.P.; Garot J.; Anselmino M.; Merlo M.; Sinagra G.; El-Battrawy I.; D'Ascenzo F.; Ferraris F.; Guenancia C.; Nijveldt R.; Castagno D.; Acha M.R.; Ng C.Y.; De Lio G.; Angelini F.; Frea S.; Raineri C.; Gallone G.; Kragholm K.H.; Ravera F.; Huang F.; Kerneis M.; Pelargonio G.; Narducci M.L.; Imazio M.; De Ferrari G.M.; Dusi V. Institution (Morena) Department of Medical Sciences, University of Turin, Turin, Italy (Morena) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Giacobbe) Department of Medical Sciences, University of Turin, Turin, Italy (Giacobbe) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Candido-Todesco) Department of Medical Sciences, University of Turin, Turin, Italy (Candido-Todesco) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Moretti) Department of Medical Sciences, University of Turin, Turin, Italy (Moretti) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Saglietto) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Bocchino) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Garot) Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hopital Prive Jacques Cartier, Ramsay Sante, Massy, France (Anselmino) Department of Medical Sciences, University of Turin, Turin, Italy (Anselmino) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Merlo) Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy (Sinagra) Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy (El-Battrawy) Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr University, Bochum, Germany (El-Battrawy) Department of Molecular and 2-Experimental Cardiology, Ruhr-University Bochum, Institut fur Forschung und Lehre (IFL), Bochum, Germany (El-Battrawy) Department of Cardiology and Rhythmology, St.Josef-Hospital, UK RUB, Ruhr University Bochum, Bochum, Germany (D'Ascenzo) Department of Medical Sciences, University of Turin, Turin, Italy (D'Ascenzo) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Ferraris) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Guenancia) Universite Bourgogne Europe-CHU DIJON, service de cardiologie-PEC2 UFR Sciences de Sante, Dijon, France (Nijveldt) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (Castagno) Department of Medical Sciences, University of Turin, Turin, Italy (Castagno) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Acha) Integrated Heart Center, Shaare Zedek Hospital, Hebrew University, Jerusalem, Israel (Ng) Cardiac Arrhythmia Center, Massachusetts General Hospital, Harvard University, Boston, MA, United States (De Lio) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Angelini) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Frea) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Raineri) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Gallone) Department of Medical Sciences, University of Turin, Turin, Italy (Gallone) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Kragholm) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Ravera) Department of Medical Sciences, University of Turin, Turin, Italy (Huang) ACTION Study Group, Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Department of Cardiology, Paris, France (Huang) Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Medical Intensive Care Unit, Paris, France (Kerneis) ACTION Study Group, Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Department of Cardiology, Paris, France (Kerneis) Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Medical Intensive Care Unit, Paris, France (Pelargonio) Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Narducci) Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Imazio) Department of Medicine, University of Udine, Cardiothoracic Department, University Hospital Santa Maria della Misericordia, ASUFC, Udine, Italy (De Ferrari) Department of Medical Sciences, University of Turin, Turin, Italy (De Ferrari) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Dusi) Department of Medical Sciences, University of Turin, Turin, Italy (Dusi) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy Publisher Oxford University Press Abstract Aims: Long-term arrhythmic risk after myocarditis remains uncertain, and optimal management is debated. We aimed to assess the incidence and predictors of major arrhythmic events (MAEs) after myocarditis. Methods and Results: We conducted a systematic literature review and meta-analysis including 19 observational studies on myocarditis and MAEs during follow-up. Major arrhythmic events were defined as a composite of sudden cardiac death (SCD), ventricular fibrillation (VF), aborted cardiac arrest (ACA), sustained ventricular tachycardia (sVT), and appropriate implantable cardioverter defibrillator (ICD) or wearable-cardioverter defibrillator (WCD) intervention. The primary outcome was the incidence of MAEs after discharge; secondary outcomes included occurrence of each component of MAEs and the composite of all-cause mortality or heart transplantation (HTx). Three thousand nine hundred and fifty-four patients (71% male, 67% acute, 88% complicated myocarditis) were included. At presentation, 15% had high-grade atrioventricular block (AVB), 31% heart failure, 38% MAEs. At a median follow-up of 24 months (interquartile range 19-57), 28% suffered MAEs, with a median time of presentation of 12 months. The incidence of sVT, ACA/VF, appropriate ICD/WCD intervention, and SCD were 22%, 6%, 20%, and 1%, respectively. The combined rate of all-cause mortality/HTx was 11%. At meta-regression analysis, high-grade AVB, MAEs at presentation, and fulminant myocarditis were associated with higher risk of MAEs during follow-up, while male gender resulted as a protective factor. Conclusion(s): The incidence of MAEs after a complicated acute myocarditis can be high over time. Further prospective studies are needed to better stratify high-risk patients, identify those with an underlying arrhythmogenic cardiomyopathy, and guide antiarrhythmic strategies. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. <91> Accession Number 2045963493 Title Coronary artery disease: stable angina. Source Medicine (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Naderi Z.; Al-Lamee R. Institution (Naderi, Al-Lamee) Imperial College London, United Kingdom (Naderi, Al-Lamee) Imperial College Healthcare NHS Trust, United Kingdom Publisher Elsevier Ltd Abstract A global public health issue, coronary artery disease (CAD) is recognized as the leading cause of morbidity and mortality worldwide. Stable angina, a symptom of CAD, is defined as chest pain typically triggered by exertion or emotional distress and relieved by rest. Effective history-taking, assessing the nature and frequency of symptoms, a good physical examination and identifying key risk factors is vital in the initial care of patients with stable angina, allowing clinicians to opt for the most suitable test to investigate further. Over the last three decades, research has explored the most effective treatment modalities for the management of stable angina, in the form of percutaneous coronary intervention, coronary artery bypass graft surgery and medical therapy. Furthermore, understanding the definition of stable angina, its pathophysiology and patient symptomatology is key to developing trials to address some of the remaining unanswered questions. This chapter outlines some of the most important randomized controlled trials that have played a key role in developing our understanding of the complex aetiology of symptom management, most effective treatments and long-term outcomes of patients with stable angina. Copyright © 2026 Published by Elsevier Ltd. <92> [Use Link to view the full text] Accession Number 651236918 Title Cerebral Embolic Protection During Transcatheter Aortic Valve Implantation: A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis. Source Cardiology in review. (no pagination), 2026. Date of Publication: 20 May 2026. Author Naeem F.; Qamar U.; Burhan M.; Shehada W.; Balbaa E.; Gadelmawla A.F.; Tabassum S.; Husnain A.; Naeem N.; Hanif M.; Bhat V.; Muthukumar L.; Eltawansy S.; Kalra A.; Daggubati R.; Sattar Y. Institution (Naeem) From the Department of Cardiology, Massachusetts General Hospital, Boston, MA, United States (Qamar, Hanif, Bhat) Department of Internal Medicine, SUNY Upstate Medical University, New York, NY (Burhan) Department of Internal Medicine, Rawalpindi Medical University, Lahore, Pakistan (Shehada) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine (Balbaa) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Egypt (Tabassum) Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, PA, United States (Husnain) Department of Internal Medicine, Luminis Health Anne Arundel Medical Center, Parole, MD, Liberia (Naeem) Department of Internal Medicine, Rochester General Hospital, Rochester, NY, United States (Muthukumar, Daggubati, Sattar) Department of Cardiology, West Virginia University, Morgantown, WV, United States (Eltawansy) Department of Internal Medicine, Jersey Shore University Medical Center, Neptune City, NJ, United States (Kalra) Department of Cardiovascular Diseases, SUNY Upstate Medical University, New York, NY Abstract Stroke is a serious complication of transcatheter aortic valve implantation (TAVI). Cerebral embolic protection devices (CEPDs) were developed to reduce periprocedural embolization; however, their clinical efficacy remains uncertain. We conducted a systematic review and meta-analysis of 8 randomized controlled trials including 11,775 patients undergoing TAVI with or without CEPDs. Primary outcomes included stroke (any, disabling, non-disabling), new ischemic lesions, and cognitive decline assessed by the Montreal Cognitive Assessment and National Institutes of Health Stroke Scale. Secondary outcomes included mortality, bleeding, vascular complications, and acute kidney injury. Data were pooled using a random-effects model, reporting risk ratios (RRs) or mean differences with corresponding 95% confidence intervals (CIs). Subgroup, meta-regression, and trial sequential analyses were performed. CEPDs did not significantly reduce any stroke (RR: 0.92, 95% CI [0.74-1.15], P = 0.48), disabling stroke (RR: 0.80, 95% CI [0.57-1.12], P = 0.19), or non-disabling stroke (RR: 1.08, 95% CI [0.79-1.46], P = 0.64). No significant differences were observed in ischemic lesion count, National Institutes of Health Stroke Scale worsening, or Montreal Cognitive Assessment decline. The Sentinel device showed a marginal reduction in ischemic lesion count without clinical benefit. Sentinel use was associated with increased major vascular complications (RR: 1.42, 95% CI [1.01-2.01], P = 0.046), and sensitivity analysis demonstrated higher acute kidney injury with CEPDs (RR: 1.38, 95% CI [1.01-1.88], P = 0.04). Trial sequential analyses suggested futility for most outcomes. While CEPDs capture embolic debris, they do not significantly reduce stroke or cognitive decline after TAVI, limiting support for routine use. Future efforts should focus on improved device design and identifying high-risk subgroups. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <93> Accession Number 2045719054 Title Influence of Baseline Smoking Status on Intensive Blood Pressure Control: Results From the STEP Randomized Trial. Source Canadian Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Chen S.; Ji Y.; Yang R.; Peng X.; Bai J.; Fan X.; Song Q.; Cai J. Institution (Chen, Ji, Song) Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China (Yang, Peng, Bai, Cai) Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China (Fan) Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Elsevier Inc. Abstract Background The St rategy of Blood Pressure Intervention in the E lderly Hypertensive P atients (STEP) trial has proven that intensive systolic blood pressure (SBP) lowering reduces cardiovascular events. However, the cardiovascular risks posed by smoking have caused uncertainty regarding the effects of intensive SBP control in smokers. Methods In this secondary subgroup analysis of the STEP trial, the participants were categorized into nonsmokers and current smokers on the basis of their baseline smoking status. The primary outcome was a composite of cardiovascular outcomes, including stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, and death from cardiovascular causes. Cox proportional hazards regression and interaction analysis were used to assess the effects of baseline smoking status on intensive SBP control. Results A total of 8489 patients were included in this analysis. The proportion of patients who reached the intensive SBP target was smaller in current smokers during the first 9 months. Compared with nonsmokers, current smokers had a higher adjusted risk of primary outcome (hazard ratio, 1.39; 95% confidence interval, 1.03-1.88; P = 0.03) and stroke (hazard ratio, 1.66; 95% confidence interval, 1.03-2.67; P = 0.04). The interactions between baseline smoking status and SBP treatment were not statistically significant for all outcomes. Findings were similar in sensitivity analyses using 4 smoking categories and in analyses including only never and often smokers. Conclusions Smoking was associated with a higher risk of primary outcome and stroke. We observed no statistical evidence of heterogeneity in the treatment effect of intensive SBP control according to smoking status. Clinical Trial Registration NCT03015311. Copyright © 2026 Canadian Cardiovascular Society. <94> Accession Number 2045921594 Title Turning Down Ileus: Does Intraoperative Warm Humidified CO<inf>2</inf> Improve Return of Bowel Function After Open Colorectal Surgery?. Source Surgical Innovation. (no pagination), 2026. Date of Publication: 2026. Author Jaffry K.; Lekamalage B.; Arachchi A. Institution (Jaffry) Department of Surgery, Monash University, Dandenong, VIC, Australia (Jaffry, Arachchi) Department of Colorectal Surgery, Monash Health, Clayton, VIC, Australia (Lekamalage) Department of General Surgery, Tauranga Hospital, Bay of Plenty, Tauranga, New Zealand Publisher SAGE Publications Inc. Abstract Background: Postoperative ileus (POI) remains one of the most common and costly complications following open colorectal surgery, prolonging hospital stay and delaying recovery despite the widespread adoption of Enhanced Recovery After Surgery (ERAS) protocols. Warm humidified carbon dioxide insufflation (WHCI), delivered intraoperatively at 37degreeC and near-100% humidity, has emerged as a promising adjunct to preserve peritoneal physiology in open surgery. By maintaining normothermia, reducing tissue desiccation, attenuating systemic inflammation, and supporting tissue oxygenation, WHCI may directly address several mechanisms implicated in the pathogenesis of POI. Purpose(s): To outline the physiological rationale for WHCI in open abdominal surgery and introduce a multicentre randomised controlled trial designed to determine whether WHCI accelerates return of bowel function following open colorectal surgery. Research Design: Perspective article incorporating a narrative review of existing evidence and the protocol overview of a forthcoming multicentre, single-blinded randomised controlled trial. Study Sample: The proposed trial will enrol 264 adults (132 per arm) undergoing elective or emergency open colorectal surgery across three Monash Health hospitals (Dandenong, Monash Medical Centre, and Casey), with randomisation stratified by urgency. Data Collection and Analysis: The primary outcome will be the proportion of patients regaining bowel function (passage of flatus or stool) within 72 hours postoperatively, assessed at 24-hour intervals. Secondary outcomes include length of stay, readmission, return to theatre, postoperative nausea and vomiting, and use of oral Gastrografin follow-through. Sample size calculations anticipate a reduction in POI from 30-35% to 15%, with alpha = 0.05 and 80% power, allowing for 10% attrition. Result(s): Existing evidence from open colorectal, cardiac, and orthopaedic surgery demonstrates reductions in peritoneal mesothelial injury, lower postoperative C-reactive protein, improved wound and core temperature, and reduced intra-wound particulate contamination. However, no adequately powered trial has yet evaluated whether these physiological benefits translate into faster return of bowel function. Conclusion(s): WHCI is a physiologically grounded, low-risk, and low-cost intraoperative adjunct that may directly address several mechanisms implicated in the pathogenesis of POI. If validated by the proposed trial, WHCI could redefine perioperative best practice and extend the thermoregulatory standards of laparoscopy into open surgery. Copyright © The Author(s) 2026 <95> [Use Link to view the full text] Accession Number 651239572 Title Direct Oral Anticoagulant Monotherapy Versus Dual Antiplatelet Therapy After Left Atrial Appendage Closure: A Meta-Analysis of Randomized Trials. Source Circulation. Cardiovascular interventions. (pp e016554), 2026. Date of Publication: 20 May 2026. Author Ammirabile N.; Giacoppo D.; Mazzone P.M.; Landolina D.; Capodanno D. Institution (Ammirabile, Giacoppo, Mazzone, Capodanno) Division of Cardiology, University of Catania, Italy (Landolina) Cardiology Unit, Umberto I Hospital, Siracusa, Italy <96> Accession Number 2045938237 Title Machine learning prediction models for myocardial injury after non-cardiac surgery: A scoping review. Source Trends in Anaesthesia and Critical Care. 68 (no pagination), 2026. Article Number: 101662. Date of Publication: 01 Jun 2026. Author Nadesan P.; Gandhi B.; Schwalm J.