Total documents retrieved: 147 Results Generated From: Embase <1980 to 2026 Week 39> Embase Weekly Updates (updates since 2026-09-17) - (147 records) <1> Accession Number 651658898 Title Effects of remimazolam vs. propofol on plasma neurofilament light chain and postoperative delirium in frail elderly patients undergoing major non-cardiac surgery: a prospective, randomized, assessor-blinded controlled trial. Source BMC anesthesiology. 26(1) (no pagination), 2026. Date of Publication: 30 Jun 2026. Author He X.-Y.; Zhang S.-H.; Xie L.; Bao J.-T.; An M.-Z.; Li Z.-P.; Zhou Q.-H.; Jia X.-Y. Institution (He, Xie, Bao) Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou city, Zhejiang Province, China (He, Zhang, Xie, Bao, An, Li, Jia) Department of Anesthesiology and Pain Medicine, Jiaxing First Hospital, No. 1882, Zhonghuan South Road ,Zhejiang Province, China (Zhou) Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital of Jiaxing University, 1518 North Ring City Road ,Zhejiang Province, China Abstract BACKGROUND: The relationship between remimazolam administration and early neurological complications, particularly postoperative delirium (POD), in elderly patients undergoing major non-cardiac surgery remains unclear. Plasma neurofilament light chain (NfL) is a potential biomarker for central nervous injury. This study aims to compare the effects of remimazolam and propofol on postoperative plasma NfL concentrations and the incidence of POD in frail elderly patients undergoing major non-cardiac surgery. <br/>METHOD(S): This was a single-center randomized controlled trial on frail patients who underwent non-cardiac surgery. Participants were randomized to receive either Remimazolam (Group R) or Propofol (Group P) for induction and maintenance of general anesthesia, with all other anesthetic management standardized. The primary outcome was plasma NfL concentration on postoperative day 1, and the incidence of POD was assessed as a key clinical secondary endpoint. The secondary endpoint encompassed the incidence of hypotension during the anesthesia induction, as well as the time-weighted average of the area under the curve below the baseline for mean arterial pressure (AUB-MAP). <br/>RESULT(S): A total of 123 patients were enrolled. No significant differences were observed in plasma NfL concentrations on postoperative day 1 between Group R and Group P (123.3[83.6-198.2] vs. 149.0[102.0-226.6], pg/ml, P = 0.186, respectively); and similarly, no differences in POD were found between Group R and Group P (6/62[9.7%] vs. 7/61[11.5%], unadjusted odds ratio 0.827, 95% CI 0.261-2.62, P = 0.746). In the secondary outcomes, the incidence of hypotension during the anesthesia induction in Group R was significantly decreased (3[4.8%] vs. 19[31.3%], P < 0.001). And the time-weighted average of AUB-MAP in Group R was higher than Group P (-21.3 +/- 10.7 vs. -25.4 +/- 9.6, mmHg, P = 0.03). <br/>CONCLUSION(S): In frail elderly patients undergoing major non-cardiac surgery, remimazolam group shows no significant difference from propofol in plasma NfL levels or POD incidence on the first day. Due to its advantage in maintaining hemodynamic stability, remimazolam may be a safer anesthetic option for frail patients sensitive to hemodynamic changes. TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2400093862.<br/>Copyright © 2026. The Author(s). <2> Accession Number 2045752154 Title Gender Gaps in Cardiothoracic Surgery: Are Patient Outcomes Shaped by Workforce Inequity?. Source Thoracic and Cardiovascular Surgeon. 74(6) (pp 445-449), 2026. Date of Publication: 01 Sep 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.<br/>Copyright © 2026 the author(s), published by De Gruyter. <3> Accession Number 651658875 Title 'Aspirin versus ticagrelor for the management after coronary revascularization - a systematic review and meta-analysis of randomised trials'. Source BMC cardiovascular disorders. 26(1) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Regmi D.R.; Regmi S.; Upreti S.; Gautam N. Institution (Regmi) Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal (Regmi, Upreti) Tribhuvan University Teaching Hospital, Kathmandu, Nepal (Gautam) Gulmi Durbar Basic Hospital, Gulmi, Nepal Abstract OBJECTIVE: To compare the efficacy and safety of ticagrelor monotherapy versus aspirin monotherapy in patients with coronary artery disease undergoing coronary revascularization. <br/>METHOD(S): We conducted a systematic review and meta-analysis of RCTs comparing ticagrelor monotherapy with aspirin monotherapy after PCI or CABG. MEDLINE, Embase, Cochrane Central, Scopus, ClinicalTrials.gov and Google Scholar were searched up to 19th January 2026. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction and stroke. Secondary outcomes included all-cause mortality, myocardial infarction, stroke, major bleeding, repeat revascularization and stent thrombosis. Risk ratios (RRs) with 95% CIs were pooled using a random-effects model with restricted maximum likelihood estimation and Knapp-Hartung adjustment. <br/>RESULT(S): Five randomised trials involving 25,994 participants were included, of whom 12,998 received ticagrelor monotherapy and 12,996 received aspirin monotherapy. Ticagrelor monotherapy was associated with a significantly lower risk of MACE than aspirin monotherapy (RR 0.86, 95% CI 0.78 to 0.95; p = 0.012; I2 = 0%). All-cause mortality was also reduced with ticagrelor (RR 0.86, 95% CI 0.77 to 0.97; p = 0.023; I2 = 0%). No significant differences were observed for myocardial infarction (RR 0.87, 95% CI 0.70 to 1.07; p = 0.138; I2 = 0%), stroke (RR 1.01, 95% CI 0.85 to 1.19; p = 0.913; I2=0%), major bleeding (RR 1.00, 95% CI 0.84 to 1.20; p = 0.976; I2 = 0%), repeat revascularization (RR 0.89, 95% CI 0.58 to 1.37; p = 0.452; I2 = 45.8%) or stent thrombosis (RR 0.88, 95% CI 0.20 to 3.90; p = 0.481; I2 = 0%). <br/>CONCLUSION(S): Ticagrelor monotherapy was associated with a potential reduction in MACE and all-cause mortality compared with aspirin monotherapy after coronary revascularisation, without increasing major bleeding. However, these findings were driven primarily by PCI trials, particularly the GLOBAL LEADERS and GLASSY trial program, and should be interpreted cautiously because PCI and CABG populations were analyzed together. TRIAL REGISTRATRION: CRD420261286239.<br/>Copyright © 2026. The Author(s). <4> Accession Number 2044601943 Title Cardiac Surgery 2025 Reviewed. Source Thoracic and Cardiovascular Surgeon. 74(6) (pp 433-444), 2026. Date of Publication: 01 Sep 2026. Author Kirov H.; Caldonazo T.; Mukharyamov M.; Runkel A.; Fleckenstein P.; Freiburger S.; Siemeni T.; Doenst T. Institution (Kirov, Caldonazo, Mukharyamov, Runkel, Fleckenstein, Freiburger, Siemeni, Doenst) Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, University Hospital Jena, Jena, Germany Publisher Georg Thieme Verlag Abstract For the 12th consecutive time, we systematically reviewed the cardio-surgical literature for the past year, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach for a results-oriented summary. In 2025, the discussion on the value of randomized and observational evidence continued, showing converging results in the treatment of coronary artery disease and further diverging results in the field of invasive aortic valve therapies. Across randomized trials, meta-analyses, and registries, coronary artery bypass grafting (CABG) consistently provides superior long-term outcomes compared with percutaneous coronary intervention in complex coronary artery disease, driven primarily by sustained reductions in future myocardial infarctions. In addition, atrial fibrillation after CABG was shown to be more frequent than expected, but its long-term burden was negligible, while prolonged dual antiplatelet therapy after CABG for acute coronary syndrome offered no benefit but increased bleeding risk. The valve treatment arena in 2025 was heavily affected by the new guidelines, which clarified many aspects in mitral and tricuspid valve treatment but generated great controversy for aortic stenosis treatment. The latter was based on a reduction of the age cut-off for transcatheter aortic valve implantation to 70 years (unsupported by new data) and the selective reliance on only randomized studies (despite contradictory risk-adjusted registry evidence). Across mitral and tricuspid valve disease, publications showed improvements in symptoms and quality of life without survival benefits with transcatheter therapies and the most consistent long-term outcomes with surgery, particularly when appropriately timed and performed in experienced centers. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation, but it provides up-to-date information for patient-specific decision-making.<br/>Copyright © 2026 Thieme All rights reserved. <5> Accession Number 2046371273 Title Murray law-based quantitative flow ratio for functional assessment of coronary lesions: a systematic review and meta-analysis. Source International Journal of Cardiovascular Imaging. 42(9) (pp 1769-1777), 2026. Date of Publication: 01 Sep 2026. Author Skalidis I.; Bennar W.; Garin D.; Pittet T.; Wenaweser P.; Jelisejevas J.; Cioffi G.M.; Meier P.; Simioni L.; Kamdem M.M.; Beretta G.S.; Akodad M.; Hovasse T.; Garot P.; Puricel S.; Togni M.; Cook S. Institution (Skalidis, Bennar, Garin, Pittet, Wenaweser, Jelisejevas, Cioffi, Meier, Simioni, Kamdem, Beretta, Puricel, Togni, Cook) Department of Cardiology, HFR - Fribourg Cantonal Hospital and University, Fribourg, Switzerland (Skalidis) School of Medicine, University of Crete, GreeceGreece (Akodad, Hovasse, Garot) Ramsay Sante, Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Massy, France Publisher Springer Science and Business Media B.V. Abstract Angiography-derived coronary physiology has emerged as an attractive alternative to pressure-wire-based fractional flow reserve (FFR) for functional lesion assessment. Murray law-based quantitative flow ratio (microQFR) represents a simplified, single-view approach, but its diagnostic performance across diverse clinical settings remains incompletely defined. To evaluate the diagnostic accuracy of microQFR for identifying functionally significant coronary lesions using invasive FFR as the reference standard. We performed a systematic review and diagnostic accuracy meta-analysis in accordance with PRISMA-DTA recommendations. Studies assessing microQFR against invasive FFR (<= 0.80) with extractable lesion-level data were included. Sensitivity and specificity were pooled using a bivariate random-effects model. Secondary analyses explored performance in patients undergoing transcatheter aortic valve implantation (TAVI) and in calcified coronary lesions. Seven studies comprising 1,826 coronary lesions were included. microQFR demonstrated a pooled sensitivity of 0.807 (95% CI 0.690-0.888) and specificity of 0.944 (95% CI 0.893-0.971), with a positive likelihood ratio of 14.41, negative likelihood ratio of 0.20, and diagnostic odds ratio of 70.6. Specificity remained consistently high, whereas sensitivity showed substantial variability. In exploratory subgroup analyses, sensitivity was 0.77 (95% CI 0.64-0.87) in TAVI patients (2 studies; 236 lesions) and 0.72 (95% CI 0.66-0.78) in calcified lesions (2 studies; 691 lesions); these findings are hypothesis-generating only. microQFR demonstrates promising diagnostic accuracy with consistently high specificity. However, its moderate sensitivity, negative likelihood ratio of 0.20, and reduced performance in calcified lesions limit its ability to safely exclude functionally significant disease. Prospective validation is required before microQFR can be recommended as a standalone decision-making tool.<br/>Copyright © The Author(s), under exclusive licence to Springer Nature B.V. 2026. <6> Accession Number 2042776611 Title Surgical Myectomy with Anterior Mitral Leaflet Extension Versus Isolated Myectomy in Patients with Hypertrophic Obstructive Cardiomyopathy. Source Thoracic and Cardiovascular Surgeon. 74(6) (pp 468-476), 2026. Date of Publication: 01 Sep 2026. Author Heeringa T.J.P.; Hoogewerf M.; Hegeman R.; Wylick D.V.; Stecher D.; Cramer M.J.; De Zan G.; Koop Y.; Meijer R.C.A.; Zuithoff N.P.A.; Harst P.V.D.; Guglielmo M.; Vaartjes I.; Mokhles M.M.; Van Der Kaaij N.P. Institution (Heeringa, Hoogewerf, Wylick, Meijer, Mokhles, Van Der Kaaij) Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, Netherlands (Hegeman) Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Utrecht, Netherlands (Hegeman) Department of Cardiothoracic Surgery, Amsterdam University Medical Centres, Amsterdam, Netherlands (Stecher) Department of Cardiothoracic Surgery, Medical Centre Leeuwarden, Leeuwarden, Netherlands (Cramer, De Zan, Harst, Guglielmo) Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands (Koop, Zuithoff, Vaartjes) Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands Publisher Georg Thieme Verlag Abstract Background This study evaluated the echocardiographic parameters and complication rates of surgical myectomy with concomitant anterior mitral leaflet extension (SM + AMLE) and isolated SM in hypertrophic obstructive cardiomyopathy (HOCM) patients. Methods All HOCM patients undergoing SM + AMLE (2006-2015) and isolated SM (2015-2020) in our centre were analysed. The primary outcome was left ventricular outflow tract (LVOT)-gradient and surgical reoperation (SM/mitral surgery). Secondary outcomes were aortic cross-clamping (ACC) time, iatrogenic ventricular septal defect (VSD), and mortality at 30-day and 3-year follow-up. Mixed-effects models assessed postoperative changes in LVOT-gradient measurements over time until a 3-year follow-up. Results This cohort (n = 59) consisted of 34 (58%) SM + AMLE and 25 (42%) isolated SM procedures. There were 32 (54%) males and 27 (46%) females with a mean age of 55 +/- 13 years at the time of the intervention. Postoperatively, no differences were observed over time in the median LVOT-gradient (p = 0.34). In the SM + AMLE group, 6% (n = 2) required surgical reoperation (due to patch dehiscence) versus 0% in the SM group. In the SM + AMLE group, the ACC time was significantly higher (86 minutes [interquartile range [IQR]: 74-103]) than in the isolated SM group (48 minutes [IQR: 39-57]; p < 001). In both groups, the VSD complication rate was 0%, and neither procedure led to death at 3-year follow-up. Conclusion HOCM-patients who underwent SM + AMLE had comparable clinical and echocardiographic outcomes to patients who underwent isolated SM. This suggests that increasing procedural complexity may not improve outcomes. However, given potential confounding, this should be interpreted with caution, future prospective randomised controlled trials are necessary.<br/>Copyright © 2026 The Author(s). <7> Accession Number 2048533247 Title The 2026 American Association for Thoracic Surgery (AATS) expert consensus document: Surgical management of primary chest wall malignancies. Source Journal of Thoracic and Cardiovascular Surgery. 172(4) (pp 789-809.e2), 2026. Date of Publication: 01 Oct 2026. Author Raymond D.P.; Abdelsattar Z.M.; Brown L.M.; Campbell S.R.; Guerra J.J.; Mangla A.; Meguid R.A.; Mesko N.W.; Moran S.L.; Rocco G.; Shen K.R.; Towe C.W.; Tong B.C.; Walsh G.L.; Donington J.S. Institution (Raymond) Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Center for Chest Wall Disease, Cleveland Clinic, Cleveland, Ohio, United States (Abdelsattar) Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Loyola University Medical Center and Edward Hines Veterans Affairs Hospital, Maywood, Ill, United States (Brown) Division of General Thoracic Surgery, Department of Surgery, UC Davis Health, Sacramento, Calif, United States (Campbell) Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, United States (Guerra, Walsh) Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex, United States (Mangla) Division of Sarcoma and Cutaneous Oncology, Department of Hematology and Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, United States (Meguid) Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo, United States (Mesko) Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, United States (Moran) Department of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minn, United States (Rocco) Department of Surgery, Thoracic Service, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, NY, United States (Shen) Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn, United States (Towe) Division of Thoracic and Esophageal Surgery, Department of Surgery, Case Western Reserve School of Medicine, University Hospitals, Cleveland, Ohio, United States (Tong) Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC, United States (Donington) Section of Thoracic Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, Ill, United States Publisher Elsevier Inc. Abstract Objective: The management of chest wall primary malignancies is challenging for thoracic surgeons because of the rarity and diversity of disease processes requiring nuanced knowledge. This document reviews the existing literature and provides multidisciplinary consensus recommendations for evaluation and treatment of chest wall primary malignancies. <br/>Method(s): The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary panel of medical oncologists, radiation oncologists, orthopedic surgeons, plastic and reconstructive surgeons, and thoracic surgeons with significant expertise in the management of chest wall malignancies. A focused literature review was performed with the assistance of a medical librarian. The panel used a modified Delphi method to develop expert consensus statements with a class of recommendations and level of evidence for 6 themes: (1) diagnosis and staging, (2) tumors treated with primary resection, (3) tumors treated with resection after induction therapy, (4) tumors not treated with primary surgical resection, (5) technical surgical principles, and (6) postoperative management. <br/>Result(s): Consensus was achieved on 34 statements on the basis of extensive literature review and current clinical experience spanning 11 high-volume institutions. These statements provide a standard for initial evaluation of a suspected chest wall neoplasm, histology directed management of a diverse group of malignancies, surgical management principles, and postoperative management. <br/>Conclusion(s): This multidisciplinary expert consensus document provides a framework upon which thoracic surgeons can approach the management of primary chest wall malignancies. Accurate diagnosis and staging, multidisciplinary treatment planning, and careful attention to surgical techniques to achieve an R0 (microscopically negative margin) resection are all vital elements. Furthermore, multi-institutional efforts are required to advance our understanding of chest wall malignancies.<br/>Copyright © 2026 The Authors <8> Accession Number 2049553293 Title Preoperative Pulmonary Blood Flow, Cardiopulmonary Bypass, and Lung Inflammation in Children With Congenital Heart Disease: Post Hoc Analysis of a Single-Center Prospective Cohort. Source Pediatric Critical Care Medicine. (pp 1-10), 2026. Date of Publication: 2026. Author Sartori A.; Simonato M.; Carnielli V.; Carollo C.; Di Salvo G.; Vida V.; Padalino M.; Cogo P. Institution (Sartori, Simonato) Department of Women's and Children's Health, University of Padova, Padova, Italy (Simonato) PCare laboratory, Fondazione Istituto di Ricerca Pediatrica, "Citta della Speranza, ", Padova, Italy (Carnielli) Division of Neonatology, Polytechnic University of Marche and "G. Salesi" Children's Hospital, Ancona, Italy (Carollo) Anesthesiology and Intensive Care Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy (Di Salvo) Division of Pediatric Cardiology, Department for Women's and Children's Health, University of Padova, Padova, Italy (Vida, Padalino) Pediatric and Congenital Cardiac Surgical Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy (Padalino) Department of Precision and Regenerative Medicine and Jonian Area, University of Bari, Bari, Italy (Cogo) Department of Medicine, University Hospital S. Maria della Misericordia, University of Udine, Udine, Italy Publisher Lippincott Williams and Wilkins Abstract Objective: - To evaluate inflammatory biomarkers and lipidomic profiles in tracheal aspirates (TA) of infants with congenital heart disease (CHD), by pulmonary blood flow (Qp) high/low grouping at the time of cardiac surgery on cardiopulmonary bypass (CPB), and to examine associations across CHD phenotypes. <br/>Design(s): - Post hoc analysis of patient samples obtained from a single-center prospective study. <br/>Setting(s): - Pediatric Cardiovascular Surgery Unit, Padova, Italy. <br/>Patient(s): - Samples from 79 infants with CHD who were enrolled in a prospective study were analyzed and classified by Qp (33/79 low and 46/79 high) according to pulmonary valve size at surgery. We also studied 23 infants without cardiorespiratory disease who served as controls. <br/>Intervention(s): - None. <br/>Measurements and Main Results: - Clinical data and lung mechanics at the time of anesthesia induction, at surgery end, and every 6 hours for 24 hours were collected. TA samples collected before and after surgery were used to quantify epithelial lining fluid (ELF) total proteins (TP), surfactant protein B (SP-B), and cytokines. The lipidomic profile was generated by mass spectrometry. Before surgery, ELF TP and SP-B were increased in CHD infants compared with controls. Sphingomyelin and phosphatidylglycerol percentages were significantly increased, whereas lysophosphatidylcholines and plasmalogens were significantly decreased. In the post-surgery samples, proinflammatory cytokines increased, especially in the low Qp group. This inflammatory response was associated with reduced dynamic compliance in the first 12 hours, and with longer respiratory support and ICU stay compared with the high Qp group. In the low Qp group, cytokine increase was associated with reduced oxygen diffusion capacity, and with the degree and length of minimum temperature during CPB. <br/>Conclusion(s): - In this post hoc analysis of TA samples from CHD infants undergoing surgery with CPB, we have shown that preoperative Qp phenotype was associated with an enhanced inflammatory response, highlighting potential opportunities for phenotype-specific strategies to improve postoperative outcome.<br/>Copyright © 2026 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies <9> Accession Number 2049709340 Title Renoprotective Effects of Dexmedetomidine Versus Dopamine in High-Risk Renal Patients Undergoing Off-Pump Coronary Artery Bypass Grafting:A Prospective, Randomized, Comparative Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Maity S.; Kumar S.; Daga M.K. Institution (Maity) Department of Cardiac Anesthesia, B.M. Birla Heart Research Center, Kolkata, India (Kumar, Daga) Department of Cardiothoracic and Vascular Surgery, B.M. Birla Heart Research Center, Kolkata, India Publisher W.B. Saunders Abstract Objectives: To compare the renoprotective effects of dexmedetomidine and low-dose dopamine versus normal saline (control) in high-risk renal patients undergoing off-pump coronary artery bypass grafting (OPCAB). <br/>Design(s): Prospective, open-label, randomized, parallel-group comparative study. <br/>Setting(s): Department of Cardiac Anaesthesiology and Critical Care at a tertiary-level cardiac surgical center. <br/>Participant(s): In total, 105 adult patients aged >=60 years with preexisting moderate renal insufficiency (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or serum creatinine >=1.1 mg/dL) and 1 or more additional risk factors (diabetes mellitus, hypertension, or left ventricular ejection fraction <45%), scheduled for elective OPCAB. No patients were excluded after randomization. <br/>Intervention(s): Patients were randomized equally into 3 groups: group A received dexmedetomidine infusion at 0.4 mug/kg/h (without a loading dose), group B received dopamine infusion at 3 mug/kg/min, and group C (control) received normal saline at 3 mL/h. Infusions were commenced after induction of anesthesia and continued for the first 24 postoperative hours. <br/>Measurements and Main Results: Urine output, serum creatinine, blood urea nitrogen (BUN), and eGFR were measured at baseline and at 24 and 48 postoperative hours. Acute kidney injury (AKI) was defined per Acute Kidney Injury Network (AKIN) criteria. Hemodynamic parameters and adverse events were recorded throughout. Group A demonstrated significantly higher urine output than groups B and C at days 1 and 2 (p < 0.01). Serum creatinine and BUN were significantly lower in group A versus groups B and C at both time points (p < 0.05), although the absolute differences were not clinically significant. eGFR was markedly higher in group A compared with groups B and C at days 1 and 2 (p < 0.0001). No patient in any group developed AKI by AKIN criteria or required renal replacement therapy. Adverse events, including arrhythmias and need for intra-aortic balloon pump, were comparable across groups (p = 0.31). <br/>Conclusion(s): Dexmedetomidine infusion was superior to dopamine in improving urine output and eGFR in high-risk renal patients undergoing OPCAB, although differences in serum creatinine and BUN were not clinically significant. Neither drug prevented AKI beyond the control group. Dexmedetomidine may offer a favorable renal physiological profile in this patient population, warranting further investigation with more sensitive biomarkers.<br/>Copyright © 2026 Elsevier Inc. <10> Accession Number 2048816236 Title Efficacy and safety of SP16 in preventing acute kidney injury in at-risk subjects with chronic kidney disease undergoing elective cardiac surgery using the heart-lung-machine (EASE-AKI): study protocol for a prospective, randomised, double-blind, placebo-controlled clinical trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 551. Date of Publication: 01 Dec 2026. Author Jobst-Schwan T.; Bihlmaier K.; Austin D.; Gelber C.; Kaemmerer-Suleiman A.-S.; Suleiman M.; Cesnjevar R.; Harig F.; Schiffer M. Institution (Jobst-Schwan, Bihlmaier, Schiffer) Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, Germany (Austin, Gelber) Serpin Pharma, Manassas, VA, United States (Kaemmerer-Suleiman, Suleiman, Cesnjevar, Harig) Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, Germany Publisher BioMed Central Ltd Abstract Background: Cardiac surgery using cardiopulmonary bypass uses controlled hypoperfusion which leads to relative organ damage. Acute kidney injury is the most frequent and most important organ failure, in particular in patients with chronic kidney disease. To date, there are no approved drug treatments that could effectively prevent acute kidney injury. SP16, an agonist of the low-density lipoprotein receptor-related protein 1, has been shown to exert both kidney- and cardioprotective effects in preclinical trials. Early clinical use of SP16 in phase I trials was safe. Administration of SP16 had beneficial trends on inflammatory response and infarct size in patients with ST-segment elevation myocardial infarction. The primary objective of this phase IIa trial is to demonstrate that injection of SP16 is safe and superior to placebo in preventing cardiac surgery-associated acute kidney injury within 7 days after surgery. <br/>Method(s): This randomised, double-blinded, placebo-controlled, single-centre study evaluates the efficacy and safety of SP16 in 120 high-risk chronic kidney disease patients with disease stage G2-G3b undergoing cardiac surgery who are randomised into one of two treatment groups in a 1:1 ratio: SP16 (12 mg) or placebo. The study medication is administered via two subcutaneous injections, with the first dose given before surgery, followed by an additional dose after 9 h. Primary endpoints are the incidence of acute kidney injury during 7 days post-surgery and the frequency of adverse events within 72 h after index surgery. Important secondary endpoints include the incidence of major adverse kidney events at day 90 and impact on cardiac function. Safety assessments encompass adverse events, vital signs, electrocardiograms and routine safety laboratory tests. Additional evaluations include pharmacokinetics and immunological biomarkers. <br/>Discussion(s): This single-centre phase IIa trial will assess the incidence of cardiac surgery-associated acute kidney injury, describing the kidney-protective potential of SP16 and its safety profile in patients undergoing cardiac surgery. Trial registration: EUCT, EUCT number 2025-522491-89-00. Registered on February 2, 2026, https://euclinicaltrials.eu/ctis-public/view/2025-522491-89-00. Patient recruitment is planned to start on August 1, 2026.<br/>Copyright © The Author(s) 2026. <11> Accession Number 2048932725 Title Brain protection in open arch surgery. Source Annals of Cardiothoracic Surgery. 15(4) (no pagination), 2026. Article Number: 48. Date of Publication: 31 Jul 2026. Author Okita Y. Institution (Okita) Cardio-Aortic Center, Takatsuki General Hospital, Kosobe, 1-3-13, Takatsuki, Osaka, Japan (Okita) Kobe University, Kobe, Japan Publisher AME Publishing Company Abstract This review outlines the history of aortic arch surgery and examines classifications of hypothermia and mechanisms of perioperative neurological injuries. Risk factors for these neurological insults are explored, as well as cerebral monitoring systems available to mitigate such injuries. Furthermore, a comparative literature analysis evaluates outcomes among deep hypothermic circulatory arrest, retrograde cerebral perfusion, and antegrade cerebral perfusion. Finally, technical considerations for cerebral perfusion delivery and contemporary trends in temperature management are discussed.<br/>Copyright © AME Publishing Company. <12> Accession Number 2048830219 Title A narrative review of PCSK9 inhibitors: from evolocumab to novel discoveries. Source Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number: 1800502. Date of Publication: 2026. Author Liu H.-H.; Li S.; Li J.-J. Institution (Liu) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Heart Failure Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Li, Li) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Cardiometabolic Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Frontiers Media SA Abstract The application of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represents a crucial milestone in the field of lipid-lowering therapy. As the first PCSK9 inhibitor to be approved globally, evolocumab has not only offered an entirely novel therapeutic option for patients with familial hypercholesterolemia but also established a paradigm for the development of subsequent anti-PCSK9 monoclonal antibodies. This narrative review provides an overview of the discovery of PCSK9 and its role in low-density lipoprotein cholesterol metabolism, detailing the developmental trajectory and key clinical trials of evolocumab, and underscoring its central importance and transformative impact on lipid-lowering therapeutics. On this basis, we conduct a comparative analysis of the differences in mechanism of action, clinical efficacy and safety among the marketed PCSK9 inhibitors, and dissect the limitations and unmet needs in current clinical practice. Furthermore, this review explores the pleiotropic effects of PCSK9 beyond lipid metabolism, and comments on its potential application value and latest research advances in diseases such as infection, liver disease, and malignancy. Finally, we prospect the future development directions of PCSK9-targeted therapy, aiming to provide an integrated reference perspective for basic research and clinical practice in this field.