-D.; Petch J.; Sibbald M.; Khemani E. Institution (Nadesan, Gandhi) Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (Schwalm, Petch, Sibbald) Department of Medicine, Division of Cardiology, Hamilton Health Sciences, Hamilton, ON, Canada (Schwalm, Petch) Population Health Research Institute, Hamilton, ON, Canada (Schwalm, Khemani) Hamilton Health Sciences Knowledge Centre, Hamilton, ON, Canada (Petch) Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, ON, Canada (Petch) Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada (Khemani) Department of Anesthesia and Pain Management, McMaster University, Hamilton, ON, Canada Publisher Churchill Livingstone Abstract Purpose: Myocardial injury after non-cardiac surgery (MINS) is common and often under detected. Machine learning (ML) has been proposed as a tool for perioperative risk stratification and to support targeted postoperative troponin monitoring. This scoping review summarizes current evidence on ML models developed to predict MINS. Source: Five databases were searched in January 2025. Eligible studies applied at least one ML method to predict MINS in adult surgical patients and reported at least one performance metric. Findings were synthesized narratively. Principal findings: Of 2463 records screened, nine studies met inclusion criteria. Six reported internal validation and three external validation. Median AUROC was 0.777 (IQR 0.770-0.788) for internally validated models and 0.805 (range 0.790-0.821) for externally validated models. Common predictors included age, hemoglobin, renal function markers, perioperative biomarkers, and intraoperative hemodynamic variables. Conclusion(s): Available supervised prediction models for MINS show variable discrimination, but the evidence base is small, heterogeneous, and largely at high risk of bias. Current studies do not establish clinical readiness or superiority of more complex ML approaches over regression-based models. Standardized outcome ascertainment, transparent reporting, clinically meaningful performance evaluation, and robust external validation are needed before implementation can be considered. Copyright © 2026 <97> [Use Link to view the full text] Accession Number 651240106 Title Preoperative single-level ultrasound-guided superficial parasternal intercostal plane block and pulmonary recovery after cardiac surgery with sternotomy: a randomised controlled trial. Source European journal of anaesthesiology. (no pagination), 2026. Date of Publication: 20 May 2026. Author Huette P.; Daumin C.; Fontaine R.; Lefebvre T.; Tarpin P.; Beyls C.; Gubler B.; Mahjoub Y.; Ollier A.; Abou-Arab O. Institution (Huette) From the Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital (PH, CD, RF, UR UPJV 7518 SSPC Research Unit, Jules Verne University of Picardie (PH, PT, CB, Immunology Department & EA4666-HEMATIM, Amiens University Hospital, Department of Biostatistics, Amiens Picardy University Hospital (AO), Laboratoire MP3CV, CURS, Universite Picardie Jules Verne, Amiens (BG), France <98> [Use Link to view the full text] Accession Number 651236751 Title Partial Oral Antibiotic Therapy in Infective Endocarditis: Evidence, Patient Selection, and Practical Implementation. Source Cardiology in review. (no pagination), 2026. Date of Publication: 20 May 2026. Author Khatami S.; Faghihi M.; Talebi-Taher M.; Yousefifard M. Institution (Khatami, Faghihi, Yousefifard) From the Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Talebi-Taher) Infectious Diseases Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of Abstract Infective endocarditis (IE) is a life-threatening infection traditionally treated with 4-6 weeks of intravenous (IV) antibiotics. Emerging data, including the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial and recent meta-analyses, suggest that selected clinically stable patients can safely transition early to oral regimens, but practical guidance on implementation is limited. We conducted a comprehensive narrative review of randomized trials, observational studies, ongoing clinical trials, meta-analyses, and contemporary guidelines addressing partial oral antibiotic therapy in adult IE. Evidence consistently shows that after at least 10 days of effective IV treatment, patients who are afebrile, hemodynamically stable, have negative blood cultures, and no uncontrolled infection on imaging can be transitioned to dual oral regimens with high bioavailability and pathogen-directed activity. In this population, oral step-down therapy yields similar rates of death, relapse, embolic events, and unplanned cardiac surgery compared with prolonged IV therapy, while substantially reducing hospital length of stay and line-related complications. Data in people who inject drugs, those with multidrug-resistant pathogens, or severe heart failure remain limited, and robust pharmacokinetic validation of some oral beta-lactam-based combinations is still needed. Overall, partial oral antibiotic therapy represents a safe, evidence-based, and stewardship-aligned strategy for many patients with left-sided native or prosthetic valve IE when applied within structured protocols and strict selection criteria. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <99> [Use Link to view the full text] Accession Number 651236830 Title Leadless Pacemakers in the Setting of Surgical and Transcatheter Tricuspid Valve Procedures. Source Circulation. Arrhythmia and electrophysiology. (pp e015000), 2026. Date of Publication: 20 May 2026. Author Abou Deb G.; Abou Deb F.; Kozhuharov N.; Albouaini K. Institution (Abou Deb, Albouaini) Royal Liverpool University Hospitals, United Kingdom (G.A.D., United Kingdom (Abou Deb) University of Chester, United Kingdom (F.A.D.), United Kingdom (Kozhuharov) Inselspital, Bern University Hospital, University of Bern, Switzerland Abstract Transvenous pacing is increasingly recognized as problematic in patients with prior or concomitant tricuspid valve intervention, owing to risks of leaflet interference, prosthetic dysfunction, and progression of tricuspid regurgitation. Leadless pacemakers offer a valve-sparing alternative; however, their safety and performance in structurally altered right heart anatomy remain incompletely defined. We conducted a systematic review to evaluate procedural feasibility, electrical performance, device-valve interaction, and clinical outcomes of leadless pacemaker implantation in patients undergoing surgical or transcatheter tricuspid valve interventions. Thirty-four studies comprising 272 patients were included, encompassing surgical repair, bioprosthetic replacement, valve-in-valve procedures, transcatheter edge-to-edge repair, and transcatheter tricuspid valve replacement. Leadless pacemakers were implanted via transfemoral, transjugular, or direct surgical approaches, achieving a procedural success rate of 99.3%. Electrical performance was consistently favorable, with stable capture thresholds, sensing amplitudes, and impedance during follow-up. Device-valve interaction was infrequent and generally manageable. Leadless pacemaker-related complications were rare (1.1%), with no device-related mortality. Within the included studies of patients undergoing surgical or transcatheter tricuspid valve interventions, no study demonstrated worsening tricuspid regurgitation attributable to the leadless pacemaker or its delivery system. Across a broad spectrum of complex tricuspid anatomies, leadless pacemakers demonstrated excellent feasibility, durable electrical performance, and a low complication profile, supporting their role as a valve-sparing pacing strategy in this population. These findings support leadless pacing in patients with prior tricuspid intervention, although prospective comparative data are required to define its role relative to alternative pacing modalities. <100> Accession Number 2045711383 Title Methylene Blue for Prevention of Perioperative Neurocognitive Disorders: Mechanisms and Recent Clinical Evidence. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 602971. Date of Publication: 2026. Author Wu Y.; Wang J.; Wan X. Institution (Wu, Wang) Department of Anesthesiology, Bethune International Peace Hospital, Shijiazhuang, China (Wan) Department of Intensive Care Unit, Changhai Hospital, Navy Medical University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Background: Perioperative neurocognitive disorders (PND), encompassing postoperative delirium (POD) and delayed neurocognitive recovery (dNCR), affect 15-40% of elderly surgical patients and are associated with accelerated long-term cognitive decline and increased mortality. Currently, no pharmacological agent is universally accepted for PND prevention. Methylene blue (MB), a phenothiazine derivative with unique mitochondrial redox properties, has emerged as a promising multimodal neuroprotectant. Objective(s): This review synthesizes evidence supporting MB's neuroprotective mechanisms and evaluates emerging clinical data regarding its efficacy as a preventive strategy for PND in elderly surgical patients. Method(s): We conducted a comprehensive narrative review of preclinical and clinical studies investigating MB's role in perioperative neuroprotection, with particular emphasis on mechanistic pathways and randomized controlled trial evidence. Result(s): MB exerts neuroprotection through multiple convergent mechanisms: functioning as an alternative electron carrier in the mitochondrial electron transport chain, activating the Nrf2/antioxidant response element (ARE) pathway, suppressing microglia-mediated neuroinflammation, inhibiting tau protein aggregation, and preserving blood-brain barrier integrity. Recent randomized controlled trials demonstrate that single-dose intraoperative intravenous MB (2 mg/kg) significantly reduces POD incidence (from 24% to 7%, number needed to treat = 6) in elderly patients undergoing major non-cardiac surgery. Biomarker studies confirm attenuated neuronal injury (reduced serum S100beta) and decreased systemic inflammation following MB administration. Conclusion(s): MB represents a mechanism-based therapeutic strategy targeting the mitochondrial and inflammatory core of PND pathophysiology. Large-scale, multicenter randomized controlled trials with extended neurocognitive follow-up are warranted to establish MB's definitive role in perioperative neuroprotection and to optimize dosing protocols for high-risk populations. Copyright © 2026 Wu et al. <101> Accession Number 2045396734 Title Risk of stroke after bariatric surgery: a systematic review, meta-analysis and meta-regression. Source Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 62(1) (no pagination), 2026. Article Number: 107. Date of Publication: 01 Dec 2026. Author Matar H.; Al Radaideh D.; Banat S.O.; Sinjlawi S.A.; Aldeeb A.M.; Bany-yasin H.; Rasheed W.M.; Almitwali M.M.; Aldeeb O.M. Institution (Matar, Rasheed) Jordan University of Science and Technology, Irbid, Jordan (Al Radaideh, Banat, Sinjlawi, Almitwali) Yarmouk University, Irbid, Jordan (Aldeeb) Cairo University, Giza, Egypt (Bany-yasin) University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom (Aldeeb) University of Jordan, Amman, Jordan Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Obesity is a major global health challenge, strongly associated with diabetes, hypertension, and cardiovascular disease, all of which increase stroke risk. Bariatric surgery is among the most effective treatments for severe obesity, leading to significant and sustained weight loss and improvements in metabolic health. However, its long-term impact on cerebrovascular outcomes remains unclear. Method(s): We searched multiple databases for cohort studies that compared stroke incidence in patients undergoing bariatric surgery. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was quantified using the I2 statistic. Meta-regression was performed to explore the effects of age, BMI and follow-up duration. Result(s): Eighteen studies comprising 2,125,741 patients were included. Pooled analysis of 16 studies (975,351 patients) showed that bariatric surgery was associated with a 29% lower risk of stroke compared with non-surgical care (HR = 0.71, 95% CI 0.65-0.77, p < 0.0001). Heterogeneity was moderate (I2 = 60.6%) but resolved in sensitivity analyses. No significant publication bias was detected and meta-regression showed no effect modification by age, BMI or follow-up duration. Conclusion(s): This meta-analysis provided a robust evidence that bariatric surgery is associated with a significantly reduced risk of stroke in patients with obesity. The findings highlight bariatric surgery not only as an effective intervention for weight loss and metabolic improvement but also as a meaningful strategy for long-term cerebrovascular risk reduction. Incorporating bariatric surgery into comprehensive cardiovascular and stroke prevention strategies could have substantial public health impact. Copyright © The Author(s) 2026. <102> Accession Number 2045865977 Title Unmasking platypnoea-orthodeoxia syndrome: a systematic review of the pathophysiology, clinical spectrum and outcomes of percutaneous intracardiac shunt closure. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Ermongkonchai T.; Ha F.J.; Yudi M.B.; Yeoh J.; Anandaraj A.; Theuerle J.; Lim H.S.; Wilson W.; English K.; Teo E.; Koshy A.N. Institution (Ermongkonchai, Yudi, Yeoh, Anandaraj, Theuerle, Lim, Koshy) Department of Cardiology, Austin Health, Heidelberg, VIC, Australia (Ha) Department of Cardiology, Victorian Heart Hospital, Clayton, VIC, Australia (Yudi, Yeoh, Anandaraj, Theuerle, Lim) Department of Medicine, The University of Melbourne, Victoria, Parkville, Australia (Wilson, English, Teo, Koshy) Department of Cardiology, The Royal Melbourne Hospital, Parkville, Australia Publisher BMJ Publishing Group Abstract Background: Platypnoea-orthodeoxia syndrome (POS) is a rare but underdiagnosed cause of positional dyspnoea and hypoxaemia. It results from right-to-left interatrial shunting through a patent foramen ovale (PFO) or atrial septal defect (ASD), often precipitated by anatomical or functional distortions. Objective(s): We systematically characterised the clinical spectrum, anatomical correlates and procedural outcomes associated with percutaneous closure in patients diagnosed with intracardiac POS. Method(s): A systematic search of PubMed, Embase and MEDLINE databases was conducted. Case reports, case series and observational studies were included if they involved patients with POS with percutaneous closure of PFO/ASD. Result(s): A total of 469 patients from 196 studies (183 case reports/series, 13 observational studies) were identified (mean age 68.3+/-14.1 years; 51% female). Common symptoms included orthodeoxia (95%), exertional dyspnoea (42%) and platypnoea (35%) with a median time from symptoms to diagnosis of 13 (IQR 4-26) weeks. Anatomical contributors included aortic dilation (33%), thoracic structural abnormalities/surgery (33%) and right heart disorders (15%). A mean PFO/ASD diameter of 11.5+/-5.2 mm and a pulmonary blood flow/systemic blood flow ratio of 0.89+/-0.34 was noted. Amplatzer occluders were the most used device (60% of closures). Postclosure oxygen saturation improved significantly (pre: 79.5+/-8.7% vs post: 94.5+/-5.0%). Symptomatic improvement was reported in 82% of cases, with a low procedural complication rate of 5%. Conclusion(s): POS remains an underdiagnosed clinical entity, where systematic evaluation for POS should be considered in patients with positional desaturation and unexplained hypoxaemia. Percutaneous closure of the interatrial shunt offers significant symptomatic and physiological benefit with a favourable safety profile. PROSPERO registration number: CRD420250652717. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <103> Accession Number 2045600748 Title Combining external placebo-arm data in a prevention trial: effects of cocoa extract supplementation on cardiovascular disease. Source European Journal of Epidemiology. (no pagination), 2026. Date of Publication: 2026. Author Hamaya R.; Li S.; Rist P.M.; Shadyab A.H.; Manson J.E.; Sesso H.D. Institution (Hamaya, Li, Rist, Manson, Sesso) Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States (Li) Division of Life Sciences and Medicine, Institute of Public Health Sciences, University of Science and Technology of China, Hefei, China (Rist, Manson, Sesso) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Shadyab) Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States (Manson) Mary Horrigan Connors Center for Women's Health Research, Brigham and Women's Hospital, Boston, MA, United States Publisher Springer Science and Business Media B.V. Abstract Rigorous integration of external controls in large-scale cardiovascular prevention randomized controlled trials (RCTs) is under-explored. The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), a primary prevention RCT of cocoa extract supplementation, initially showed a statistically non-significant effect on total cardiovascular disease (CVD). We aimed to obtain more robust estimates of cocoa extract effects by integrating external control data from The VITamin D and OmegA-3 TriaL (VITAL), a similarly designed large-scale RCT. We analyzed 21,442 COSMOS participants (median 3.6-year follow-up) and used the VITAL omega-3 placebo arm as an external control. Outcomes included the original COSMOS primary CVD endpoint (a composite of myocardial infarction [MI], stroke, cardiovascular death, and coronary revascularization) and major adverse cardiovascular events (MACE; MI, stroke, and cardiovascular death). Two statistical approaches were used: a propensity score-based inverse probability weighting (IPW)-weighted Cox proportional hazard model and a doubly robust method to estimate 4-year risk ratios (RRs) and 95% confidence intervals (CIs) via bootstrapping. IPW-weighted VITAL-placebo data showed similar covariate distributions and 4-year event rates to COSMOS-placebo. While COSMOS data alone showed non-significant RRs (CVD: 0.91 [95% CI 0.79, 1.04]; MACE: 0.84 [0.70, 1.00]), incorporating VITAL-placebo showed protective effects of cocoa extract for cardiovascular endpoints ; RRs were 0.87 [0.76, 0.98] for CVD and 0.80 [0.68, 0.93] for MACE in Cox models; and those were 0.84 [0.74, 0.95] for CVD and 0.77 [0.67, 0.89] for MACE in the doubly robust method. E-values and sensitivity analyses indicated robustness. The present results suggest that original non-significant results of COSMOS could be due to type 2 error. While additional assumptions are needed, external control integration offers a feasible approach to strengthen interpretations of large-scale prevention trials. Copyright © Springer Nature B.V. 2026. <104> Accession Number 2045599801 Title The clinical use of cryoprecipitate and fibrinogen concentrate: A scoping review. Source Transfusion. (no pagination), 2026. Date of Publication: 2026. Author Hess A.S.; White S.K.; Crowe E.P.; Raval J.S.; Andrews J.; Cohn C.S.; Covington M.L.; Cushing M.M.; Jacquot C.; Khan J.; Panigrahi A.K.; Saifee N.H.; Tobian A.A.R.; McFarland M.M.; Stanworth S.J.; Metcalf R.A. Institution (Hess) New Zealand Blood Service, Christchurch, New Zealand (White, Metcalf) Department of Pathology, University of Utah, Salt Lake City, UT, United States (Crowe, Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MD, United States (Raval) Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States (Andrews) Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States (Andrews) Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States (Cohn) Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States (Covington) Department of Pathology, Mass General Brigham, Harvard University, Boston, MA, United States (Cushing) Department of Pathology, Weill Cornell Medicine, Cornell University, New York, NY, United States (Jacquot) Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC, United States (Khan) Department of Pathology, University of Virginia, Charlottesville, VA, United States (Panigrahi) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States (Panigrahi) Department of Pathology, Stanford University, Stanford, CA, United States (Saifee) Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States (Saifee) Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, WA, United States (McFarland) University of Utah, Spencer S. Eccles Health Sciences Library, Salt Lake City, UT, United States (Stanworth) John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Stanworth) NHS Blood and Transplant, Oxford, United Kingdom (Metcalf) ARUP Laboratories, Salt Lake City, UT, United States Publisher John Wiley and Sons Inc Abstract Background: Acquired hypofibrinogenemia poses significant bleeding risks. Concentrated sources of fibrinogen, whether cryoprecipitate or fibrinogen concentrates, are widely used. This scoping review aimed to identify and map the available evidence on fibrinogen supplementation. Study Design and Methods: We used the JBI Manual and PRISMA-ScR guidelines. We included patients of all ages treated with fibrinogen supplementation. The concept was treatment with cryoprecipitate or fibrinogen concentrate (prophylactically or therapeutically); and context was any clinical setting worldwide. Eligible studies included randomized trials and observational studies with comparator arms. Comprehensive searches of three databases were performed on February 21, 2025. Primary studies meeting inclusion criteria were selected. UpSet data visualizations displayed studies with intersecting sets of characteristics. Result(s): From 8181 references screened, 134 met inclusion criteria, of which 61 were randomized trials and 16 propensity-matched observational cohort studies. The highest proportion of trials focused on cardiovascular surgery (28/61; 46%) then trauma (12/61; 20%) populations and mainly assessed use of fibrinogen therapeutically (34/61; 56%). More trials evaluated fibrinogen concentrate (53/61; 87%) compared to cryoprecipitate (8/61; 13%). Commonly reported outcomes included bleeding, transfusion needs, or mortality. Studies inconsistently reported dosing, timing, and definitions of hypofibrinogenemia. Studies evaluating certain key populations-including obstetrics and pediatrics-were limited. All but one propensity-matched study was in either cardiovascular surgery or trauma. Discussion(s): There is a growing body of literature informing use of fibrinogen supplementation, particularly in cardiovascular surgery and trauma populations. Meta-analyses appear feasible to inform evidence-based guideline development; however, variability in dosing, timing, and definitions highlights the need for more harmonized research. Copyright © 2026 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB. <105> Accession Number 2045865507 Title Regional analgesia techniques as adjuncts to general anesthesia in pediatric cardiac surgery: an updated systematic review and meta-analysis of randomized controlled trials. Source Regional Anesthesia and Pain Medicine. (no pagination), 2026. Date of Publication: 2026. Author Wegner B.F.M.; Wegner G.R.M.; Gonzalez G.L.; Felippe V.A.; Marinho A.; Nascimento T.S.; Sharma A. Institution (Wegner) Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil (Wegner) Universidade Federal da Fronteira Sul Campus Passo Fundo Curso de Graduacao em Medicina, Passo Fundo, Brazil (Gonzalez) Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil (Felippe) Instituto Nacional de Cancer, Rio de Janeiro, Brazil (Marinho) Universidade Federal de Sao Paulo, Sao Paulo, Brazil (Nascimento, Sharma) University of Iowa Health Care, Iowa City, IA, United States Publisher BMJ Publishing Group Abstract Background: Regional analgesia (RA) is increasingly used in pediatric cardiac surgery, but evidence supporting its benefit remains fragmented. This systematic review and meta-analysis aimed to determine the "class effect" of RA. Method(s): A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Data sources included PubMed, Embase, Cochrane Library, and Web of Science, searched up to July 10, 2025. We included RCTs of pediatric patients undergoing cardiac surgery that compared any RA technique (neuraxial, peripheral nerve blocks, or local infiltration) against general anesthesia with systemic analgesia alone. Result(s): 31 RCTs (n=2245) were included. Adjunctive RA was associated with significant reductions in intraoperative fentanyl (MD -2.50 microg.kg-1; 95% CI -3.84 to -1.15; 95% PI -9.51 to 4.52; I2=97%), 24-hour intravenous morphine (MD -0.33 mg.kg-1; 95% CI -0.55 to -0.11; 95% PI -1.17 to 0.51; I2=96%), and improved recovery. Benefits included shorter time to tracheal extubation (MD -1.72 hours; 95% CI -2.93 to -0.52; 95% PI -7.78 to 4.34; I2=99%), reduced ICU stay (MD -0.25 days; 95% CI -0.34 to -0.16; 95% PI -0.61 to 0.11; I2=93%), and prolonged time to first analgesia (MD 2.95 hours; 95% CI 1.86 to 4.04; 95% PI -1.42 to 7.31; I2=97%). Subgroup analyses showed outcome-specific, inconsistent effects. Conclusion(s): There is very low to low certainty of evidence that adjunctive RA is associated with reduced opioid exposure and improved recovery in pediatric cardiac surgery. Substantial heterogeneity and imprecision markedly reduce confidence in the estimated effects, which should therefore be interpreted cautiously. Registration: PROSPERO CRD420251073543. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <106> Accession Number 2045868908 Title Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial. Source European Heart Journal. 47(20) (pp 2440-2448), 2026. Date of Publication: 21 May 2026. Author Yuan X.; Ju F.; Wu H.; Zhao Y.; Liu S.; Wang X.; Zhu J.; Su P.; Xu F.; Feng W.; Yang Y.; Wang Y.; Sun H. Institution (Yuan) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Ju) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Wu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Zhao) Medical Research and Biometrics Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Wang) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Liu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Wang) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Zhu) Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (Su) Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, China (Xu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Feng) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Yang) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Wang) Medical Research and Biometrics Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China (Sun) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, China Publisher Oxford University Press Abstract Background and Aims: While surgical left atrial appendage occlusion (SLAAO) reduces stroke in atrial fibrillation (AF) patients, its efficacy in patients without pre-operative AF but with CHA2DS2-VASc >=2 remains uncertain despite their high post-operative AF risk (15-54%). The aim of this study was to evaluate whether prophylactic SLAAO reduces post-operative thrombo-embolic events in valvular surgery patients. Method(s): The OPINION was a multicentre, open-label, randomized, superiority trial conducted at three cardiac surgery centres in China. Eligible non-AF patients with CHA2DS2-VASc >=2 and an indication for valve repair or replacement due to mitral or aortic valve lesions were randomly assigned (1:1) to undergo SLAAO (intervention arm) or not undergo SLAAO (control arm) during surgery. The primary outcome was a composite of ischaemic stroke, transient ischaemic attack (TIA), or cardiovascular mortality assessed at 1 year. The primary analysis was done in the intention-to-treat population. Result(s): Between April 2021 and June 2024, a total of 2157 patients were enrolled and randomized. After exclusion of 39 patients who withdrew informed consent, 2118 participants were included in the intention-to-treat population (1062 in the SLAAO group and 1056 in the control group). Baseline characteristics were well-balanced between the SLAAO group and control group (mean age 55.5 [11.4] vs 55.6 [11.5] years, P = .65; female 32.9% vs 32.3%, P = .78; CHA<inf>2</inf>DS<inf>2</inf>-VASc score 2.88 [0.98] vs 2.87 [0.96], P = .83; median EuroSCORE II 1.58% [1.42%] vs 1.56% [1.28%], P = .74). The 1-year primary endpoint occurred in 73 (6.9%) patients in the SLAAO group and in 87 (8.2%) patients in the control group (hazard ratio 0.83; 95% confidence interval 0.61-1.14; P = .25). Conclusion(s): For valvular surgery patients with CHA2DS2-VASc scores >=2 but no pre-operative AF, routine prophylactic left atrial appendage closure did not significantly reduce the incidence of the primary composite endpoint (ischaemic stroke, TIA, and cardiovascular mortality) at 1-year follow-up. Trial Registration: ChiCTR.org registry ChiCTR2100042238. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <107> Accession Number 651218620 Title The Effect of Tirzepatide vs. Dulaglutide on Major Adverse Cardiovascular Events (MACE-4 and MACE-5) in Patients With Type 2 Diabetes and Established Atherosclerotic Cardiovascular Disease. Source Diabetologie und Stoffwechsel. Conference: Diabetes. Umwelt. Leben. Perspektiven aus allen Blickwinkeln, DDG 2026. Berlin Germany. 21(Supplement 1) (pp S78-S79), 2026. Date of Publication: 01 May 2026. Author McGuire D.; D'Alessio D.; Miller D.; Weerakkody G.; Nicholls S.; Seufert J. Institution (McGuire) University of Texas Southwestern Medical Center and Parkland Health, Dallas, TX, United States (D'Alessio) Division of Endocrinology, Duke University, Department of Medicine, Durham, NC, United States (Miller, Weerakkody) Eli Lilly and Company, Indianapolis, IN, United States (Nicholls) Victorian Heart Institute, Monash University, Melbourne, Australia (Seufert) Abteilung Endokrinologie und Diabetologie, Universitatsklinikum Freiburg, Klinik fur Innere Medizin II, Freiburg, Germany Publisher Georg Thieme Verlag Abstract Did tirzepatide(TZP) reduce MACE-4 and MACE-5 risk more than dulaglutide(DULA) in patients with type 2 diabetes(T2D) and established atherosclerotic cardiovascular disease(ASCVD)? Methodology In SURPASS-CVOT, TZP was non-inferior to DULA in reducing the risk of major adverse cardiovascular events(MACE-3: CV death, MI, or stroke) in T2D and ASCVD patients. This analysis evaluated differences in extended CV outcomes, assessing TZP(<= 15mg) vs DULA(1.5mg) on MACE-4(CV death, MI, stroke, or coronary revascularisation) and MACE -5(MACE-4 or hospitalisation due to unstable angina [UA]). Results MACE-4 occurred in 1089(16.5 %) receiving TZP vs 1217(18.5 %) receiving DULA(HR 0.88; 95 %CI 0.81-0.96). With prior coronary artery disease(CAD), MACE-4 occurred in 875(18.6 %) receiving TZP, and 967(20.5 %) receiving DULA(HR 0.89; 95 %CI 0.81-0.97). Without prior CAD, MACE-4 occurred in 214(11.3 %) receiving TZP, and 250(13.3 %) receiving DULA(HR 0.84; 95 %CI 0.70-1.01). MACE-5 occurred in 1112(16.9 %) receiving TZP and 1240(18.8 %) receiving DULA(HR 0.88; 95 % CI 0.81-0.96). Coronary revascularisation occurred in 527(8.0 %) vs 617(9.4 %)(HR 0.84; 95 %CI 0.75-0.95). Hospitalisation due to UA occurred in 110(1.7 %) vs 148(2.2 %)(HR 0.74; 95 %CI 0.57-0.94). Conclusions Among T2D and ASCVD patients, TZP was associated with a lower risk of MACE-4, MACE-5, coronary revascularisation, and UA hospitalisation vs DULA. <108> Accession Number 651224258 Title Crystalloid fluids choices during cardiopulmonary bypass, outcomes of acid-base and lactate levels in cardio surgery. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 18 May 2026. Author Pabarjay M.; Azarfarin R.; Alizadeh-Ghavidel A.; Hamidi S.H.; Bakhshandeh H.; Tarkhan F.; Alijanpour S. Institution (Pabarjay) Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Azarfarin) Echocardiography Research Center, Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Alizadeh-Ghavidel) Heart Valve Disease Research Center, Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Hamidi) Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Bakhshandeh) Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Tarkhan) Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Alijanpour) Department of Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of Abstract BACKGROUND: Ultrafiltration is integral to cardiopulmonary bypass, yet the optimal replacement fluid for zero-balance ultrafiltration requires further investigation to guide clinical practice. This study aimed to compare the efficacy of Normal saline, Ringer's solution, and Ringer's lactate on lactate management, acid-base balance, and clinical outcomes. METHOD(S): This semi-experimental study enrolled 90 patients undergoing cardiopulmonary bypass (CPB) into three groups of 30. In Group-R, Ringer's solution was used as replacement fluid in Z-BUF. In Group-RL, Ringer's lactate and in Group-NS, Normal saline was used. Lactate and pH levels were measured at five points: before CPB and after anesthesia induction, after cardioplegia, before starting Z-BUF, after Z-BUF and after CPB. RESULT(S): While there was no significant difference in baseline lactate (T1), an increasing trend was observed up to T3. At T4, immediately after Z-BUF, lactate levels were significantly higher in Group-RL (3.5 +/- 1.0 mEq/L) compared to Group-R (2.3 +/- 1.0 mEq/L) and Group-NS (1.9 +/- 0.6 mEq/L) (p < 0.05). By T5, lactate in Group-RL decreased, showing no significant difference between groups. There were no statistically significant differences in pH between groups at any time point. However, the magnitude of pH decrease from T3 to T4 was smaller in Group-RL (7.38 +/- 0.05 to 7.37 +/- 0.03) compared to Group-R (7.39 +/- 0.05 to 7.35 +/- 0.04) and Group-NS (7.41 +/- 0.07 to 7.35 +/- 0.05). CONCLUSION(S): While Ringer's lactate demonstrated favorable pH stability, its clinical superiority in preventing significant acidosis or reducing bicarbonate requirements, and the implications for postoperative nursing monitoring and fluid management protocols, require validation in larger trials. Copyright © 2026. The Author(s). <109> Accession Number 2045865295 Title Mechanical versus biological aortic valve replacement in patients aged 50-70 years: a systematic review and meta-analysis. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Trevis J.; Cheong J.; Wilkinson C.; Ogundimu E.; Maier R.; Austin D.; Akowuah E. Institution (Trevis, Cheong, Wilkinson, Maier, Austin, Akowuah) Academic Cardiovascular Unit, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom (Wilkinson) Hull York Medical School, University of York, York, United Kingdom (Ogundimu) Department of Mathematical Sciences, Durham University, Durham, United Kingdom (Maier, Austin) Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom (Akowuah) Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom Publisher BMJ Publishing Group Abstract Objectives: The optimal prosthetic aortic valve replacement (AVR) for long-term outcomes in patients aged 50-70 years remains uncertain. International guidelines differ; contemporary randomised trials are lacking, and use of bioprosthetic valves has increased. This review synthesised evidence comparing efficacy and safety outcomes between valve types in this age group. Method(s): A systematic review and meta-analysis of randomised and observational studies comparing mechanical and bioprosthetic AVR in patients aged 50-70 years was conducted. Medline, Embase and the Cochrane Library were searched. The primary outcome was overall survival; secondary outcomes were major bleeding, reoperation and stroke. Data were pooled using inverse variance random-effects meta-analysis and presented as HRs with 95% CIs. Result(s): 30 studies involving 120 844 patients were included, 29 of which were observational. Mechanical valves were associated with better overall survival (HR 0.88; 95% CI 0.81 to 0.94; p=0.001). Stroke rates did not differ significantly (HR 1.07; 95% CI 0.91 to 1.27; p=0.37). Mechanical valves carried a higher risk of major bleeding (HR 1.60; 95% CI 1.43 to 1.78; p<0.001), while bioprosthetic valves had higher reoperation rates (HR 0.44; 95% CI 0.33 to 0.57; p<0.001). Conclusion(s): Drawing largely from observational data, mechanical valves were associated with superior overall survival but increased bleeding due to lifelong anticoagulation. Bioprosthetic valves offer lower bleeding risk but higher reoperation rates from structural degeneration. The growing use of bioprosthetic valves in this age group may lead to more reinterventions in older, more comorbid patients. Contemporary randomised trials are needed to evaluate outcomes with modern valve designs. PROSPERO registration number: CRD42024540272. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <110> Accession Number 2045843389 Title Systemic Embolic Events in People Who Inject Drugs With Patent Foramen Ovale and Right-Sided Infective Endocarditis: A Systematic Review. Source Open Forum Infectious Diseases. 13(5) (no pagination), 2026. Article Number: ofag245. Date of Publication: 01 Nov 2026. Author Cuervo G.; Chesdachai S.; Gerberi D.; DeSimone C.V.; Deshmukh A.J.; Miro J.M.; El Sabbagh A.; DeSimone D.C.; Baddour L.M. Institution (Cuervo) Infectious Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Cuervo) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Cuervo) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Chesdachai) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Chesdachai) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Gerberi) Department of Library Services, Mayo Clinic, Rochester, MN, United States (DeSimone) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Miro) Infectious Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Miro) Reial Academia de Medicina de Catalunya, Barcelona, Spain (El Sabbagh) Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States (DeSimone) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (DeSimone) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Baddour) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Baddour) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Publisher Oxford University Press Abstract Background: Knowing the prevalence of patent foramen ovale (PFO) and the increasing number of people who inject drugs (PWID) with right-sided infective endocarditis (RSIE), we aimed to better characterize the syndrome of injection drug use, RSIE, and PFO with systemic embolic events. Method(s): A systematic search across multiple databases was independently screened using predefined criteria (from inception until September 2025). Published cases of adult PWID diagnosed with RSIE and ischemic stroke or other systemic embolic event were included, provided they had PFO assessment. Individuals were excluded if they had cardiac implantable electronic device (CIED) infections or any other conditions associated with systemic or paradoxical embolism. Result(s): The review identified 13 studies with 14 young patients, mostly without comorbidities, predominantly infected with Staphylococcus aureus. In most cases, echocardiography revealed large tricuspid valve vegetations. Neuroimaging confirmed multiple ischemic infarcts, while 5 patients showed emboli outside the central nervous system (4 of them as the only systemic embolism). At least 11 (79%) patients had echocardiographic evidence of right-to-left shunting. Management included cardiac surgery in 6 cases that involved valve replacement or repair, percutaneous PFO closure in 2 cases, and percutaneous mechanical aspiration in 1 case. Three patients (21%) died during hospitalization, and only 27.3% patients had outpatient follow-up. Conclusion(s): RSIE with systemic embolism in PWID with PFO has rarely been reported, affects younger patients without sex predominance, and was usually due to S. aureus with large tricuspid vegetations. Right-to-left shunting was characteristic, and outcomes were poor despite combined medical, surgical, and interventional therapies. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. 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. <111> Accession Number 2045843863 Title Negative-pressure wound therapy in thoracic and abdominal surgery: meta-analysis of randomized trials. Source BJS Open. 10(3) (no pagination), 2026. Article Number: zrag027. Date of Publication: 01 Jun 2026. Author Lakha A.S.; Neves S.; Alemour Y.; McGivern H.; Gordon-Weeks A. Institution (Lakha) Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (Lakha) Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Neves) Thames Valley Foundation School, Oxford, United Kingdom (Alemour) Bodleian Healthcare Libraries, University of Oxford, Oxford, United Kingdom (McGivern) Department of Integrative Biology, Sorbonne University, Paris, France (Gordon-Weeks) Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (Gordon-Weeks) Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom Publisher Oxford University Press Abstract Background: Around 30 000 patients undergo emergency laparotomy in the UK each year, and a similar number of patients undergo open cardiothoracic surgery. Surgical site infection is a common complication associated with increased morbidity, prolonged hospital stay, and higher healthcare costs. Negative-pressure wound therapy has been proposed as a prophylactic strategy to reduce wound complications, but trial evidence has been inconsistent. Method(s): This systematic review and meta-analysis was carried out using PRISMA guidelines and was registered prospectively in PROSPERO (CRD420251010516). A literature search was carried out in March 2025 (updated December 2025), and titles and abstracts were screened against predefined inclusion criteria. Trials assessing patients undergoing open thoracic or abdominal surgery for any indication in adult patients assessing the risk of surgical site infection as an outcome were included. Quality assessment was performed using Cochrane's risk-of-bias 2 tool. Summary statistics for outcomes of interest underwent meta-analyses to a confidence interval of 95% and are presented as forest plots. Result(s): Some 12 427 patients across 45 randomized trials in abdominal and thoracic surgery were included for analysis. Negative-pressure wound therapy significantly reduced surgical site infection compared with standard dressings (odds ratio (OR) 0.53, 95% confidence interval 0.42 to 0.66). The effect was consistent across commercial devices (PICOTM and PrevenaTM). Negative-pressure wound therapy was associated with shorter hospital stay (mean difference -1.67 (95% confidence interval -3.19 to -0.16) days), but not with reduced risk of organ/space infection (OR 0.92, 0.67 to 1.25), wound dehiscence, or reoperation. Only three studies included thoracic surgery and no significant difference in surgical site infection was found (OR 0.44, 0.00 to 45.25). Publication bias was detected; trim-and-fill analysis attenuated but did not eliminate the benefit (adjusted OR 0.70, 0.54 to 0.90). Adverse events and patient-reported outcomes were reported infrequently, and showed no consistent differences. Conclusion(s): Negative-pressure wound therapy was associated with a nearly 50% reduction in SSI and shorter hospital stay after open abdominal surgery, with consistent benefit across device types. However, evidence of publication bias, and limited long-term and patient-reported outcome data suggest that effect size may be overestimated. Selective use in high-risk patients is supported. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <112> Accession Number 2045571733 Title Effects of prehabilitation programmes on postoperative outcomes in older adults undergoing major abdominal, cardiac or vascular surgery: a systematic review. Source Aging Clinical and Experimental Research. 38(1) (no pagination), 2026. Article Number: 120. Date of Publication: 01 Dec 2026. Author Buckinx F.; Rousseau A.-F.; Louis E.; De Roover A.; Detry O.; Durieux R.; Gillain S.; Kaba A.; Kaux J.-F.; Tchana-Sato V.; Bruyere O. Institution (Buckinx, Bruyere) Research Unit in public health, epidemiology and health economics, University of Liege, Liege, Belgium (Kaux, Bruyere) Department of Physical Activity and Rehabilitation Sciences, University of Liege, Liege, Belgium (Rousseau) Intensive Care Department, University Hospital of Liege, Liege, Belgium (Rousseau) Research Unit for a Life-Course Perspective on Health & Education (RUCHE), University of Liege, Liege, Belgium (Louis) Hepato-Gastroenterology and Digestive Oncology Department, University Hospital of Liege, Liege, Belgium (De Roover, Detry) Department of Abdominal Surgery and Transplantation, University Hospital of Liege, Liege, Belgium (Durieux, Tchana-Sato) Division of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium (Gillain) Geriatric Department, University Hospital of Liege, Liege, Belgium (Kaba) Department of Anaesthesiology, Service of Abdominal Surgery, University Hospital of Liege, Liege, Belgium (Kaux) Department of Physical Medicine, Rehabilitation and Sports Traumatology FIMS Collaborative Centre of Sports Medicine, FIFA Medical Centre of Excellence, SportS2, Liege, Belgium Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Older adults undergoing major abdominal, cardiac, or vascular surgery are highly vulnerable to postoperative complications, prolonged hospitalisation, functional decline, and mortality. Sarcopenia and frailty reduce physiological reserve, underscoring the potential role of prehabilitation in improving resilience to surgical stress and postoperative outcomes. Objective(s): To evaluate the effects of exercise-based prehabilitation, alone or combined with nutritional, psychological, or educational components, on postoperative outcomes, including complications, length of stay, readmissions, mortality, quality of life, and economic indicators, as well as on body composition, functional reserve, and biological markers, in adults aged >= 65 years undergoing major abdominal, cardiac, or vascular surgery. Method(s): Medline, Scopus and EMBASE were searched for Randomised Controlled trials assessing prehabilitation programmes in older adults undergoing major abdominal, cardiac or vascular surgery. Data on study characteristics, interventions, outcomes, and methodological quality were extracted and synthesized narratively. Result(s): Nine studies (n = 36-182; mean/median age 68-82) were included. Interventions lasted 2-6 weeks and involved exercise alone or multimodal programmes, delivered in-person, remotely, or via hybrid approaches. Vascular surgery studies showed modest reductions in complications and hospital stay, whereas abdominal surgery studies generally reported no significant improvements, except for isolated reductions in severe complications or gains in functional reserve. No studies involving cardiac surgery were identified. Conclusion(s): Prehabilitation in older adults remains understudied, especially in frail patients, the oldest old, and cardiac surgery. Robust trials are needed to assess individualized, multimodal, sarcopenia-targeted interventions and to integrate biological markers to clarify underlying mechanisms. Copyright © The Author(s) 2026. <113> Accession Number 2045848515 Title Exploring the Potential of AI and Augmented Reality in Cardiovascular Disease Management: A Narrative Review. Source Current Cardiology Reviews. 22(4) (no pagination), 2026. Date of Publication: 2026. Author Khan A.M.; Villalobos A.; Kakadiya A.D.; Kaur H.; Tabassum S.; Faisal A.M.; Pardeshi R.; Shah D.; Ponnada S.C.; Patel K. Institution (Khan) OSF Saint Francis Medical Centre, Peoria, IL, United States (Villalobos) Ponce Health Sciences University, Ponce, United States (Kakadiya) GMERS Medical College & Hospital, Ahmedabad, India (Kaur) Government Medical College, Patiala, India (Tabassum) Dr. V.R.K Women's Medical College, Telangana, Aziz Nagar, India (Faisal) Danylo Halytsky Lviv National Medical University, Lviv, Ukraine (Pardeshi) GCS Medical College, Hospital and Research Center, Ahmedabad, India (Shah) B.J. Medical College, Ahmedabad, India (Ponnada) Great Eastern Medical School and Hospital, Srikakulam, India (Patel) Government Medical College, Surat, India Publisher Bentham Science Publishers Abstract Introduction: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide, with their rising incidence demanding a shift toward more personalized treatment approaches. Artificial intelligence (AI) and augmented reality (AR) are two newly evolving technologies that have found extensive usage in the field of cardiovascular medicine and surgery. AI-based models involve machine learning and deep learning neural networks. These primarily form the basis of prediction models, allowing the prediction of risk, survival, and risk stratification of patients. Method(s): A literature search was conducted using PubMed and Google Scholar, and it included studies published between 2003 and 2024. Articles were selected based on clinical relevance and applicability to cardiovascular disease management using artificial intelligence (AI) and AR. Keywords used included "cardiovascular disease", "artificial intelligence", "augmented reality", "diagnostic imaging", and "risk prediction". Studies were screened manually for inclusion based on the title and abstract review, followed by full-text evaluation for relevance and quality. Result(s): This narrative review highlights how artificial intelligence (AI) and augmented reality (AR) are increasingly being applied in cardiovascular disease management. Despite recent studies, there remains a lack of proper evaluation of these models' efficacy, and therefore multiple large-scale trials are needed. Discussion(s): Networks such as Convolutional Neural Networks (CNNs) and Natural Language Processing (NLP) have been used to improve image interpretation and documentation processes. Conclusion(s): Further and larger studies are needed to test the efficacy and safety of these models. This narrative review summarizes recent findings in AI and AR and offers perspectives on future research. Copyright 2026, Bentham Science Publishers <114> Accession Number 2045650924 Title Cerebral embolic protection devices for transcatheter aortic valve replacement: A meta-analysis and trial sequential analysis. Source American Heart Journal. 299 (no pagination), 2026. Article Number: 107449. Date of Publication: 01 Sep 2026. Author Elbenawi H.; Hassan I.; Abdelgalil M.S.; Hanna M.; Almotawally S.; Fayed M.; Mohamed K.A.; Elnaggar H.; Abouainain L.; Hamed B.M.; Ibrahim A.; Khatib A.A.; Elhelw M.; Hassan E.; Eisa M.; Zaaya M.; Ibrahim R.; Goldsweig A.M.; Saad M.; Alfonso F.; Alkhouli M.; Elgendy I.Y. Institution (Elbenawi, Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Hassan) DeBakey Heart & Vascular Center, Houston Methodist Academic Institute, Houston, TX, United States (Abdelgalil, Almotawally) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Hanna) Department of Cardiology, Assiut University, Assiut, Egypt (Fayed) Department of Neurology, University of Florida, Gainesville, FL, United States (Mohamed) Department of Internal Medicine, Hartford Hospital, Hartford, CT, United States (Elnaggar) Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt (Abouainain) Faculty of Medicine, University of Jordan, Amman, Jordan (Hamed) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Ibrahim) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Khatib) Department of Internal Medicine, MedStar Health, Baltimore, MD, United States (Elhelw) Department of Internal Medicine, University of Kentucky, Lexington, KY, United States (Hassan) Department of Internal Medicine, Ascension Saint Agnes Hospital, Baltimore, MD, United States (Eisa) Internal Medicine Department, Rochester General Hospital, Rochester, NY, United States (Zaaya) Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, United States (Ibrahim) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center and University of Massachusetts-Baystate, Springfield, MA, United States (Saad) Department of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, United States (Alfonso) Department of Cardiology, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain (Elgendy) Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, United States Publisher Elsevier Inc. Abstract Background Transcatheter aortic valve replacement (TAVR) is associated with periprocedural stroke risk due to embolic debris. The efficacy and safety of cerebral embolic protection devices (CEPDs) remain uncertain, with conflicting results between trials. We performed a meta-analysis of randomized controlled trials (RCTs) of current-generation CEPDs for TAVR. Methods Electronic databases were searched for RCTs comparing clinical outcomes with routine CEPD use vs no CEPD use. Outcomes of interest included any stroke, disabling stroke, and all-cause mortality. Risk ratios (RR) or mean differences with 95% confidence intervals (CIs) were pooled using random-effects models. The analysis was complemented by meta-regression and trial sequential analyses. Results The meta-analysis included 8 RCTs (5 filter-based and 3 shield-based) with 11,596 patients. CEPD use was not associated with a lower incidence of any stroke (RR 0.92; 95% CI 0.75-1.14), disabling stroke (RR 0.80; 95% CI 0.55-1.15), new magnetic resonance imaging-detected lesions (RR 1.00; 95% CI 0.93-1.07), or all-cause mortality (RR 1.04; 95% CI 0.71-1.51). Trial sequential analysis provided conclusive meta-analytic evidence and affirmed the absence of CEPD benefit. Meta-regression showed no significant association between stroke risk and patient-level covariates, including age, sex, or the presence of diabetes, prior stroke, or atrial fibrillation (all P ' .05). Conclusions Current-generation CEPD devices during TAVR did not significantly reduce the risk of any stroke, disabling stroke, or all-cause mortality. Trial sequential analysis indicates that, at least with available data, cumulative evidence appears sufficient to question the predefined benefit thresholds for existing systems. These findings suggest the lack of routine use of current-generation CEPD in TAVR. Copyright © 2026 . <115> Accession Number 2045652554 Title Single Versus Double Perclose Devices for TF-TAVR Access Closure. Source JACC: Asia. 6(6) (pp 898-906), 2026. Date of Publication: 01 Jun 2026. Author Jiang J.; Wang L.; Hu P.; Ren K.; Lin X.; Zhu Q.; Fan J.; He Y.; Guo Y.; Liu Q.; Liang J.; Li H.; Yan H.; Wang