<br/>Copyright © 2026 Liu, Li and Li. <13> Accession Number 2046443191 Title A Systematic Review of the Clinical Impact of GLP-1 Receptor Agonists in Hidradenitis Suppurativa. Source American Journal of Clinical Dermatology. 27(5) (pp 909-923), 2026. Date of Publication: 01 Sep 2026. Author Visan M.-A.; Carroll E.; Ryan S.-L.; Pender E.; Costache D.-O.; Caruntu C.; Hughes R.; Kirby B. Institution (Visan, Carroll, Ryan, Pender, Hughes, Kirby) Dermatology Department, St. Vincent's University Hospital, Dublin, Ireland (Visan, Caruntu) Physiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Visan, Costache) Dermatology Department, Carol Davila Central Military Emergency University Hospital, Bucharest, Romania (Carroll, Pender, Hughes, Kirby) School of Medicine, Charles Institute of Dermatology, University College Dublin, Dublin, Ireland (Costache) Dermatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Caruntu) Prof. Dr. N. Paulescu National Institute of Diabetes, Nutrition, Metabolic Diseases, Bucharest, Romania Publisher Adis Abstract Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease which imposes a significant burden in terms of pain, disability, and comorbidities. Obesity and metabolic dysfunction are highly prevalent in HS, contributing to disease severity. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used in type 2 diabetes and obesity, have shown additional anti-inflammatory properties that may be relevant in HS.However, data on their clinical benefit remain limited. <br/>Method(s): We performed a systematic review of PubMed/MEDLINE, Scopus, Web of Science, and Embase through June 2025, following PRISMA guidelines. Studies reporting outcomes in HS patients treated with GLP-1RAs were included. Information on clinical severity, quality of life, metabolism, inflammatory markers, and healthcare use were extracted. Findings were critically assessed and summarized descriptively, with pooled analysis applied where outcomes were consistently reported. This review was registered with PROSPERO (CRD420251110220). <br/>Result(s): Nineteen studies including 67,568 patients were identified. Pooled analysis showed that 60% of patients achieved clinical improvement in Hurley stage (95% CI 52-67). Dermatology Life Quality Index (DLQI) improved by a mean of -3.83 points (95% CI -5.14 to -2.51). Clinical benefit was observed despite modest weight reduction (mean BMI change -2.64 kg/m<sup>2</sup>). Inflammatory and metabolic markers improved, with significant reductions in mean C-reactive protein (-1.35 mg/L, 95% CI -2.33 to -0.36) and HbA1c (-0.39%, 95% CI -0.59 to -0.18). Large real-world cohorts showed decreased antibiotic and corticosteroid use and lower hospitalization rates, though results for biologic use, surgical procedures, and cardiovascular outcomes were mixed. Two studies reported reduced risk of major adverse cardiovascular events, while one HS-diabetes cohort suggested persistent excess cardiovascular risk compared with diabetes-only controls. <br/>Conclusion(s): This systematic review suggests that GLP-1RAs are associated with improvements in HS severity, quality of life, metabolic and inflammatory parameters, and may additionally reduce healthcare utilization and cardiometabolic risk, observed alongside weight loss. However, current evidence remains limited and heterogeneous, and the relative contribution of weight-dependent and weight-independent effects cannot be determined. Prospective studies and controlled trials are needed to clarify the role of GLP-1RAs in HS management.<br/>Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <14> Accession Number 2047473844 Title Long-term survival after percutaneous coronary intervention or coronary artery bypass grafting in patients with diabetes and multivessel disease. Source Journal of Thoracic and Cardiovascular Surgery. 172(4) (pp 1021-1032.e7), 2026. Date of Publication: 01 Oct 2026. Author Ameen C.; Hansson E.C.; Milojevic M.; Omerovic E.; Jeppsson A.; Nielsen S.J. Institution (Ameen, Hansson, Omerovic, Jeppsson, Nielsen) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (Hansson, Jeppsson, Nielsen) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Milojevic) Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia (Milojevic) Department of Cardiac Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland (Omerovic) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden Publisher Elsevier Inc. Abstract Objective: The study objective was to compare mortality risks, survival times, and regional differences after coronary artery bypass grafting or percutaneous coronary intervention in patients with diabetes and multivessel disease in a large nationwide cohort of patients. <br/>Method(s): The SWEDEHEART registry was used to identify 26,166 patients with diabetes and multivessel disease who underwent percutaneous coronary intervention (n = 16,739, 64.0%) or coronary artery bypass grafting (n = 9427, 36.0%) in Sweden from 2006 to 2020. Individual patient data from 5 mandatory national registries were merged. Inverse probability of treatment weighting was used to compare groups. Sensitivity analyses included multivariable Cox regression and instrumental variable analysis. The median follow-up time was 5.5 years (range, 0-15 years). <br/>Result(s): Weighted all-cause mortality (hazard ratio, 0.80; 95% CI, 0.76-0.84) and cardiovascular mortality (hazard ratio, 0.73; 95% CI, 0.68-0.78) risks were lower after coronary artery bypass grafting compared with percutaneous coronary intervention. The weighted median survival time was 0.9 years longer (95% CI, 0.5-1.4) after coronary artery bypass grafting compared with percutaneous coronary intervention, with markedly longer survival found in patients with left main stem stenosis or 3-vessel disease (+4.1; 95% CI, 3.3-4.9 and +3.4; 95% CI, 2.8-4.0 years, respectively). The results of the sensitivity analyses supported the primary analysis. The percutaneous coronary intervention-to-coronary artery bypass grafting ratio varied markedly across Sweden's 19 health care regions, ranging from 0.9 to 7.6. <br/>Conclusion(s): Coronary artery bypass grafting was associated with significantly lower risk of all-cause and cardiovascular mortality as well as longer weighted median survival time compared with percutaneous coronary intervention in patients with diabetes and multivessel disease, particularly among patients with left main stem stenosis or 3-vessel disease.<br/>Copyright © 2026 The Authors <15> Accession Number 2048852609 Title Functional mitral valve regurgitation outcomes by treatment modality: a systematic review and meta-analysis of reconstructed survival data. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 755. Date of Publication: 01 Dec 2026. Author Dastjerdi P.; Tavakoli K.; Narimani-Javid R.; Anaraki N.; Shayesteh H.; Hosseini Mohammadi N.S.; Momeni S.; Nikfar R.; Rahmati S.; Mohsen A.; Hosseini K.; Soleimani H. Institution (Dastjerdi, Tavakoli, Anaraki, Shayesteh, Hosseini Mohammadi, Momeni, Nikfar, Rahmati, Soleimani) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Narimani-Javid) Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mohsen) Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, United States (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Publisher BioMed Central Ltd Abstract Background: Functional mitral regurgitation (FMR) carries poor prognosis, and optimal management remains debated. Mitral Transcatheter Edge-to-Edge Repair (MTEER) is an alternative to surgical repair (SMVR) or optimized medical therapy (OMT), but long-term outcomes are uncertain. <br/>Method(s): PubMed, Embase, Scopus, and the Cochrane Library were searched for studies reporting Kaplan-Meier curves of MTEER, SMVR, or OMT in FMR. Individual patient data (IPD) were reconstructed using the Liu method with accuracy checks. Pooled IPD were analyzed with Cox and time-varying Cox models, landmark, time-restricted, and restricted mean survival time analyses. <br/>Result(s): Sixteen studies (n = 4,570) were included. Patients undergoing MTEER were older and higher risk, with greater prevalence of atrial fibrillation, prior myocardial infarction, chronic kidney disease, higher EuroSCORE, and more frequent NYHA class >= III compared with SMVR. Over up to 60 months, both MTEER (HR: 0.65; 95% CI: 0.57-0.75; p < 0.001) and SMVR (HR: 0.39; 95% CI: 0.33-0.46; p < 0.001) significantly reduced all-cause mortality versus OMT, whereas MTEER carried higher mortality risk than SMVR (HR: 1.68; 95% CI: 1.43-1.97; p < 0.001). MTEER was less effective than SMVR in reducing recurrent MR > 2 (HR: 3.31; 95% CI: 1.62-6.75; p < 0.001) and reoperation (HR: 4.62; 95% CI: 2.22-9.61; p < 0.001). In contrast, MTEER reduced hospitalization risk by 30% compared to OMT (HR: 0.70; 95% CI: 0.64-0.77; p < 0.001) and decreased MACE by 21% (HR: 0.79; 95% CI: 0.73-0.84; p < 0.001). <br/>Conclusion(s): MTEER improves survival and reduces hospitalization and MACE compared with OMT but is less durable than SMVR, with higher risks of recurrent MR, reoperation, and late mortality.<br/>Copyright © The Author(s) 2026. <16> Accession Number 2048840399 Title Chronic kidney disease following pediatric cardiac surgery: a systematic review and meta-analysis. Source BMC Pediatrics. 26(1) (no pagination), 2026. Article Number: 814. Date of Publication: 01 Dec 2026. Author Badeli H.; Motiei M.; Nejad A.T.; Hassanzadeh-Rad A. Institution (Badeli, Motiei, Hassanzadeh-Rad) Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Nejad) Inflammatory Lung Diseases Research Center, Department of Internal Medicine, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet the true burden of CKD remains unclear due to limited data. <br/>Objective(s): To determine the pooled prevalence of chronic kidney disease among pediatric patients with a history of cardiac surgery. <br/>Material(s) and Method(s): A systematic literature search was conducted in PubMed, Scopus, and Web of Science from inception to March 1, 2025. Eligible studies included those reporting CKD prevalence in patients under 18 years of age who had undergone any type of cardiac surgery. We performed this systematic review and meta-analysis following PRISMA guidelines and Cochrane Collaboration recommendations using a random-effects model. Pooled prevalence estimates were calculated with 95% confidence intervals (95% CI). <br/>Result(s): Data from five prospective studies involving 1002 pediatric patients were included. The studies were published between 2016 and 2022 and conducted in Canada, France, the United States, and Belgium. The pooled prevalence of CKD was 16% (95% CI: 9.0-26.0%), with moderate heterogeneity across studies (I2 = 49.5%, p = 0.09). Sensitivity analysis confirmed the stability of the pooled estimate. <br/>Conclusion(s): The findings of this analysis highlight the need for long-term renal monitoring in this population, although further high-quality studies with standardized definitions and extended follow-up are warranted to confirm and refine these estimates.<br/>Copyright © The Author(s) 2026. <17> Accession Number 2048962991 Title To Evaluate Recovery Profile of Patients Receiving IV Dexmedetomidine versus IV Clonidine. Source International Journal of Current Pharmaceutical Review and Research. 17(8) (pp 251-255), 2025. Date of Publication: 2025. Author Khalde V.Y.; Pare T.; Pare A.; Kumar N.S.; Nair V.; Kale P. Institution (Khalde, Pare) Department of Anaesthesiology, Saishree Vitalife, Hospital, Maharashtra, Pune, India (Pare) Department of Anaesthesiology, Deenanath Mangeshkar Hospital, Saishree Vitalife, Hospital, Maharashtra, Pune, India (Nair, Kale) Zen Hospital, Mumbai, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Pneumoperitoneum for laparoscopic surgeries induces a cardiovascular response characterized by abrupt elevations of arterial pressure and systemic vascular resistance. Adequate preloading, along with the use of drugs: Alpha adrenergic agonists like Clonidine, Dexmeditomidine, and beta blocking agents like Esmolol, high doses of Opioids like Fentanyl, Remifentanyl, or Vasodilators etc are often used to avoid circulatory responses to pneumo-peritonium. Hence, this study was conducted with an objective to compare IV Dexmedetomidine and IV Clonidine in the evaluation of the recovery characteristics by Ramsay Sedation Scale (RSS) in patients undergoing laparoscopic surgeries under isoflurane anaesthesia. <br/>Material(s) and Method(s): A randomized, double-blinded, prospective study was conducted among 90 patients divided into three groups with 30 patients in each group. Group C received Inj. Clonidine 2 mug/kg I.V. in 100cc normal saline slowly over 20 min in the preoperative holding area before shifting patient to OT. Group D received Inj. Dexmedetomidine 1mug/kg I.V. in 100cc normal saline slowly over 20min and Group K received Inj. Normal saline 20cc slowly over 20min. <br/>Result(s): Post operatively, recovery profile of the patients which was assessed using Ramsay sedation scale among the respective three groups was statistically not significant. <br/>Conclusion(s): The study drugs at this dosage, could not be used for day care surgery. However larger studies are required to draw final conclusions regarding use of these drugs in day care surgery.<br/>Copyright This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided original work is properly credited. <18> Accession Number 2048852610 Title Direct oral anticoagulants versus vitamin K antagonists after left atrial appendage occlusion: a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 754. Date of Publication: 01 Dec 2026. Author Dai Y.; Chang J.; Guo J. Institution (Dai, Chang) International Medical Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (Guo) Department of Nursing, Guang'anmen Hospital, Academy of Chinese Medical Sciences, No. 5 Beixiange, Xicheng District, Beijing, China Publisher BioMed Central Ltd Abstract Background: Non-valvular atrial fibrillation (NVAF) elevates the risk of stroke owing to thrombus development, especially in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) provides stroke prophylaxis for those unable to tolerate prolonged anticoagulant therapy. This meta-analysis evaluates the effectiveness and safety of direct oral anticoagulants (DOACs) in comparison to vitamin K antagonists (VKAs) following LAAO, concentrating on ischemic stroke, systemic embolism (SE), severe bleeding, and device-related thrombosis. <br/>Method(s): A comprehensive literature search was conducted in Web of Science, Cochrane Library, Embase, and PubMed for studies published between 2017 and 2025. The inclusion criteria were trials involving patients undergoing LAAO who were treated with either DOAC or VKA regimens. The primary outcomes included transient ischemic attack (TIA), SE, ischemic stroke, and major hemorrhage. Any major adverse event was defined as a composite of major bleeding, stroke, SE, device-related thrombosis, and all-cause mortality, and analyzed as a secondary/exploratory outcome due to heterogeneity in component reporting across studies. Meta-analysis was performed using random-effects models for all pooled analyses, given the anticipated clinical and methodological heterogeneity across studies. Subgroup and sensitivity analyses were conducted to further assess the robustness of the findings. <br/>Result(s): Twenty-one studies were included. DOACs had a considerably reduced incidence of serious bleeding (OR = 0.88, 95% CI: 0.80-0.98) and any major adverse event (OR = 0.88, 95% CI: 0.82-0.95) than VKAs, but there was no discernible difference in stroke or SE rates (OR = 0.86, 95% CI: 0.69-1.05). Exploratory subgroup analyses suggested potential differences in certain groups (e.g., North America, longer follow-up), but these should be interpreted as exploratory. Secondary outcomes, including peri-device leaks and device-related thrombosis, did not differ significantly between groups. <br/>Conclusion(s): DOACs may provide comparable thromboembolic protection with a lower risk of major bleeding than VKAs after LAAO. However, most available evidence is derived from non-randomized studies and remains subject to residual confounding, selection bias, and moderate-to-low certainty of evidence. Therefore, the observed benefits of DOACs should be interpreted cautiously. Further large-scale prospective studies and randomized controlled trials are needed to confirm these findings and inform optimal post-LAAO anticoagulation strategies.<br/>Copyright © The Author(s) 2026. <19> Accession Number 2048445038 Title Intramyocardial injection of allogeneic human induced pluripotent stem cell-derived cardiomyocytes in advanced ischemic heart failure: an early-stage randomized trial. Source Nature Medicine. 32(9) (pp 3331-3338), 2026. Date of Publication: 01 Sep 2026. Author Zhang H.; Menasche P.; Fan J.; Gao L.; Luo H.; Xue Y.; Zhu X.; Wang Q.; Li C.; Xu Y.; Zhang A.; Wang J.; Wang D. Institution (Zhang, Luo, Xue, Zhu, Wang) Department of Cardiac Surgery, Nanjing Drum Tower Hospital Affiliated Hospital of Medical School, Nanjing University, Nanjing, China (Menasche) Department of Cardiovascular Surgery, University Paris-Cite, INSERM Unit 970, Paris Cardiovascular Research Center (PARCeC), Hopital Europeen Georges Pompidou, Paris, France (Fan, Wang, Li, Xu, Zhang, Wang) HELP Therapeutics, Nanjing, China (Gao) Institute for Regenerative Medicine, State Key Laboratory of Cardiology and Medical Innovation Center, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China Publisher Nature Research Abstract A treatment for heart failure that could promote myocardial regeneration has long been sought. Here we conduct the HEAL-CHF trial (n = 20; 18 male and 2 female), in which patients with advanced heart failure with reduced ejection fraction (left ventricular ejection fraction <=45%) were randomized to receive intramyocardial injections of allogeneic human induced pluripotent stem cell-derived cardiomyocytes or were uninjected. Both groups received concomitant coronary artery bypass grafting. The primary endpoint was safety, defined as the incidence of sustained ventricular tachycardia during the 1- to 6-month postoperative period and tumorigenicity at 12 months of follow-up. Neither sustained ventricular tachycardia nor tumorigenicity was observed in either patient group. Early post-transplantation ventricular arrhythmias occurred in patients in the cell therapy group during the first 4 weeks, as all 10 patients in this group developed accelerated idioventricular rhythm, typically emerging 5 to 7 days post-transplantation. Clinically significant ventricular tachycardia (>140 bpm), which occurred in 2 patients, peaked at 2 to 3 weeks post-procedure and resolved completely after cardioversion. Secondary efficacy analyses indicated that cell transplantation provided significantly greater improvements in 6-min walk distance, global myocardial perfusion (as assessed by the summed rest score on <sup>99m</sup>Tc single-photon emission computed tomography-computed tomography) and relative wall thickening, compared with coronary artery bypass grafting alone. No significant between-group differences were observed for left ventricular ejection fraction, left ventricular volumes, myocardial scar size, New York Heart Association functional class or Minnesota Living with Heart Failure Questionnaire scores at 12 months. In view of the arrhythmic events observed, future studies will need to determine the risk-to-benefit ratio associated with human induced pluripotent stem cell-derived cardiomyocyte therapy. ClinicalTrials.gov registration: NCT03763136.<br/>Copyright © The Author(s), under exclusive licence to Springer Nature America, Inc. 2026. <20> Accession Number 2044079947 Title Perioperative and Long-Term Cardiorenal Outcomes of SGLT2 Inhibitors in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis. Source Cardiovascular Drugs and Therapy. 40(5) (pp 1781-1792), 2026. Date of Publication: 01 Oct 2026. Author Rajpar N.A.; Meghwar S.; Nabi R.; Khaskheli S.A.; Khan S.; Rehman A.; Fatima M.; Abbasi S.U.A.M.; Shaikh N.; Nabi Z.; Ahmed S.; Ahmed R. Institution (Rajpar) Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Meghwar, Khaskheli, Shaikh) Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Nabi) Islamic International Medical College, Rawalpindi, Pakistan (Khan) Nishtar Medical University and Hospital, Multan, Pakistan (Rehman, Abbasi) Allama Iqbal Medical College, Lahore, Pakistan (Fatima) People's University of Medical and Health Sciences for Women-Nawabshah, Nawabshah, Pakistan (Nabi) KRL Hospital, Islamabad, Pakistan (Ahmed) Sunderland Royal Hospital, Sunderland, United Kingdom (Ahmed) Newcastle University Medical School, Newcastle, United Kingdom (Ahmed) The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom Publisher Springer Abstract Background: Cardiac-surgery-associated acute kidney injury (CSA-AKI) occurs in 20-30% of patients undergoing valve surgery or CABG and is linked to prolonged ICU stay, increased costs, and higher mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially for diabetes, confer cardiovascular and renal protection. We conducted the first meta-analysis to evaluate perioperative SGLT2i use in cardiac surgery patients. <br/>Method(s): Randomized controlled trials and observational studies evaluating SGLT2i in cardiac surgery patients were identified through comprehensive database searches to July 2025. Risk of bias was assessed with RoB 2.0 and the Newcastle-Ottawa Scale. Pooled effect estimates were calculated as risk ratios (RR) with 95% confidence intervals using Mantel-Haenszel random-effects models. Heterogeneity was quantified with I2, with prespecified subgroup and sensitivity analyses performed. <br/>Result(s): Perioperative SGLT2i use significantly reduced acute kidney injury (RR 0.39, 95% CI 0.29-0.53; I2=1%). Secondary outcomes showed reduced heart failure hospitalization (RR 0.49, 95% CI 0.36-0.67; I2=0%) and major adverse cardiovascular events (RR 0.64, 95% CI 0.48-0.85; I2=50%). A reduction in mortality was observed (RR 0.51, 95% CI 0.30-0.86; I2=47%), although this effect was primarily driven by observational studies and not confirmed in randomized trials. No significant differences were observed for stroke, myocardial infarction, hypoglycaemia, or urinary tract infection. <br/>Conclusion(s): Perioperative SGLT2 inhibitor use was associated with improved renal and cardiovascular outcomes after cardiac surgery. While a mortality benefit was suggested, it was not confirmed in randomized trials. Larger, high-quality RCTs are required to establish definitive efficacy and guide perioperative use.<br/>Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <21> Accession Number 2048896700 Title AI-based tools for predicting and early diagnosis of graft rejection in solid organ transplantation - a systematic review. Source Transplantation Reviews. 40(4) (no pagination), 2026. Article Number: 101054. Date of Publication: 01 Dec 2026. Author Henderson D.; Niederegger T.; Munzinger R.; Karakas E.; Hildinger J.; Iske J.; Heiland M.; Cetrulo C.L.; Lellouch A.G.; Knoedler L. Institution (Henderson) Faculty of Medicine, Universite Paris Cite, Paris, France (Henderson) IHU Reconnect, AP-HP, Paris, France (Niederegger, Munzinger, Heiland, Knoedler) Charite - Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, Berlin, Germany (Karakas) University of Heidelberg, Medical Faculty, Heidelberg, Germany (Hildinger, Iske) Klinik fur Herz-, Thorax-, und Gefaschirurgie, Deutsches Herzzentrum der Charite, Berlin, Germany (Hildinger, Iske) Universitatsmedizin Berlin, Berlin, Germany (Cetrulo, Lellouch, Knoedler) Division of Plastic and Reconstructive Surgery, Cedars-Sinai Hospital, Los Angeles, CA, United States (Cetrulo, Lellouch) Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Lellouch) Universite Paris Cite, Inserm, The Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France (Lellouch) AP-HP, Hopital Europeen Georges Pompidou, Hematology Department, Paris, France Publisher Elsevier Inc. Abstract Background: Solid organ transplantation (SOT) is the standard therapeutic approach to end-stage organ failure. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has emerged as a promising tool for analyzing large, complex datasets, enabling both prediction of rejection risk and early detection of established graft injury. This systematic review synthesizes current evidence on AI-based approaches for predicting future rejection risk and detecting active rejection in human SOT, evaluates their performance, and identifies gaps for future research. <br/>Method(s): This review followed PRISMA 2020 guidelines. PubMed/MEDLINE, EMBASE, and Web of Science were searched up to April 30, 2025, using terms related to AI and graft rejection. Eligible studies included peer-reviewed original research using AI to predict, detect, or monitor rejection in humans. Three reviewers independently screened titles, abstracts, and full texts, resolving disagreements by consensus. Due to heterogeneity in methods and objectives, meta-analysis was not feasible. <br/>Result(s): Of 195 studies identified, 62 met inclusion criteria. Most focused on kidney transplantation (n = 49, 79%), followed by heart (n = 6, 10%), liver (n = 4, 6%), lung (n = 1, 2%), and pancreas (n = 1, 2%). One study addressed multiple organs. Among diagnostic studies, AI, particularly ML and DL, demonstrated high diagnostic performance in non-kidney transplantation, often exceeding reported AUC of 0.90. In kidney transplantation, DL models, including convolutional neural networks and transformer-based architectures, reached accuracies up to 99.89% and AUCs up to 0.99. ML methods such as XGBoost, Bayesian classifiers, and logistic regression also performed well, with XGBoost achieving AUCs of 0.95-0.97, Bayesian classifiers reaching accuracies of 93.3% to 97%, and logistic regression models reporting AUC values up to 0.969. Among predictive studies, ML-based models similarly demonstrated strong discriminative performance. <br/>Conclusion(s): AI models using ML and DL may show strong potential, particularly in kidney transplantation, for non-invasive early detection of active graft rejection and prediction of future rejection risk, across diverse data types. The exceptionally high performance reported by some studies warrants careful interpretation. Challenges such as lack of standardization, limited validation, and interpretability must be addressed through well-designed multicentre studies to support clinical translation.<br/>Copyright © 2026 <22> Accession Number 2048827193 Title Safety and efficacy of sacubitril/valsartan vs. benazepril administered as initial treatment for STEMI patients with mid-range ejection fraction: a propensity score matching analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1752230. Date of Publication: 2026. Author Wang Y.; Su L.; Zhou Q.; Tian J.; Zhi W.; Fu Y.; Wang Q.; Jiang Y.; Gu X. Institution (Wang, Su, Zhou, Tian, Zhi, Fu, Wang, Jiang, Gu) The Fifth Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, China Publisher Frontiers Media SA Abstract Objective - We assessed the safety and efficacy of initial treatment with sacubitril/valsartan (S/V) in STEMI patients with mid-range left ventricular ejection fraction (LVEF, 40%-49%). Methods - We consecutively enrolled STEMI patients who received successful reperfusion therapy at the Second Hospital of Hebei Medical University between January 2019 and January 2025. Clinic follow-up visits were performed at 2 weeks and 1 month after treatment initiation. PSM was used to balance baseline characteristics between the benazepril and S/V cohorts, minimizing selection bias and confounding. Echocardiographic parameters were assessed at baseline (within 24 h of symptom onset) and at the 1-month follow-up. Major adverse cardiac events (MACE) and safety outcomes were systematically reported. Results - A total of 134 eligible patients were enrolled, including 96 in the S/V cohort and 38 in the benazepril cohort. After 1:1 PSM, 35 patients were included in each matched group, with well-balanced baseline characteristics. After 1 month of treatment, the S/V group showed a significantly greater reduction in left ventricular end-systolic volume (LVESV), as well as greater improvements in left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (GLS), compared with the benazepril group (all P < 0.05). There were no significant between-group differences in the incidence of major adverse cardiac events (MACE) or safety endpoints (all P > 0.05). Conclusion - In STEMI patients with mid-range LVEF, initial S/V and benazepril treatment had comparable safety profiles. S/V showed superior efficacy in improving short-term cardiac systolic function, as measured by surrogate echocardiographic endpoints. These preliminary findings require validation in larger, prospective randomized controlled trials with longer follow-up to confirm whether these benefits translate into improved long-term clinical outcomes.<br/>Copyright © 2026 Wang, Su, Zhou, Tian, Zhi, Fu, Wang, Jiang and Gu. <23> Accession Number 2048918517 Title Closed-loop insulin delivery for glycaemic control in hospitalised and perioperative adults: A systematic review and meta-analysis of randomised controlled trials. Source Diabetes Research and Clinical Practice. 240 (no pagination), 2026. Article Number: 113519. Date of Publication: 01 Oct 2026. Author Zhong J.; Zhao C.; Shuai X.; Wang H.; Qi R.; Yang S.; Cheng L. Institution (Zhong, Zhao, Shuai, Wang, Qi, Yang, Cheng) Affiliated Hospital of Panzhihua University, Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine, Sichuan, Panzhihua, China (Cheng) Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China Publisher Elsevier Ireland Ltd Abstract We evaluated whether closed-loop insulin delivery improves glycaemic control in hospitalised and perioperative adults. PubMed/MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov were searched from inception to 29 June 2026 for randomised controlled trials comparing closed-loop or automated insulin delivery with usual care or conventional insulin therapy. Random-effects meta-analyses were conducted; risk of bias was assessed using RoB 2 and certainty of evidence using GRADE. Seven trials involving 375 analysed participants were included. Closed-loop insulin delivery increased time in target glucose range by 23.91 percentage points (95% CI 19.40 to 28.43; I<sup>2</sup> = 0%) and reduced mean glucose by 1.79 mmol/L (95% CI 1.06 to 2.53 lower; I<sup>2</sup> = 36.3%); certainty was moderate for both outcomes. Two trials involving 69 participants reported compatible participant-level data for clinically significant hyperglycaemia, and both estimates favoured closed-loop insulin delivery, although the evidence was exploratory and imprecise. No severe hypoglycaemic events occurred in either group, precluding reliable estimation of comparative safety. Closed-loop insulin delivery may improve glycaemic process measures, but larger pragmatic trials are needed to establish clinical benefits, safety, and implementation feasibility.<br/>Copyright © 2026 Elsevier B.V. <24> [Use Link to view the full text] Accession Number 2043043604 Title Association of Preoperative Frailty and Postoperative Outcomes in Older Adults Undergoing Major Cardiac Procedures: A Systematic Review and Meta-Analysis. Source Anesthesia and Analgesia. 143(4) (pp 684-695), 2026. Date of Publication: 01 Oct 2026. Author Thangavelu V.; Bhatia O.; Hasija A.; Rajapakse N.; Yan E.; Saripella A.; Englesakis M.; Chung F. Institution (Thangavelu, Bhatia, Rajapakse, Chung) Temerty Faculty of Medicine, University of Toronto, Toronto, OH, Canada (Hasija) Michael G. DeGroote School of Medicine, McMaster University, Hamilton, OH, Canada (Yan, Saripella, Chung) Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, OH, Canada (Yan) Postgraduate PhD Program, Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, OH, Canada (Englesakis) Library & Information Services, Department of Anesthesia and Pain Management, University Health Network, Toronto, OH, Canada Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Frailty, characterized by reduced physiological resilience, is a pivotal risk factor in older adults undergoing major cardiac procedures. Although previous analyses have linked frailty to adverse surgical outcomes, knowledge gaps persist due to methodological inconsistency across frailty tools and limited synthesis of complications such as delirium, infection, and renal dysfunction. The objective of this systematic review and meta-analysis is to determine the prevalence of preoperative frailty in older adults undergoing major cardiac procedures, and assess its association with postoperative outcomes, including cardiac, respiratory, renal, infectious, stroke, and bleeding complications, postoperative delirium, hospital and intensive care unit (ICU) length of stay, nonhome discharge, hospital readmission, and both 30-day and 1-year mortality. <br/>METHOD(S): - A prespecified protocol was registered with PROSPERO (CRD#42024574916), following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase, and Cochrane databases were searched for English-language studies of patients undergoing major cardiac procedures, including coronary artery bypass grafting (CABG), aortic or mitral valve replacement or repair, transcatheter aortic valve replacement (TAVR), or combined procedures. Validated frailty instruments (eg, Fried Frailty Phenotype, Clinical Frailty Scale) were required to determine preoperative frailty, along with reporting at least 1 postoperative outcome. Noncardiac surgeries, minor procedures, case reports, and reviews were excluded. Random-effects meta-analyses generated odds ratio (OR) or standardized mean difference (SMD) values with 95% confidence intervals (CI). <br/>RESULT(S): - Nineteen studies (n = 11, 667; mean +/- SD age 71.9 +/- 8.1 years, 28% female) met inclusion criteria, spanning North America, Europe, Asia, and Oceania. The overall prevalence of preoperative frailty was 16.8%. Frailty was significantly associated with delirium (OR, 4.11; 95% confidence interval [CI], 2.00-8.45; P <.001), infection (OR, 3.72; 95% CI, 2.27-6.12; P <.001), renal complications (OR, 2.72; 95% CI, 2.05-3.60; P <.001), and extended hospital (SMD, 0.69 ; 95% CI, 0.35-1.02; P <.001) and ICU (SMD, 0.72; 95% CI, 0.51-0.94; P <.001) stays. Frailty increased the odds of 30-day (OR, 3.58; 95% CI, 2.16-5.93; P <.001) and 1-year (OR, 2.25; 95% CI, 1.56-3.25; P <.001) mortality. <br/>CONCLUSION(S): - Frailty affects nearly 1 in 5 older adults requiring major cardiac procedures. Frailty was significantly associated with adverse postoperative outcomes, including delirium, infections, renal complications, extended length of stay, and mortality. As frailty is potentially modifiable, targeted strategies-such as prehabilitation, nutritional optimization, and enhanced perioperative monitoring-may improve outcomes. Incorporating routine frailty screening into standard preoperative practice allows for earlier identification of high-risk patients, efficient resource allocation, and perioperative care planning.<br/>Copyright © 2025 International Anesthesia Research Society <25> Accession Number 2049338758 Title Risk factors for pressure ulcer development among adults undergoing surgery: A systematic review. Source Journal of Wound Care. 35(9) (pp 722-736), 2026. Date of Publication: 02 Sep 2026. Author Badrie S.; Avsar P.; George S.; Kurian S.; Moore Z.; Wilson H. Institution (Badrie) School of Medicine, Royal College in Ireland, Dublin, Ireland (Avsar, George, Kurian, Moore, Wilson) Skin Wounds and Trauma Research Centre, Royal College in Ireland, University of Medicine and Health Sciences, Dublin, Ireland (Avsar, George, Kurian, Moore, Wilson) School of Nursing and Midwifery, Royal College in Ireland, University of Medicine and Health Sciences, Dublin, Ireland Publisher MA Healthcare Ltd Abstract Objective: To examine risk factors for pressure ulcer (PU) development among adults undergoing surgery. <br/>Method(s): A total of five electronic databases were searched from inception to March 2024. Study selection, data extraction and quality appraisal were performed by two independent reviewers, using the Crowe Critical Appraisal Tool (CCAT v1.4; Michael Crowe, James Cook University, Australia), with scores =75% indicating high methodological quality. Results were categorised and reported as preoperative, intraoperative and postoperative risk factors, with percentages representing the proportion of studies assessing each risk factor in which it was statistically significant. Due to methodological heterogeneity, findings were synthesised narratively. <br/>Result(s): A total of 41 studies were included, 20 (48.8%) of which had retrospective designs. Among the preoperative risk factors, Braden score was statistically significant in 11 (68.8%) of the 16 studies assessing this factor, age in 19 (61.3%) of 31 studies, and diabetes in 11 (61.1%) of 18 studies. Among intraoperative risk factors, duration of surgery was statistically significant in 15 (53.6%) of 28 studies assessing this factor, patient positioning in nine (60.0%) of 15 studies, and type of surgery in nine (60.0%) of 15 studies. Postoperatively, Braden Scale score was statistically significant in five (83.3%) of six studies, while sepsis and pneumonia were each statistically significant in all three (100%) studies assessing these factors. The mean methodological quality score was 82+/-9.7%. <br/>Conclusion(s): This systematic review identified several risk factors for PU development across the included studies during the preoperative, intraoperative, and postoperative surgical period. Due to the complex interplay between competing factors that impact PU development during surgery, the development of a core outcome set of risk factor variables for inclusion in future studies may enhance homogeneity and support risk stratification alongside optimisation of modifiable exposure factors. Declaration of interest: The authors have no conflicts of interest to declare.<br/>Copyright © 2026 MA Healthcare Ltd. <26> Accession Number 2049301197 Title All-cause mortality and appropriate implantable cardioverter-defibrillator shocks with first-line catheter ablation versus antiarrhythmic drugs in ischemic ventricular tachycardia: A systematic review and Meta-analysis of randomized controlled trials. Source International Journal of Cardiology. 464 (no pagination), 2026. Article Number: 134775. Date of Publication: 01 Dec 2026. Author Garnica D.-E.; Bautista-Mier H.; Isaac R.; Nudelman J.; Rojas-Marulanda J.; Luna-Pisciotti S.; Giraldo-Ramirez S.; Saenz L.C.; Romero J.; Tapias Avendano C.A. Institution (Isaac, Luna-Pisciotti, Giraldo-Ramirez, Saenz, Tapias Avendano) Department of Electrophysiology, Fundacion CardioInfantil - LaCardio, Bogota, Colombia (Garnica, Isaac, Luna-Pisciotti, Giraldo-Ramirez, Tapias Avendano) Universidad de La Sabana, Chia, Colombia (Bautista-Mier) Universidad Nacional de Colombia, Bogota, Colombia (Nudelman, Rojas-Marulanda) Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, Colombia (Romero) Cardiac Arrhythmia Service, SUNY Upstate Medical University, Syracuse, NY, United States Publisher Elsevier Ireland Ltd Abstract Background: Ventricular tachycardia (VT) in ischemic cardiomyopathy is associated with recurrent implantable cardioverter-defibrillator (ICD) therapies, heart failure progression, and excess mortality. Randomized trials have shown that first-line catheter ablation reduces recurrent ventricular arrhythmia, but none was individually powered to detect realistic differences in all-cause mortality. <br/>Method(s): We performed a systematic review and meta-analysis of randomized controlled trials comparing first-line catheter ablation with antiarrhythmic drug (AAD) therapy in antiarrhythmic-naive patients with ischemic cardiomyopathy and ICD-confirmed VT. The principal outcomes were all-cause mortality and appropriate ICD shocks, analyzed separately. Secondary outcomes included VT storm and heart failure hospitalization. <br/>Result(s): Three multicenter trials (SURVIVE-VT, VANISH-2, and MANTRA-VT) enrolling 618 patients were included. All-cause mortality did not differ significantly between treatment strategies (RR 0.88, 95% CI 0.63-1.22; P = 0.434). Because follow-up duration differed across trials, a parallel time-to-event meta-analysis using hazard ratios from the original trial reports was also performed and showed a concordant direction of effect (HR 0.84, 95% CI 0.58-1.22; P = 0.36). Appropriate ICD shocks were significantly reduced with catheter ablation compared with AAD therapy (RR 0.76, 95% CI 0.59-0.98; P = 0.033). VT storm (RR 0.88, 95% CI 0.62-1.24; P = 0.46) and heart failure hospitalization (RR 0.78, 95% CI 0.36-1.71; P = 0.53) did not differ significantly. A post-hoc power calculation indicated that the mortality analysis remained substantially underpowered. <br/>Conclusion(s): In antiarrhythmic-naive patients with ischemic cardiomyopathy and VT, first-line catheter ablation reduced appropriate ICD shocks but did not demonstrate a statistically significant reduction in all-cause mortality. The available randomized evidence remains underpowered for firm conclusions regarding survival.<br/>Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <27> [Use Link to view the full text] Accession Number 2032793584 Title Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial. Source Circulation: Cardiovascular Interventions. 17(6) (pp 457-473), 2024. Date of Publication: 01 Jun 2024. Author Pracon R.; Spertus J.A.; Broderick S.; Bangalore S.; Rockhold F.W.; Ruzyllo W.; Demchenko E.; Nageh T.; Grossman G.B.; Mavromatis K.; Manjunath C.N.; Smanio P.E.P.; Stone G.W.; John Mancini G.B.; Boden W.E.; Newman J.D.; Reynolds H.R.; Hochman J.S.; Maron D.J.; Harrington R.; Williams D.; Alexander K.P.; Berger J.; Mark D.; O'Brien S.M.; Rosenberg Y.; Shaw L.J.; Ballantyne C.; Beyar R.; Bhargava B.; Buller C.; Carvalho A.; Chaitman B.R.; Diaz R.; Doerr R.; Dzavik V.; Goodman S.; Gosselin G.; Hachamovitch R.; Hamm C.; Held C.; Helm M.; Huber K.; Jiang L.; Keltai M.; Kohsaka S.; Lang I.; Lopes R.; Lopez-Sendon J.; Maggioni A.; Noel Bairey Merz C.; Min J.; Peterson E.; Picard M.H.; Selvanayagam J.; Senior R.; Sharir T.; Steg G.; Szwed H.; Van de Werf F.; Weintraub W.; White H.; Calfas K.; Champagne M.A.; Davidson M.; Fleg J.; McCullough P.A.; Stone P.; Fremes S.; Guyton R.; Mack M.; Mohr F.; Rao A.; Sabik J.; Shapira O.; Taggart D.; Tatoulis J.; Blankenship J.; Brener S.; Colombo A.; de Bruyne B.; Kereiakes D.; Lefevre T.; Moses J.; Mahaffey K.; Cruz-Flores S.; Danchin N.; Feen E.; Garcia M.J.; Hauptman P.; Laddu A.A.; Passamani E.; Pina I.L.; Simoons M.; Skali H.; Thygesen K.; Waters D.; Endsley P.; Esposito G.; Kanters J.; Pownall J.; Stournaras D.; Friedrich M.; Kwong R.; Oliver D.; Harrell F.; Blume J.; Lee K.; Kullo I.; McManus B.; Newby K.; Cohen D.; Bugiardini R.; Celutkiene J.; Escobedo J.; Hoye A.; Lyubarova R.; Mattina D.; Peteiro J.; Berman D.; Leipsic J.; Ali Z.; Mathew R.; Sidhu M.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Michael Gibson C.; Lamas G.; Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.; Kirby R.; Jeffries N.; Boden W.; Denaro J.E.; Mavromichalis S.; Chan K.; Cobb G.; Contreras A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.; Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison C.; Hogan I.; Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.; Lang B.; Mohamed S.; Esquenazi-Karonika S.; Mathews P.; Naumova A.; Lyo J.; Setang V.; Xavier M.; Mark D.B.; Anstrom K.; Baloch K.; Blount J.; Cowper P.; Davidson-Ray L.; Drew L.; Harding T.; David Knight J.; Liu D.M.; O'Neal B.; Redick T.; Jones P.; Nugent K.; Wang G.J.; Phillips L.; Goyal A.; Hetrick H.; Hayes S.W.; Friedman J.D.; James Gerlach R.; Hyun M.; Miranda-Peats R.; Slomka P.; Thomson L.; Kwong R.Y.; Mongeon F.P.; Michael S.; Hung J.; Scherrer-Crosbie M.; Zeng X.; Eckstein J.; Guruge B.; Streif M.; Genereux P.; Alfonso M.A.; Corral M.P.; Garcia J.J.; Horst J.; Jankovic I.; Konigstein M.; Lustre M.B.; Peralta Y.; Sanchez R.; Arsanjani R.; Budoff M.; Elmore K.; Gomez M.; Hague C.; Hindoyan N.; Nakanishi R.; Barbara Srichai-Parsia M.; Yeoh E.; Youn T.; Maggioni A.P.; Bianchini F.; Ceseri M.; Lorimer A.; Magnoni M.; Orso F.; Sarti L.; Tricoli M.; Barbosa L.M.; Duarte T.B.; Soares T.C.; de Aveiro Morata J.; Carvalho P.; de Carvalho Maffei N.; Egydio F.; Kawakami A.; Oliveira J.; Piloto E.R.; Pozzibon J.; Camara D.; Mowafy N.; Spindler C.; Dai H.; Feng F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.; Zhang J.; Zhang L.; Zhang N.; Zhong H.; Escobar C.; Martin M.E.; Pascual A.; Moraga P.; Hernandez V.; Castro A.; Posada M.; Fernandez S.; Villanueva J.L.N.; Selgas R.; Abergel H.; Juliard J.M.; Alsweiler C.; Claes K.; Goetschalckx K.; Luyten A.; Robesyn V.; Selvanayagam J.B.; Murphy D.; Garcevic N.; Stojkovic J.; Ahmed A.; Bhatt R.; Chadha N.; Kumar V.; Lubna S.; Naik P.; Pandey S.; Ramasamy K.; Saleem M.; Sharma P.; Siddaram H. Institution (Pracon, Ruzyllo) National Institute of Cardiology, Warsaw, Poland (Spertus) Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, United States (Broderick, Rockhold) Duke Clinical Research Institute, Durham, NC, United States (Bangalore, Newman, Reynolds, Hochman) Cardiovascular Clinical Research Center, New York University, Grossman School of Medicine, United States (Rockhold) Department of Biostatistics and Bioinformatics, Duke University, School of Medicine, Durham, NC, United States (Demchenko) Almazov National Medical Research Centre, Saint Petersburg, Russian Federation (Nageh) Southend University Hospital, United Kingdom (Grossman) Moinhos de Vento Hospital, Porto Alegre, Brazil (Grossman) Cardionuclear Clinic, Porto Alegre, Brazil (Mavromatis) Emory University, Atlanta VA Healthcare System, GA, United States (Manjunath) Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India (Smanio) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (John Mancini) Center for Cardiovascular Innovation, The University of British Columbia, Vancouver, Canada (Boden) VA New England Healthcare System, Boston University, School of Medicine, MA, United States (Maron) Department of Medicine, Stanford University, CA, United States (Setang, Xavier) Statistical and Data Coordinating Center (SDCC) (Alexander, O'Brien) Economics and Quality of Life Coordinating Center (EQOL CC), Duke Clinical Research Institute, Durham, NC, United States (Mark, Anstrom, Baloch, Blount, Cowper, Davidson-Ray, Drew, Harding, David Knight, Liu, O'Neal, Redick) Saint Luke's Mid America Heart Institute, Kansas City, MO, United States (Spertus, Jones, Nugent, Wang) ISCHEMIA Imaging Coordinating Center (ICC) (Shaw, Oliver, Phillips, Goyal, Hetrick) Nuclear Core Lab (Berman, Hayes, Friedman, James Gerlach, Hyun, Miranda-Peats, Slomka, Thomson) CMR Core Lab (Friedrich, Kwong, Mongeon, Michael) Echo Core Lab (Picard, Hung, Scherrer-Crosbie, Zeng) ECG, ETT CoreLab (Chaitman, Eckstein, Guruge, Streif) Angiographic Core Lab (Ali, Genereux, Alfonso, Corral, Garcia, Horst, Jankovic, Konigstein, Lustre, Peralta, Sanchez) CCTA Core Lab (John Mancini, Min, Leipsic, Arsanjani, Budoff, Elmore, Gomez, Hague, Hindoyan, Nakanishi, Barbara Srichai-Parsia, Yeoh, Youn) Academic Research Organizations (AROs), Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Italy (John Mancini, Min, Leipsic, Arsanjani, Budoff, Elmore, Gomez, Hague, Hindoyan, Nakanishi, Barbara Srichai-Parsia, Yeoh, Youn) Academic Research Organizations (AROs), Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Switzerland (Maggioni, Bianchini, Ceseri, Lorimer, Magnoni, Orso, Sarti, Tricoli) Brazilian Clinical Research Institute (BCRI), Brazil (Carvalho, Lopes, Barbosa, Duarte, Soares, de Aveiro Morata, Carvalho, de Carvalho Maffei, Egydio, Kawakami, Oliveira, Piloto, Pozzibon) Canadian Heart Research Centre (CHRC), Canada (Goodman, Camara, Mowafy, Spindler) China Oxford Centre for International Health Research, China (Diaz, Escobar, Martin, Pascual) Foundation for Biomedical Research of La Paz University Hospital (FIB-HULP), Spain (Lopez-Sendon, Moraga, Hernandez, Castro, Posada, Fernandez, Villanueva, Selgas) French Alliance for Cardiovascular Trials (FACT), France (Steg, Abergel, Juliard) Green Lane Coordinating Centre Ltd. (GLCC), Malaysia (Steg, Abergel, Juliard) Green Lane Coordinating Centre Ltd. (GLCC), New Zealand (Steg, Abergel, Juliard) Green Lane Coordinating Centre Ltd. (GLCC), Singapore (Steg, Abergel, Juliard) Green Lane Coordinating Centre Ltd. (GLCC), Taiwan (Republic of China) (Steg, Abergel, Juliard) Green Lane Coordinating Centre Ltd. (GLCC), Thailand (White, Alsweiler) KU Leuven Research & Development, Belgium (Van de Werf, Claes, Goetschalckx, Luyten, Robesyn) South Australian Health and Medical Research Institute Ltd (SAHMRI), Australia (Selvanayagam, Murphy) Contract Research Organizations (CROs) for ISCHEMIA Trial, FOCUS Clinical Research Center d.o.o., Belgrade, Serbia (Garcevic, Stojkovic) iProcess Global Research Inc., India Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) did not find an overall reduction in cardiovascular events with an initial invasive versus conservative management strategy in chronic coronary disease; however, there were conservative strategy participants who underwent invasive coronary angiography early postrandomization (within 6 months). Identifying factors associated with angiography in conservative strategy participants will inform clinical decision-making in patients with chronic coronary disease. <br/>METHOD(S): Factors independently associated with angiography performed within 6 months of randomization were identified using Fine and Gray proportional subdistribution hazard models, including demographics, region of randomization, medical history, risk factor control, symptoms, ischemia severity, coronary anatomy based on protocol-mandated coronary computed tomography angiography, and medication use. <br/>RESULT(S): Among 2591 conservative strategy participants, angiography within 6 months of randomization occurred in 8.7% (4.7% for a suspected primary end point event, 1.6% for persistent symptoms, and 2.6% due to protocol nonadherence) and was associated with the following baseline characteristics: enrollment in Europe versus Asia (hazard ratio [HR], 1.81 [95% CI, 1.14-2.86]), daily and weekly versus no angina (HR, 5.97 [95% CI, 2.78-12.86] and 2.63 [95% CI, 1.51-4.58], respectively), poor to fair versus good to excellent health status (HR, 2.02 [95% CI, 1.23-3.32]) assessed with Seattle Angina Questionnaire, and new/more frequent angina prerandomization (HR, 1.80 [95% CI, 1.34-2.40]). Baseline low-density lipoprotein cholesterol <70 mg/dL was associated with a lower risk of angiography (HR, 0.65 [95% CI, 0.46-0.91) but not baseline ischemia severity nor the presence of multivessel or proximal left anterior descending artery stenosis >70% on coronary computed tomography angiography. <br/>CONCLUSION(S): Among ISCHEMIA participants randomized to the conservative strategy, angiography within 6 months of randomization was performed in <10% of patients. It was associated with frequent or increasing baseline angina and poor quality of life but not with objective markers of disease severity. Well-controlled baseline low-density lipoprotein cholesterol was associated with a reduced likelihood of angiography. These findings point to the importance of a comprehensive assessment of symptoms and a review of guideline-directed medical therapy goals when deciding the initial treatment strategy for chronic coronary disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522. GRAPHIC ABSTRACT: A graphic abstract is available for this article.<br/>Copyright © 2024 American Heart Association, Inc. <28> Accession Number 2049028761 Title Percutaneous Vacuum-Assisted Debulking of Infected and Non-Infected Left-Sided Cardiac Masses Using the AngioVac System: A Systematic Review of Published Case Reports and Case Series. Source Journal of Clinical Medicine. 15(17) (no pagination), 2026. Article Number: 6669. Date of Publication: 01 Sep 2026. Author Bratosin F.; DeSanctis J.; Simeunovic G. Institution (Bratosin, DeSanctis, Simeunovic) Corewell Health West, Department of Infectious Disease, Grand Rapids, MI, United States (DeSanctis, Simeunovic) Michigan State University, College of Human Medicine, Grand Rapids, MI, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Left-sided intracardiac masses (infected vegetations and non-infected thrombotic/tumor lesions) are traditionally managed with surgery in many cases, but procedural risk can be prohibitive. We systematically reviewed published experience with the AngioVac system for percutaneous debulking of left-sided cardiac masses. <br/>Method(s): PubMed, Scopus, and Web of Science were searched for reports through November 2025, supplemented by hand-searching of congress abstract supplements; records were screened and assessed independently by two reviewers. Adult patients undergoing AngioVac removal of infected or non-infected left-sided cardiac masses were included. The primary effectiveness endpoint was technical success (>=70% debulking without conversion to open surgery). Safety outcomes included procedure-related complications. Data were synthesized descriptively due to heterogeneous designs and reporting. Patient-level and study-level data were distinguished a priori, pooled means were weighted by the number of patients contributed by each report, and pre-specified sensitivity analyses addressed possible patient overlap between reports from the same institution and exclusion of a non-intracardiac (aortic arch) target. <br/>Result(s): A total of 30 studies were included (predominantly single-patient reports, 90.0%). The pooled cohort comprised 42 patients; 23/42 (54.8%) had infective endocarditis (IE) and 45.2% had non-infected masses. Mean age was 62.9 years (range 30.0-86.0); sex distribution was female 47.6%, male 42.9%, and not reported 9.5%. All 42 patients were deemed to be at a prohibitively high risk of surgery. Access was mainly transseptal (29/42, 69.0%) or transapical (8/42, 19.0%). Mass size was reported in 23/42 (54.8%), with mean 23.3 mm, median 20.0 mm, and range 11.0-57.0 mm. Technical success was achieved in 35/42 (83.3%); residual mass occurred in 6/42 (14.3%) and one patient had cardiac perforation requiring conversion to open heart surgery (1/42, 2.4%). Procedure-related complications included valvular dysfunction (paravalvular leak or progressive mitral regurgitation), cardiac perforation, and cerebral infarctions (4/42, 9.5%). There were two deaths (2/42, 4.8%) after successful debulking, one in-hospital with recurrent embolic events and septic shock, and the other 4 months after the procedure following procedure-related progressive mitral regurgitation. Complications clustered in transapical procedures (3/8, 37.5% vs. 0/29 transseptal; p = 0.007) and in fungal endocarditis (2/2; p = 0.012). New clinically apparent embolic events occurred in 2/42 (4.8%), both in patients without documented cerebral protection, the choice of which to apply in the total population was unrelated to mass size (mean 23.5 vs. 23.2 mm). Estimates were stable in sensitivity analyses (technical success 32/38, 84.2% after maximal-overlap de-duplication; 31/37, 83.8% restricted to strictly intracardiac targets). Length of stay was reported in 8/42 (19.0%) with a median of 3.5 days (range 1.0-30.0). <br/>Conclusion(s): In published, highly selected non-surgical candidates, left-sided AngioVac debulking achieved >=70% mass reduction in 83% of the 42 patients, with 4.8% mortality and one patient (2.4%) converting to emergency surgery. Because the evidence consists almost entirely of single-patient reports subject to publication bias, and because technical success is operator-reported and did not preclude death, these data do not support substituting debulking for a guideline-indicated operation. The technique is best positioned as a bridge or palliative strategy, with transapical access and fungal aetiology identified as signals warranting particular caution.<br/>Copyright © 2026 by the authors. <29> Accession Number 2049014305 Title Risk factors for leg wound infection after conventional and no-touch vein harvesting: insights from a multicentre randomised trial. Source Scandinavian Cardiovascular Journal. 60(1) (no pagination), 2026. Article Number: 2730710. Date of Publication: 2026. Author Unosson H.; Dalen M.; Jensevik Eriksson K.; Hultkvist H.; James S.; Jeppsson A.; Kimose H.H.; Modrau I.S.; Ragnarsson S.; Sartipy U.; Thelin S.; Vikholm P.; Friberg O. Institution (Unosson, Friberg) Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Orebro, Sweden (Unosson) Faculty of Medicine and Health, School of Health Sciences, Orebro University, Orebro, Sweden (Dalen, Sartipy) Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden (Dalen, Sartipy) Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (Jensevik Eriksson, James) Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (Hultkvist) Department of Cardiothoracic and Vascular Surgery, Linkoping University Hospital, Linkoping, Sweden (Hultkvist) Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Medicine, Linkoping University, Linkoping, Sweden (James) Department of Medical Sciences, Uppsala University, Cardiology, Sweden (Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Jeppsson) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Kimose, Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Kimose, Modrau) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Ragnarsson) Department of Cardiothoracic and Vascular Surgery, Skane University Hospital, Lund, Sweden (Ragnarsson) Department of Clinical Sciences, Lund University, Lund, Sweden (Thelin, Vikholm) Department of Thoracic Surgery, Uppsala University Hospital, Uppsala, Sweden (Thelin, Vikholm) Department of Surgical Sciences, Thoracic Surgery, Uppsala University, Sweden (Friberg) Faculty of Medicine and Health, School of Medical Sciences, Orebro University, Orebro, Sweden Publisher Taylor and Francis Ltd. Abstract Objectives: To identify patient- and procedure-related risk factors for surgical site infection following open saphenous vein graft harvesting for coronary artery bypass grafting, using either conventional or no-touch techniques. <br/>Design(s): We conducted a sub-study of the SWEDEGRAFT multicentre randomised trial (ClinicalTrials.gov: ID NCT03501303) comparing conventional and no-touch saphenous vein harvesting for coronary artery bypass grafting. The outcome was leg wound infection, defined as a wound healing disturbance requiring antibiotic treatment. Univariable and multivariable logistic regression assessed associations between prespecified covariates and infection. <br/>Result(s): Of 900 patients, 860 were followed up at 3 months. The proportion of patients with leg wound infections was 12.0%. In the adjusted analysis, covariates independently associated with leg wound infection were the use of the no-touch harvesting technique (adjusted OR 2.78; 95% CI 1.75-4.44) and left ventricular ejection fraction <30% (adjusted OR 3.66; 95% CI 1.29-10.38). Female sex showed a numerically higher risk that did not reach statistical significance (adjusted OR 1.76; 95% CI 0.98-3.16). No significant statistical interaction was found between sex or diabetes mellitus and vein harvest technique regarding the risk of infection. There were significant differences in leg wound infections among the participating centres. <br/>Conclusion(s): The no-touch vein harvesting technique and poor left ventricular systolic function were independently associated with infectious complications at the vein harvest site after coronary artery bypass grafting. The findings also suggest that female patients may be at higher risk, although the estimate was imprecise. These results could be helpful, should a selective use of the no-touch technique be desired. Clinical Registration Number: ClinicalTrials.gov: ID NCT03501303.<br/>Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <30> Accession Number 629302263 Title Comparison of Scientific Publications from Three Different Clinical Disciplines of German Universities. Source Thoracic and Cardiovascular Surgeon. 67(6) (pp 488-493), 2019. Date of Publication: 28 Jun 2018. Author Schwarzer M.; Alscher L.; Doenst T. Institution (Schwarzer, Alscher, Doenst) Department of Cardiothoracic Surgery, University Hospital Jena, Am Klinikum 1, Jena, Germany Publisher Georg Thieme Verlag Abstract Background Scientific publications are important for the advancement in medicine. Surgical disciplines including cardiac surgery are frequently considered not scientifically leading. However, a specific comparison between surgical and nonsurgical disciplines has not yet been performed. We thus compared scientific output of German departments of cardiac surgery with nonsurgical cardiology departments and surgical departments not addressing the heart (general surgery) of 34 universities in Germany. Methods For each university, the personnel working at the different departments were identified on the internet homepage in 2014. We searched for publications of these persons in 2011 to 2013 on PubMed, identified author position, coauthors, and type of article, as well as journal impact factor (JIF). Results There were 931 academic persons in cardiac surgery, 1,486 in general surgery, and 1,814 in cardiology with 12,096 publications related to these persons on PubMed. Cardiology published most manuscripts, including manuscripts from research conducted (first author), initiated (senior author), or both. Cardiac surgery had the least publications and had fewer authors from other departments or institutions. The average JIF was higher in cardiology compared with the two surgical disciplines. However, relating the number of publications to the number of employees in the departments, the differences were no longer apparent. Conclusion We conclude that the number of publications in German universities appears to be a function of the number of academic personnel and not of the discipline. The lower JIFs in surgery may be due to the smaller surgical fields and/or due to less high impact interdisciplinary/interinstitutional publications in surgery.<br/>Copyright © 2019 by Thieme Medical Publishers, Inc. <31> Accession Number 2048800825 Title Stellate ganglion block for attenuating postoperative sore throat after double-lumen tube intubation in thoracic surgery: a randomized clinical study. Source Perioperative Medicine. 