J.; Liu X. Institution (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China (Wang, Liu) Transvascular Implantation Devices Research Institute, Hangzhou, China (Wang, Liu) Binjiang Institute of Zhejiang University, Hangzhou, China Publisher Elsevier Inc. Abstract Background The Double Perclose ProGlide (Abbott Vascular Devices) is widely adopted device for closing the main arterial access in transfemoral transcatheter aortic valve replacement (TF-TAVR). Previous observational studies have compared the single device vs double device approach, yielding controversial results and highlighting a gap in clinical randomized controlled trials. Objectives The authors sought to evaluate the effectiveness and safety of single vs double Perclose ProGlide devices in patients undergoing TF-TAVR. Methods The Single-Closure trial was been launched in 2024 ( NCT06173115 ). It is an investigator-initiated, open-label, multicenter, noninferior, randomized controlled trial designed to compare the clinical outcomes of single vs double Perclose closure devices. Eligible participants include patients over 65 years of age with severe aortic stenosis and indicated for TF-TAVR. These patients are randomly assigned in a 1:1 ratio to either the single Perclose closure group or the double Perclose closure group. Results The primary endpoint of the trial is the composite of access site or access-related major and minor vascular complications during hospitalization for the index procedure, as defined by the Valve Academic Research Consortium 3 criteria. Conclusions This trial aims to compare the clinical outcomes of single vs double Perclose closure. Results of this trial may provide valuable insights into the optimal strategy for large-bore vascular closure. Copyright © 2026 The Authors. <116> Accession Number 2045652559 Title Design of IKISS-LM Randomized Controlled Trial. Source JACC: Asia. 6(6) (pp 929-937), 2026. Date of Publication: 01 Jun 2026. Author Gupta A.; Revaiah P.C.; Nevali K.P.; Chhikara S.; S. S.; Maurya P.; Mehta A.; Vijayvergiya R.; Narayanan S.; Mahesh N.K.; Gopi A.; Sharma P.; Singh B.; Sharma R.; Bhatia T.; Khanna R.; Kasinadhuni G.; Kaur N.; Parikh C.; Manoria P.; Arneja J.; Singh N.; Kumar R.; Vipperla S.; Goyal P.; Phatarpekar A.; A J.; Dugal J.S.; Abbot A.K.; Mathen P.G.; Santosh V.K.; Seth A.; Mamas M.A.; Mullasari A.S. Institution (Gupta, Singh, Singh, A) Department of Cardiology, Army Institute of Cardiothoracic Sciences (AICTS), Pune, India (Revaiah, Santosh) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Nevali) Department of Cardiology, NRI Academy of Medical Sciences, Guntur, India (Chhikara) Department of Cardiology, Montefiore Medical Center, Bronx, NY, United States (S.) Department of Cardiology, Meenakshi Mission Hospital and Research Centre, Tamil Nadu, Madurai, India (Maurya) Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India (Mehta, Dugal) Department of Cardiology, Jehangir Hospital, Pune, India (Vijayvergiya) Department of Cardiology, Advanced Cardiac Center, PGIMER, Chandigarh, India (Narayanan) Department of Cardiology, Little Flower Hospital and Research Centre, Kerala, Angamaly, India (Mahesh) Department of Cardiology, Saint Gregorios Medical Mission Multi-Speciality Hospital, Kerala, Parumala, India (Gopi) Department of Cardiology, Metromed International Cardiac Center, Kerala, Calicut, India (Sharma, Kumar, Abbot) Department of Cardiology, Army Hospital Research and Referral, New Delhi, India (Sharma, Bhatia) Department of Cardiology, Shree Guru Ram Rai Institute of Medical & Health Sciences, Uttarakhand, Dehradun, India (Khanna) Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh, Lucknow, India (Kasinadhuni) Department of Cardiology, KIMS, Seethamadhara, Andhra Pradesh, Visakhapatnam, India (Kaur) Department of Cardiology, Command Hospital Air Force Bangalore, Karnataka, Bengaluru, India (Parikh) Department of Cardiology, SRM and Kikabhai Heart Hospital, Maharashtra, Mumbai, India (Manoria) Department of Cardiology, Manoria Heart and Critical Care Hospital, Madhya Pradesh, Bhopal, India (Arneja) Department of Cardiology, Arneja Heart and Multispeciality Hospital, Maharashtra, Nagpur, India (Vipperla) Department of Cardiology, Indus Hospital, Andhra Pradesh, Visakhapatnam, India (Goyal) Department of Cardiology, Synergy Plus Hospital, Uttar Pradesh, Agra, India (Phatarpekar) Department of Cardiology, Symbiosis Speciality Hospital, Mumbai, India (Mathen) Department of Cardiology, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (Seth) Department of Cardiology, Fortis Escorts Heart Institute, New Delhi, India (Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom (Mullasari) Department of Cardiology, Madras Medical Mission, Tamil Nadu, Chennai, India Publisher Elsevier Inc. Abstract Background Percutaneous coronary intervention (PCI) with drug-eluting stents is an alternative to coronary artery bypass graft surgery for distal left main bifurcation disease (dLMBD) lesions. In noncomplex dLMBD, provisional stenting strategy (PSS) is preferred. The European Bifurcation Club consensus recommends routine kissing balloon inflation (KBI) in distal left main (LM) bifurcation PCI using PSS, based on anecdotal reports and non-LM trials. Objectives This study evaluates routine KBI vs no KBI in noncomplex dLMBD undergoing PSS with intravascular imaging. Methods This prospective, single-blind, multicenter randomized controlled trial is being conducted across 27 centers in India. Eligible patients have noncomplex dLMBD (defined by DEFINITION [Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents] criteria) and undergo LM crossover stenting to either the left anterior descending or left circumflex artery. All procedures use intravascular ultrasound or optical coherence tomography. Participants are randomized to KBI or no KBI. The primary endpoint is 1-year angiographic side branch ostium restenosis (>50% diameter stenosis). Secondary endpoints include: 1) target lesion failure (defined as the composite of cardiac death, target-vessel myocardial infarction, and clinically driven target lesion revascularization) at 1 year; 2) individual outcomes of all-cause mortality, cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis; and 3) angiographic restenosis of the main vessel or side branch. If angiographic follow-up is <70%, the 1-year target lesion failure rate will be assessed as a non-inferiority primary endpoint, with continued enrolment toward >=1,000 patients to ensure adequate power. Conclusions The IKISS-LM (Impact of Kissing Balloon Inflation on Provisional Left Main Bifurcation Percutaneous Coronary Intervention: A Prospective Multicenter Randomized Controlled Trial) trial evaluates whether routine KBI improves side branch ostium patency and clinical outcomes after PSS in noncomplex dLMBD, aiming to refine evidence-based strategies for LM bifurcation PCI. (Impact of Kissing balloon inflation on provisional Left Main Percutaneous Coronary Intervention: A Prospective Multicenter Randomized Trial [IKISS-LM Trial]; CTRI/2024/09/073616 ) Copyright © 2026 The Authors. <117> Accession Number 2045611576 Title Combination antibiotic therapy in Staphylococcus aureus endocarditis: evidence, controversies, and future directions. Source Infection. (no pagination), 2026. Date of Publication: 2026. Author Meena D.S.; Kumar D.; Bohra G.K. Institution (Meena, Kumar, Bohra) Division of Infectious Diseases, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India Publisher Springer Science and Business Media Deutschland GmbH Abstract Staphylococcus aureus is now the leading cause of infective endocarditis (IE) worldwide and is associated with high mortality and frequent complications. Combination antimicrobial therapy has long been proposed to enhance bactericidal activity, improve biofilm penetration, and limit resistance; however, its true clinical value remains uncertain. This narrative review examines the experimental and clinical evidence for combination regimens in Staphylococcus aureus infective endocarditis (S. aureus IE). We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library through September 2025 for randomised trials, comparative observational studies, major guidelines, and key experimental reports. Evidence is synthesised across methicillin-susceptible and methicillin-resistant strains, and across native and prosthetic valve disease. We summarise the biological rationale, potential benefits, and stewardship impact of combination therapy. We also highlight the practical implications for when to consider, avoid, or de-escalate combination therapy, and outline priorities for future research. We find that evidence for combination therapy in S. aureus endocarditis remains limited and largely observational. Adjunctive rifampin and aminoglycosides have not shown consistent clinical benefit and are associated with increased toxicity. Beta-lactam combinations with vancomycin or daptomycin may reduce the bacteremia duration, but this has not translated into improved survival. Emerging regimens, particularly daptomycin combined with ceftaroline show promise in persistent bacteremia, although evidence remains observational. Overall, current data do not support routine use of combination therapy and favour a selective, case-based approach. High-quality multicentre studies integrating microbiological, pharmacodynamic, and clinical endpoints are urgently needed to define optimal combination strategies. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <118> Accession Number 2045513117 Title Optimizing Recovery After Thoracotomy: Evidence-Based Non-Opioid and Multimodal Analgesia - A Narrative Review. Source Current Pain and Headache Reports. 30(1) (no pagination), 2026. Article Number: 66. Date of Publication: 01 Dec 2026. Author Ali S.; Sohail F.; Fazal F.; Jauhar V.; Kashaf S.; Bansari S. Institution (Ali) Medicine, The Aga Khan University Hospital, P.O. Box 3500, Stadium Road, Karachi, Pakistan (Sohail) MBBS, Jinnah Sindh Medical University, Rafiqui H.J. Shaheed Road, Karachi, Pakistan (Fazal) MBBS, Karachi Metropolitan University, Karachi, Pakistan (Jauhar) MBBS, Dow University of Health and Sciences, Karachi, Pakistan (Kashaf, Bansari) MBBS, Liaquat University of Medical Health Science, Jamshoro, Pakistan Publisher Springer Abstract Purpose of Review: After open thoracic surgery, post-thoracotomy pain remains an important postoperative problem affecting nearly half of patients. It can give rise to respiratory problems, delayed rehabilitation, prolonged hospitalizations, and chronic post-thoracotomy pain syndrome. Despite the reality that opioids are currently the primary source of anesthesia after surgery, their consumption is restricted by complications, including prolonged dependency, tolerance, and respiratory impairment. Recent Findings: To maximize recovery after the thoracotomy, this narrative review incorporates some of the most current studies on opioid-free strategies. In addition to local anesthetic techniques, which include thoracic epidural analgesia, paravertebral block, and erector spinae plane block, the current study highlights the effectiveness of non-opioid pharmaceutical agents, which include acetaminophen, non-steroidal anti-inflammatory drugs, gabapentinoids, ketamine-based, steroids, and intravenous lidocaine. Physical therapy, respiratory therapy, and psychological assistance are examples of complementary non-pharmacologic interventions that improve postoperative recovery. Summary: By integrating such techniques as Enhanced Recovery. After Surgery (ERAS) pathways, individualized multidisciplinary analgesic procedures that reduce opioid consumption, promote the recovery process, and perhaps decrease the probability of chronic postoperative pain. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <119> [Use Link to view the full text] Accession Number 651203602 Title Optimizing conduits and intraoperative graft quality in coronary artery bypass graft surgery. Source Current opinion in cardiology. (no pagination), 2026. Date of Publication: 15 May 2026. Author Majeed H.; Pelletier M. Institution (Majeed) Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada (Pelletier) Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States Abstract PURPOSE OF REVIEW: Optimization of conduits and intraoperative graft assessment remain central determinants of long-term success in coronary artery bypass grafting (CABG). This review is timely, given the recent publication of randomized data refining conduit selection, harvesting strategies, and modalities for physiologic graft verification. RECENT FINDINGS: Over the past year, accumulating randomized and registry-based evidence has strengthened support for multi-arterial revascularization, while clarifying the risks and benefits of certain arterial grafting and associated techniques. Parallel investigations have emphasized atraumatic great saphenous vein (GSV) harvesting and no-touch techniques, to mitigate endothelial injury and enhance patency. Intraoperative graft assessment has increasingly shifted toward routine use of objective physiologic tools, particularly transit-time flow measurement (TTFM) with adjunctive Doppler/ultrasound or fluorescence angiography, and emerging data refining quantitative thresholds and quality benchmarks. SUMMARY: Contemporary evidence underscores that durable surgical revascularization depends on integrated biologic, technical, and physiologic optimization. Standardizing conduit selection, minimizing conduit injury, and adopting routine intraoperative graft assessment may reduce early technical failure and improve long-term graft performance. Ongoing trials and implementation research will determine how best to translate these advances into consistent, high-quality CABG practice. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <120> Accession Number 651215225 Title Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding. Source The Cochrane database of systematic reviews. 5 (pp CD007871), 2026. Date of Publication: 18 May 2026. Author Kvisselgaard A.D.; Wolthers S.A.; Wikkelso A.J.; Holst L.B.; Drivenes B.; Afshari A. Institution (Kvisselgaard) Department of Anaesthesia and Intensive Care, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark (Kvisselgaard) Danish Aneasthesia Allergy Centre, Allergy Clinic 1, Copenhagen University Hospital Gentofte, Copenhagen, Denmark (Wolthers) Prehospital Centre Zealand, Naestved, Denmark (Wolthers, Wikkelso, Afshari) Department for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Wikkelso) Department of Anaesthesiology and Intensive Care Medicine, Roskilde Hospital, Roskilde, Denmark (Holst, Afshari) Juliane Marie Centre - Anaesthesia and Surgical Clinic Department 4013, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (Drivenes) Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Abstract BACKGROUND: Severe bleeding and coagulopathy are serious clinical conditions that are associated with high mortality. Thromboelastography (TEG) and thromboelastometry (ROTEM) are increasingly used to guide transfusion strategy, but their roles remain disputed. This is an update of a review that was first published in 2011 and updated in January 2016. OBJECTIVE(S): The objective was to evaluate the benefits and harms of TEG-/ROTEM-guided transfusion strategies for bleeding in adults and children by comparing TEG-ROTEM-guided transfusion with standard treatment. SEARCH METHOD(S): In this updated review, we identified randomised controlled trials (RCTs) from the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE(R) ALL; Embase; Web of Science Core Collection and Biosis Previews via Clarivate; CINAHL EBSCO; and the WHO Global Index Medicus incl. LILACS (from 2015 up to 5 January 2025). We searched for ongoing clinical trials and unpublished studies in the following registries during the aforementioned period: ISRCTN, ClinicalTrials.gov, CentreWatch, and UMIN-CTR. We contacted trial authors, authors of previous reviews, and manufacturers in the field. The original searches were run in October 2010 and January 2016. SELECTION CRITERIA: We included all RCTs, irrespective of blinding or language, that compared transfusion guided by TEG or ROTEM to transfusion guided by clinical judgement, guided by standard laboratory tests, or a combination. We also included interventional algorithms including both TEG and ROTEM in combination with standard laboratory tests or other devices. The primary analysis included trials on TEG or ROTEM versus any comparator. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data; we resolved any disagreements by discussion. We presented pooled estimates of the intervention effects on dichotomous outcomes as risk ratios (RRs) with 95% confidence intervals (CIs). Due to skewed data, meta-analysis was not provided for continuous outcome data. Our primary outcome measure was all-cause mortality. We performed subgroup and sensitivity analyses to assess the effect of a TEG- or ROTEM-guided algorithm in adults and children on various clinical and physiological outcomes. We evaluated potential bias by examining trial methodological components using the Cochrane Risk of Bias 1 and assessed the risk of random error through Trial Sequential Analysis (TSA). MAIN RESULTS: This systematic review included 35 randomised trials (n = 3096), with most involving patients undergoing elective cardiac surgery. Hence, 18 trials and 1603 participants were added since the previous update of this review. TEG-/ROTEM-guided transfusion algorithms may be associated with a reduction in mortality (RR 0.76, 95% CI 0.63 to 0.92; 19 trials; 1865 participants, I2= 0%; random-effects model; very low-certainty evidence), but the evidence is very uncertain. This aligns with results from a previous update of this review. Additionally, TEG-/ROTEM-guided transfusion algorithms may reduce bleeding volume (standardised mean difference -0.31, 95% CI -0.51 to -0.11; 19 trials; 1523 participants, I2 = 72%, random-effects model; very low-certainty evidence), but the evidence is very uncertain. No effects on the need for packed red blood cells were seen; RR 0.94 (95% CI 0.87 to 1.01; 21 trials, 2003 participants; I2 = 91%; random-effects model; very low-certainty evidence), but the evidence is very uncertain. Furthermore, reductions may be observed in the use of fresh frozen plasma (RR 0.52, 95% CI 0.35 to 0.76; 18 trials; 1536 participants; I2 = 94%, random-effects model; very low-certainty evidence), platelet transfusions (RR 0.69, 95% CI: 0.55 to 0.87; 20 trials; 1607 participants; I2 = 60%; random-effects model; very low-certainty evidence), and in the risk of surgical re-intervention (RR 0.63, 95% CI 0.45 to 0.88; 13 trials; 1204 participants; I2 = 0%; fixed-effect model; very low-certainty evidence), but the evidence is very uncertain. Using the GRADE framework, the certainty of the evidence was judged to be very low across all outcomes. TSA for mortality indicated that 64% of the required information size had been reached, with the monitoring boundary for benefit crossed. AUTHORS' CONCLUSION(S): TEG-/ROTEM-guided transfusion algorithms may reduce the risk of mortality, bleeding volume, and the need for fresh frozen plasma, platelets, and surgical re-intervention, but the evidence is very uncertain. Furthermore, the results were primarily based on the adult population undergoing elective cardiac surgery. Hence, the conclusion remains unchanged from the previous update of this review. There is a need for large, low risk of bias randomised controlled trials evaluating TEG/ROTEM across diverse clinical settings, including paediatric and neonatal populations, sepsis, trauma, obstetrics, and high-risk surgical and critically ill cohorts requiring major transfusion. Future studies should be adequately powered and prioritise patient-centred outcomes such as long-term survival, adverse events, cost-effectiveness, and the role of TEG/ROTEM in coagulopathy and severe haemorrhage. Copyright © 2026 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. <121> Accession Number 651212492 Title Cardiovascular and Renal Outcomes of GLP-1 Receptor Agonists in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Source European heart journal. Quality of care & clinical outcomes. (no pagination), 2026. Date of Publication: 16 May 2026. Author Ahmed M.; Hashmi T.M.; Shahzad M.; Zia R.; Ashraf H.; Ahmed R.; Rashid M.; Greene S.J.; Mentz R.J.; Fudim M.; Fonarow G.C.; Rana J.S. Institution (Ahmed, Hashmi, Zia, Ashraf) Rawalpindi Medical University, Rawalpindi, Pakistan (Shahzad) Dow University of Health Sciences, Karachi, Pakistan (Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (Ahmed) National Heart and Lung Institute, Imperial College London, United Kingdom (Rashid) Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Keele, United Kingdom (Greene, Mentz, Fudim) Division of Cardiology, Duke University Medical Center, Durham, NC, United States (Greene, Mentz, Fudim) Duke Clinical Research Institute, Durham, NC, United States (Fonarow) Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA, United States (Rana) Division of Cardiology, Kaiser Permanente Northern California, Oakland, CA, United States (Rana) Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States Abstract BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a foundational therapeutic option for type 2 diabetes mellitus (T2DM), offering glycemic control and cardiovascular benefits. This systematic review and meta-analysis evaluates the impact of GLP-1RAs on cardiovascular outcomes in patients with T2DM. METHOD(S): We conducted a comprehensive search of PubMed, Embase, and Cochrane Library up to March 31, 2025, for randomized controlled trials (RCTs) comparing GLP-1RAs with placebo in T2DM patients. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled using a random-effects model. RESULT(S): Twenty RCTs involving 83,004 patients were included. GLP-1RAs significantly reduced the risk of major adverse cardiovascular events (RR 0.87, 95% CI 0.83-0.92), all-cause death (RR 0.89, 95% CI 0.84-0.93), cardiovascular death (RR 0.88, 95% CI 0.81-0.94), myocardial infarction (RR 0.87, 95% CI 0.79-0.96), stroke (RR 0.88, 95% CI 0.81-0.96) and composite renal outcome (RR 0.80, 95% CI 0.73-0.88) compared to placebo. In addition, a trend of reduction in heart failure hospitalizations (RR 0.93, 95% CI 0.85-1.01), and coronary revascularization (RR = 0.87, 95% CI 0.74 to 1.01) was observed with GLP-1 RAs without reaching statistical significance. CONCLUSION(S): GLP-1RAs are associated with improved cardiovascular outcomes in patients with T2DM. These findings support current guideline recommendations and highlight their cardioprotective benefits beyond glycemic control in patients with T2DM. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <122> 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. <123> [Use Link to view the full text] Accession Number 651214994 Title Continuous Ultrasound-Guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoracotomy. Source The Clinical journal of pain. (no pagination), 2026. Date of Publication: 18 May 2026. Author Habeeb R.M.; Sultan W.A.; Basune M.E.; Safan A.G. Institution (Habeeb) Assistant professor of Anesthesia and Intensive Care Department Faculty of Medicine-Menoufia University Abstract OBJECTIVES: To compare postoperative analgesia using continuous ultrasound-guided Erector spinae plane block versus Thoracic Paravertebral Block, with dynamic visual analogue scale (VAS) during coughing as the primary outcome. Secondary outcomes included static VAS (at rest), hemodynamic changes, side effects, total opioid consumption, time of first rescue analgesia, length of hospitalization, anesthesia recovery time, Post-Anesthesia Care Unit stay, time to first ambulation, and patient satisfaction. METHOD(S): The study included 40 cases scheduled for elective thoracotomy admitted to the cardiothoracic surgery unit of Menoufia University Hospital. Subjects were equally randomized into two groups 20 patients each receiving either ultrasound guided Erector Spinae Plane Block ESPB or Thoracic Paravertebral Block TPVB (control group). Both groups received 20 mL of 0.25% bupivacaine as a loading dose followed by continuous infusion of 0.125% bupivacaine at 5 mL/h, with patient-controlled boluses of 20 mL on demand. RESULT(S): Dynamic Visual Analogue Scale scores were significantly lower in the ESPB group at 6, 9, 12, and 24 hours (P=0.008, 0.035, 0.001, 0.006). Morphine consumption was significantly reduced in the ESPB group (P<0.001). Hypotension was more frequent in TPVB (40% vs 10%, P=0.028). No significant differences were observed in hospital stay or patient satisfaction. DISCUSSION(S): The utilization of continuous ultrasound-guided ESPB demonstrated better postoperative Visual Analogue Scale scores significant decrease in opioid consumption, with fewer side effects than TPVB. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <124> [Use Link to view the full text] Accession Number 2045075071 Title 261 Surgical Indications of Thoracic Disc Herniations: A Formalized Classification-Driven Consensus on Endoscopic and Retropleural Approaches. Source Neurosurgery. Conference: CONGRESS OF NEUROLOGICAL SURGEONS 75TH ANNUAL MEETING. Los Angeles United States. 72(Supplement 1) (pp 62-62), 2026. Date of Publication: 01 Apr 2026. Author Giraldo J.P.; Choy W.; Alan N.; White M.D.; Farber S.H.; Ramos O.; Rudy R.F.; Lee K.; Snyder L.A.; Turner J.D.; Uribe J.S. Publisher Wolters Kluwer Medknow Publications Abstract INTRODUCTION: Thoracic disc herniations (TDH) are rare spinal pathologies that pose significant surgical challenges due to their anatomical complexity and potential for severe neurological deficits. In this study, the authors provide a comparative analysis of minimally invasive techniques for TDHs (endoscopic discectomy [ED] and retropleural thoracic discectomy [RTD]) focusing on their indications, surgical techniques, and outcomes, with the aim to clarify and formalize selection criteria for each approach through a structured evaluation of the literature and integration of expert clinical insights. METHOD(S): A structured review of the literature was performed using PubMed, Embase, Google Scholar, and Cochrane databases from January 1970 to March 2025. Search terms included ("thoracic disc herniation" AND "endoscopic" OR "retropleural" AND "surgery") and ("TDH" AND "minimally invasive" AND "spine surgery"). From an initial pool of 2272 articles, 1132 duplicates were removed. The remaining 1590 were screened by title and abstract. A total of 165 articles were reviewed in full text, with 116 studies meeting inclusion criteria for analysis. Criteria included a clear description of surgical technique, disc morphology, patient factors, and clinical outcomes. Expert commentary and institutional experience were also reviewed to contextualize findings and develop a practical decision-making framework. No statistical analysis was performed. RESULT(S): This review identified anatomical and clinical indications favoring each surgical technique. Endoscopic approaches were preferred for soft, lateralized, or for aminal herniations-particularly at lower thoracic levels-due to their minimally invasive profile and association with shorter recovery times (Farber 0-II and select Farber II-III cases within the literature gray zone). Retropleural thoracic discectomy was more commonly employed for central or paracentral herniations with significant spinal cord compression or calcification, offering better exposure and more complete decompression (Farber II-IV). A literature gray zone exists in the management of Farber Type II-III thoracic disc herniations, driven by institutional preferences, surgeon experience, and patient comorbidities. Recent studies support that, in appropriately selected patients, endoscopic discectomy results in reduced hospital stays, shorter operative times, and fewer postoperative complications, though it remains limited in addressing central or calcified disc pathology. Retropleural approaches, while associated with slightly higher morbidity, provided superior visualization and decompression in complex cases. Both techniques were associated with favorable neurological outcomes and improvements in pain and function. CONCLUSION(S): The findings of this evidence-based review support a formalized, anatomy-based decision-making approach to the surgical management of thoracic disc herniations (TDHs). Selection between endoscopic and retropleural discectomy should be guided by disc location, consistency, the degree of spinal cord compression, and patient-specific factors. As surgical tools and techniques continue to evolve, future approaches may be more precisely tailored using the current classification systems of TDHs, including refinement of treatment strategies within the gray zone of Farber Type II-III lesions. This structured framework has the potential to enhance surgical consistency, optimize patient outcomes, and minimize complication rates across varying clinical scenarios. Copyright © 2026. Congress of Neurological Surgeons 2026. All rights reserved. <125> Accession Number 651200905 Title Glucocorticoids to reduce permanent pacemaker implantation after TAVI: the GLUCO-TAVI randomised trial. Source EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 22(10) (pp 545-554), 2026. Date of Publication: 15 May 2026. Author Fuertes-Kenneally L.; Torres-Mezcua F.; Herrero-Brocal M.; Quesada Rico J.A.; Ferrer R.A.; Ballester S.C.; Rocamora J.P.; Siscar P.B.; Valencia J.; Torres-Saura F.; Lopez Clemente D.M.; Riquelme C.Y.; Lopez Clemente J.C.; Palencia T.L.; Ortiz de Salazar C.L.-M.; Rubio A.L.; De la Hoz Maranon L.; Mateo Soler J.M.; Martinez J.G.; Ruiz-Nodar J.M. Institution (Fuertes-Kenneally, Torres-Mezcua, Herrero-Brocal, Rocamora, Siscar, Valencia, Torres-Saura, Lopez Clemente, Riquelme, Lopez Clemente, Palencia, Ortiz de Salazar, Rubio, De la Hoz Maranon, Mateo Soler, Martinez, Ruiz-Nodar) Cardiology Department, Dr. Balmis General University Hospital, Alicante, Spain (Fuertes-Kenneally, Torres-Mezcua, Herrero-Brocal, Ferrer, Ballester, Rocamora, Siscar, Valencia, Torres-Saura, Lopez Clemente, Riquelme, Lopez Clemente, Palencia, Ortiz de Salazar, Rubio, De la Hoz Maranon, Mateo Soler, Martinez, Ruiz-Nodar) Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain (Quesada Rico, Ruiz-Nodar) Department of Clinical Medicine, Miguel Hernandez University, Alicante, Spain (Ballester) Department of Pharmacy, Dr. Balmis General University Hospital, Alicante, Spain Abstract BACKGROUND: Despite the growing demand for transcatheter aortic valve implantation (TAVI), there is no strategy to prevent its most common complication: cardiac conduction disturbances (CCD). These disturbances often necessitate permanent pacemaker implantation (PPI), leading to high morbidity and costs. Post-TAVI CCD may be transient, resulting from inflammation. AIMS: We aimed to evaluate the feasibility, safety, and preliminary efficacy of glucocorticoids in preventing PPI in patients undergoing TAVI. METHOD(S): This pilot study followed a Prospective Randomised Open-label Blinded Endpoint (PROBE) design. One hundred TAVI patients were randomised 1:1 to standard care or methylprednisolone (7 mg/kg administered 1 hour preprocedure), followed by prednisone (15 mg every 12 hours for 5 days). Electrocardiograms and inflammatory biomarkers were assessed pre- and post-intervention, and at 1 month and 1 year. The primary efficacy endpoint was the 1-month incidence of PPI. Secondary outcomes included 1-year PPI, new left bundle branch block (LBBB), LBBB and PPI, other CCD, mortality, and procedural complications. RESULT(S): The primary efficacy outcome occurred in 16% of the control group and 8% of the intervention group, reflecting a 50% relative risk (RR) reduction in PPI (RR 0.50, 95% confidence interval [CI]: 0.16-1.55; p=0.23). There was no significant difference in 1-year PPI (RR 0.67, 95% CI: 0.26-1.73; p=0.41) or new LBBB (RR 1.12, 95% CI: 0.66-1.89; p=0.66). The intervention was safe, without differences in complications, mortality (4% vs 12%; p=0.27), or adverse events (n=3). CONCLUSION(S): Glucocorticoids in TAVI are feasible and safe. The observed numerical difference in PPI did not reach statistical significance. Large-scale trials are needed to confirm the results of this pilot study. <126> Accession Number 651201306 Title Risk of Cardiovascular Events in Patients with Osteoporosis on Romosozumab Treatment Compared with Denosumab: A Multicenter Observational Cohort Study. Source Endocrinology and metabolism (Seoul, Korea). (no pagination), 2026. Date of Publication: 15 May 2026. Author Ahn S.H.; Boo D.; Kim K.J.; Choi J.; Yoon H.; Jung C.Y.; You S.C.; Oh J.S.; Hong N. Institution (Ahn) Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea (Boo, You) Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea (Boo, You) Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, South Korea (Kim, Choi) Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea (Yoon) Big Data Research Center, Asan Institute of Life Science, Asan Medical Center, Seoul, South Korea (Jung) Biomedical Research Institute, Inha University Hospital, Incheon, South Korea (Oh) Department of Information Medicine, Asan Medical Center, Seoul, South Korea (Hong) Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea Abstract Background: Romosozumab, a potent anabolic agent for osteoporosis, has been associated with an increased risk of adjudicated cardiovascular events compared with alendronate in postmenopausal women, although such an association was not observed in a placebo-controlled trial. Evidence from real-world clinical practice remains limited. Method(s): In this multicenter observational study, we analyzed patients aged >=50 years who were newly prescribed romosozumab 120 mg monthly or denosumab 60 mg every 6 months for osteoporosis at three tertiary hospitals in South Korea between January 1, 2020, and the end of each site's data collection period. The primary outcomes were major adverse cardiovascular events (MACE; acute myocardial infarction, ischemic stroke, or sudden cardiac death) and all cardiovascular adverse events (CVAEs; MACE, heart failure, peripheral artery disease, and non-coronary revascularization), assessed at 1- and 3-year follow-up. Large-scale 1:1 propensity score matching and Cox proportional hazards models were applied within a common data model framework with individual-level meta-analysis. Result(s): A total of 4,896 patients were included in the MACE analysis (4,758 in the CVAE analysis). At 1 year, the incidence rate of MACE did not differ significantly between the romosozumab and denosumab groups (9.20 per 1,000 person-years vs. 6.43 per 1,000 person-years; adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 0.64 to 3.19). The risk of CVAE was also similar between groups (16.23 per 1,000 person-years vs. 15.45 per 1,000 person-years; aHR, 1.05; 95% CI, 0.62 to 1.78). At 3 years, no significant differences were observed for MACE (aHR, 1.51; 95% CI, 0.79 to 2.88) or CVAE (aHR, 1.04; 95% CI, 0.69 to 1.58). Conclusion(s): In real-world clinical practice, romosozumab use was not associated with a statistically significant increase in cardiovascular risk compared with denosumab. <127> [Use Link to view the full text] Accession Number 651194079 Title Major adverse cardiovascular events after liver transplantation: A call for a shared definition. Source Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. (no pagination), 2026. Date of Publication: 11 May 2026. Author Biolato M.; Pedicino D. Institution (Biolato) Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy (Pedicino) Department of Cardiovascular Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy Abstract Cardiovascular complications are a leading cause of morbidity and mortality after liver transplantation. Major Adverse Cardiovascular Events (MACE) are increasingly used as composite endpoints in both clinical trials and observational studies; however, definitions are highly variable, limiting comparability. Liver transplant recipients present unique pathophysiological features and perioperative risks that are not adequately captured by standard cardiovascular frameworks. We conducted a systematic review of 49 studies reporting MACE after liver transplantation, including randomized trials, prospective and retrospective cohort studies, and registry-based analyses. Data on study design, follow-up, MACE definitions, and the components included in composite endpoints were extracted and analyzed descriptively. None of the studies applied the classical three-point MACE definition (non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death). Components included in composite endpoints varied widely: myocardial infarction and heart failure were reported in 78% of studies, stroke in 68%, arrhythmias in 35%, and cardiac death in 35%. Pulmonary embolism was inconsistently included. Heart failure and arrhythmias accounted for a substantial proportion of events, whereas ischemic events represented a minority. Based on event frequency, pathophysiology, and prognostic relevance, we propose that post-transplant MACE include coronary artery disease (defined as myocardial infarction, unstable angina requiring hospitalization, or coronary revascularization, including elective procedures), stroke, heart failure requiring hospitalization, clinically significant arrhythmias (including perioperative events within 30 d of transplantation), cardiac arrest, and cardiovascular death. All non-fatal components should require cardiovascular hospitalization. Pulmonary embolism should be excluded. This definition represents the authors' proposal and requires further consensus and formal validation. A structured international process, ideally using Delphi methodology and a position paper endorsed by transplant societies, could provide a reference framework for future studies, improving comparability, risk stratification, and clinical management of liver transplant recipients. Copyright © 2026 American Association for the Study of Liver Diseases. <128> Accession Number 651198357 Title TAVR in Low-Risk Patients at Long-Term Follow-Up: Promising Outcomes With Remaining Uncertainties from an Updated Meta-analysis. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 12 May 2026. Author Di Pietro G.; Improta R.; Tocci M.; Bruno E.; Colantonio R.; Mancone M. Institution (Di Pietro) Department of Clinical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy (Improta, Tocci, Bruno, Colantonio, Mancone) Department of Clinical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy <129> Accession Number 651194329 Title Randomized Clinical Trial Comparing Effects of Pulsatile versus Non-Pulsatile Cardiopulmonary Bypass on Neurological Outcomes. Source The Annals of thoracic surgery. (no pagination), 2026. Date of Publication: 11 May 2026. Author Rajesh S.; Dayi K.; Lussier M.J.; McKeone D.J.; Halstead E.S.; Kunselman A.R.; Myers J.L.; Undar A. Institution (Rajesh, Dayi, Lussier) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, United States (McKeone) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA; Department of Pediatrics, Division of Pediatric Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA (Halstead) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA; Division of Pediatric Hematology/Oncology, Division of Pediatric Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA; Department of Molecular and Precision Medicine, Penn State College of Medicine, Hershey, PA, USA (Kunselman) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA (Myers) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA; Department of Pediatrics, Division of Pediatric Cardiology, Penn State College of Medicine, Hershey, PA, USA; Department of Surgery, Penn State College of Medicine, Hershey, PA, USA (Undar) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA; Department of Pediatrics, Division of Pediatric Cardiology, Penn State College of Medicine, Hershey, PA, USA; Department of Surgery, Penn State College of Medicine, Hershey, PA, USA; Department of Biomedical Engineering, College of Engineering, The Pennsylvania State University, University Park, PA, USA. Electronic address: aundar@pennstatehealth.psu.edu Abstract BACKGROUND: The objective of this secondary analysis was to examine the impact of two perfusion modalities on S100B levels and neural injury outcomes in congenital heart surgery patients undergoing cardiopulmonary bypass. METHOD(S): Pediatric patients (<18 years) were randomly assigned to nonpulsatile or pulsatile perfusion. S100B levels were measured in patients at five timepoints (baseline prior to incision, three-to-five minutes on pump, right before weaning off CPB, one hour after CPB, and twenty-four hours after CPB). All patients were assessed for short-term clinical outcomes and with chart review for post-surgical neural injury: stroke, seizure, white matter injury, developmental delays, behavioral issues, memory loss, unexplained loss of consciousness, hearing impairment, and attention-deficit/hyperactivity disorder. RESULT(S): 144 consecutive patients were enrolled (70 nonpulsatile, 74 pulsatile). Pulsatile perfusion produced similar bypass characteristics to non-pulsatile perfusion and created a greater pulsatility index in the middle cerebral artery and arterial line. S100B levels at all measured timepoints were similar between both perfusion modalities. 36 patients had neural injuries (15 non-pulsatile, 21 pulsatile). Additionally, S100B levels at all measured timepoints were similar in patients with and without neural injury. In all groups, S100B levels rose during bypass and were greatest prior to weaning from CPB and one hour after CPB. Twenty-four-hour S100B levels had a weak association with clinical outcomes (0.25<rS<0.5). CONCLUSION(S): The choice of perfusion modality did not appear to affect S100B levels. Additionally, the measurements of S100B may not be sufficiently sensitive to reliably predict neural injury in patients with congenital heart defects undergoing cardiopulmonary bypass. Copyright © 2026. Published by Elsevier Inc. <130> Accession Number 651201721 Title Comparison of self-expanding transcatheter heart valves for aortic stenosis: the multicentre, randomised, controlled, non-inferiority DOUBLE-CHOICE trial. Source EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 22(10) (pp 555-565), 2026. Date of Publication: 15 May 2026. Author Feistritzer H.-J.; Lauten P.; Rudolph T.K.; Rudolph V.; Geisler T.; Massberg S.; Adam M.; Baldus S.; Sossalla S.; Joner M.; Moellmann H.; Wolf A.; Kim W.-K.; Borger M.A.; Noack T.; Boening A.; Bleiziffer S.; Hohenstein S.; Hoesler N.; Buske M.; Majunke N.; Lankisch N.; Roeder M.V.; Desch S.; Thiele H.; Abdel-Wahab M.; Of The Double-Choice Investigators O.B. Institution (Feistritzer, Borger, Noack, Buske, Majunke, Lankisch, Roeder, Desch, Thiele, Abdel-Wahab) Heart Center Leipzig at Leipzig University, Leipzig, Germany (Lauten, Bleiziffer) Zentralklinik Bad Berka, Bad Berka, Germany (Rudolph, Rudolph, Bleiziffer) Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (Geisler) University Hospital Tubingen, Tubingen, Germany (Massberg) Department of Medicine I, Ludwig Maximilian University Munich, Munich, Germany (Adam, Baldus) Heart Center, University of Cologne, Cologne, Germany (Sossalla, Kim, Boening) University Hospital Giesen, Giesen, Germany (Joner) Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany (Moellmann) Department of Cardiology, St. Johannes Hospital Dortmund, Dortmund, Germany (Wolf) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal, Germany (Hohenstein) Helios Health Institute, Leipzig, Germany (Hoesler) Leipzig Heart Science, Leipzig, Germany Abstract BACKGROUND: Although withdrawn from the market, the specific design of the ACURATE neo2 valve might influence the design of future transcatheter aortic valve platforms. AIMS: We aimed to evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) using the ACURATE neo2 valve compared with the Evolut platform in selected anatomies. METHOD(S): In this investigator-initiated, 2x2 factorial, open-label, randomised, multicentre, non-inferiority trial, patients with symptomatic, severe aortic stenosis were randomised to the ACURATE neo2 or an Evolut PRO/PRO+/FX valve. The primary endpoint was a composite of all-cause mortality, stroke, moderate/severe prosthetic valve regurgitation, and permanent pacemaker implantation at 30 days. Non-inferiority of the ACURATE neo2 to an Evolut valve was tested in the intention-to-treat population (absolute non-inferiority margin of -6%, alpha of 0.05). RESULT(S): At 10 sites in Germany, 835 patients were randomised. Within 30 days, the primary endpoint occurred in 60/389 patients (15.4%) in the ACURATE neo2 group and in 120/395 patients (30.4%) in the Evolut group (rate difference 15.0%, lower boundary of the 1-sided 95% confidence interval [CI]: 10.1%; p for non-inferiority<0.001, 2-sided 95% CI: 9.1-20.7; p for difference<0.001). A permanent pacemaker was implanted in 42/374 patients (11.2%) in the ACURATE neo2 group and in 101/381 patients (26.5%) in the Evolut group (p for difference <0.001). Rates of moderate/severe prosthetic valve regurgitation were low for both valves (1.3% vs 1.7%; p for difference=0.6). CONCLUSION(S): In selected anatomies, TAVI with the ACURATE neo2 was non-inferior to TAVI with an Evolut valve, with significantly lower rates of the primary endpoint, driven by lower permanent pacemaker implantation at 30 days. <131> Accession Number 651199499 Title Meta-Analysis of Transcatheter Versus Surgical Aortic Valve Replacement in Low Surgical Risk Patients: An Update. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 12 May 2026. Author Jarade C.; Levett J.Y.; Zolotarova T.; Filion K.B.; Toutounchi H.; Eisenberg M.J. Institution (Jarade) Faculty of Medicine, American University of Beirut, Lebanon (Levett) Division of Cardiac Surgery, Department of Surgery, McGill University, Montreal, QC, Canada (Zolotarova, Toutounchi) Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, QC, Canada (Filion) Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada (Eisenberg) Division of Cardiac Surgery, Department of Surgery, McGill University, Montreal, QC, Canada; Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada; Division of Cardiology, Jewish General Hospital/McGill University, Montreal, QC, Canada Abstract BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly considered as an alternative to surgical aortic valve replacement (SAVR) for low-risk patients with aortic stenosis. However, its long-term efficacy remains uncertain. OBJECTIVE(S): To compare clinical outcomes and procedural complications of TAVR versus SAVR in low-risk patients with aortic stenosis. METHOD(S): We updated our 2019 systematic review by searching MEDLINE, EMBASE, and Cochrane Central (May 2019-April 2025) for randomized controlled trials (RCTs) comparing TAVR and SAVR in low-risk patients with aortic stenosis. We extracted outcomes at 30 days, 12 months, and >= 5 year follow-up. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using random-effects models. Risk of bias was assessed using the Cochrane Risk of Bias (RoB) 2 tool. RESULT(S): Five RCTs (n=4,532) were included. TAVR reduced 30-day all-cause mortality (RR: 0.45, 95% CI: 0.37-0.55), cardiovascular mortality (RR: 0.45, 95% CI: 0.38-0.54), atrial fibrillation (RR: 0.21, 95% CI: 0.10-0.41), and life-threatening bleeding (RR: 0.28, 95% CI: 0.13-0.58), but increased pacemaker implantation (RR: 3.10, 95% CI: 1.23-7.82). Mortality benefits persisted at 12 months. At >= 5 years, results were inconclusive due to wide CIs across outcomes, including all-cause death (RR: 0.99, 95% CI: 0.72-1.35), cardiovascular death (RR: 0.93, 95% CI: 0.64-1.35), atrial fibrillation (RR: 0.44, 95% CI: 0.16-1.22), endocarditis (RR: 0.70, 95% CI: 0.33-1.45) and aortic reintervention (RR: 1.21, 95% CI: 0.59-2.49). CONCLUSION(S): TAVR shows early clinical benefits in low-risk patients with aortic stenosis, but long-term outcomes compared to SAVR remain uncertain. Individualized heart team decision-making remains essential. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <132> Accession Number 651199564 Title Rectus sheath catheters versus thoracic epidural analgesia for pain management after open surgery - A systematic review and meta-analysis. Source The British journal of surgery. (no pagination), 2026. Date of Publication: 13 May 2026. Author Fankhauser C.D.; Breitenstein S.; Gelpke H.; Madjdpour C.; Meili G.; Sultan-Beyer L.; Wyss T.R.; Kaufmann E. Institution (Fankhauser) Division of Urology, Department of Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Fankhauser, Kaufmann) Faculty of Health Sciences and Medicine, University of Lucerne, Switzerland (Fankhauser, Kaufmann) Clinic for Urology, University Teaching and Research Hospital of the University of Lucerne, Switzerland (Fankhauser, Breitenstein, Madjdpour) University of Zurich, Zurich, Switzerland (Breitenstein, Gelpke) Department of Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Madjdpour) Department of Anesthesiology, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Meili, Sultan-Beyer) Department of Gynecology and Obstetrics, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Wyss) Department of Vascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Wyss) Department of Interventional Radiology and Vascular Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland Abstract INTRODUCTION: Thoracic epidural analgesia remains the gold standard for postoperative pain management after major open surgery, but is potentially associated with hypotension, urinary retention, and delayed recovery. Rectus sheath catheters offer a simple regional alternative that avoids sympathetic blockade while maintaining somatic analgesia. This review aims to compare analgesic efficacy, complications, recovery, patient satisfaction, and costs between rectus sheath catheters and thoracic epidural anaesthesia in open surgical procedures. METHOD(S): This systematic review was registered with PROSPERO (CRD420251234467). A systematic PubMed search was conducted to identify studies comparing continuous wound infusion via rectus sheath catheters with thoracic epidural anaesthesia in adult patients undergoing open abdominal, pelvic, thoracic, or vascular surgery. Randomized clinical trials, as well as prospective and retrospective comparative studies, were included. A meta-analysis was performed for randomized trials. RESULT(S): 31 studies (21 prospective, 10 retrospective) involving 2162 patients were included. Rectus sheath catheters and thoracic epidural anaesthesia did not differ significantly with respect to postoperative pain (SMD: -0.35; 95%CI: -2.01-1.32) or opioid consumption (SMD: -0.32; 95%CI: -1.71-1.07). No differences were observed in recovery of bowel function, urinary retention, time to mobilisation, or length of hospital stay. Rectus sheath catheters significantly reduced the risk of hypotension compared with thoracic epidural anaesthesia (RR: 0.40; 95%CI: 0.26-0.60) and were associated with lower costs ranging from $500 to $6632 per case. Subgroup analyses suggested less urinary retention and earlier mobilisation with rectus sheath catheters in non-visceral surgery and non-laparotomy incisions. CONCLUSION(S): Rectus sheath catheters provide analgesia comparable to thoracic epidural anaesthesia with fewer complications, facilitating earlier recovery and potential cost savings. Considering the growing shift toward fast-track surgery, rectus sheath catheters represent a pragmatic and resource-efficient alternative for postoperative pain management in open surgical procedures. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. <133> Accession Number 2045336306 Title 3D models and simulations training improves TEE performance on pediatric patients with simple valvular congenital heart disease compared to traditional apprenticeship training: a clinical randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 285. Date of Publication: 01 Dec 2026. Author Ou X.; Qiu Q.; Yang X.; Gao Y.; Zhang G.; Zhang N.; Liu J.; Zhang S.; Wei W.; Xu Y. Institution (Ou, Qiu, Gao, Zhang, Zhang, Liu, Zhang, Wei, Xu) Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Yang) Paediatrics School, Guangzhou Medical University, Guangzhou, China Publisher BioMed Central Ltd Abstract Background: Transesophageal echocardiography (TEE) is indispensable for intraoperative guidance and evaluation in pediatric cardiac surgery. While simulation-based medical education offers a promising alternative to the traditional apprenticeship model, evidence directly comparing its efficacy in improving live pediatric TEE performance remains limited. This study aimed to evaluate whether simulation-based training using a 3D pediatric TEE simulator is superior to traditional apprenticeship training for enhancing clinical TEE proficiency among anesthesia residents. Method(s): First- through third-year anesthesia resident physicians without prior echocardiography experience were randomized into two groups. All participants first completed a standardized 2-hour web-based foundational course. Subsequently, the intervention group (Simulation group, Group S; n = 22) received 1 h of supervised hands-on practice using the BabyWorks simulator, while the control group (Traditional group, Group T; n = 22) received 1 h of bedside apprenticeship training on live patients. One week later, all participants were assessed on their ability to independently acquire 11 standardized TEE views in pediatric patients. Performance was scored across three dimensions (imaging angle, anatomical structure, and image clarity), with a maximum total score of 110 points. The total examination duration (time) was also recorded. Result(s): Baseline knowledge scores were comparable between groups. In the clinical assessment, Group S achieved significantly higher total performance scores than Group T (Group S: 88.60 +/- 15.60 vs. Group T: 64.70 +/- 16.70; p < 0.001). Group S also demonstrated shorter examination durations (Group S: 447.60s vs. Group T: 584.50s; p = 0.007). Specifically, Group S significantly outperformed Group T in 7 of the 11 anatomical landmarks (p < 0.05), primarily in the technically demanding transgastric and advanced mid-esophageal views. Regarding dimensions, Group S scored higher in angle (p = 0.031), clarity (p < 0.001), and structures (p < 0.001). Conclusion(s): In summary, this trial provides robust evidence that 3D simulation training significantly improves live TEE performance among novice operators compared to conventional training, contributing valuable insights toward optimizing echocardiography education and enhancing perioperative safety in pediatric cardiac care. Trial registration: Chinese Clinical Trial Registry (ChiCTR.org.cn). Registration number: ChiCTR2500105325. Date of the study first posted on ChiCTR.org.cn: 2025-07-02. Date of the enrolment of the first research participant: 202507-03. Copyright © The Author(s) 2026. <134> [Use Link to view the full text] Accession Number 2045463222 Title Surgical versus percutaneous revascularization in multivessel non-ST-elevation acute coronary syndrome: a meta-analysis of 77 989 patients. Source Coronary Artery Disease. (no pagination), 2026. Article Number: 10.1097/MCA.0000000000001642. Date of Publication: 2026. Author Elbahloul M.A.; Elbataa A.; Hajali M.; Kasem A.W.; Alalalmeh S.O.; El-Moslemani M.; Zanaty M.A.; Shawky A.; Awad A.K.; Amabile A.; Baudo M.; Torregrossa G.; Hirji S. Institution (Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Kafr El-Shaikh (Elbataa, Kasem) Faculty of Medicine, Al Azhar University of Cairo, Cairo, Egypt (Hajali) Faculty of Medicine, Hashemite University, Zarqa, Jordan (Alalalmeh) Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates (El-Moslemani) Faculty of Medicine, Al-Azhar University, Damietta (Zanaty) Faculty of Medicine, South Valley University, Qena (Shawky) Faculty of Medicine, Benha University, Qalyubia (Awad) Department of Cardiothoracic Surgery, Ain-Shams University, Cairo, Egypt (Amabile) Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine and UPMC Heart and Vascular Institute, Pittsburgh (Baudo, Torregrossa) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood (Torregrossa) Department of Cardiac Surgery, Lankenau Medical Center, Wynnewood, Pennsylvania (Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, MA, United States Publisher Lippincott Williams and Wilkins Abstract Multivessel coronary artery disease (MVD) significantly complicates the management of patients with non-ST-elevation acute coronary syndrome, worsening their clinical and angiographic outcomes. However, the optimal revascularization strategy in this subset of patients is still controversial. Our systematic review and meta-analysis aimed to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with MVD and non-ST-elevation acute coronary syndrome . We performed a comprehensive search of four electronic databases (PubMed, Scopus, WOS, and Cochrane) from inception till 15 December 2024. The outcomes were reported as a relative risk (RR) and 95% confidence interval (CI) in the random-effect model. Our primary outcome was all-cause mortality, while the secondary outcomes were major adverse cardiovascular events (MACCE), myocardial infarction (MI), cardiac death, repeated revascularization, and stroke. Fourteen studies, comprising 77 989 patients, were included. CABG was associated with lower risk of all-cause mortality (RR: 0.80, 95% CI: 0.68-0.93), MACCE (RR: 0.70, 95% CI: 0.59-0.83), MI (RR: 0.53, 95% CI: 0.42-0.67), cardiac death (RR: 0.77, 95% CI: 0.68-0.89), and repeated revascularization (RR: 0.41, 95% CI: 0.33-0.51) in long-term follow-up. However, stroke incidence was higher with CABG in long-term follow-up (RR: 1.36, 95% CI: 1.07-1.73). CABG and PCI showed no significant difference in clinical outcomes at 30-day follow-up. This meta-analysis showed that CABG was associated with favorable long-term outcomes compared to PCI, including lower mortality, MACCE, MI, and repeated revascularization. Time-dependent hazard ratio showed that CABG was associated with better survival over a 16-year follow-up period. perioperative outcomes were comparable in both CABG and PCI. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <135> [Use Link to view the full text] Accession Number 2045462723 Title Management and outcomes of post-myocardial infarction left ventricular pseudoaneurysm: A case-level systematic review. Source Critical Pathways in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Karimanasseri C.; Rahimov D.; Sankisa D.; Nasher N.; Mustafa M.; Allimulla A.; Vizzeswarapu S.; Plestis K.A.; Entwistle J.W.; Bavaria J.E.; Tchantchaleishvili V. Institution (Karimanasseri, Sankisa, Mustafa, Allimulla, Vizzeswarapu) Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Rahimov, Nasher, Plestis, Entwistle, Bavaria, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States Publisher Lippincott Williams and Wilkins Abstract Left ventricular pseudoaneurysm (LVPA) is a rare mechanical complication of acute myocardial infarction (MI) associated with significant mortality. Given the paucity of available data in the literature, we sought to pool existing evidence to better understand the current management strategies and outcomes. Electronic search was performed in February 2025 to identify all studies reporting management of post-MI LVPA. A total of 158 reports, with a total of 159 patients were included. Patient-level data were extracted for analysis. A total of 159 patients were included in the analysis. The median age was 65 years [Interquartile range (IQR), 57-75], and 70% (106/159) of patients were male. The most frequent site of MI was inferior wall (31.4%, 49/156) and the most common method of MI management was thrombolysis (49%, 64/131). The median time from MI to presentation signs/symptoms of LVPA was 21 days [IQR, 0-152]. The most common LVPA location was the anterior/apical wall (27.7%, 44/159). Sixty-six percent of patients (105/159) underwent surgical repair, while 22% of patients (35/159) were managed medically and 5.7% (9/159) of patients underwent transcatheter repair. In-hospital/30-day mortality was 10% (16/159), with operative mortality after surgical repair of 4.8% (5/105). Mortality from reoperative surgery was 18.8% (3/16) as opposed to 2.2% (2/89) in patients without redo sternotomy (p = 0.004). Periprocedural mortality among patients treated with transcatheter intervention occurred in a single case (11.1%), involving a patient with prior coronary artery bypass grafting. At a median follow-up of 6 months [IQR, 1-12], overall survival was 86.1% (137/159). Surgery remains the standard therapy of LVPA, with acceptable operative risk, however, re-operative sternotomy carries higher surgical risk. In carefully selected patients, percutaneous repair may serve as a viable alternative to surgery. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <136> [Use Link to view the full text] Accession Number 2045268403 Title 140: PROGNOSTIC VALUE OF BODY COMPOSITION IN HEART TRANSPLANT RECIPIENTS: A REVIEW AND META-ANALYSIS. Source Critical Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Merchant K.; Antar M.; Rodriguez Ferreira E.; Jena A.; Sarangi S.; Banker H.; Ghosh S.; Navarrete Rios A.; Singh A.; Hamza Shah S.; Bordini J.; Kumar U. Institution (Merchant, Jena, Ghosh) Mayo Clinic, Jacksonville (Antar, Rodriguez Ferreira, Navarrete Rios, Hamza Shah, Bordini) Ascension St. Joseph (Sarangi) UIC- Peoria (Banker) Tuscon Medical Center (Singh) WorcesterMAUnited States (Kumar) Aga Khan University Publisher Lippincott Williams and Wilkins <137> Accession Number 2045776270 Title Assessment of Quality of Life in Patients Following Coronary Artery Bypass Grafting: A Systematic Review of Physical, Psychological, and Social Outcomes. Source International Journal of Drug Delivery Technology. 16(45 supplement) (pp 414-422), 2026. Date of Publication: 2026. Author Kalita M.; Rabha P.; Dehingia M.; Lahkar P.; Medhi M.; Ao N. Institution (Kalita) Medical Surgical Nursing (CTVS) Department, Royal School of Nursing, The Assam Royal Global University, India (Rabha) Mental Health Nursing Department, NEMCARE Institute of Nursing Sciences, Mirza, Assam, India (Dehingia, Medhi) Community Health Nursing Department, Royal School of Nursing, The Assam Royal Global University, India (Lahkar) Obstetrics and Gynaecological Nursing Department, Royal School of Nursing, The Assam Royal Global University, India (Ao) Child Health Nursing Department, Royal School of Nursing, The Assam Royal Global University, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Coronary artery bypass grafting is a surgery for people with bad coronary artery disease. It helps them live longer and have a heart. It is not just about living longer. It is also about how people feel after the surgery. This is called quality of life. Quality of life after coronary artery bypass grafting is affected by things. These include how healthy people feel, how they feel inside, and how they get along with others. Different studies have different results. Aim and Objective: We want to know how coronary artery bypass grafting affects quality of life. We are looking at how people feel mentally and socially after the surgery. Method(s): We looked at studies on the internet using big databases like PubMed, Scopus, and Web of Science. We only looked at studies from 2013 to 2025. We used keywords like artery bypass grafting, quality of life, and physical recovery. We followed the rules to make sure our review was good. We picked studies that fit our rules and looked at them closely. Result(s): We found about 3,200 studies at first. Only 22 of them were good enough to use. Most of these studies showed that people felt better after the surgery. They had symptoms that could exercise more and could do more things. How people felt mentally was different. Some people still felt anxious or depressed. How people felt socially was also different. Most people went back to work. Spent time with others. This depended on who they were and how sick they were. Conclusion(s): Coronary artery bypass grafting helps people feel better physically. How people feel mentally and socially is not always the same. We need to help people in all areas of their lives to make sure they recover well in the long run. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <138> Accession Number 651193077 Title Machine learning model predicts acute kidney injury in pediatric patients after cardiac surgery: a systematic review and meta-analysis. Source BMC nephrology. (no pagination), 2026. Date of Publication: 12 May 2026. Author Fan X.; Zhuang J.; Xiong Z.; Chen Z.; Yang N.; Li T. Institution (Fan, Zhuang, Xiong, Chen, Yang) Department of Nursing, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Fan, Zhuang) School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China (Li) Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China Abstract BACKGROUND: Acute kidney injury (AKI) is a common complication following pediatric cardiac surgery, frequently leading to poor outcomes and even death in severe cases. Early prevention remains the primary intervention strategy. Studies have developed prediction models to identify at-risk children at an early stage. This study systematically evaluate existing AKI prediction models to support their clinical utility and future refinement. METHOD(S): PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang and SinoMed were searched from inception to 31 December, 2024. The search of references from included studies, as well as the manual search, extended until November 30, 2025. Literature searching, screening, and data extraction were done by two authors. Quality evaluation according to prediction model risk of bias assessment tool (PROBAST). Area under the receiver operating characteristic curve (AUROC) was pooled using a random-effects model to summarize the overall performance of existing models, exploring sources of heterogeneity of performance through subgroup analysis and meta-regression. Sensitivity analysis and Egger's method were used to analyze the stability of the included studies and to identify publication bias. This study was registered with PROSPERO (CRD42024593112) and reported following the Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis: Checklist for Systematic Reviews and Meta-Analysis (TRIPOD-SRMA). RESULT(S): A total of 2189 studies were screened which represented the total number of studies retrieved from the database search, the search of references from included studies, and the manual search. Nineteen studies were included in this review. Included studies differed in study design, AKI definition, predictor screening, model development and validation and model performance. The overall pooled AUROC was 0.850 (95% CI, 0.810-0.890), but all studies were evaluated as high risk of bias using the PROBAST. Heterogeneity in model performance was high, and study design and development methods were identified as possible sources of heterogeneity in pooled AUROC. Included studies were stable and free of publication bias. CONCLUSION(S): This systematic review suggested that machine learning models for predicting postoperative AKI in pediatric cardiac surgery indicated good discriminative ability. However, the high risk of bias across all included studies and the significant heterogeneity in model performance indicated that the reported performance may be overestimated. The high heterogeneity observed highlights the substantial variability in model performance, which is likely driven by differences in study design and development methods. The clinical utility of these models was currently limited due to the lack of external validation in most studies and the methodological limitations identified. Future research must incorporate rigorous study design, transparent reporting based on the TRIPOD guidelines, and external validation to develop prediction models with clinical utility. Copyright © 2026. The Author(s). <139> [Use Link to view the full text] Accession Number 2044995632 Title Pulmonary Artery Denervation for the Treatment of Patients With Pulmonary Hypertension Secondary to Left-Sided Heart Failure: Rationale and Design of the Randomized Controlled PADN-HF-PH Trial. Source Cardiology Discovery. (no pagination), 2026. Date of Publication: 08 Jan 2026. Author Wang Q.; Zhang J.; Zhang H.; Liang M.; Xie D.; Cheng B.; Zhuang W.; Chen X.; Zhang C.; Huang W.; Shen J.; Wang Z.; Liu B.; He R.; Chen S.; Han Y. Institution (Wang) Department of Congenital Heart Disease, General Hospital of Northern Theater Command, Liaoning, Shenyang, China (Zhang, Zhang, Xie, Chen) Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, Nanjing, China (Liang, Han) Department of Cardiology, General Hospital of Northern Theater Command, Liaoning, Shenyang, China (Cheng) Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Sichuan, Chengdu, China (Zhuang) Department of Cardiovascular, The First Affiliated Hospital, Fujian Medical University, Fijian, Fuzhou, China (Chen) Department of Cardiology, The Xiamen Cardiovascular Hospital of Xiamen University, Fujian, Xiamen, China (Zhang) Department of Cardiology, Guangdong Provincial Peoples Hospital, Guangdong, Guangzhou, China (Huang) Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Shen) Department of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Wang) Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, Harbin, China (Liu) Department of Cardiology, The Second Hospital of Jilin University, Jilin, Changchun, China (He) Department of Cardiology, Huaihe Hospital of Henan University, Henan, Kaifeng, China Publisher Wolters Kluwer Health Abstract Abstract - It remains uncertain whether combined pulmonary artery denervation (PADN) and guideline-directed medical therapy (GDMT) can effectively reduce clinical worsening in patients with heart failure (HF) and pulmonary hypertension (PH) associated with left heart disease. The PADN-HF-PH is a prospective, multicenter, randomized, controlled trial designed to assess the superiority of PADN for the treatment of patients with PH secondary to left-sided HF despite GDMT. A total of 264 subjects with PH secondary to left-sided HF who meet the inclusion criteria and none of the exclusion criteria will be dynamically randomized (at a 1:1 ratio) to the PADN plus GDMT group or the GDMT alone group, stratified by PH secondary to left-sided HF phenotypes and participating sites. The GDMT strategy is based on the 2023 European Society of Cardiology Guidelines for HF. The primary endpoint is the composite of all-cause death, rehospitalization due to HF, requirement for intravenous medication (inotropes, diuretics, or vasodilators) due to worsening of HF, referral for heart/lung transplantation, or 6-minute walk distance decreased by >10% or >30 m compared with baseline when the last enrolled subject has at least 6 months of follow-up. The safety endpoint is the incidence of adverse events of special interest, defined as complications occurring within 30 d after the PADN procedure. The PADN-HF-PH trial is specifically designed to evaluate the effectiveness and safety of adding PADN to GDMT in patients with PH associated with left heart disease who are experiencing HF. The primary objective of this study is to generate new evidence regarding the potential benefits of combining PADN with GDMT in reducing clinical worsening events among these patients (NCT05824923). Copyright © 2026 The Chinese Medical Association, published by Wolters Kluwer Health, Inc.

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