15(1) (no pagination), 2026. Article Number: 77. Date of Publication: 01 Dec 2026. Author Zhang S.; Wang S.; He Z.; Wang Y. Institution (Zhang) Graduate School, Qinghai University, Qinghai, Xining, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China (He, Wang) Department of Anesthesiology, Qinghai Provincial People's Hospital, Qinghai, Xining, China Publisher BioMed Central Ltd Abstract Background: For thoracic surgery patients who undergo double-lumen endotracheal intubation, postoperative sore throat (POST) remains one of the most common postoperative complication. <br/>Objective(s): To evaluate whether preoperative ultrasound-guided stellate ganglion block (SGB) can reduce the incidence and severity of POST, and decrease the postoperative throat VAS score in patients undergoing double-lumen tube (DLT) intubation for thoracic surgery. <br/>Method(s): This prospective, randomized, double-blind, controlled clinical trial enrolled 120 patients undergoing elective thoracic surgery with DLT intubation. Participants were randomized into two groups: the SGB group (n = 60) received 2-3 ml of 0.25% ropivacaine under ultrasound guidance on the right stellate ganglion, while the control group (n = 60) received no regional anesthetic intervention prior to anesthesia induction. The primary outcomes included the incidence and severity of POST and the visual analogue scale (VAS) scores for throat pain. Secondary outcomes included the incidence of postoperative hoarseness, cough, and postoperative pulmonary complications (PPCs), as well as the levels of serum inflammatory markers before and 1 day after surgery. <br/>Result(s): The incidence of POST was significantly lower in the SGB group at 1 h, 6 h, and 24 h postoperatively compared to the control group (10.3%, 13.8%, and 5.2% vs. 44.1%, 35.6%, and 20.3%, respectively, p < 0.05). The severity grading of POST in the SGB group was also lower than that in the control group at all three time points (p < 0.05). Additionally, the throat VAS scores in the SGB group at 1 h and 6 h postoperatively (0.45 +/- 1.45 and 0.34 +/- 1.05, respectively) were significantly lower than those in the control group (1.88 +/- 2.54 and 0.93 +/- 1.41, respectively; p < 0.05). Cough incidence was significantly lower in the SGB group at 1 h and 6 h (both 5.2%) than in the control group (both 20.3%, P = 0.014). <br/>Conclusion(s): Preoperative ultrasound-guided SGB significantly alleviates POST and reduces the early postoperative cough incidence in thoracic surgery patients undergoing DLT intubation. Trial registration: The study was registered on Chinese Clinical Trial Registry, (ChiCTR2500106117) on 17/07/2025.<br/>Copyright © The Author(s) 2026. <32> Accession Number 2047189892 Title A Randomized Controlled Trial Comparing the TruSteer and FXD Double Curve Delivery Systems for Left Atrial Appendage Occlusion With the Watchman FLX Pro Device-The GUIDE-LAAO Study. Source Catheterization and Cardiovascular Interventions. 108(3) (pp 899-907), 2026. Date of Publication: 01 Sep 2026. Author Taieb P.; Frazzetto M.; Teixeira P.S.; Filby S.J. Institution (Taieb, Frazzetto, Teixeira, Filby) Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Taieb) Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel Publisher John Wiley and Sons Inc Abstract Background: Deflectable delivery systems have been introduced to enhance coaxial alignment and procedural efficacy during left atrial appendage occlusion (LAAO), yet randomized comparisons with conventional fixed-curve systems are lacking. <br/>Aim(s): The GUIDE-LAAO trial evaluated whether the TruSteer deflectable delivery system is non-inferior to the FXD Double Curve (FXD DC) delivery system for procedural success in patients undergoing LAAO with the Watchman FLX Pro device. <br/>Method(s): In this prospective, randomized, all-comers trial, 50 patients with non-valvular atrial fibrillation undergoing LAAO were assigned 1:1 to TruSteer (n = 25) or FXD DC (n = 25). The primary endpoint was procedural success, defined as successful device implantation without major procedural or periprocedural complications. Secondary endpoints included technical success, device success, procedural efficiency, and safety outcomes. <br/>Result(s): Procedural success occurred in 100% of TruSteer-treated patients and 84% of FXD DC-treated patients (risk difference 16%; 95% confidence interval -6.9% to 34.7%), meeting criteria for non-inferiority; superiority was not demonstrated (p = 0.11). Technical and device success were 100% with TruSteer and 92% with FXD DC. Procedural time (34.6 +/- 7.1 vs. 36.5 +/- 13.0 min), fluoroscopy time (22.3 +/- 4.4 vs. 22.1 +/- 7.2 min), and contrast volume (34.5 +/- 12.1 vs. 36.8 +/- 13.5 mL) were similar. Periprocedural complications occurred in 4% and 16%, respectively, with no deaths or strokes. <br/>Conclusion(s): In this first randomized comparison of LAAO delivery systems, TruSteer was non-inferior to a standard fixed-curve system, with comparable efficiency and safety in an unselected population. These findings provide randomized evidence supporting deflectable delivery technology in contemporary LAAO practice and inform future studies in anatomically complex subsets.<br/>Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. <33> Accession Number 2048795232 Title Effect of the active cycle breathing technique on pain, anxiety and arterial blood oxygen saturation in patients undergoing coronary artery bypass grafting. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 529. Date of Publication: 01 Dec 2026. Author Solati Kooshkqazi M.; Rakhshan M.; Roosta H.; Shirazi F. Institution (Solati Kooshkqazi) School of Nursing and Midwifery, Shiraz University of Medical Sciences, Namazi Square, Shiraz, Iran, Islamic Republic of (Rakhshan) Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Roosta) Al-Zahra Heart and Martyr Hejazi Hospital, Astaneh Crossroads, Shiraz, Iran, Islamic Republic of (Shirazi) Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Purpose: Addressing pain and anxiety after coronary artery bypass grafting (CABG) is essential. This research evaluates the associations between the Active Cycle of Breathing Technique (ACBT) and pain levels, anxiety, and blood oxygen saturation in patients recovering from CABG surgery. <br/>Method(s): Seventy-six patients undergoing CABG surgery were randomly assigned using permuted block randomization (19 blocks of 4 participants) to either the intervention group (n = 38) or the control group (n = 38). After exclusions (2 reoperations in control, 1 withdrawal in intervention), 73 patients completed the study (intervention: n = 37; control: n = 36). The intervention group received ACBT alongside standard respiratory care, consisting of four sessions (two sessions daily at 10:00 AM and 5:00 PM on postoperative days 2 and 3), with each session lasting 10 min and including three phases: breathing control, thoracic expansion exercises, and coughing technique. The control group received standard respiratory care with incentive spirometry (10-20 deep breaths per session) over the same schedule. Outcome measures pain (Visual Analog Scale), anxiety (State-Trait Anxiety Inventory), and arterial oxygen saturation (pulse oximetry) were assessed before intervention and after each of the four sessions by a blinded research assistant. Data were analyzed using repeated measures ANOVA. <br/>Result(s): Baseline pain levels differed significantly between groups (p = 0.005), with the intervention group reporting higher pain. After adjusting for baseline differences, the ACBT group demonstrated significantly lower pain scores after the second (p < 0.001), third (p = 0.007), and fourth (p < 0.001) sessions compared to the control group. Anxiety levels were significantly lower in the ACBT group after all four sessions (p = 0.005, p = 0.019, p = 0.010, p = 0.004, respectively). Arterial oxygen saturation was significantly higher in the ACBT group after all four sessions (p < 0.001). Repeated measures ANOVA revealed significant group effects for pain (p < 0.001), anxiety (p = 0.006), and oxygen saturation (p < 0.001). Time effects were significant for anxiety (p < 0.001) and oxygen saturation (p < 0.001), but not for pain (p = 0.491). The group x time interaction was significant only for oxygen saturation (p < 0.001). <br/>Conclusion(s): ACBT was associated with lower pain and anxiety and higher arterial oxygen saturation in patients after CABG surgery. These findings suggest that ACBT may warrant consideration for integration into postoperative respiratory care protocols, pending further research with stronger methodological controls. However, the absence of participant blinding and potential attention bias limit causal inference, and future studies with sham controls are needed.<br/>Copyright © The Author(s) 2026. <34> Accession Number 2042877513 Title Reperfusion therapy for older patients with acute myocardial infarction and cardiogenic shock. Source Cardiovascular Revascularization Medicine. 90 (pp 57-62), 2026. Date of Publication: 01 Sep 2026. Author Kiyohara Y.; Minami K.; Freeman L.; Wilson Tang W.H.; Pinney S.P.; Yano Y.; Naito T.; Miyashita S. Institution (Kiyohara) Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside and West, New York, NY, United States (Minami) Medical Training Center, Saga University Hospital, Saga, Japan (Freeman) Department of Medicine, Ashikaga Red Cross Hospital, Tochigi, Japan (Wilson Tang) Department of Cardiovascular Medicine Heart, Vascular, and Thoracic Institute Cleveland Clinic Foundation, Cleveland, OH, United States (Pinney) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Yano, Naito, Miyashita) Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan (Miyashita) Department of Critical Care Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier Inc. Abstract Background Reperfusion therapy is the cornerstone of treatment for acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). However, older adults with AMI and CS face higher risks of adverse outcomes and procedure-related complications. Since this population is under-represented in clinical trials, the efficacy of reperfusion therapy remains unclear. We performed a meta-analysis to evaluate the impact of reperfusion therapy on mortality in older adults with AMI and CS. Methods We searched PUBMED and EMBASE through 4/1/2025 for studies comparing reperfusion therapy with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) and non-reperfusion therapy for AMI and CS in patients aged >=75 years. We included prospective and retrospective observational trials reporting clinical outcomes. The primary outcome was set as short-term mortality, and the secondary outcome was long-term mortality. We performed subgroup analysis of the primary outcome for patients with ST-segment elevation myocardial infarction and those without. Results Our search identified 14 eligible studies in a total of 4583 patients. Reperfusion therapy was associated with significantly reduced short-term mortality, compared with non-reperfusion therapy with high heterogeneity (odds ratio (OR): 0.47; 95% confidence interval (CI): 0.30-0.73, I <sup> 2 </sup> = 76.8%). There was no significant difference in long-term all-cause mortality between reperfusion and non-reperfusion therapy (OR: 0.66; 95% CI: 0.34-1.26, I <sup> 2 </sup> = 79.7%). The subgroup analyses were largely consistent with the main findings. Conclusions Reperfusion therapy was associated with reduced short-term mortality, compared to non-reperfusion therapy for older patients with AMI and CS. Reperfusion therapy showed a tendency towards reduced long-term mortality.<br/>Copyright © 2026 Elsevier Inc. <35> Accession Number 2024792744 Title Confirmation of Safety of Titanium Wire in Sternotomy Closure, A Randomized Prospective Study. Source Thoracic and Cardiovascular Surgeon. 72(1) (pp 70-76), 2022. Date of Publication: 14 Mar 2023. Author Eraqi M.; Diab A.H.; Matschke K.; Alexiou K. Institution (Eraqi) Klinikum Bayreuth GmbH, Bayreuth, Germany (Eraqi, Diab, Matschke, Alexiou) Department of Cardiac Surgery, Heart Center Dresden, University Hospital Carl Gustav Carus, Dresden, Germany Publisher Georg Thieme Verlag Abstract Background There are many factors that are known to increase the risk of sternal wound infection (SWI); some studies have reported that nickel is a risk factor for SWI. Titanium wires have only been used as an alternative to steel wires in patients with known allergy to nickel. However, there is a paucity of literature regarding the safety of using titanium wires compared to that on the safety of steel wires for sternum closure after cardiac surgery. Therefore, this study aimed to demonstrate the noninferiority of titanium wires, even in patients without a known allergy. Methods A total of 322 patients who underwent elective full median sternotomy were randomly assigned to sternal closure either by titanium wires (n = 161) or by stainless steel wires. Results Fourteen patients had sternal instability, six (3.7%) patients in the titanium group and eight (5%) patients in the stainless steel group (p = 0.585). There was no statistically significant difference between both groups in terms of postoperative wound infection (p = 0.147). Patients in the titanium group experienced statistically significant lower postoperative pain than those in the stainless steel group (p = 0.024). The wire type was not an independent risk factor for SI, as shown by univariate and logistic regression analyses. Conclusion Titanium wires are a good alternative and have been proven to be safe and effective for sternal closure. The surgeon should be aware of the possibility of developing an allergic reaction to the wires, especially in patients with previous multiple allergic histories.<br/>Copyright © 2022 Georg Thieme Verlag. All rights reserved. <36> [Use Link to view the full text] Accession Number 2048359897 Title Determining when patients with thyroid illnesses should be cleared for surgery. Source Current Opinion in Endocrinology, Diabetes and Obesity. 33(5) (pp 172-178), 2026. Date of Publication: 01 Oct 2026. Author Paul A.; Abraham A.A.; George T. Institution (Paul, Abraham, George) Department of General Medicine, Christian Medical College and Hospital, Tamil Nadu, Vellore, India Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Thyroid dysfunction often delays surgery during preoperative evaluation, though evidence on perioperative risk and biochemical optimization is limited. This review explores recent literature on perioperative outcomes in hypothyroidism and hyperthyroidism, focusing on surgery delays, rapid optimization strategies, and areas of uncertainty. Recent findings - Observational studies and meta-analyses link subclinical hypothyroidism with adverse cardiovascular outcomes in cardiac surgeries, but evidence for non-cardiac surgeries is limited. Overt hypothyroidism is associated with complications like impaired wound healing, prolonged ventilation, and cardiovascular issues, making euthyroid state preferable before surgery, despite retrospective, heterogeneous data. For hyperthyroid patients undergoing total thyroidectomy, recent literature questions the need for biochemical euthyroid state; evidence for non-thyroid surgeries is sparse and extrapolated from thyroid surgeries. Selective use of liothyronine and therapeutic plasma exchange in severe or urgent cases shows promise, but evidence is limited and low quality. Summary - Current management of thyroid dysfunction is largely consensus-driven and based on limited evidence. Routine elective surgery optimization is advised for overt thyroid disease; however, in urgent cases, surgery after starting appropriate therapy and multidisciplinary planning is often reasonable. Future research should focus on prospective outcome data, rapid correction strategies, and the role of modern care pathways in reducing endocrine-related surgical risks.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <37> Accession Number 2048815277 Title Perioperative outcomes and predictors of mortality after pericardiectomy for constrictive pericarditis in Africa: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 38. Date of Publication: 01 Dec 2026. Author Afolabi O.G.; Okunlola A.I.; Ishola D.T.; Adegbamigbe A.B.; Oluwajuyigbe M.E. Institution (Afolabi) Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria (Okunlola, Adegbamigbe, Oluwajuyigbe) Department of Surgery, Federal Teaching Hospital Ido-Ekiti, Ido-Ekiti, Nigeria (Ishola) Kharkov National Medical University, Kharkiv, Ukraine Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Constrictive pericarditis remains a significant cause of heart failure in Africa, predominantly due to tuberculosis; however, pericardiectomy outcomes across African settings have not been systematically synthesised. This review aimed to determine the pooled perioperative mortality following pericardiectomy for constrictive pericarditis in the African population and identify predictors of early death. <br/>Method(s): We searched PubMed, Scopus, African Journals Online, Cochrane Library, and Web of Science from inception to May 2026, supplemented by Google Scholar and citation tracking. Two reviewers independently screened the records and extracted the data, with a third reviewer resolving any disagreements. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Series. Perioperative mortality and aetiology were pooled using a random-effects model with Freeman-Tukey double arcsine transformation. The certainty of evidence was rated using GRADE. This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 statement. <br/>Result(s): Of the 2148 records identified, 16 studies met the eligibility criteria and were included in the narrative synthesis, spanning South Africa, Cote d'Ivoire, Ethiopia, Ghana, Senegal, Gabon, and Nigeria. Eleven studies (604 patients) contributed to the pooled mortality analyses. The pooled perioperative mortality was 10.0% (95% confidence interval 6.5-14.0%), with substantial heterogeneity (I2 = 51.5%) and evidence of funnel plot asymmetry on Egger's test (p = 0.004). Mortality was numerically highest in the East African cohorts (12.9%) and lowest in the Southern African cohorts (8.5%) in the subgroup analysis. In eleven studies with extractable presumed or clinically diagnosed aetiological data, the pooled proportion attributed to tuberculous or infectious aetiology was 72.5% (95% confidence interval 51.4 to 89.3%; I2 = 96.4%), whereas in the nine studies reporting histology- or culture-confirmed ('definite') tuberculous aetiology as a distinct category, the pooled proportion was 32.5% (95% confidence interval 26.1 to 39.2%; I2 = 60.9%), indicating that diagnostic certainty was a major driver of the heterogeneity in the broader aetiological estimate. Preoperative New York Heart Association functional class IV was the most consistently reported predictor of early mortality across studies. The certainty of evidence for the pooled mortality estimate was rated as very low. <br/>Conclusion(s): Pericardiectomy for constrictive pericarditis in Africa carries a pooled perioperative mortality of approximately 10%. Tuberculous aetiology was common but highly heterogeneous in how it was diagnosed across studies, and advanced preoperative NYHA functional class IV was consistently associated with higher perioperative mortality, although this association was derived predominantly from retrospective, unadjusted, or single-study analyses. Given the very low certainty of the underlying evidence, these findings should be regarded as hypothesis-generating associations rather than established causal predictors; standardised, prospectively collected outcome data across African surgical centres are needed to determine whether earlier referral or other interventions could reduce this mortality burden. Clinical trial number: Not applicable.<br/>Copyright © The Author(s) 2026. <38> Accession Number 2038565327 Title Stroke volume variation-guided goal-directed fluid therapy versus central venous pressure-guided fluid management in off-pump coronary artery bypass grafting: A randomised comparison of vasopressor requirement and postoperative renal outcomes. Source International Journal of Medical Anesthesiology. 9(7) (pp 47-51), 2026. Date of Publication: 01 Jul 2026. Author Hurtado I.; Sinisterra G.; Perea J. Institution (Hurtado, Sinisterra, Perea) Department of Cardiac Anaesthesiology, Bucaramanga Research Centre for Cardiac Sciences, Bucaramanga, Colombia Publisher AkiNik Publications Abstract Leading cardiac anaesthesiologists have argued for over a decade that dynamic indices of fluid responsiveness should replace static pressure-based targets in cardiac surgery, yet central venous pressure (CVP) remains the default guide in many centres worldwide. This randomised, single-blind research compared stroke volume variation (SVV)-guided goal-directed fluid therapy (GDFT) with CVP-guided conventional fluid management in 70 patients undergoing off-pump coronary artery bypass grafting (OPCAB) at Bucaramanga Research Centre for Cardiac Sciences, Bucaramanga, Colombia between November 2024 and June 2025. The main outcomes were intraoperative vasopressor requirement and postoperative acute kidney injury (AKI) by KDIGO criteria within 72 hours. The SVV-guided group received markedly less crystalloid (1340 +/- 92 versus 2050 +/- 125 mL; p < 0.001), required less norepinephrine (0.04 +/- 0.02 versus 0.08 +/- 0.03 mcg/kg/min; p < 0.001) and had a lower AKI incidence (8.6% versus 25.7%; p = 0.049). SVV-guided GDFT in OPCAB surgery reduces fluid overload, vasopressor demand and early postoperative renal injury compared with CVP-guided management.<br/>Copyright © 2026, AkiNik Publications. All rights reserved. <39> Accession Number 2048806821 Title Optimizing hemostasis in thoracic surgery: a systematic review and meta-analysis of perioperative antifibrinolytic therapy. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 39. Date of Publication: 01 Dec 2026. Author Hamza M.; Shah Z.; Saqib H.W.; Shahid S.R.; Khurshid M.M.; Irfan S.; Khalid A.A.; Singh A.; Chaudhry I.U.H.; Shah A.R. Institution (Hamza, Chaudhry) Abbottabad International Medical Institute, Abbottabad, Pakistan (Shah) Frontier Medical and Dental College, Abbottabad, Pakistan (Saqib) Islamic International Medical College, Rawalpindi, Pakistan (Shahid) Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan (Khurshid) Anglia Ruskin University, Chelmsford, United Kingdom (Irfan) Services Institute of Medical Sciences, Lahore, Pakistan (Khalid) Peshawar Medical College, Peshawar, Pakistan (Singh) Southampton General Hospital, University Hospital, Southampton, United Kingdom (Shah) Freeman Hospital High Heaton, Newcastle Upon Tyne, United Kingdom Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Excessive perioperative bleeding remains a major challenge in non-cardiac thoracic surgeries. Antifibrinolytic therapy can enhance hemostasis and reduce transfusion requirements, although its use carries a theoretical risk of postoperative thromboembolic complications that warrants evaluation alongside its hemostatic benefits. Main text: Methods: For this systematic review and meta-analysis, we searched multiple databases for studies that compared antifibrinolytic therapy with placebo or no intervention in adult patients undergoing non-cardiac thoracic surgery. Primary outcomes included intraoperative and early postoperative bleeding and blood transfusion requirements. Additionally, thromboembolic events, length of hospital and ICU stay, respiratory complications, and all-cause postoperative mortality were also analyzed. Standardized mean differences (SMDs), mean differences (MDs), or odds ratios (ORs) with 95% confidence intervals (CIs) were used for pooled estimates, while the I2 statistic was used to assess heterogeneity. <br/>Result(s): Fifteen studies were included. Antifibrinolytics significantly reduced postoperative 24-hour (SMD - 1.04, 95% CI - 1.64 to - 0.43) and 12-hour (SMD - 1.06, 95% CI - 2.22 to 0.10) blood loss, intraoperative blood loss (SMD - 0.48, 95% CI - 1.05 to 0.08), total RBC transfusion (SMD - 0.54, 95% CI - 0.80 to - 0.28) and duration of hospital stay (MD - 0.96 days, 95% CI - 1.84 to - 0.08). IV route reduced 24-hour blood loss same topical, and aprotinin shortened hospital stay. Sensitivity analyses confirmed robustness, while meta regression identified publication year as a key moderator, explaining 19% of variance. No significant differences were observed for ICU stay, hemoglobin levels, thromboembolic events, respiratory complications, or mortality. <br/>Conclusion(s): Perioperative antifibrinolytic therapy in non-cardiac thoracic surgery improves hemostatic control, reduces transfusion requirements, and shortens hospitalization, with no significant increase in thromboembolic, respiratory, or mortality outcomes observed; however, these safety analyses were based on a limited number of studies and should be interpreted with caution.<br/>Copyright © The Author(s) 2026. <40> Accession Number 2048747277 Title Letter by Li and Xiong Regarding Article, "Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial". Source Circulation. 154(4) (pp e40-e41), 2026. Date of Publication: 28 Jul 2026. Author Li W.; Xiong Q. Institution (Li) Department of Cardiology, Fengcheng People's Hospital, The Affiliated Fengcheng Hospital of Yichun University, Jiangxi, China (Xiong) Department of Cardiology, Fengcheng People's Hospital, The Affiliated Fengcheng Hospital of Yichun University, Jiangxi, China Publisher Lippincott Williams and Wilkins Abstract We read with great interest the report by Rodes-Cabau et al on the ANDES randomized clinical trial comparing short-term direct oral anticoagulation (DOAC) with dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC).1 This pragmatic, multicenter trial substantially advances the evidence base in an area previously informed mainly by small randomized studies and observational data. We would like to offer several methodological considerations focusing on the estimand and effect measures, the handling of multicenter and device heterogeneity, and the integration of device-related thrombosis (DRT) with clinical outcomes in a time-dependent framework.<br/>Copyright © 2026 American Heart Association, Inc. <41> Accession Number 2048427353 Title Systematic Ambulatory ECG Monitoring for Preventing Life-Threatening Cardiovascular Events Following TAVR. Source Circulation: Cardiovascular Interventions. 19(8) (no pagination), 2026. Article Number: e016288. Date of Publication: 30 Apr 2026. Author Fischer Q.; Nault I.; Cepas-Guillen P.; Avvedimento M.; Benavent-Garcia C.; Pelletier-Beaumont E.; Philippon F.; Rodes-Cabau J. Institution (Fischer, Nault, Cepas-Guillen, Avvedimento, Benavent-Garcia, Pelletier-Beaumont, Philippon, Rodes-Cabau) Cardiology Department, Quebec Heart and Lung Institute, Laval University, QC, Canada Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Although ambulatory ECG (AECG) monitoring has been assessed after transcatheter aortic valve replacement (TAVR), its impact on life-threatening cardiovascular events remains unclear. This study aimed to evaluate whether systematic AECG monitoring after TAVR reduces life-threatening cardiovascular events during the first year of follow-up. <br/>METHOD(S): - The study included 1217 consecutive patients who underwent TAVR and were discharged without a permanent pacemaker. Of these, 211 consecutive patients received systematic 14-day AECG monitoring at discharge as part of the RECORD (Assessment of Arrhythmic Burden With Post-Procedural Continuous Electrocardiographic Monitoring in Patients Undergoing Transcatheter Aortic Valve Implantation) registry. The remaining 1006 patients who underwent TAVR within the 3 years before and after the registry period without systematic AECG monitoring constituted the control group. The primary end point was a composite of sudden cardiac death, syncope/presyncope due to symptomatic arrhythmias, or stroke at 1-year. <br/>RESULT(S): - Baseline and procedural characteristics were similar between groups, except for a higher use of self-expandable valves in the control group (P=0.005). Systematic AECG monitoring was associated with a lower incidence of the primary endpoint (1.9% versus 6.6%; adjusted hazard ratio, 0.27 [0.10-0.74]; P=0.011), mainly driven by a lower rate of sudden death or arrhythmic syncope/presyncope (0.9% versus 4.0%; adjusted hazard ratio, 0.22 [0.05-0.89]; P=0.034). All sudden death cases occurred in the control group, at a median of 96 (33-235) days after TAVR. New-onset atrial fibrillation was diagnosed in 8.9% of the systematic AECG patients (versus 1.8% in the control group; adjusted hazard ratio, 5.31 [2.47-11.38]; P<0.001), leading to new oral anticoagulation in 71.4% of cases. Stroke and permanent pacemaker implantation rates at 1 year were similar between groups, although permanent pacemaker implantation occurred earlier in the AECG group (25 versus 104 days; P<0.001). <br/>CONCLUSION(S): - Systematic AECG monitoring after TAVR enabled earlier detection of severe arrhythmias and was associated with fewer life-threatening cardiovascular events within 1 year. These findings support the need for a randomized trial. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT04298593.<br/>Copyright © 2026 American Heart Association, Inc. <42> Accession Number 635378130 Title Tranexamic Acid in Neuroanesthesia and Neurocritical Care: Time for Its Critical Appraisal. Source Journal of Neuroanaesthesiology and Critical Care. 6(3) (pp 257-266), 2019. Article Number: JNACC1900159. Date of Publication: 26 Jul 2019. Author Hooda B.; Muthuchellappan R. Institution (Hooda) Department of Anaesthesiology and Critical Care, Army Hospital Research and Referral, New Delhi, India (Muthuchellappan) Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India Publisher Georg Thieme Verlag Abstract There is a renewed interest in the use of antifibrinolytics, especially tranexamic acid (TxA), in varied clinical settings such as trauma, perioperative bleeding, cardiac surgery, and multilevel spine instrumentation procedures. Because of its prothrombotic potential, the use of TxA in neurosurgical disorders has not gained popularity since this subset of the population is more prone to developing thromboembolic complications. However, recent studies have shown that TxA reduces blood loss, reduces the need for allogeneic blood transfusion, and is associated with minimal side effects. In this narrative review, Google Scholar, PubMed, and EMBASE databases were searched to identify publications relevant to the current use of TxA in varied neurosurgical and critical care settings. These publications were analyzed, and a summary of the findings and the role of future research on this drug are presented in this review.<br/>Copyright © 2019 Indian Society of Neuroanaesthesiology and Critical Care. <43> Accession Number 2046481893 Title Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (SNaPP): an international, randomised, controlled, phase 4 trial. Source The Lancet Respiratory Medicine. 14(9) (pp 761-774), 2026. Date of Publication: 01 Sep 2026. Author Leslie K.; Darvall J.N.; Chan M.T.V.; Peyton P.J.; Myles P.S.; Corcoran T.B.; Short T.G.; Olesnicky B.L.; Webb A.R.; Devlin N.; Tran-Duy A.; Maxwell-Wright H.; Schultz-Ferguson C.; Fitzpatrick P.; Sidiropoulos S.; Braat S.; Story D.A. Institution (Leslie, Darvall, Peyton, Devlin, Tran-Duy, Maxwell-Wright, Schultz-Ferguson, Fitzpatrick, Sidiropoulos, Braat, Story) University of Melbourne, Melbourne, VIC, Australia (Leslie, Darvall) Royal Melbourne Hospital, Melbourne, VIC, Australia (Chan) Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong Special Administrative Region, Hong Kong (Peyton, Sidiropoulos, Story) Austin Hospital, Melbourne, VIC, Australia (Myles, Webb) Monash University, Melbourne, VIC, Australia (Myles) The Alfred, Melbourne, VIC, Australia (Corcoran) University of Western Australia and Royal Perth Hospital, Perth, WA, Australia (Short) University of Auckland and Auckland City Hospital, Auckland, New Zealand (Olesnicky) University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia (Webb) Frankston Hospital, Melbourne, Australia Publisher Elsevier Ltd Abstract Background: Sugammadex and neostigmine are used to reverse aminosteroid neuromuscular-blocking drugs at the end of surgery. We aimed to determine whether reversal of neuromuscular blockade with sugammadex reduces the incidence of postoperative pulmonary complications or death compared with neostigmine. <br/>Method(s): We conducted a pragmatic, international, multicentre, randomised, controlled, phase 4 trial involving 44 hospitals in Australia, Aotearoa New Zealand, and Hong Kong. Eligible patients were adults (aged >=40 years) who were having abdominal or thoracic surgery under general anaesthesia and lasting at least 2 h, with an expected postoperative hospital stay of 1 night or longer. Patients were randomly assigned (1:1) to sugammadex or neostigmine, administered intravenously in doses chosen by the attending anaesthesiologist, for reversal of rocuronium-induced or vecuronium-induced neuromuscular blockade at the end of surgery. Randomisation was done via a web-based service, in random permuted blocks of varying sizes of 2 and 4 and stratified by centre. Patients, research staff who were responsible for outcome assessments, and members of the endpoint adjudication committee were masked to group assignment. The primary outcome was postoperative pulmonary complications or death up to hospital discharge (or postoperative day 7 if still in hospital). The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000394640) and is closed to accrual. <br/>Finding(s): Patients were recruited between July 21, 2023, and July 3, 2025; 3498 patients were included in the intention-to-treat population (1745 [49.9%] in the sugammadex group and 1753 [50.1%] in the neostigmine group). Postoperative pulmonary complications or death occurred in 331 (19.0%) of 1743 patients in the sugammadex group and 377 (21.5%) of 1752 patients in the neostigmine group (risk ratio [RR] 0.88 [95% CI 0.77-1.00]; p=0.049). Death occurred in one (0.1%) and two (0.1%) patients (RR 0.50 [95% CI 0.05-5.53]; p >0.99), atelectasis in 320 (18.4%) of 1742 patients and 370 (21.1%) of 1750 patients (0.86 [0.76-0.99]; p=0.030), pneumonia in 37 (2.1%) of 1742 patients and 38 (2.2%) of 1750 patients (0.98 [0.62-1.53]; p=0.92), and pulmonary aspiration in four (0.2%) of 1742 and seven (0.4%) of 1750 patients (0.57 [0.17-1.96]; p=0.38) in the sugammadex and neostigmine groups, respectively. Acute respiratory distress syndrome was not reported. No adverse events were deemed to be treatment related. <br/>Interpretation(s): Sugammadex reduced the incidence of postoperative pulmonary complications or death compared with neostigmine. The risk reduction was small with atelectasis of uncertain clinical significance being the most common complication. Sugammadex can be considered as a first-line drug for reversal of aminosteroid-induced neuromuscular blockade at the end of surgery. <br/>Funding(s): Australian Medical Research Future Fund and the Hong Kong Health and Medical Research Fund.<br/>Copyright © 2026 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license <44> Accession Number 2047576478 Title Artificial intelligence and biomarker-driven prediction of post-coronary artery bypass grafting atrial fibrillation: Integrating clinical, genomic, and metabolic insights. Source Heart Rhythm O2. 7(9) (pp 1800-1808), 2026. Date of Publication: 01 Sep 2026. Author Ghani M.U.; Prasad A.; Nagarajan J.S.; Patel D.T.; Desai R.; Gnanaguruparan S.; Chatterjee S. Institution (Ghani) Department of Internal Medicine, Central Michigan University, Mt. Pleasant, MI, United States (Prasad) Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, TX, United States (Nagarajan) Department of Medicine, SUNY Upstate Medical University, Syracuse, New York (Patel) Department of Medicine, Mercy Catholic Medical Center, Darby, PA, United States (Desai) Independent Researcher, Outcomes Research, Atlanta, GA, United States (Gnanaguruparan) Division of Cardiology, Christiana Hospital, Newark, DE, United States (Chatterjee) Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States Publisher Elsevier B.V. Abstract Background Postoperative atrial fibrillation (POAF) remains one of the most frequent and consequential complications after coronary artery bypass grafting, occurring in 15%-30% of patients and contributing to increased morbidity, prolonged hospitalization, and higher long-term mortality. Despite decades of investigation, traditional risk models have shown limited predictive accuracy owing to the multifactorial nature of POAF. Objective This review synthesizes the emerging evidence from recent studies applying artificial intelligence (AI) and machine learning (ML) approaches for POAF prediction, with focus on clinical, biochemical, genomic, and molecular dimensions. Methods We conducted a structured narrative review of PubMed/MEDLINE, Embase, and Google Scholar for studies evaluating AI and ML-based prediction of POAF following isolated coronary artery bypass grafting published from January 2020 through 2025. Search terms included POAF, coronary artery bypass grafting, ML, AI, pharmacogenomics, and biomarkers. A total of 9 studies met inclusion criteria and were synthesized narratively given the heterogeneity in study designs and outcomes. Results Across studies, modern algorithms demonstrate areas under the curve receiver operating characteristic between 0.80 and 0.93, with performance exceeding that reported for traditional clinical risk scores. However, external validation, model calibration, and biases remain to be fully addressed before clinical translation is considered. Conclusion The convergence of interpretable AI, metabolic and genetic biomarkers, and clinical data offers a promising path toward individualized risk stratification and targeted postoperative management.<br/>Copyright © 2026 Heart Rhythm Society. <45> Accession Number 2049042586 Title Molecular Mechanisms of Intimal Hyperplasia in Saphenous Vein Grafts After Coronary Artery Bypass Grafting. Source Cells. 15(17) (no pagination), 2026. Article Number: 1520. Date of Publication: 01 Sep 2026. Author Lazovic D.M.; Cvetkovic D.; Kocica M.K.; Nesic S.; Ivanisevic D.; Aleksic V.; Kocica M.J.; Klac J.; Grujic D.; Jovicic V.; Juricic S. Institution (Lazovic, Cvetkovic, Ivanisevic, Aleksic, Kocica, Grujic, Jovicic) Clinic for Cardiac Surgery, University Clinical Center of Serbia, Belgrade, Serbia (Lazovic, Cvetkovic, Kocica, Ivanisevic, Jovicic) Faculty of Medicine, University of Belgrade, Belgrade, Serbia (Kocica, Nesic) Center for Anesthesiology, Reanimatology and Intensive Care Medicine, University Clinical Center of Serbia, Belgrade, Serbia (Klac, Juricic) Clinic for Cardiology, University Clinical Center of Serbia, Belgrade, Serbia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Coronary artery disease is a leading cause of morbidity and mortality in modern medicine. In contrast, surgical myocardial revascularization via coronary artery bypass grafting (CABG) remains the gold standard of treatment for complex multivessel disease. The great saphenous vein remains the most frequently used conduit due to its availability and technical simplicity, but its long-term patency is significantly inferior to that of arterial grafts. The primary pathological process responsible for vein graft failure is intimal hyperplasia, which represents a complex response of the vascular wall to surgical trauma, vein arterialization, inflammation, and hemodynamic stress. This process is characterized by endothelial dysfunction, inflammatory cell activation, proliferation and migration of vascular smooth muscle cells, and extracellular matrix remodeling. Underpinning these alterations are numerous molecular pathways, including NF-kappaB, MAPK, PI3K/Akt, TGF-beta, and mTOR signaling, as well as substantial contributions from oxidative stress, cytokines, growth factors, and microRNAs. Contemporary research indicates that the phenotypic transformation of vascular smooth muscle cells constitutes the central event in the development of intimal hyperplasia. Understanding the cellular and molecular mechanisms underlying this disease's onset enables the development of novel therapeutic strategies to preserve long-term graft patency. This review paper aims to provide a systematic overview of current knowledge regarding the molecular and cellular mechanisms of intimal hyperplasia development in vein grafts following CABG.<br/>Copyright © 2026 by the authors. <46> Accession Number 2028162240 Title A Controlled Trial Comparing One-Year Hemodynamics of Two Bovine Pericardial Valves. Source Thoracic and Cardiovascular Surgeon. 73(2) (pp 132-140), 2023. Date of Publication: 05 Dec 2023. Author Sohn S.H.; Kang Y.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y. Institution (Sohn, Kang, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, South Korea (Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, South Korea Publisher Georg Thieme Verlag Abstract Background This randomized controlled trial was designed to compare 1-year hemodynamic performances and clinical outcomes after aortic valve replacement (AVR) using a recently introduced (the AVALUS group) and worldwide used (the CEPME group) bovine pericardial bioprostheses. Methods Patients were screened to enroll 70 patients in each group based on a noninferiority design. The primary endpoint of the trial was the mean pressure gradient across the aortic valve (AVMPG) at 1 year after surgery. One-year echocardiographic data were obtained from 92.1% (129 of 140 patients) of the study patients. Results There were no differences in baseline characteristics, including sex and body surface area (1.64 +/- 0.18 vs. 1.65 +/- 0.15 m 2) between the groups. The AVMPG on 1-year echocardiography was 14.0 +/- 4.3 and 13.9 +/- 5.1 mmHg in the AVALUS and CEPME groups, respectively (the p-value for noninferiority was 0.0004). In the subgroup analyses for the respective size of the prostheses, AVMPG of the 19-mm prostheses was significantly lower in the AVALUS group than in the CEPME group (14.0 +/- 4.3 vs. 20.0 +/- 4.7 mmHg, p = 0.012), whereas those of the other sizes were not significantly different between the two groups. There were no significant differences in the effective orifice area (1.49 +/- 0.40 vs. 1.53 +/- 0.38 cm 2, p = 0.500) or effective orifice area index (0.91 +/- 0.22 vs 0.93 +/- 0.23 cm 2 /m 2, p = 0.570) in all the patients, or in the subgroup analysis for the 19-mm prosthesis. There were no differences in the 1-year clinical outcomes between the two groups. Conclusion The 1-year hemodynamic and clinical outcomes of the AVALUS group were noninferior to those of the CEPME group (NCT03796442).<br/>Copyright © 2023. Thieme. All rights reserved. <47> Accession Number 637286141 Title Bibliometric Analysis of 50 Most Cited Articles Comparing Lobectomy with Sublobar Resection. Source Thoracic and Cardiovascular Surgeon. 71(4) (pp 307-316), 2021. Date of Publication: 08 Feb 2022. Author Tekneci A.K.; Ozgur G.K.; Akcam T.I.; Cagirici U. Institution (Tekneci, Ozgur, Akcam, Cagirici) Department of Thoracic Surgery, Ege University, School of Medicine, Izmir, Turkey Publisher Georg Thieme Verlag Abstract Background Recent years have seen an increase in the number of studies of the sublobar resection approach in non-small cell lung cancer (NSCLC) surgery. The purpose of this bibliometric analysis is to assess the significance and impact of articles comparing sublobar resection and lobectomy in NSCLC surgery. Material and Methods The Web of Science database was searched to identify studies comparing sublobar resection and lobectomy in NSCLC surgery published between 2005 and 2020 (accessed: September 11, 2020). The 50 most cited articles were analyzed by years, countries, authors, authors' affiliations, journals, journals' addresses, and impact factors. Results The bibliometric analysis revealed that the most cited article had 443 citations, while the total number of citations of all articles was 2,820. The mean number of citations, in turn, was 56.4 +/- 75.62 (1-443) times. The highest number of publications over the past 15 years was in 2016, with eight articles. The Annals of Thoracic Surgery (n = 10; 20%) had the highest number of publications on the list. The articles included in the present study were mostly (n = 35, 70%) published in U.S. journals. While multiple subject matters and analyses were presented by many studies, survival was the topic of greatest interest, with 37 (74%) studies. Conclusion This study revealed that interest in studies comparing sublobar resection with lobectomy has increased in recent years. It also presents both quantitative and qualitative analyses of the most cited articles in the literature on this topic. Therefore, it can serve as a guide for researchers.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <48> Accession Number 2048780865 Title Impact of liposomal bupivacaine parasternal block combined with rectus sheath block on postoperative pain in patients undergoing sternotomy for cardiac surgery: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 533. Date of Publication: 01 Dec 2026. Author Huang Y.; Hong M.; Mao Q.; Liang D.; Liu G.; Huang M.; Zhong H.; Lu Y.; Zhong Y.; Chen Y. Institution (Huang, Hong, Mao, Liang, Liu, Huang, Zhong, Lu, Zhong, Chen) Department of Anesthesiology and Operating Center, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China Publisher BioMed Central Ltd Abstract Objective: To compare the effects of liposomal bupivacaine and ropivacaine for ultrasound-guided parasternal block combined with rectus sheath block (PSB + RSB) on acute and chronic postoperative pain in patients undergoing cardiac sternotomy, so as to provide an evidence-based basis for optimizing the multimodal analgesia regimen for such surgeries. <br/>Method(s): A total of 90 patients scheduled for elective median sternotomy cardiac and great vessel surgery at the Institute of Cardiovascular Diseases, The First Affiliated Hospital of Guangxi Medical University from April 2024 to February 2025 were enrolled. They were divided into the liposomal bupivacaine group (group LB, n=45) and the ropivacaine group (group ROP, n=45) using the random number table method. After endotracheal intubation under general anesthesia, group LB was given 40 mL of 266 mg liposomal bupivacaine injection for bilateral PSB+RSB, while group ROP was administered 40 mL of 0.375% ropivacaine injection for the same block regimen.The following outcomes were recorded at different postoperative time points: cumulative consumption of analgesic drugs (calculated as morphine milligram equivalents, MMEs), scores of Numeric Rating Scale (NRS, 0-10 points) for pain assessment, scores of Quality of Recovery-15 (QoR-15) scale, and the incidence of adverse events. <br/>Result(s): A total of 88 patients completed the study (2 patients in group LB were excluded due to surgical duration exceeding 8 hours). At 24 h and 48 h after the first postoperative awakening, the cumulative MMEs consumption in group LB was significantly lower than that in group ROP [55.30(47.80,62.10) vs 68.00(48.40,80.00) mg, 76.30(68.80, 83.10) mg vs 86.00(63.40,119.60), all P < 0.05]. At 4 h and 12 h post-extubation, the activity-related NRS scores in group LB were significantly lower than those in group ROP [2.00(2.00, 2.00) points vs 2.00(2.00,3.00) points, 2.00(2.00,3.00) points vs 3.00(2.00,4.00) points, all P < 0.05]. At 24 h, 48 h and 72 h post-extubation, the QoR-15 scores in group LB were significantly higher than those in group ROP [(85.4+/-11.78) points vs (74.7+/-9.89) points, (91.6+/-10.4) points vs (86.8+/-8.6) points, (107.1+/-9.87) points vs (100.0+/-9.15) points, all P < 0.05]. The incidence of postoperative nausea and vomiting in group LB (16.3%, 7/43) was significantly higher than that in group ROP (2.2%, 1/45) (P < 0.05). There were no significant differences between the two groups in postoperative endotracheal extubation time, ICU stay time, hospital stay, and the incidence of chronic postsurgical pain (CPSP) at 3 months after surgery. <br/>Conclusion(s): The use of liposomal bupivacaine for PSB+RSB block in patients undergoing cardiac sternotomy can significantly reduce postoperative analgesic consumption, optimize early analgesic effect, and improve postoperative recovery quality. However, attention should be paid to the risk of nausea and vomiting, and individualized selection should be made after balancing the benefits and risks in clinical application. Trial registration: Trial registration:This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400084078) on May 10, 2024 (https://www.chictr.org.cn/).<br/>Copyright © The Author(s) 2026. <49> Accession Number 2039337037 Title Effectiveness of Gentamicin-Collagen Sponges in Preventing Sternal Wound Infections. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2025. Date of Publication: 25 Jun 2025. Author Glam R.; Ronai T.; Makhoul M.; Friedman T.; Raad M.; Adler Z.; Cohen O.; Medalion B.; Bolotin G. Institution (Glam, Makhoul, Friedman, Raad, Adler, Cohen, Medalion, Bolotin) Department of Cardiothoracic Surgery, Rambam Health Care Campus, Haifa, Israel (Ronai) Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel Publisher Georg Thieme Verlag Abstract Background This study aimed to evaluate whether the combined use of gentamicin-collagen sponges and topical vancomycin reduces the incidence of sternal wound infections (SWIs) in patients at high risk for infection following cardiac surgery. Methods A single-center, retrospective study compared two groups of high-risk cardiac surgery patients from June 2018 to September 2021. High-risk patients, identified through departmental consensus, had multiple SWI risk factors. The study group (278 patients) received gentamicin-collagen sponges plus topical vancomycin, whereas the control group (309 patients) received only topical vancomycin. The primary outcome was SWI incidence. Results The incidence of SWI was significantly lower in the study group, with 2.8% (8/278) compared with 9% (28/309) in the control group (p = 0.002). After adjusting for known risk factors, the odds of infection in the control group were 4.64 times higher (95% confidence interval [CI]: 1.63-13.21) than in the study group. The rate of deep sternal wound infections (DSWI) was 1.8% in the study group versus 4.2% in the control group (p = 0.09), with adjusted odds of DSWI being 4.1 times higher in the control group (95% CI: 0.99-16.86). Although the p-value was borderline (p = 0.05), no significant differences in mortality rates were observed between the two groups. Conclusion The use of gentamicin-collagen sponges as part of a prophylactic regimen significantly reduces the incidence of SWI in high-risk cardiac surgery patients, suggesting its potential benefit as an adjunctive treatment in preventing postoperative infections.<br/>Copyright © 2025. Thieme. All rights reserved. <50> Accession Number 636681128 Title Scientific Publishing Differences between Sexes in Cardiology, Cardiac, and General Surgery. Source Thoracic and Cardiovascular Surgeon. 70(2) (pp 143-151), 2022. Date of Publication: 11 Dec 2021. Author Farber G.; Alscher L.; Heyne E.; Doenst T.; Schwarzer M. Institution (Farber, Alscher, Heyne, Doenst, Schwarzer) Department of Cardiothoracic Surgery, Jena University Hospital, Thuringen, Jena, Germany Publisher Georg Thieme Verlag Abstract Background Research and scientific publications are important for the advancement of science but also for the individual career development. While women have become the majority of students in medicine we do not know about female presence and scientific activity in cardiac surgery. We thus aimed to compare scientific output of women and men in German University departments of cardiac surgery with cardiology departments focusing on the same organ and surgical departments not addressing the heart (general surgery) of 34 universities in Germany. Methods Personnel working at University departments was identified on the institutions internet homepage in 2014. Publications in 2011 to 2013 on PubMed were identified. Author and manuscript characteristics were determined. Results A lower proportion of women were working in cardiac surgery (25%) compared with cardiology (35%) and general (32%) surgery independent of executive function or academic degree. Scientifically active women published fewer manuscripts per capita than men both, in total and as first author. Additionally, the mean and the cumulated journal impact factor of the journals chosen was lower for women compared with men in cardiology but not in cardiac and general surgery. Conclusion We conclude that the differences in scientific activity between women and men are more pronounced in cardiology compared with general and cardiac surgery, indicating that a higher proportion of women in a field does not result in reduced differences between sexes. The low number of women together with the lower number of manuscripts in cardiac surgery may render the appointment of women as directors challenging.<br/>Copyright © 2022 American Society of Civil Engineers (ASCE). All rights reserved. <51> Accession Number 634475735 Title Influence of Left Atrial Appendage Amputation on Natriuretic Peptides-A Randomized Controlled Trial. Source Thoracic and Cardiovascular Surgeon. 69(2) (pp 117-123), 2021. Date of Publication: 31 Mar 2019. Author Grieshaber P.; Arneth B.; Steinsberger F.; Niemann B.; Oswald I.; Renz H.; Boning A. Institution (Grieshaber, Steinsberger, Niemann, Oswald, Boning) Department of Adult and Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen, Germany (Arneth, Renz) Institute for Laboratory Medicine and Pathobiochemistry, Giessen University Hospital, Giessen, Germany Publisher Georg Thieme Verlag Abstract Background: Closure or amputation of the left atrial appendage (LAA) is a common therapy for atrial fibrillation (AF). As the LAA is a hormone-producing organ, however, amputation is still somewhat controversial. We examined patients after surgical AF therapy with or without LAA amputation to determine the influence of LAA amputation on pro-atrial natriuretic peptide (proANP) and B-type natriuretic peptide (BNP) plasma levels and on clinical severity of heart failure. <br/>Method(s): Twenty-one consecutive patients were prospectively randomized to either undergo LAA amputation (n = 10) or no LAA amputation (n = 11) between 05/2015 and 10/2015. All patients underwent coronary and/or valve surgery and concomitant AF surgery with either cryoablation (n = 3) or radio frequency ablation (n = 17). ProANP and BNP levels were measured preoperatively and until 800 days postoperatively. <br/>Result(s): Baseline proANP values were comparable between the groups (without LAA amputation: 4.2 +/- 2.1 nmol/L, with LAA amputation: 5.6 +/- 3.6 nmol/L). Postoperatively, proANP levels rose markedly in both groups. Even after LAA amputation, proANP levels remained elevated for 7 days postoperatively but fell to baseline levels at day 31 and remained on baseline level at 800 days postoperatively. ProANP levels in the LAA amputation group (5.8-9.7 nmol/L) were not significantly lower than in the group without LAA amputation (9.2-14.1 nmol/L; p = 0.357). BNP levels also rose after surgery in both groups until day 7. At 800 days after surgery, BNP levels were back at baseline levels in both groups. Clinical follow-up at 2 years postoperatively showed no difference in heart failure symptoms or need for heart failure medication between the groups. <br/>Conclusion(s): In contrast to commonly held beliefs about the endocrine and reservoir functions of the LAA, there seems to be no clinically relevant detrimental effect of LAA amputation on natriuretic peptide levels and severity of heart failure until up to 2 years postoperatively.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <52> Accession Number 632381656 Title Levosimendan Reduces Mortality and Low Cardiac Output Syndrome in Cardiac Surgery. Source Thoracic and Cardiovascular Surgeon. 68(5) (pp 400-408), 2020. Date of Publication: 26 Nov 2019. Author Weber C.; Esser M.; Eghbalzadeh K.; Sabashnikov A.; Djordjevic I.; Maier J.; Merkle J.; Choi Y.-H.; Madershahian N.; Liakopoulos O.; Deppe A.C.; Wahlers T.C.W. Institution (Weber, Esser, Eghbalzadeh, Sabashnikov, Djordjevic, Maier, Merkle, Choi, Madershahian, Liakopoulos, Deppe, Wahlers) Department of Cardiothoracic Surgery, University of Cologne, Kerpener Street 62, Cologne, Germany Publisher Georg Thieme Verlag Abstract Background There has been conflicting evidence concerning the effect of levosimendan on clinical outcomes in patients undergoing cardiac surgery. Therefore, we performed a systematic review and conducted this meta-analysis to provide evidence for/against the administration of levosimendan in cardiac surgery patients. Methods We performed a meta-analysis from literature search in PubMed, EMBASE, and Cochrane Library. Only randomized controlled trials comparing the administration of levosimendan in cardiac surgery patients with a control group (other inotrope, standard therapy/placebo, or an intra-aortic balloon pump) were included. In addition, at least one clinical outcome had to be mentioned: Mortality, myocardial infarction, low cardiac output syndrome (LCOS), acute kidney injury, renal replacement therapy, atrial fibrillation, prolonged inotropic support, length of intensive care unit, and hospital stay. The pooled treatment effects (odds ratio [OR], 95% confidence intervals [CI]) were assessed using a fixed or random effects model. Results The literature search retrieved 27 randomized, controlled trials involving a total of 3,198 patients. Levosimendan led to a significant reduction in mortality (OR: 0.67; 95% CI: 0.49-0.91; p = 0.0087). Furthermore, the incidence of LCOS (OR: 0.56, 95% CI: 0.42-0.75; p < 0.0001), acute kidney injury (OR: 0.63; 95% CI: 0.46-0.86; p = 0.0039), and renal replacement therapy (OR: 0.70; 95% CI: 0.50-0.98; p = 0.0332) was significantly decreased in the levosimendan group. Conclusion Our meta-analysis suggests beneficial effects for the prophylactic use of levosimendan in patients with severely impaired left ventricular function undergoing cardiac surgery. The administration of levosimendan was associated with a reduced mortality, less LCOS, and restored adequate organ perfusion reflected in less acute kidney injury.<br/>Copyright © 2020 Georg Thieme Verlag. All rights reserved. <53> Accession Number 632535903 Title Platelet inhibition with ticagrelor versus clopidogrel in diabetic patients after percutaneous coronary intervention for chronic coronary syndromes. Source Thrombosis and Haemostasis. 120(8) (pp 1221-1229), 2020. Date of Publication: 15 Jul 2020. Author Liu Z.; Tian R.; Wang Y.; Chen Q.; Li J.; Xu L.; Zhang S. Institution (Liu, Tian, Li, Zhang) Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Wang) Medical Research and Biometrics Center, Fu-Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Chen) Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Xu) Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China Publisher Georg Thieme Verlag Abstract Background Clopidogrel is currently the only P2Y <inf>12</inf>inhibitor with class I recommendation in patients after percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS). Diabetic patients have reduced therapeutic response to clopidogrel. Purpose This study assessed the antiplatelet effect of ticagrelor versus clopidogrel in diabetic patients after recent PCI for CCS. Methods Eligible patients were randomly assigned to receive ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily, in addition to aspirin 100 mg once daily for 15 days. P2Y <inf>12</inf>reaction unit (PRU) and percent inhibition were measured by VerifyNow P2Y <inf>12</inf>assay. High on-treatment platelet reactivity (HOPR) was defined as PRU > 208. Bleeding was assessed by the Platelet Inhibition and Patient Outcomes criteria. Cardiac ischemic events were evaluated as adverse events. Results The baseline characteristics of the patients (n = 39) were well balanced between the two groups. Both before and 2 to 4 hours after the final study dose on day 15, PRU was lower (41.3 +/- 35.8 vs. 192.6 +/- 49.5, p < 0.001; 36.6 +/- 25.8 vs. 187.6 +/- 70.9, p < 0.001), percent inhibition was higher (83.0% [70.5%, 96.0%] vs. 16.0% [0%, 25.0%], p < 0.001; 85.0% [76.0%, 96.5%] vs. 25.0% [0%, 39.0%], p < 0.001), and HOPR occurred less frequently (0% [0/20] vs. 26.3% [5/19], p = 0.020; 0% [0/20] vs. 31.6% [6/19], p = 0.008) in the ticagrelor group (n = 20) compared with the clopidogrel group (n = 19). No major or minor bleeding, or serious adverse events occurred in both groups. Conclusion Ticagrelor achieved greater peak and trough platelet inhibition than did clopidogrel in diabetic patients after recent PCI for CCS, which suggests the potential use of ticagrelor in this clinical setting.<br/>Copyright © 2020 Georg Thieme Verlag. All rights reserved. <54> Accession Number 634023072 Title Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis of Randomized Trials. Source Thoracic and Cardiovascular Surgeon. 70(5) (pp 413-421), 2022. Date of Publication: 21 Jan 2021. Author Xu M.; Hu J.; Yan J.; Yan H.; Zhang C. Institution (Xu, Yan) Department of Anesthesiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Hu, Yan) Department of Anesthesiology, Xiangya Hospital, Central South University, Hunan, Changsha, China (Zhang) Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Hunan, Changsha, China Publisher Georg Thieme Verlag Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982-6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336-2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137-0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198-0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451-0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.<br/>Copyright © 2022 Georg Thieme Verlag. All rights reserved. <55> Accession Number 636226120 Title Cardiovascular Mortality after Venous Thromboembolism: A Meta-Analysis of Prospective Cohort Studies. Source Seminars in Thrombosis and Hemostasis. 48(4) (pp 481-489), 2022. Date of Publication: 08 Oct 2021. Author Noumegni S.R.; Grangereau T.; Demir A.; Bressollette L.; Couturaud F.; Hoffmann C. Institution (Noumegni, Grangereau, Bressollette, Hoffmann) Department of Vascular Medicine, Brest Teaching Hospital, Brest University, EA 3878 GETBO, Brest, France (Noumegni, Bressollette, Couturaud, Hoffmann) EA3878 (GETBO), Western Brittany Thrombosis Study Group, Brest University, Brest, France (Grangereau) Department of Cardiovascular Medicine, Guingamp Hospital, Guingamp, France (Demir) Department of Vascular Medicine, Bordeaux Teaching Hospital, Bordeaux, France (Couturaud) Department of Internal Medicine and Pneumology, Brest Teaching Hospital, Brest, France Publisher Thieme Medical Publishers, Inc. Abstract Many studies from current literature show that cardiovascular diseases in patients with venous thromboembolism (VTE) are more frequent than in the general population without VTE. However, data summarizing the impact of cardiovascular diseases on mortality of patients with VTE are lacking. In this systematic review and meta-analysis, we aimed to determine the frequency and incidence rate of cardiovascular death in patients with VTE. MEDLINE and EMBASE were searched from January 1, 2000 to February 28, 2021. Eligible studies were observational prospective cohort studies including patients with VTE and reporting all causes of death. Cardiovascular death was defined as deaths that result from new or recurrent pulmonary embolism, death due to acute myocardial infarction, sudden cardiac death or heart failure, death due to stroke, death due to cardiovascular procedures or hemorrhage, death due to ruptured aortic aneurysm or aortic dissection and death due to other cardiovascular causes. Random-effect models meta-analysis served to determine all pooled effect size of interest with their 95% confidence interval (CI). Thirteen observational studies enrolling 22,251 patients were identified and included. The mean/median age varied between 49 and 75 years. The proportion of men ranged from 38.3 to 53.2%. The overall pooled frequency of cardiovascular death in patients with VTE was 3.9% (95% CI: 2.5-5.6%), while the overall pooled frequency of all-cause mortality was 12.0% (95% CI: 9.1-15.4%). The pooled proportion of cardiovascular death among all causes of deaths in patients with VTE was 35.2% (95% CI: 22.2-49.3%). The pooled incidence rate of cardiovascular death was 1.92 per 100 patient-years (95% CI: 0-4.1). The frequency of cardiovascular death in patients with VTE was significantly higher than in patients without VTE (risk ratio: 3.85, 95% CI: 2.75-5.39). Based on this updated meta-analysis from 13 prospective cohort studies, cardiovascular death in patients with VTE is more frequent than in the general population without VTE.<br/>Copyright © 2022 Thieme Medical Publishers, Inc.. All rights reserved. <56> Accession Number 626818204 Title Predicting the Quality of Warfarin Therapy: Reframing the Question. Source Thrombosis and Haemostasis. 119(4) (pp 509-511), 2019. Date of Publication: 22 Feb 2019. Author Barnes G.D. Institution (Barnes) Department of Internal Medicine, University of Michigan, Frankel Cardiovascular Center, Ann Arbor, MI, United States Publisher Georg Thieme Verlag <57> Accession Number 633005883 Title Edoxaban versus Warfarin in Patients with Atrial Fibrillation at the Extremes of Body Weight: An Analysis from the ENGAGE AF-TIMI 48 Trial. Source Thrombosis and Haemostasis. 121(2) (pp 140-149), 2021. Date of Publication: 13 Sep 2020. Author Boriani G.; Ruff C.T.; Kuder J.F.; Shi M.; Lanz H.J.; Antman E.M.; Braunwald E.; Giugliano R.P. Institution (Boriani) Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena University Hospital, Modena, Italy (Ruff, Kuder, Antman, Braunwald, Giugliano) Timi Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Department of Medicine, Harvard Medical School, Boston, MA, United States (Shi) Daiichi Sankyo Inc., Basking Ridge, NJ, United States (Lanz) Daiichi Sankyo Europe GmbH, Munich, Germany Publisher Georg Thieme Verlag Abstract Background a The effects of anticoagulants at extremes of body weight (BW) are not well described. The aim of this study was to analyze the pharmacokinetics/pharmacodynamics and clinical outcomes in patients randomized to warfarin, higher dose edoxaban (HDER), and lower dose edoxaban (LDER) regimens at extremes of BW in ENGAGE AF-TIMI 48. Methods and Results a We analyzed three BW groups: low BW (LBW: <5th percentile, <=55 kg, N = 1,082), middle BW (MBW: 45th-55th percentile, 79.8-84 kg, N = 2,153), and high BW (HBW: >95th percentile, >=120 kg, N = 1,093). In the warfarin arm, LBW patients had higher rates of stroke/systemic embolism (SSE: 6.5 vs. 4.7 in MBW vs. 1.6% in HBW, P <inf>trend</inf>< 0.001), major bleeding (MB: 9.3 vs. 7.7 vs. 6.5%, P <inf>trend</inf>= 0.08), and worse net clinical outcome of systemic embolic event, MB, or death (31.5 vs. 19.1 vs. 16.0%, P <inf>trend</inf>< 0.0001). The time-in-Therapeutic range with warfarin was lowest in LBW patients (63.0 vs. 69.3 vs. 70.1% patients, P <inf>trend</inf>< 0.001). The pharmacokinetic/pharmacodynamic profile of edoxaban was consistent across BW groups. The risk of SSE was similar between HDER and warfarin for each of the three weight groups (P <inf>int</inf>= 0.52, P <inf>int-Trend</inf>= 0.86). MB was reduced by LDER versus warfarin (P <inf>int</inf>= 0.061, P <inf>int-Trend</inf>= 0.023), especially in LBW patients. Net clinical outcomes were improved by HDER versus warfarin (P <inf>int</inf>= 0.087, P <inf>int-Trend</inf>= 0.027), especially in LBW patients. Conclusion a Patients with LBW in ENGAGE AF-TIMI 48 had in general a more fragile clinical status and poorer international normalized ratio control. The pharmacokinetic/pharmacodynamic profile of edoxaban was consistent across extremes of BW, resulting in similar efficacy compared with warfarin, while major or clinically relevant non-MB and net outcomes were most favorable with edoxaban as compared to warfarin in LBW patients.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <58> Accession Number 631106918 Title Sutureless versus Stented Bioprostheses for Aortic Valve Replacement: The Randomized PERSIST-AVR Study Design. Source Thoracic and Cardiovascular Surgeon. 68(2) (pp 114-123), 2020. Date of Publication: 29 Nov 2018. Author Lorusso R.; Folliguet T.; Shrestha M.; Meuris B.; Kappetein A.P.; Roselli E.; Klersy C.; Nozza M.; Verhees L.; Larracas C.; Goisis G.; Fischlein T. Institution (Lorusso) Department of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC +), P. Debyelaan, 25, Maastricht, Netherlands (Folliguet) Chirurgie Cardiaque and Transplantation, Assistance Publique Hopital, Henri Mondor, Universite Paris 12, UPEC, France (Shrestha) Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany (Meuris) Cardiac Surgery Department, Universitaire Ziekenhuizen Leuven, Leuven, Belgium (Kappetein) Thoraxcenter, Erasmus Medical Centre, Rotterdam, Netherlands (Roselli) Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States (Klersy) Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy (Nozza, Verhees, Larracas, Goisis) LivaNova Plc, London, United Kingdom (Fischlein) Department of Cardiac Surgery, Klinikum Nurnberg, Paracelsus Medical University, Nuremberg, Germany Publisher Georg Thieme Verlag Abstract Introduction Sutureless biological valves for surgical aortic valve replacement (SAVR), characterized by the absence of anchoring sutures at the aortic annulus, are gaining popularity because of ease and reproducibility of implant, shorter operating times, and enhancement of minimally invasive approaches. The stentless configuration of the sutureless valve was designed to achieve optimal hemodynamic performance. Materials and Methods PERSIST-AVR (PERceval Sutureless Implant versus STandard Aortic Valve Replacement) is a prospective, randomized, adaptive, open-label, international, postmarket trial (NCT02673697). The primary objective of the trial is to assess the safety and efficacy of the Perceval (LivaNova, London, UK) sutureless bioprosthesis among patients undergoing SAVR in the presence of severe aortic stenosis to demonstrate the noninferiority of Perceval as compared with standard sutured stented bioprosthetic aortic valve as an isolated procedure or combined with coronary artery bypass grafting. Sample size will be determined adaptively through interim analyses performed by an Independent Statistical Unit till a maximum of 1,234 patients, enrolled at ~60 sites in countries where the device is commercially available. Patients will be followed up for 5 years after implant. The primary end point is the number of patients free from major adverse cardiac and cerebrovascular-related events at 1 year. Additional secondary outcomes will be assessed up to 5 years. Discussion PERSIST-AVR is the first prospective, randomized study comparing in-hospital and postdischarge outcomes in a robust population of patients undergoing SAVR with either the Perceval sutureless bioprosthesis or a conventional sutured stented bioprosthesis up to 5 years.<br/>Copyright © 2020 American Institute of Physics Inc.. All rights reserved. <59> Accession Number 632381648 Title Bilateral Paravertebral Block versus Thoracic Epidural Analgesia for Pain Control Post-Cardiac Surgery: A Randomized Controlled Trial. Source Thoracic and Cardiovascular Surgeon. 68(5) (pp 409-415), 2020. Date of Publication: 16 Aug 2018. Author El Shora H.A.; El Beleehy A.A.; Abdelwahab A.A.; Ali G.A.; Omran T.E.; Hassan E.A.; Arafat A.A. Institution (El Shora, El Beleehy) Anesthesia and Surgical ICU Department, Faculty of Medicine-Tanta University, Tanta, Gharbeya, Egypt (Abdelwahab, Omran, Hassan, Arafat) Department of Cardiothoracic Surgery, Faculty of Medicine-Tanta University, Al-Giesh Street, Tanta, Gharbeya, Egypt (Ali) Department of Cardiothoracic Surgery, Faculty of Medicine-Zagazig University, Zagazig, Sharkia, Egypt Publisher Georg Thieme Verlag Abstract Background Adequate pain control after cardiac surgery is essential. Paravertebral block is a simple technique and avoids the potential complications of epidural catheters. The objective of this study is to compare the effect of ultrasound-guided bilateral thoracic paravertebral block with thoracic epidural block on pain control after cardiac surgery. Materials and Methods Between March 2016 and 2017, 145 patients who had cardiac surgery through median sternotomy were randomized by stratified blocked randomization into two groups. Group I (n = 70 patients) had bilateral ultrasound-guided thoracic paravertebral block and Group II (n = 75 patients) had thoracic epidural analgesia. The primary end point was the postoperative visual analogue scale (VAS). The duration of mechanical ventilation, intensive care unit (ICU), and hospital stay were the secondary end points. The study design is a randomized parallel superiority clinical trial. Results Both groups had similar preoperative and operative characteristics. No significant difference in VAS measured immediately after endotracheal extubation then after 12, 24, and 48 hours between groups (p = 0.45). Pain score significantly declined with the repeated measures (p < 0.001) and the decline was not related to the treatment group. Postoperative pain was significantly related to diabetes mellitus (p = 0.039). Six patients in group I (8.5%) required an additional dose of morphine versus three patients (4%) in group II (p = 0.30). Patients in group I had significantly shorter ICU stay (p = 0.005) and lower incidence of urinary retention (p = 0.04) and vomiting (p = 0.018). No difference was found in operative complications between groups. Conclusion This randomized parallel controlled trial demonstrates that ultrasound-guided paravertebral block is safe and effective method for relieving post-cardiac surgery sternotomy pain compared with thoracic epidural analgesia but not superior to it.<br/>Copyright © 2020 Georg Thieme Verlag. All rights reserved. <60> Accession Number 626053671 Title Antiplatelet Therapy versus Anticoagulation after Surgical Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Source Thrombosis and Haemostasis. 119(2) (pp 328-339), 2019. Date of Publication: 07 Jan 2019. Author An K.R.; Belley-Cote E.P.; Um K.J.; Gupta S.; McClure G.R.; Jaffer I.H.; Pandey A.; Spence J.; Van Der Wall S.J.; Eikelboom J.W.; Whitlock R.P. Institution (An, Um, McClure) Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (Belley-Cote, Gupta, Jaffer, Spence, Whitlock) Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada (Belley-Cote) Division of Cardiology, McMaster University, Hamilton, ON, Canada (Belley-Cote, Jaffer, Eikelboom, Whitlock) Population Health Research Institute, Hamilton, ON, Canada (Gupta, Jaffer, Whitlock) Division of Cardiac Surgery, McMaster University, Hamilton, ON, Canada (Pandey) Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada (Spence) Department of Anesthesia, McMaster University, Hamilton, ON, Canada (Van Der Wall) Department of Thrombosis and Hemostasis, Leiden University Medical Centre, Leiden University, Leiden, Netherlands (Eikelboom) Division of Hematology and Thromboembolism, McMaster University, Hamilton, ON, Canada (Whitlock) David Braley Cardiac, Vascular, Stroke Research Institute, 237 Barton Street East, Hamilton, ON, Canada Publisher Georg Thieme Verlag Abstract Background The optimal antithrombotic therapy after surgical bioprosthetic aortic valve replacement (BAVR) is uncertain. We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs) comparing antiplatelet therapy and anticoagulation in patients with surgical BAVR. Methods We searched Cochrane CENTRAL, MEDLINE and EMBASE from inception to 3 November 2017 for studies evaluating antiplatelet therapy versus anticoagulation early after surgical BAVR. We performed title and abstract screening, full-text review, risk of bias evaluation and data collection independently and in duplicate. We evaluated overall quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework, and pooled data using a random effects model. Results We identified 2 RCTs (n = 397) and 5 observational studies (n = 2,012) meeting our eligibility criteria. The mean follow-up for all outcomes was 3 months in RCTs, and 10 months for observational studies. Antiplatelet compared with anticoagulant therapy demonstrated a trend towards fewer major bleeds in RCTs (relative risk [RR], 0.34; 95% confidence interval [CI], 0.11-1.04, p = 0.06, I <sup>2</sup> = 0%, low quality evidence), and significantly fewer major bleeds in observational studies (RR, 0.34; 95% CI, 0.20-0.58, p <= 0.0001, I <sup>2</sup> = 0%, very low quality evidence), but stroke, thromboembolism and mortality did not show a significant difference in either RCTs or observational studies. Conclusion Antiplatelet therapy demonstrated reduced bleeding risk with no negative effects on stroke, thromboembolism or mortality compared with anticoagulation therapy after surgical BAVR. Our confidence in the results is reduced by the low quality of the available evidence.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart New York. <61> Accession Number 636912019 Title Efficacy and Safety of Aspirin for Primary Cardiovascular Risk Prevention in Younger and Older Age: An Updated Systematic Review and Meta-analysis of 173,810 Subjects from 21 Randomized Studies. Source Thrombosis and Haemostasis. 122(3) (pp 445-455), 2022. Date of Publication: 31 Dec 2021. Author Calderone D.; Greco A.; Ingala S.; Agnello F.; Franchina G.; Scalia L.; Buccheri S.; Capodanno D. Institution (Calderone, Greco, Ingala, Agnello, Franchina, Scalia, Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico - San Marco, University of Catania, Catania, Italy (Buccheri) Department of Medical Sciences, Uppsala University, Uppsala, Sweden (Buccheri) Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden Publisher Georg Thieme Verlag Abstract Aims The efficacy and safety of aspirin for primary cardiovascular disease (CVD) prevention is controversial. The aim of this study was to investigate the efficacy and safety of aspirin in subjects with no overt CVD, with a focus on age as a treatment modifier. Methods and Results Randomized trials comparing aspirin use versus no aspirin use or placebo were included. The primary efficacy outcome was all-cause death. The primary safety outcome was major bleeding. Secondary ischemic and bleeding outcomes were explored. Subgroup analyses were conducted to investigate the consistency of the effect sizes in studies including younger and older individuals, using a cut-off of 65 years. A total of 21 randomized trials including 173,810 individuals at a mean follow-up of 5.3 years were included. Compared with control, aspirin did not reduce significantly the risk of all-cause death (risk ratio: 0.96; 95% confidence interval: 0.92-1.00, p = 0.057). Major adverse cardiovascular events were significantly reduced by 11%, paralleled by significant reductions in myocardial infarction and transient ischemic attack. Major bleeding, intracranial hemorrhage, and gastrointestinal bleeding were significantly increased by aspirin. There was a significant age interaction for death (p for interaction = 0.007), with aspirin showing a statistically significant 7% relative benefit on all-cause death in studies including younger patients. Conclusion The use of aspirin in subjects with no overt CVD was associated with a neutral effect on all-cause death and a modest lower risk of major cardiovascular events at the price of an increased risk in major bleeding. The benefit of aspirin might be more pronounced in younger individuals.<br/>Copyright © 2022 Georg Thieme Verlag. All rights reserved. <62> Accession Number 635935221 Title Percutaneous Coronary Intervention with Stenting versus Coronary Artery Bypass Grafting in Stable Coronary Artery Disease. Source International Journal of Angiology. 30(3) (pp 221-227), 2021. Date of Publication: 31 Aug 2021. Author Glenn I.C.; Iacona G.M.; Mangi A.A. Institution (Glenn) Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States (Iacona, Mangi) Medstar Health Cardiac Surgery, Heart and Vascular Institute, Medstar Washington Hospital Center, 110 Irving Street Northwest, Washington, DC, United States Publisher Thieme Medical Publishers, Inc. Abstract The debate over coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with stent placement for the treatment of stable multivessel coronary artery disease (CAD) continues in spite of numerous studies investigating the issue. This paper reviews the most recent randomized control trials (RCT) and meta-analyses of pooled RCT data to help address this issue. General trends demonstrated that CABG was superior in all-cause mortality and fulfilling the need for repeat revascularization. These advantages tended to be more pronounced in multivessel CAD and diabetes, and less so in left main CAD. PCI showed a consistently lower rate of cerebrovascular events. CABG continues to offer significant advantages over PCI, even as drug-eluting stent technology continues to evolve. The ideal endpoint for comparing PCI and CABG remains to be determined. Furthermore, additional research is required to further refine patient selection criteria for each intervention.<br/>Copyright © 2021. International College of Angiology. All rights reserved. <63> Accession Number 631460325 Title Vitamin D Deficiency and Its Response to Supplementation as Stoss Therapy in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart Surgery. Source Journal of Cardiac Critical Care. 3(1) (pp 17-23), 2019. Date of Publication: 22 Oct 2019. Author Sahu M.K.; Bipin C.; Niraghatam H.V.; Karanjkar A.; Singh S.P.; Rajashekar P.; Ramakrishnan L.; Devagourou V.; Upadhyay A.D.; Choudhary S.K. Institution (Sahu, Bipin, Niraghatam, Singh, Rajashekar, Devagourou, Choudhary) Department of Cardiothoracic and Vascular Surgery, CN Centre, All India Institute of Medical Sciences, New Delhi, India (Karanjkar) Department of Cardiac Anaesthesiology, CN Centre, All India Institute of Medical Sciences, New Delhi, India (Ramakrishnan) Department of Laboratory Medicine, CN Centre, All India Institute of Medical Sciences, New Delhi, India (Upadhyay) Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India (Sahu) Department of Cardiothoracic and Vascular Surgery, CTVS Office, CN Centre, All India Institute of Medical Sciences, New Delhi, India Publisher Thieme Medical and Scientific Publishers Pvt Ltd Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels < 20ng/dL were randomized into two groups. The study group received vitD supplementation as stoss therapy at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as stoss therapy was useful in raising the serum levels before and after cardiac surgery.<br/>Copyright © 2020 Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU). <64> Accession Number 635317125 Title Anti-Xa Monitoring of Low-Molecular-Weight Heparin during Pregnancy: A Systematic Review. Source Seminars in Thrombosis and Hemostasis. 47(7) (pp 824-842), 2021. Date of Publication: 15 Jun 2021. Author Kjaergaard A.B.; Fuglsang J.; Hvas A.-M. Institution (Kjaergaard, Hvas) Department of Clinical Biochemistry, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark (Fuglsang) Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark (Fuglsang, Hvas) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Publisher Thieme Medical Publishers, Inc. Abstract Low-molecular-weight heparin (LMWH) is commonly used for preventing or treating venous thromboembolic disease (VTE) during pregnancy. The physiological changes in maternal metabolism have led to discussions on optimal LMWH dosing strategy and possible need for monitoring. The aim of this systematic review is to summarize and discuss whether LMWH dose adjustment according to anti-Xa provides superior effectiveness and safety compared with weight adjusted or fixed dosed LMWH in pregnant women. A systematic literature search was performed in PubMed, Embase, and Scopus on September 26, 2020. The study is reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Effectiveness was defined as episodes of thrombosis and safety as bleeding episodes. In total, 33 studies were included: 4 randomized controlled studies and 29 cohort studies. Prophylactic dosing strategies employing weight dosed, fixed dosed, or anti-Xa adjusted LMWH dosing performed equal in effectiveness and safety. In pregnant women with VTE or high thromboembolic risk, therapeutic weight-adjusted LMWH and weight plus anti-Xa-adjusted LMWH provided equal results in terms of effectiveness and safety. Pregnant women with mechanical heart valves (MHVs) received therapeutic anti-Xa-adjusted LMWH with four out of seven studies presenting mean peak anti-Xa within target ranges. Still, pregnant women with MHV experienced both thrombosis and bleeding with anti-Xa in target. Based on the results of this systematic review, current evidence does not support the need for anti-Xa monitoring when using LMWH as thromboprophylaxis or treatment during pregnancy. Nonetheless, the need for anti-Xa monitoring in pregnant women with MHV may need further scrutiny.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <65> Accession Number 635866431 Title Effect of Remote Ischemic Conditioning on Bleeding Complications in Surgery: A Systematic Review and Meta-Analysis. Source Seminars in Thrombosis and Hemostasis. 48(2) (pp 229-239), 2022. Date of Publication: 24 Aug 2021. Author Krag A.E.; Hvas C.L.; Kiil B.J.; Hvas A.-M. Institution (Krag, Hvas) Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark (Krag, Hvas) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Krag, Kiil) Department of Plastic and Breast Surgery, Aarhus University Hospital, Denmark (Hvas) Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Denmark Publisher Thieme Medical Publishers, Inc. Abstract Remote ischemic conditioning (RIC) is administered with an inflatable tourniquet by inducing brief, alternating cycles of limb ischemia and reperfusion. RIC possibly impacts the hemostatic system, and the intervention has been tested as protective therapy against ischemia-reperfusion injury and thrombotic complications in cardiac surgery and other surgical procedures. In the present systematic review, we aimed to investigate the effect of RIC on intraoperative and postoperative bleeding complications in meta-analyses of randomized controlled trials including adult patients undergoing surgery. A systematic search was performed on November 7, 2020 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials comparing RIC versus no RIC in adult patients undergoing surgery that reported bleeding outcomes in English publications were included. Effect estimates with 95% confidence intervals were calculated using the random-effects model for intraoperative and postoperative bleeding outcomes. Thirty-two randomized controlled trials with 3,804 patients were eligible for inclusion. RIC did not affect intraoperative bleeding volume (nine trials; 392 RIC patients, 399 controls) with the effect estimate-0.95 [-9.90; 7.99] mL (p = 0.83). RIC significantly reduced postoperative drainage volume (seven trials; 367 RIC patients, 365 controls) with mean difference-83.6 [-134.9;-32.4] mL (p = 0.001). The risk of re-operation for bleeding was reduced in the RIC group (16 trials; 838 RIC patients, 839 controls), albeit not significantly, with the relative risk 0.65 [0.39; 1.09] (p = 0.10). In conclusion, RIC reduced postoperative bleeding measured by postoperative drainage volume in this meta-analysis of adult patients undergoing surgery.<br/>Copyright © 2021 Thieme. All rights reserved. Thieme Medical Publishers, Inc. <66> Accession Number 634304153 Title Advances in the Management of Acute Venous Thromboembolism and New Therapeutic Agents. Source Seminars in Respiratory and Critical Care Medicine. 42(2) (pp 218-232), 2021. Date of Publication: 18 Feb 2021. Author Stevens H.; McFadyen J.; Chan N. Institution (Stevens, McFadyen) Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (Stevens, McFadyen) Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia (Stevens, McFadyen) Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia (Chan) Thrombosis and Atherosclerosis Research Institute, 20 Copeland Avenue, Hamilton, ON, Canada Publisher Thieme Medical Publishers, Inc. Abstract Important advances in the understanding and management of venous thromboembolism (VTE) have enhanced our ability to diagnose, prevent, and treat VTE. In this narrative review, we discuss how recent advances in the understanding and management of VTE are changing practice, highlight ongoing unmet needs in VTE management, and outline how novel therapeutic targets with little or no influence on hemostasis may help address these unmet needs.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <67> Accession Number 632515911 Title Correlation between Age and Surgical Approach for Thoracic and Lumbar Hemivertebra. Source Indian Journal of Neurosurgery. 9(2) (pp 115-121), 2020. Date of Publication: 12 Jul 2020. Author Nikova A.; Chatzipaulou V.; Malkots B.; Mustafa R.M.; Valsamidou C.; Birbilis T. Institution (Nikova, Chatzipaulou, Malkots, Mustafa, Valsamidou, Birbilis) Department of Neurosurgery, Democritus University of Thrace Medical School, Dragana, Alexandroupolis, Greece Publisher Georg Thieme Verlag Abstract Objective Hemivertebra (HV) is a congenital defect of the formation of the spinal vertebra, which can result in scoliosis or kyphosis along with the related symptomatology of spine deformity. More often than not, it is linked to other abnormalities and requires attention. Its management is surgical and it is of great importance for the physician to choose the right approach at the right time, due to its deteriorative prognosis. Methods Due to the interest of the subject, the authors investigated the world literature between 1990 and 2018 and found 45 articles, reporting thoracic, thoracolumbar, and lumbar HV in children and its postsurgical outcome, aiming to show whether the approaches are equal in terms of the final outcome. Results The chosen surgical method depends much on the level of the pathology. Despite this fact, after analyzing the included data, we found that the surgical techniques are unequal with regard to the purpose of achieving improvement. Age, caudal and cranial curves, segmental kyphosis, and scoliosis are factors playing a major role in this. Conclusion If not treated, HV leads to deterioration and dysfunction. The most optimal result, however, is achieved only when the surgical approach is applied according to age and rest of the accompanying factors, which should be considered in future management planning.<br/>Copyright © 2020 Neurological Surgeons' Society of India. <68> Accession Number 630065755 Title Longitudinally Measured Fibrinolysis Factors are Strong Predictors of Clinical Outcome in Patients with Chronic Heart Failure: The Bio-SHiFT Study. Source Thrombosis and Haemostasis. 119(12) (pp 1947-1955), 2019. Date of Publication: 28 Oct 2019. Author Van Den Berg V.J.; Bouwens E.; Umans V.A.W.M.; De Maat M.; Manintveld O.C.; Caliskan K.; Constantinescu A.A.; Mouthaan H.; Cornel J.-H.; Baart S.; Akkerhuis K.M.; Boersma E.; Kardys I. Institution (Van Den Berg, Bouwens, Manintveld, Caliskan, Constantinescu, Baart, Akkerhuis, Boersma, Kardys) Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, Netherlands (Van Den Berg, Umans, Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands (Van Den Berg, Baart) Netherlands Heart Institute, Utrecht, Netherlands (De Maat) Department of Hematology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Mouthaan) Olink Proteomics AB, Uppsala, Sweden Publisher Georg Thieme Verlag Abstract Objective This article investigates whether longitudinally measured fibrinolysis factors are associated with cardiac events in patients with chronic heart failure (CHF). Methods A median of 9 (interquartile range [IQR] 5-10) serial, tri-monthly blood samples per patient were prospectively collected in 263 CHF patients during a median follow-up of 2.2 (IQR 1.4-2.5) years. Seventy patients (cases) reached the composite endpoint of cardiac death, heart failure hospitalization, left ventricular assist device, or heart transplantation. From all longitudinal samples, we selected baseline samples in all patients and the last two samples before the event in cases or the last sample available in event-free patients. Herein, we measured plasminogen activator inhibitor 1 (PAI-1), tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), and soluble urokinase plasminogen activator surface receptor (suPAR). Associations between temporal biomarker patterns during follow-up and the cardiac event were investigated using a joint model. Results Cases were on average older and showed higher New York Heart Association class than those who remained event-free. They also had lower blood pressures, and were more likely to have diabetes, renal failure, and atrial fibrillation. Longitudinally measured PAI-1, uPA, and suPAR were independently associated with adverse cardiac events after correction for clinical characteristics (hazard ratio [95% confidence interval]) per standard deviation increase of 2.09 (1.28-3.45) for PAI-1, 1.91 (1.18-3.24) for uPA, and 3.96 (2.48-6.63) for suPAR. Serial measurements of tPA were not significantly associated with the event after correction for multiple testing. Conclusion Longitudinally measured PAI-1, uPA, and suPAR are strongly associated with adverse cardiac events during the course of CHF. If future research confirms our results, these fibrinolytic factors may carry potential for improved, and personalized, heart failure surveillance and treatment monitoring.<br/>Copyright © 2019 Georg Thieme Verlag. All rights reserved. <69> Accession Number 626675021 Title Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery. Source Thoracic and Cardiovascular Surgeon. 67(2) (pp 107-116), 2019. Date of Publication: 02 Aug 2018. Author Yamashita K.; Hu N.; Ranjan R.; Selzman C.H.; Dosdall D.J. Institution (Yamashita, Ranjan, Selzman, Dosdall) Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, 95 South 2000 East, United States (Yamashita, Ranjan, Dosdall) Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States (Hu) Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States (Hu) Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States (Selzman, Dosdall) Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, United States Publisher Georg Thieme Verlag Abstract Background a?Postoperative atrial fibrillation (POAF) is a common arrhythmia following cardiac surgery and is associated with increased health-care costs, complications, and mortality. The etiology of POAF is incompletely understood and its prediction remains suboptimal. Using data from published studies, we performed a systemic review and meta-analysis to identify preoperative clinical risk factors associated with patients at increased risk of POAF. Methods a?A systematic search of PubMed, MEDLINE, and EMBASE databases was performed. Results a?Twenty-four studies that reported univariate analysis results regarding POAF risk factors, published from 2001 to May 2017, were included in this meta-analysis with a total number of 36,834 subjects. Eighteen studies were performed in the United States and Europe and 16 studies were prospective cohort studies. The standardized mean difference (SMD) between POAF and non-POAF groups was significantly different (reported as [SMD: 95% confidence interval, CI]) for age (0.55: 0.47-0.63), left atrial diameter (0.45: 0.15-0.75), and left ventricular ejection fraction (0.30: 0.14-0.47). The pooled odds ratios (ORs) (reported as [OR: 95% CI]) demonstrated that heart failure (1.56: 1.31-1.96), chronic obstructive pulmonary disease (1.36: 1.13-1.64), hypertension (1.29: 1.12-1.48), and myocardial infarction (1.18: 1.05-1.34) were significant predictors of POAF incidence, while diabetes was marginally significant (1.06: 1.00-1.13). Conclusion a?The present analysis suggested that older age and history of heart failure were significant risk factors for POAF consistently whether the included studies were prospective or retrospective datasets.<br/>Copyright © 2019 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. <70> Accession Number 635319371 Title Safety and Efficacy of Different Antithrombotic Strategies after Transcatheter Aortic Valve Implantation: A Network Meta-Analysis. Source Thrombosis and Haemostasis. 122(2) (pp 216-225), 2022. Article Number: 210095. Date of Publication: 15 Jun 2021. Author Navarese E.P.; Grisafi L.; Spinoni E.G.; Mennuni M.G.; Rognoni A.; Ratajczak J.; Podhajski P.; Koni E.; Kubica J.; Patti G. Institution (Navarese, Kubica) Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland (Grisafi, Spinoni, Patti) Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, Novara, Italy (Grisafi, Spinoni, Mennuni, Rognoni, Patti) Department of Thoracic, Heart and Vascular Diseases, Maggiore della Carita Hospital, Novara, Italy (Ratajczak) Department of Health Promotion, Nicolaus Copernicus University, Bydgoszcz, Poland (Ratajczak, Podhajski) Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland (Koni) Department of Interventional Cardiology, Santa Corona Hospital, Pietra Ligure, Italy Publisher Georg Thieme Verlag Abstract Background The optimal pharmacological therapy after transcatheter aortic valve implantation (TAVI) remains uncertain. We compared efficacy and safety of various antiplatelet and anticoagulant approaches after TAVI by a network meta-analysis. Methods A total of 14 studies (both observational and randomized) were considered, with 24,119 patients included. Primary safety endpoint was the incidence of any bleeding complications during follow-up. Secondary safety endpoint was major bleeding. Efficacy endpoints were stroke, myocardial infarction, and cardiovascular mortality. A frequentist network meta-analysis was conducted with a random-effects model. The following strategies were compared: dual antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), oral anticoagulation (OAC), and OAC + SAPT. The mean follow-up was 15 months. Results In comparison to DAPT, SAPT was associated with a 44% risk reduction of any bleeding (odds ratio [OR]: 0.56 [95% confidence interval, CI: 0.39-0.80]). SAPT was ranked as the safest strategy for the prevention of any bleeding (p -score: 0.704), followed by OAC alone (p -score: 0.476) and DAPT (p -score: 0.437). Consistent results were observed for major bleeding. The incidence of cardiovascular death and secondary ischemic endpoints did not differ among the tested antithrombotic approaches. In patients with indication for long-term anticoagulation, OAC alone showed similar rates of stroke (OR: 0.92 [95% CI: 0.41-2.05], p = 0.83) and reduced occurrence of any bleeding (OR: 0.49 [95% CI: 0.37-0.66], p < 0.01) versus OAC + SAPT. Conclusion The present network meta-analysis supports after TAVI the use of SAPT in patients without indication for OAC and OAC alone in those needing long-term anticoagulation.<br/>Copyright © 2022 American Institute of Physics Inc.. All rights reserved. <71> Accession Number 633133634 Title Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence. Source European Journal of Pediatric Surgery. 31(1) (pp 54-64), 2021. Date of Publication: 07 Oct 2020. Author Kiblawi R.; Zoeller C.; Zanini A.; Ure B.M.; Dingemann J.; Kuebler J.F.; Schukfeh N. Institution (Kiblawi, Zoeller, Ure, Dingemann, Kuebler, Schukfeh) Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Strabetae 1, Hannover, Niedersachsen, Germany (Zanini) Department of Pediatric Surgery, University of Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa Publisher Georg Thieme Verlag Abstract Introduction The pros and cons of video-assisted thoracoscopic versus conventional thoracic surgery in infants and children are still under debate. We assessed reported advantages and disadvantages of video-assisted thoracoscopy in pediatric surgical procedures, as well as the evidence level of the available data. Materials and Methods A systematic literature search was performed to identify manuscripts comparing video-assisted thoracoscopic and the respective conventional thoracic approach in classic operative indications of pediatric surgery. Outcome parameters were analyzed and graded for level of evidence (according to the Oxford Centre of Evidence-Based Medicine). Results A total of 48 comparative studies reporting on 12,709 patients, 11 meta-analyses, and one pilot randomized controlled trial including 20 patients were identified. More than 15 different types of advantages for video-assisted thoracoscopic surgery were described, mostly with a level of evidence 3b or 3a. Most frequently video-assisted thoracoscopic surgery was associated with shorter hospital stay, shorter postoperative ventilation, and shorter time to chest drain removal. Mortality rate and severe complications did not differ between thoracoscopic and conventional thoracic pediatric surgery, except for congenital diaphragmatic hernia repair with a lower mortality and higher recurrence rate after thoracoscopic repair. The most frequently reported disadvantage for video-assisted thoracoscopic surgery was longer operative time. Conclusion The available data point toward improved recovery in pediatric video-assisted thoracoscopic surgery despite longer operative times. Further randomized controlled trials are needed to justify the widespread use of video assisted thoracoscopy in pediatric surgery.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <72> Accession Number 634475739 Title Perioperative Beta-Blocker for Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. 69(2) (pp 133-140), 2021. Date of Publication: 06 Apr 2020. Author Kim S.H.; Jang M.-J.; Hwang H.Y. Institution (Kim, Hwang) Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea (Jang) Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea Publisher Georg Thieme Verlag Abstract Background: This meta-analysis was conducted to evaluate the impact of perioperative use of beta-blocker (BB) on postoperative atrial fibrillation (POAF) after cardiac surgery other than isolated coronary artery bypass grafting (CABG). <br/>Method(s): Five online databases were searched. Studies were included if they (1) enrolled patients who underwent cardiac surgery other than isolated CABG and (2) demonstrated the impact of perioperative use of BB on POAF based on the randomized controlled trial or adjusted analysis. The primary outcome was the occurrence rates of POAF after cardiac surgery. A meta-regression and subgroup analysis were performed according to the proportion of patients with cardiac surgery other than isolated CABG and the timing of BB use, respectively. <br/>Result(s): Thirteen articles (5 randomized and 8 nonrandomized studies: n = 25,496) were selected. Proportion of enrolled patients undergoing cardiac surgery other than isolated CABG ranged from 7 to 100%. The BBs were used in preoperative, postoperative, and both periods in 5, 5, and 3 studies, respectively. The pooled analyses showed that the risk of POAF was significantly lower in patients with perioperative BB than those without (odds ratio, 95% confidence interval = 0.56, 0.35-0.91 and 0.70, 0.55-0.91 in randomized and nonrandomized studies, respectively). The risk of POAF was lower in the BB group irrespective of the proportion of nonisolated CABG. Benefit regarding in-hospital mortality was inconclusive. Perioperative stroke and length of stay were not significantly different between BB and non-BB groups. <br/>Conclusion(s): Perioperative use of BB is effective in preventing POAF even in patients undergoing cardiac surgery other than isolated CABG, although it did not translate into improved clinical outcomes.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <73> Accession Number 633716278 Title Comparison of Rocuronium and Vecuronium in Patients Undergoing Elective Ultrafast-Track Off-Pump Coronary Artery Bypass Surgery. Source Journal of Cardiac Critical Care. 3(2) (pp 68-76), 2019. Article Number: JCCC320001. Date of Publication: 15 Apr 2020. Author Shah K.S.; Kulshrestha A. Institution (Shah, Kulshrestha) Department of Anaesthesia, Breach Candy Hospital, Mumbai, Maharashtra, India Publisher Thieme Medical and Scientific Publishers Pvt Ltd Abstract Background Neuromuscular blocking drugs are necessary in cardiac surgery to facilitate smooth intubation and ventilation conditions, avoid patient movement, reduce oxygen consumption, and prevent shivering. Hemodynamic stability is very essential in cardiac surgery because the coronary reserve is below normal in such patients. Aims This study was conducted with the objective of comparing rocuronium, the near-ideal muscle relaxant with vecuronium, an already established neuromuscular blocking agent in patients undergoing elective ultrafast-track off-pump coronary artery bypass surgery (CABG). Settings and Design This prospective, randomized comparative study included 60 patients scheduled for elective off-pump CABG procedures under general anesthesia in the period between May 2015 and March 2016. Materials and Methods Patients were randomized in equal numbers to either the rocuronium group or the vecuronium group, and intubating conditions and various hemodynamic parameters were observed at different time points. Statistical Analysis Used Categorical variables were evaluated using the chi-square test, whereas the Student t -test or Mann-Whitney test were used for continuous variables. Results Pulse rate in the rocuronium group was lesser (79.97 +/- 7.42) (p < 0.05) at the time of intubation as compared with the vecuronium group (92.33 +/- 8.93). Systolic blood pressure was higher in the vecuronium group (150.70 +/- 14.05) at the time of intubation as compared with the rocuronium group (130.27 +/- 9.95) (p < 0.05). Intubating conditions, mean arterial pressure, and diastolic blood pressure changes were similar in both groups. Conclusions Rocuronium provides good-to-excellent intubating conditions and is devoid of any significant cardiovascular changes causing hemodynamic instability when compared with vecuronium in patients undergoing elective ultrafast-track off-pump CABG.<br/>Copyright © 2019 Thieme India. All rights reserved. <74> Accession Number 631460332 Title A Prospective Randomized Clinical Trial of Efficacy of Algorithm-Based Point of Care Guided Hemostatic Therapy in Cyanotic Congenital Heart Disease Surgical Patients. Source Journal of Cardiac Critical Care. 3(1) (pp 8-16), 2019. Date of Publication: 22 Oct 2019. Author Karanjkar A.; Kapoor P.M.; Sharan S.; Bhardwaj V.; Malik V.; Hasija S.; Choudhury A.; Chowdhury U.K.; Rajashekar P. Institution (Karanjkar, Kapoor, Sharan, Bhardwaj, Malik, Hasija, Choudhury) Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India (Chowdhury, Rajashekar) Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India (Kapoor) Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India Publisher Thieme Medical and Scientific Publishers Pvt Ltd Abstract Objective Point of care (POC) testing-based algorithm-guided hemostatic therapy has been used in adult as well as pediatric cardiac surgical patients to administer blood components. The authors hypothesized that implementation of POC-based algorithm in pediatric cyanotic congenital surgical patients would reduce the exposure to blood component therapy and improve the clinical outcome. Design Prospective randomized control trial. Setting Single-center academic institute. Participants One hundred seventy pediatric congenital cyanotic surgical patients. Intervention Implementation of POC and conventional tests-based algorithms. Measurements and Main Results Algorithm-based blood component therapy was administered in each group. There were no group differences regarding the demographic, clinical, and laboratory characteristics. Amount of packed red blood cells (PRBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate (primary outcomes) administered was significantly lower in POC group than that in the conventional group (p < 0.001). Among the secondary outcomes, the chest drain output at 6, 12, and 24 hours and number of re-explorations was comparable among both the groups. The duration of mechanical ventilation, duration of intensive care unit (ICU) stay, and hospital stay was significantly short in POC group (p = 0.008, <0.001 and 0.019, respectively). Conclusion Implementation of POC-based algorithm-guided hemostatic therapy reduced the exposure to blood and blood component therapy and was associated with reduced ICU and hospital stay in pediatric congenital cyanotic surgical patients.<br/>Copyright © 2020 Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU). <75> Accession Number 634277954 Title Use of Pericardium for Cardiac Reconstruction Procedures in Acquired Heart Diseases-A Comprehensive Review. Source Thoracic and Cardiovascular Surgeon. 69(1) (pp 83-91), 2021. Date of Publication: 11 Oct 2019. Author De Martino A.; Milano A.D.; Bortolotti U. Institution (De Martino, Bortolotti) Section of Cardiac Surgery, University Hospital, Pisa, Italy (Milano) Department of Cardiac Surgery, University of Bari Aldo Moro, Bari, Italy Publisher Georg Thieme Verlag Abstract Background: Reconstruction of cardiac structures has been the goal of many surgeons even before the advent of open-heart procedures with cardiopulmonary bypass. Unsatisfactory results with synthetic materials has switched the attention to biological tissues, among which pericardium, either autologous or of animal origin, has been widely used as patch material. <br/>Method(s): We have reviewed the literature to assess the effective role of pericardial tissue in the correction of various acquired cardiac lesions. Particularly, special attention was given not only to established techniques but also to detect any peculiar and unusual application of pericardium. <br/>Result(s): Autologous pericardium is frequently used as patch material particularly when limited valvular lesions must be corrected, while xenograft pericardium appears particularly useful in patients with endocarditis and extensive destruction of the intracardiac structures by infection and abscesses. Pericardium is an extremely versatile material owing to its pliability and strength; however, it tends to calcify in the long term when in contact with blood, although stability of the repair is maintained in most cases. <br/>Conclusion(s): Pericardium plays an important role in various cardiac and aortic pathologies. Tissues resistant to fibrosis and calcification to be used as patch material are the ideal solution for more successful cardiac reconstruction procedures and will hopefully be provided by the ongoing research.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <76> Accession Number 633388185 Title Does intraoperative diuretic therapy affect the thoracic fluid content and clinical outcome in patients undergoing mitral valve surgery?. Source Journal of Cardiac Critical Care. 4(2) (pp 86-90), 2020. Article Number: JCCC2080004. Date of Publication: 06 Nov 2020. Author Choudhury M.; Narula J.; Saini K.; Kapoor P.M.; Kiran U. Institution (Choudhury, Narula, Saini, Kapoor, Kiran) Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India Publisher Thieme Medical and Scientific Publishers Pvt Ltd Abstract Pulmonary congestion is inevitable in valvular heart disease. The condition worsens when a patient undergoes cardiopulmonary bypass (CPB). Thoracic fluid content (TFC) is an indicator of total volume status of lung in health and disease. We hypothesize that intraoperative diuretic therapy can improve the hemodynamic and clinical outcome in patients undergoing mitral valve surgery by decreasing TFC as measured by impedance cardiography (ICG). Sixty adult patients with critical mitral stenosis scheduled for mitral valve surgery divided into diuretic (Gr D, n = 30) and control (Gr C, n = 30) group. One mg/kg of furosemide was administered before CPB to Gr D and similar volume of normal saline to Gr C. Hemodynamic and TFC measurements were done by index of contractility (ICON), NICOM monitor at baseline, before anesthesia induction (T1), post skin closure (T2), postoperatively at 6th hour (T3), 24th hour (T4), and 48th hour (T5). The duration of mechanical ventilation (hour), intensive care unit stay (day) and inotropic score was significantly higher in Gr C (5.29 +/- 1.4 vs. 2.15 +/- 1.1; p = 0.001; 2.11 +/- 0.64 vs. 1.67 +/- 0.57, p = 0.002; 9 +/- 5.4 vs. 5.8 +/- 3.2, p = 0.05), respectively. Three patients in Gr C developed respiratory complication during their course of hospital stay. The baseline TFC value was comparable (p = 0.08). In Gr C. it gradually increased over time and never reached the baseline value, whereas in Gr D, there was slight increase in TFC till 6th postoperative hour and it came below the baseline value at 48th hour. A significantly higher TFC value in Gr C in comparison with Gr D from 6th to 48th postoperative hour (p = 0.005, 0.000, and 0.005, respectively) was observed. The ICON had a gradual improvement from 12th over 48th postoperative hour in Gr D in comparison to Gr C. The systemic vascular resistance index was decreased over time in Gr C, whereas in Gr D there was a mild fall at the end of surgery and it came back to near the baseline value at 48th postoperative hour. A continuous decrease in DO <inf>2</inf>I except at 6th postoperative hour was seen in Gr C, whereas it remained near the baseline value in Gr D. Linear regression analysis showed significant direct correlation of TFC with intraoperative fluid balance (r = 0.524, p = 0.001), cumulative fluid balance (r = 0.680, p = 0.000) and both peak and mean airway pressure (r = 0.436, p = 0.001 and r = 0.548, p = 0.001, respectively). We concluded that TFC is clearly influenced by intraoperative diuretic therapy. A decrease in TFC has an association with better hemodynamic parameters that could find interesting clinical applications in the decision, whether or not to include a diuretic as a routine therapy during intraoperative management in valve surgery patients.<br/>Copyright © 2020 Thieme India. All rights reserved. <77> Accession Number 627945846 Title Meta-analysis of valve-in-valve transcatheter versus redo surgical aortic valve replacement. Source Thoracic and Cardiovascular Surgeon. 67(4) (pp 243-250), 2019. Date of Publication: 16 Aug 2018. Author Takagi H.; Mitta S.; Ando T. Institution (Takagi, Mitta) Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, Japan (Ando) Department of Cardiology, Detroit Medical Center, Detroit, United States Publisher Georg Thieme Verlag Abstract Objective The objective of this study was to determine whether valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) is associated with better survival than redo surgical aortic valve replacement (SAVR) in patients with degenerated aortic valve bioprostheses, and we performed a meta-analysis of comparative studies. Methods To identify all comparative studies of VIV-TAVI versus redo SAVR; MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched through October 2017. For each study, data regarding all-cause mortality in both the VIV-TAVI and redo SAVR groups were used to generate odds ratios (ORs). To assess selection bias, we generated ORs and (standardized) mean differences (MDs) for baseline characteristics. Study-specific estimates were combined in the random-effects model. Results Of 446 potentially relevant articles screened initially, 6 reports of retrospective comparative studies enrolling a total of 498 patients were identified. Pooled analyses of baseline characteristics demonstrated no statistically significant differences in the proportion of women, patients with diabetes mellitus, patients with coronary artery disease, and patients with baseline New York Heart Association functional class of >=III; baseline ejection fraction; and predicted mortality between the VIV-TAVI and redo SAVR groups. Patients in the VIV-TAVI group, however, were significantly older (MD, 4.20 years) and had undergone prior coronary artery bypass grafting more frequently (OR, 2.19) than those in the redo SAVR group. Main pooled analyses demonstrated no statistically significant differences in early (30 days or in-hospital) (OR, 0.91; p = 0.83) and midterm (180 days-3 years) all-cause mortalities (OR, 1.42; p = 0.21) between the VIV-TAVI and redo SAVR groups. Conclusion In patients with degenerated aortic valve bioprostheses, especially elderly or high-risk patients, VIV-TAVI could be a safe, feasible alternative to redo SAVR. The lack of randomized data and differences in baseline characteristics in the present analysis emphasize the need for prospective randomized trials.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart * New York. <78> Accession Number 629559378 Title Impact of Prosthesis-Patient Mismatch on Survival after Mitral Valve Replacement: A Meta-analysis. Source Thoracic and Cardiovascular Surgeon. 67(7) (pp 538-545), 2019. Date of Publication: 09 Oct 2018. Author Hwang H.-Y.; Sohn S.-H.; Jang M.-J. Institution (Hwang, Sohn, Jang) Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, South Korea Publisher Georg Thieme Verlag Abstract Background: Numerous studies have demonstrated a negative impact of prosthesis-patient mismatch (PPM) on long-term clinical outcomes after aortic valve replacement. However, the impact of PPM after mitral valve replacement (MVR) on clinical outcomes is still controversial. This study was conducted to evaluate the impact of PPM on early and long-term survival after MVR. <br/>Method(s): A literature search of five databases was performed. The primary and secondary outcomes were all-cause mortality and early mortality, respectively. Subgroup analyses were performed according to the risk of bias, patients' age, proportion of female patients, and proportion of patients with mechanical MVR. <br/>Result(s): Eleven nonrandomized studies including 8,072 patients were included in this meta-analysis. The overall incidence of PPM was 58.0% (range: 10.4-85.9%). The odds ratio of early mortality in nine studies was not significantly different between the PPM and non-PPM patients (odds ratio: 1.35; 95% confidence interval [CI]: 0.98-1.86). A pooled analysis in 11 studies demonstrated that all-cause mortality after MVR was higher in the PPM than non-PPM patients (hazard ratio [HR]: 1.39; 95% CI: 1.09-1.77). This analysis revealed a moderate to high heterogeneity (I 2 = 69.4%). When pooled analyses were performed in two subgroups according to the proportion of patients with mechanical MVR, there were low heterogeneity in each group. No other subgroup analyses demonstrated a significant difference in the HR of all-cause mortality. Funnel plots and Egger's tests showed no visually and statistically significant publication bias. <br/>Conclusion(s): The present meta-analysis indicates that PPM negatively affects long-term survival after MVR.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart New York. <79> Accession Number 628228241 Title Cangrelor versus Ticagrelor in Patients Treated with Primary Percutaneous Coronary Intervention: Impact on Platelet Activity, Myocardial Microvascular Function and Infarct Size: A Randomized Controlled Trial. Source Thrombosis and Haemostasis. 119(7) (pp 1171-1181), 2019. Date of Publication: 26 May 2019. Author Ubaid S.; Ford T.J.; Berry C.; Murray H.M.; Wrigley B.; Khan N.; Thomas M.R.; Armesilla A.L.; Townend J.N.; Khogali S.S.; Munir S.; Martins J.; Hothi S.S.; McAlindon E.J.; Cotton J.M. Institution (Ubaid, Wrigley, Khan, Khogali, Munir, Martins, Hothi, McAlindon, Cotton) Heart and Lung Centre, New Cross Hospital, Wolverhampton, United Kingdom (Ford, Berry) Golden Jubilee National Hospital, Glasgow, United Kingdom (Ford, Berry) British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (Murray) Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom (Thomas) Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom (Armesilla, Cotton) School of Pharmacy, University of Wolverhampton, Wolverhampton, United Kingdom (Townend) Queen Elizabeth Hospital, Birmingham, United Kingdom Publisher Georg Thieme Verlag Abstract Background Oral P2Y12 inhibitors take more than 2 hours to achieve full effect in healthy subjects and this action is further delayed in patients with acute myocardial infarction. Intravenous P2Y12 inhibition might lead to more timely and potent anti-platelet effect in the context of emergency primary angioplasty, improving myocardial recovery. Objectives This article compares the efficacy of intravenous cangrelor versus ticagrelor in a ST-elevation myocardial infarction (STEMI) population treated with primary percutaneous coronary intervention (PPCI). Materials and Methods In an open-label, prospective, randomized controlled trial, 100 subjects with STEMI were assigned 1:1 to intravenous cangrelor or oral ticagrelor. The co-primary endpoints were platelet P2Y12 inhibition at infarct vessel balloon inflation time, 4 and 24 hours. Secondary endpoints included indices of coronary microcirculatory function: index of microvascular resistance (IMR), initial infarct size (troponin at 24 hours) and final infarct size at 12 weeks (cardiac magnetic resonance). Secondary endpoints included indices of coronary microcirculatory function (index of microvascular resistance [IMR]), initial infarct size (troponin at 24 hours), final infarct size at 12 weeks (cardiac magnetic resonance), corrected thrombolysis in myocardial infarction (TIMI) frame count, TIMI flow grade, myocardial perfusion grade, and ST-segment resolution (ClinicalTrials.gov NCT02733341). Results P2Y12 inhibition at first balloon inflation time was significantly greater in cangrelor-treated patients (cangrelor P2Y12 reaction unit [PRU] 145.2 +/- 50.6 vs. ticagrelor 248.3 +/- 55.1). There was no difference in mean PRU at 4 and 24 to 36 hours post-dosing. IMR, final infarct size, angiographic and electrocardiographic measures of reperfusion were all similar between groups. Conclusion Cangrelor produces more potent P2Y12 inhibition at the time of first coronary balloon inflation time compared with ticagrelor. Despite this enhanced P2Y12 inhibition, coronary microvascular function and final infarct size did not differ between groups.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart - New York. <80> Accession Number 636036098 Title Thoracic Paravertebral Block Ameliorates Postoperative Delirium in Geriatric Patients. Source Thoracic and Cardiovascular Surgeon. 70(5) (pp 439-444), 2022. Date of Publication: 14 Sep 2021. Author Heng L.; Wang M.; Li L.; Zhu S. Institution (Heng, Zhu) Department of Anesthesia, Xuzhou Cancer Hospital, Jiangsu Province, Xuzhou City, China (Wang) Department of Anesthesia, Xuzhou Maternity and Child Health Care Hospital, Jiangsu Province, Xuzhou City, China (Wang) Department of Anesthesia, The People's Hospital of Jiawang District of Xuzhou, Jiangsu Province, Xuzhou City, China (Li) Intensive Care Unit, Xuzhou No. 1 People's Hospital, College Road, Jiangsu Province, Xuzhou City, China Publisher Georg Thieme Verlag Abstract Objectives ?Thoracic surgery often causes postoperative delirium (POD) in geriatric patients. This study aimed to explore the effect of ultrasound-guided continuous thoracic paravertebral block (UG-TPVB) on POD in geriatric patients undergoing pulmonary resection. Methods ?Total 128 patients who underwent pulmonary resection were randomly allocated to either the conventional patient-controlled analgesia (PCA) group or the UG-TPVB group (n = 64 per group). The consumption of opioid agents (propofol and remifentanil), postoperative hospital stay, postoperative pulmonary atelectasis, postoperative nausea/vomiting, and postoperative itchiness were recorded. The diagnosis of delirium was dependent on the Nursing Delirium Screening Scale. The postoperative pain was assessed by visual analogue scale (VAS) score. The serum levels of interleukin (IL)-1beta, IL-6, and tumor necrosis factor-alpha were used to evaluate the postoperative neuroinflammation. Results ?The consumption of propofol and remifentanil, postoperative hospital stay, postoperative pulmonary atelectasis, postoperative nausea/vomiting, and postoperative itchiness in the UG-TPVB group were lower than that in the PCA group. Compared with the PCA group, the prevalence of POD was decreased in the UG-TPVB group. In addition, use of UG-TPVB not only reduced postoperative pain (VAS score) but also decreased postoperative neuroinflammation compared with PCA in geriatric patients undergoing pulmonary resection. Conclusions ?This study determined the benefits of UG-TPVB over PCA, providing an effectiveness approach to alleviate POD in geriatric patients undergoing pulmonary resection.<br/>Copyright © 2022 Georg Thieme Verlag. All rights reserved. <81> Accession Number 634475740 Title Preoperative Statin Therapy for Atrial Fibrillation and Renal Failure after Cardiac Surgery. Source Thoracic and Cardiovascular Surgeon. 69(2) (pp 141-147), 2021. Date of Publication: 07 Jun 2020. Author Kuhn E.W.; Liakopoulos O.J.; Choi Y.-H.; Rahmanian P.; Eghbalzadeh K.; Slottosch I.; Deppe A.C.; Wahlers T.C.W. Institution (Kuhn, Liakopoulos, Choi, Rahmanian, Eghbalzadeh, Slottosch, Deppe, Wahlers) Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany Publisher Georg Thieme Verlag Abstract Background: Performing cardiac surgery in patients with cardiovascular risk factors incorporates a steady risk for the development of postoperative complications. Perioperative statin intake was associated with an improvement of perioperative outcomes in these patients. However, the European Association for Cardio-Thoracic Surgery guidelines regarding the perioperative statin treatment were changed recently due to large studies reporting about relevant adverse effects related to statin therapy. <br/>Method(s): All relevant databases were searched including the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and the metaRegister of Controlled Trials. Various registries were screened (National Research Register, the ClinicalTrials.gov, and gray literature) with search on online conference indices of relevant scientific meetings. No language restrictions were applied. <br/>Result(s): We identified 10 randomized controlled studies summarizing 3,468 participants undergoing various kinds of cardiac surgical procedures. All included studies presented with marked differences regarding study design. Pooled analysis indicated that statin pretreatment was associated with a formally reduced incidence of postoperative atrial fibrillation (AF) (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.39-1.00; p = 0.05) but with an increased incidence of renal failure (OR 1.20, 95% CI 1.01-1.44; p = 0.04) compared with control. Substantial heterogeneity was observed among studies reporting about AF. <br/>Conclusion(s): Current but sparse evidence reveals that statin pretreatment is associated with a higher rate of postoperative renal failure compared with control therapy but is ineffective to substantially reduce postoperative AF. Given the relevant heterogeneity among included studies, statin pretreatment cannot be generally recommended.<br/>Copyright © 2021 Georg Thieme Verlag. All rights reserved. <82> Accession Number 625955735 Title Cardiogenic Necrotizing Enterocolitis: A Clinically Distinct Entity from Classical Necrotizing Enterocolitis. Source European Journal of Pediatric Surgery. 29(1) (pp 14-22), 2019. Date of Publication: 15 Aug 2018. Author Siano E.; Lauriti G.; Ceccanti S.; Zani A. Institution (Siano, Zani) Division of General and Thoracic Surgery, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada (Lauriti) Department of Pediatric Surgery, Spirito Santo Hospital, Pescara, G. d'Annunzio University, Chieti-Pescara, Italy (Ceccanti) Pediatric Surgery Unit, Sapienza University of Rome, Azienda Policlinico Umberto i, Rome, Italy (Zani) Department of Surgery, University of Toronto, Toronto, ON, Canada Publisher Georg Thieme Verlag Abstract Aim The main purpose of this study was to investigate if necrotizing enterocolitis (NEC) has a different presentation and outcome in patients with congenital heart defect (CHD) (cardiogenic NEC) from those without (classical NEC). Materials and Methods A systematic review of the literature on the characteristics of infants with NEC and CHD was performed by three independent investigators using a defined strategy (PubMed, Cochrane, Embase, and Web of Science). A meta-analysis was conducted on studies comparing NEC in infants with CHD and non-CHD infants using RevMan 5.3. Results Systematic review: Of 7,291 abstracts screened, 126 full-text articles were analyzed and 51 studies were included. NEC had an incidence of 5.1% in CHD infants (7,728/151,046, range 0-24%) and 0.8% in non-CHD infants (26,430/3,256,891, range 0.1-8.9%; p < 0.0001). In very low birth weight infants, NEC occurred in 6.3% of CHD patients (6,361/100,454pts) and in 8.9% of non-CHD (23,201/257,794pts; p < 0.0001). In CHD cases, NEC occurred before cardiac surgery in 48% cases and surgery for NEC was required in 31% infants (2,037/6,683). Meta-analysis: In eight comparative studies, the incidence of NEC was higher in CHD infants (6%, 768/13,145) than in infants with no CHD (0.9%, 32,625/3,354,323pts; p < 0.00001, odds ratio [OR] 1.84, 95% confidence interval [CI] 1.7-1.9). The overall mortality was higher in infants with CHD and NEC (38%, 243/640) than in those without CHD (27%, 6651/24810; p < 0.00001, OR 3.4, 95% CI 2.8-4.1). Conclusion This is the first evidence-based study showing that infants with cardiogenic NEC have different demographics and outcomes than those with classical NEC. The risk of developing NEC and the mortality rate are higher among infants with CHD than in those without. Conversely, the need for intestinal surgery is lower in babies with cardiogenic NEC than in those with classical NEC. Further studies are needed to establish preventative and management interventions that are specific to infants with or at risk of developing cardiogenic NEC.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart - New York. <83> Accession Number 620125977 Title Is 300 Seconds ACT Safe and Efficient during MiECC Procedures?. Source Thoracic and Cardiovascular Surgeon. 67(3) (pp 191-202), 2019. Date of Publication: 31 Dec 2017. Author Bauer A.; Hausmann H.; Schaarschmidt J.; Szlapka M.; Scharpenberg M.; Eberle T.; Hasenkam J.M. Institution (Bauer, Schaarschmidt) Department of Cardiovascular Perfusion, MediClin Heart Center Coswig, Lerchenfeld 1, Coswig, Saxony-Anhalt, Germany (Bauer, Hasenkam) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Bauer, Hasenkam) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Hausmann, Szlapka) Department of Cardiothoracic and Vascular Surgery, MediClin Heart Center Coswig, Coswig, Saxony-Anhalt, Germany (Scharpenberg) Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany (Eberle) Department of Anesthesia and Intensive Care Medicine, MediClin Heart Center Coswig, Coswig, Saxony-Anhalt, Germany Publisher Georg Thieme Verlag Abstract Introduction The recommended minimum activated clotting time (ACT) level for cardiopulmonary bypass (CPB) of 480 seconds originated from investigations with bubble oxygenators and uncoated extracorporeal circulation (ECC) systems. Modern minimal invasive ECC (MiECC) systems are completely closed circuits containing a membrane oxygenator and a tip-to-tip surface coating. We hypothesized that surface coating and the closed-loop design allow the MiECC to safely run with lower ACT levels and that an ACT level of 300 seconds can be safely applied without thromboembolic complications. The aim of this study was to investigate the potential risks during application of reduced heparin levels in patients undergoing coronary surgery. Methods In this study, 68 patients undergoing coronary artery bypass grafting with MiECC were randomized to either the study group with an ACT target of 300 seconds or the control group with an ACT of 450 seconds. All other factors of MiECC remained unchanged. Results The study group received significantly less heparin and protamine (heparin [international units] median [min-max], Red-AC: 32,800 [23,000-51,500] vs. Full-AC: 50,000 [35,000-65,000] p < 0.001; protamine [international units], Red-AC: 18,000 [10,000-35,000] vs. Full-AC: 30,000 [20,000-45,000] p < 0.001). The ACT in the study group was significantly lower at the start of MiECC (mean +/- standard deviation: study group 400 +/- 112 vs. control group 633 +/- 177; p < 0.0001). Before termination of CPB the ACT levels were: study group 344 +/- 60 versus control group 506 +/- 80. In both groups, the values of the endogenous thrombin potential (ETP) decreased simultaneously. None of the study participants experienced thromboembolic complications. Conclusion Since no evidence of increased thrombin formation (ETP) was found from a laboratory standpoint, we concluded that the use of MiECC with a reduced anticoagulation strategy seems possible. This alternative anticoagulation strategy leads to significant reduction in dosages of both heparin and protamine. We can confidently move forward with investigating this anticoagulation concept. However, to establish clinical safety of ACT below 300 seconds, we need larger clinical studies.<br/>Copyright © 2019 Georg Thieme Verlag KG Stuttgart. New York. <84> Accession Number 2048854498 Title Off-Pump CABG With and Without Sternotomy: A Meta-Analysis of Comparative Studies. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 3088217. Date of Publication: 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Publisher John Wiley and Sons Inc Abstract Objectives: Minimally invasive coronary artery bypass grafting (MICS-CABG) has emerged as a less invasive alternative to conventional off-pump CABG (OPCAB), but direct comparative evidence remains limited. This meta-analysis synthesizes outcomes from randomized controlled trials (RCTs) and propensity-adjusted observational studies comparing these two off-pump strategies. <br/>Method(s): A comprehensive literature search was conducted according to PRISMA 2020. Eligible studies compared MICS-CABG and sternotomy OPCAB under strictly off-pump conditions. Quantitative synthesis was limited to RCTs and cohort studies using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW) to reduce confounding. Random-effects meta-analyses accounted for clinical and methodological heterogeneity. <br/>Result(s): Twelve of 40 eligible studies were included in the meta-analysis, comprising 3 RCTs, 1 IPTW cohort study, and 8 PSM cohort studies. Although the primary analysis suggested lower postoperative mortality (OR 0.54, 95% CI 0.38-0.77), this finding was not consistently supported across complementary analyses. Exclusion of the largest IPTW study reversed the direction of the pooled estimate (OR 1.34), and no significant mortality difference was observed in the multivessel subgroup (OR 1.55). In the subgroup analysis restricted to patients with multivessel disease, no statistically significant difference in mortality was observed (OR 1.55). MICS-CABG was consistently associated with longer operative time but shorter length of hospital stay, although substantial heterogeneity was observed. <br/>Conclusion(s): In comparisons restricted to off-pump strategies, MICS-CABG was associated with shorter hospital stay but longer operative time, without consistent differences in major adverse cardiovascular and cerebrovascular events. The apparent mortality benefit observed in the primary analysis was not consistently supported across complementary analyses. Sternotomy OPCAB remains a robust standard strategy, whereas MICS-CABG may represent a less invasive alternative for selected patients.<br/>Copyright © 2026 Shotaro Yoshida et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <85> Accession Number 2038548360 Title A randomised trial of carbon dioxide flushing to reduce vascular brain injury in patients undergoing TAVI. Source EuroIntervention. 22(16) (pp 883-890), 2026. Date of Publication: 17 Aug 2026. Author Khawaja S.A.; Hanna L.; Singh A.; Lucarelli C.; Garg P.; Malik I.; Hadjiloizou N.; Ruparelia N.; Hartley A.; Khamis R.; Shin M.S.; Gibbs R.; Mikhail G.W. Institution (Khawaja, Hanna, Singh, Lucarelli, Garg, Malik, Hadjiloizou, Ruparelia, Hartley, Khamis, Shin, Gibbs, Mikhail) Imperial College Healthcare NHS Trust, London, United Kingdom (Khawaja, Hanna, Lucarelli, Khamis, Gibbs, Mikhail) Imperial College London, London, United Kingdom Publisher Europa Group Abstract BACKGROUND: Stroke remains a significant concern in patients undergoing transcatheter aortic valve implantation (TAVI). Despite advances in TAVI technology and techniques, stroke rates have remained unchanged, with trials of cerebral embolic protection devices failing to reduce rates. The concept of air emboli has not been previously investigated in TAVI procedures. We hypothesised that gaseous emboli could play a significant role in TAVI and that carbon dioxide (CO<inf>2</inf>) flushing of the TAVI valves could reduce the incidence of new neurological lesions post-TAVI. AIMS: We aimed to demonstrate the neuroprotective benefits of CO<inf>2</inf> flushing in TAVI patients. <br/>METHOD(S): INTERCEPTavi is a single-centre, blinded, randomised controlled pilot trial that studied the effects of flushing TAVI valves with CO<inf>2</inf> versus conventional saline on neurological outcomes post-TAVI, assessed using magnetic resonance imaging (MRI) and transcranial Doppler (TCD). Patients with aortic stenosis were randomised after obtaining vascular access. Periprocedural TCD assessed solid and gaseous emboli to the brain. Post-procedure, patients underwent brain MRI to detect lesions. Here, we report the primary outcome of feasibility, as well as the secondary MRI and mechanistic TCD outcomes. <br/>RESULT(S): A total of 60 patients were recruited and randomised 1:1 to CO<inf>2</inf> and saline flushing (TAVI-CO<inf>2</inf>) versus saline flushing only (TAVI-S). CO<inf>2</inf> flushing significantly reduced the average number of lesions per patient (TAVI-CO<inf>2</inf>: 4 lesions/patient vs TAVI-S: 8.5 lesions/patient; p=0.031). The total infarct area was numerically lower in the TAVI-CO<inf>2</inf> group (40.32 mm2 vs 93.20 mm2), although this did not reach statistical significance (p=0.111). Similarly, TCD showed fewer microembolic signals in the TAVI-CO<inf>2</inf> arm, primarily due to a reduction in gaseous emboli, but this difference was not statistically significant (p=0.5). <br/>CONCLUSION(S): INTERCEPTavi is a pioneering, first-in-human randomised trial that demonstrated that CO<inf>2</inf> flushing of the TAVI valve reduces the number of cerebral lesions measured on MRI. CO<inf>2</inf> flushing is an accessible, costeffective method that can be easily implemented in any catheter laboratory to provide neurological advantages.<br/>Copyright © 2026, Europa Group. All rights reserved. <86> Accession Number 2048901799 Title Pooled Efficacy and Safety of Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants or Antiplatelets: A Meta-Analysis of the Landmark Randomized Trials. Source Journal of Cardiovascular Electrophysiology. 37(9) (pp 2122-2123), 2026. Date of Publication: 01 Sep 2026. Author Knijnik L.M.; Rao B.; DeLurgio D.B. Institution (Knijnik, Rao, DeLurgio) Emory University, Atlanta, GA, United States Publisher John Wiley and Sons Inc Abstract Background: Landmark randomized controlled trials (RCTs) comparing left atrial appendage occlusion (LAAO) against direct oral anticoagulants (DOACs) are individually underpowered for small but clinically meaningful differences. We performed a pooled meta-analysis to provide more precise efficacy and safety data. <br/>Method(s): Utilizing random-effects models, we pooled data from 5890 patients across four landmark RCTs (PRAGUE-17, CLOSURE-AF, OPTION, and CHAMPION-AF) at their longest follow-up. <br/>Result(s): There were no significant differences between LAAO and antithrombotics in cardiovascular mortality (5.3% vs. 4.8%, p = 0.33), all-cause stroke (3.3% vs. 2.8%, p = 0.31), systemic embolism (0.2% vs. 0.1%, p = 0.68), or major bleeding (6.6% vs. 6.8%, p = 0.85). Non-procedural bleeding was significantly lower with LAAO (9.2% vs. 16.7%; RR 0.55; 95% CI 0.47-0.64; p < 0.0001), though there was a numerical trend toward more ischemic stroke events (2.7% vs. 2.0%; RR 1.35; 95% CI 0.97-1.88; p = 0.08). <br/>Conclusion(s): LAAO offers similar overall efficacy and safety to modern antithrombotics. It represents a clinical trade-off: accepting a known upfront procedural risk for a robust, long-term reduction in non-procedural bleeding, potentially at the cost of a slight numerical increase in ischemic stroke.<br/>Copyright © 2026 Wiley Periodicals LLC. <87> Accession Number 2048815422 Title Clinical maturity of 3D printing and bioprinting technologies: A systematic analysis of clinical trials across medical applications. Source International Journal of Bioprinting. 12(4) (no pagination), 2026. Article Number: 026190175. Date of Publication: 28 Aug 2026. Author Alvarez-Lorenzo C.; Perez-Mananes R.; Vallet-Regi M. Institution (Alvarez-Lorenzo) Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma Group (GI-1645), Faculty of Pharmacy, Faculty of Pharmacy, Institute of Materials (iMATUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain (Perez-Mananes) Department of Orthopaedic Surgery and Traumatology, Musculoskeletal Tumour Unit, CSUR Sarcomas, Advanced Planning and 3D Manufacturing Unit, Gregorio Maranon General University Hospital, Madrid, Spain (Perez-Mananes) Gregorio Maranon Health Research Institute, Madrid, Spain (Perez-Mananes) Department of Surgery, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain (Vallet-Regi) Department of Chemistry in Pharmaceutical Sciences, School of Pharmacy, Institute for Health Research Hospital 12 de Octubre (i+12), Complutense University of Madrid, Madrid, Spain Publisher AccScience Publishing Abstract Three-dimensional (3D) printing and bioprinting technologies are increasingly being integrated into clinical research and healthcare, enabling the development of patient-specific medical devices, anatomical models, and bioengineered constructs. This study analyzed registered clinical trials in ClinicalTrials.gov to characterize the current clinical landscape and relative degree of clinical maturity of medical 3D printing and bioprinting technologies across different application domains. Search terms included 3D printing, bioprinting, additive manufacturing, patient-specific devices, surgical guides, scaffolds, and biofabrication. Eligible studies involved human subjects and clinical applications related to diagnosis, treatment, surgical planning, or rehabilitation. The identified trials (ca. 700) were categorized into four main domains: patient-specific anatomical models, disease models, orthoses and assistive devices, and implantable prostheses and regenerative scaffolds. Anatomical models represent the most extensively translated application, with widespread use in surgical planning, procedural simulation, and patient communication across multiple specialties. Orthoses and assistive devices also account for a substantial proportion of studies, reflecting the growing adoption of digital workflows for personalized rehabilitation solutions. Implantable prostheses and scaffolds constitute a rapidly expanding area, particularly in orthopedics and maxillofacial surgery, where customization improves anatomical fit and functional outcomes. In contrast, bioprinting-based disease models and regenerative constructs remain limited to early-stage clinical investigations. Overall, the distribution and design of clinical trials reveal a gradient of translational development, with mechanically driven applications showing broader clinical adoption than biologically complex systems. Continued advances in materials, manufacturing processes, and regulatory frameworks will be critical to support large-scale clinical validation and broader implementation of these technologies in personalized and regenerative medicine.<br/>Copyright: © 2026 Author(s). This is an Open-Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ <88> [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. 42(10) (no pagination), 2026. Date of Publication: 01 Oct 2026. Author Habeeb R.M.; Sultan W.A.; Basune M.E.; Safan A.G. Institution (Habeeb) Anesthesia and Intensive Care Department, Faculty of Medicine, Menoufia University Abstract OBJECTIVES: To compare postoperative analgesia using continuous ultrasound-guided erector spinae plane block (ESPB) versus thoracic paravertebral block (TPVB), with dynamic visual analog 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, postanesthesia care unit stay, time to first ambulation, and patient satisfaction. <br/>METHOD(S): The study included 40 cases scheduled for elective thoracotomy admitted to the cardiothoracic surgery unit of Menoufia University Hospital. Patients were equally randomized into 2 groups, 20 patients each receiving either ultrasound-guided ESPB or 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. <br/>RESULT(S): Dynamic visual analogue pain 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. <br/>DISCUSSION(S): The utilization of continuous ultrasound-guided ESPB demonstrated better postoperative visual analogue pain scale scores and a significant decrease in opioid consumption, with fewer side effects than TPVB.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <89> Accession Number 2048847085 Title "Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Source Journal of Cardiovascular Electrophysiology. 37(9) (pp 2097-2111), 2026. Date of Publication: 01 Sep 2026. Author Al-Janabi A.A.H.; Al-Shammari A.S.; Hageen A.W.; Al-Tuaama A.Z.H.; Al-Ibraheem A.M.T.; Shahzaib M.; Rathi D.; Hamzah K.A.; shweliya M.A.; Kurmasha Y.H.; Wagdy M.; Refaat M.M. Institution (Al-Janabi, Al-Ibraheem, Hamzah) Department of Internal Medicine, ALkindy college of medicine/University of Baghdad, Baghdad, Iraq (Al-Shammari, shweliya) Department of Internal Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq (Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt (Al-Tuaama) Department of Internal Medicine, Privolzhsky Research Medical University, Novgorod, Nizhny, Russian Federation (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Rathi) Dow University of Health Sciences, Karachi, Pakistan (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Wagdy) Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt (Refaat) Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Publisher John Wiley and Sons Inc Abstract We aim to compare the impact of left atrial appendage closure vs. medical therapy on clinical outcomes in patients with atrial fibrillation, focusing on key clinical outcomes relevant to thromboembolic prevention. We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing LAAC with medical therapy in AF adults. PubMed, Embase, Scopus, ClinicalTrial. gov, and Cochrane Library were searched from inception to March 2026. Outcomes included all-cause mortality, any stroke, ischemic stroke, hemorrhagic stroke, major bleeding, systemic embolism and cardiac death. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Reconstructed individual patient-level survival data from published Kaplan-Meier curves were used for time-to-event analyses. Trial sequential analysis (TSA) assessed the conclusiveness of cumulative evidence. Six randomized controlled trials involving 7004 patients were included. LAAC demonstrated comparable outcomes to medical therapy for all-cause mortality, any stroke, major bleeding, systemic embolism, and cardiac death. There was a non-significant trend toward increased ischemic stroke and reduced hemorrhagic stroke with LAAC. Reconstructed time-to-event analyses showed similar cumulative incidence of stroke and bleeding outcomes over follow-up. TSA demonstrated that the required information size was not reached for any major endpoint, indicating that current evidence remains underpowered and additional randomized trials are needed. LAAC provides similar overall efficacy and safety compared with medical therapy for stroke prevention in AF but should currently remain reserved for selected patients rather than replacing oral anticoagulation broadly. Further adequately powered trials with longer follow-up are required.<br/>Copyright © 2026 Wiley Periodicals LLC. <90> Accession Number 2048747112 Title Letter by Wang and Wang Regarding Article, "Cardiac Allograft Vasculopathy Inhibition With Alirocumab: The CAVIAR Trial". Source Circulation. 154(5) (pp e185-e186), 2026. Date of Publication: 04 Aug 2026. Author Wang C.; Wang H. Institution (Wang, Wang) Department of Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China Publisher Lippincott Williams and Wilkins <91> Accession Number 2048131756 Title Epigenetics, inflammation and postoperative complications: a scoping review. Source British Journal of Anaesthesia. 137(4) (pp 1017-1031), 2026. Date of Publication: 01 Oct 2026. Author Wilson R.; Fern C.; Woolcock K.; Goodyear C.; Shelley B. Institution (Wilson, Fern, Shelley) Anaesthesia, Perioperative Medicine and Critical Care Research Group, School of Medicine, Scotland, Glasgow, United Kingdom (Wilson, Woolcock, Goodyear) School of Infection and Immunity, University of Glasgow, Scotland, Glasgow, United Kingdom (Wilson, Shelley) Department of Anaesthesia, Golden Jubilee National Hospital, Scotland, Clydebank, United Kingdom Publisher Elsevier Ltd Abstract Background: Excessive postoperative inflammation is associated with multisystem complications after surgery, culminating in morbidity, mortality and increased healthcare costs. Epigenetic modifications regulate gene transcription without altering DNA sequences and can augment powerful inflammatory responses. Translational studies have emerged, investigating how epigenetic mechanisms influence perioperative inflammation and complications. This scoping review consolidates studies in this expanding field and provides informed recommendations for future research. <br/>Method(s): The protocol for this scoping review was created using best-practice guidelines and was prospectively registered and published. Searches were conducted using Medline and Embase and included studies published in English between 1946 and 2025. Two reviewers independently screened titles and abstracts, then full texts of studies before data extraction. Included studies investigated postoperative complications alongside epigenetic mechanisms and inflammation. <br/>Result(s): Studies (n=15 451) were assessed for title and abstract screening, and 26 articles were included in the review. Included studies were published between 2016 and 2025. Cardiac surgery was investigated most often, followed by general and colorectal surgery. Several surgical specialities were not represented. Most studies investigated microRNA mechanisms, investigating either a small number of microRNAs (<=8) or using whole transcriptome approaches. DNA methylation and histone modifications were investigated less commonly. Complications were variably defined in the included studies, and most studies focused on a small number of complications. Inflammation was heterogeneously assessed, with most studies using C-reactive protein and interleukin-6 or both, whereas other studies used broader proteomic approaches to quantify inflammation. <br/>Conclusion(s): DNA methylation and histone modifications are less researched epigenetic mechanisms in perioperative inflammation. Future studies should recruit patients with homogeneous surgical insults. Studies should use standard measures of inflammation to enhance generalisability, whereas experimental approaches (including transcriptomics and proteomics) could advance mechanistic understanding in exploratory studies. Future research would benefit from consistent use of validated definitions of postoperative complications to enable comparison between studies.<br/>Copyright © 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <92> Accession Number 2045345892 Title Efficacy of Surgeon-Administered Regional Anesthesia in Cardiac Surgery: A Double-Blinded, 2-Center, Randomized, Placebo-Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2800-2807), 2026. Date of Publication: 01 Sep 2026. Author Rasmussen J.J.; Bisgaard J.; Honge J.L.; Sperling P.K.; Simonsen C.; Juhl-Olsen P.; Modrau I.S. Institution (Rasmussen, Honge, Juhl-Olsen, Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Bisgaard, Sperling) Department of Anesthesiology, Aalborg University Hospital, Aalborg, Denmark (Bisgaard) Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (Simonsen) Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark (Juhl-Olsen, Modrau) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Publisher W.B. Saunders Abstract Objectives: Managing pain after median sternotomy is a clinical challenge of balancing adequate pain relief with avoidance of excessive opioid consumption. While regional anesthesia techniques are increasingly recommended and applied in cardiac surgery, evidence of sustained postoperative benefit remains limited and heterogeneous. The authors aimed to evaluate the efficacy and safety of long-acting regional infiltration anesthesia in patients undergoing coronary artery bypass grafting. <br/>Design(s): The trial was conducted as a double-blinded, placebo-controlled trial in which participants were randomized 1:1 to intervention or placebo. <br/>Setting(s): Cardiothoracic departments at 2 Danish university hospitals. <br/>Participant(s): Patients undergoing non-emergent coronary artery bypass grafting. <br/>Intervention(s): Participants were allocated to receive surgeon-administered intraoperative infiltration of the sternum and chest wall with either 62.5 mL of bupivacaine with epinephrine, clonidine, and dexamethasone or an equivalent volume of isotonic saline solution as placebo. <br/>Measurements and Main Results: The primary endpoint was total opioid consumption within the first 24 postoperative hours. Secondary endpoints included patient-reported postoperative pain, as well as measures of recovery, respiratory impact, and chronic opioid use. A total of 113 patients were randomized, with 100 patients completing the trial and being included in the final analysis. No difference in opioid consumption was observed between the two groups. The median oral morphine equivalents were 62.3 mg (interquartile range, 70.8 mg) in the active intervention group and 64.0 mg (interquartile range, 46.8 mg) in the placebo group (p = 0.649). None of the secondary or safety endpoints showed significant differences. <br/>Conclusion(s): In this double-blind, randomized trial, surgeon-administered regional anesthesia did not reduce opioid consumption or provide additional clinical benefits following median sternotomy.<br/>Copyright © 2026 The Authors <93> Accession Number 2026748415 Title Impact of Complete Revascularization in the ISCHEMIA Trial. Source Journal of the American College of Cardiology. 82(12) (pp 1175-1188), 2023. Date of Publication: 19 Sep 2023. Author Stone G.W.; Ali Z.A.; O'Brien S.M.; Rhodes G.; Genereux P.; Bangalore S.; Mavromatis K.; Horst J.; Dressler O.; Poh K.K.; Nath R.K.; Moorthy N.; Witkowski A.; Dwivedi S.K.; Bockeria O.; Chen J.; Smanio P.E.P.; Picard M.H.; Chaitman B.R.; Berman D.S.; Shaw L.J.; Boden W.E.; White H.D.; Fremes S.E.; Rosenberg Y.; Reynolds H.R.; Spertus J.A.; Hochman J.S.; Maron D.J.; Harrington R.; Williams D.; Alexander K.P.; Berger J.; Mark D.; Ballantyne C.; Beyar R.; Bhargava B.; Buller C.; Carvalho A.T.; Diaz R.; Doerr R.; Dzavik V.; Goodman S.; Gosselin G.; Hachamovitch R.; Hamm C.; Held C.; Helm M.; Huber K.; Jiang L.; Keltai M.; Kohsaka S.; Lang I.; Lopes R.; Lopez-Sendon J.; Maggioni A.; Mancini J.; Bairey Merz C.N.; Min J.; Peterson E.; Ruzyllo W.; Selvanayagam J.; Senior R.; Sharir T.; Steg G.; Szwed H.; Van de Werf F.; Weintraub W.; White H.; Calfas K.; Champagne M.A.; Davidson M.; Fleg J.; McCullough P.A.; Newman J.; Stone P.; Menasche P.; Fremes S.; Guyton R.; Mack M.; Mohr F.; Rao A.; Sabik J.; Shapira O.; Taggart D.; Tatoulis J.; Blankenship J.; Brener S.; Colombo A.; de Bruyne B.; Kereiakes D.; Lefevre T.; Moses J.; Mahaffey K.; Cruz-Flores S.; Danchin N.; Feen E.; Garcia M.J.; Hauptman P.; Laddu A.A.; Passamani E.; Pina I.L.; Simoons M.; Skali H.; Thygesen K.; Waters D.; Endsley P.; Esposito G.; Kanters J.; Pownall J.; Stournaras D.; Friedrich M.; Kwong R.; Oliver D.; Harrell F.; Blume J.; Lee K.; Kullo I.; McManus B.; Newby K.; Cohen D.; Bugiardini R.; Celutkiene J.; Escobedo J.; Hoye A.; Lyubarova R.; Mattina D.; Peteiro J.; Smanio P.; Berman D.; Leipsic J.; Mathew R.; Sidhu M.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Gibson C.M.; Lamas G.; Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.; Kirby R.; Jeffries N.; Denaro J.E.; Mavromichalis S.; Chan K.; Cobb G.; Contreras A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.; Naumova A.; Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison C.; Hogan I.; Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.; Lang B.; Mohamed S.; Esquenazi-Karonika S.; Mathews P.; Setang V.; Xavier M.; Bagai A.; Broderick S.; Crowder M.; Cyr D.; Garg J.; Gu X.; Hatch L.; Heath A.; Huang Z.; Leimberger J.; Marcus J.; Page C.; Parker W.; Pennachi W.; Rockhold F.; Stevens S.; Stone A.; Thompson O.; Ussery S.; White J.; Williams M.K.; Xing W.; Zhu S.; Anstrom K.; Baloch K.; Blount J.; Cowper P.; Davidson-Ray L.; Drew L.; Harding T.; Knight J.D.; Minshall Liu D.; O'Neal B.; Redick T.; Jones P.; Nugent K.; Jingyan Wang G.; Phillips L.; Goyal A.; Hetrick H.; Hayes S.W.; Friedman J.D.; Gerlach R.J.; Hyun M.; Miranda-Peats R.; Slomka P.; Thomson L.; Mongeon F.P.; Michael S.; Hung J.; Scherrer-Crosbie M.; Zeng X.; Eckstein J.; Guruge B.; Streif M.; Alfonso M.A.; Corral M.P.; Garcia J.J.; Jankovic I.; Konigstein M.; Lustre M.B.; Peralta Y.; Sanchez R.; Arsanjani R.; Budoff M.; Elmore K.; Gomez M.; Hague C.; Hindoyan N.; Mancini G.J.; Nakanishi R.; Srichai-Parsia M.B.; Yeoh E.; Youn T.; Maggioni A.P.; Bianchini F.; Ceseri M.; Lorimer A.; Magnoni M.; Orso F.; Sarti L.; Tricoli M.; Carvalho A.; Barbosa L.M.; Bello Duarte T.; Colaiacovo Soares T.; de Aveiro Morata J.; Carvalho P.; de Carvalho Maffei N.; Egydio F.; Kawakami A.; Oliveira J.; Restelli Piloto E.; Pozzibon J.; Camara D.; Mowafy N.; Spindler C.; Dai H.; Feng F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.; Zhang J.; Zhang L.; Zhang N.; Zhong H.; Escobar C.; Martin M.E.; Pascual A.; Moraga P.; Hernandez V.; Castro A.; Posada M.; Fernandez S.; Narro Villanueva J.L.; Selgas R.; Abergel H.; Juliard J.M.; Alsweiler C.; Claes K.; Goetschalckx K.; Luyten A.; Robesyn V.; Murphy D.; Garcevic N.; Stojkovic J.; Ahmed A.; Bhatt R.; Chadha N.; Kumar V.; Lubna S.; Naik P.; Pandey S.; Ramasamy K.; Saleem M.; Sharma P.; Siddaram H. Institution (Stone, Shaw) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Ali) St Francis Hospital, Roslyn, NY, United States (Ali, Horst, Dressler) Cardiovascular Research Foundation, New York, NY, United States (O'Brien, Rhodes) Duke Clinical Research Institute, Durham, NC, United States (Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, United States (Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, New York, NY, United States (Mavromatis) Emory University School of Medicine, Atlanta, GA, United States (Poh) National University Heart Center Singapore and the Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Nath) Dr Ram Manohar Lohia Hospital, New Delhi, India (Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research, Karnataka, Bangalore-Karnataka, India (Witkowski) National Institute of Cardiology, Warsaw, Poland (Dwivedi) King George Medical University, Lucknow Up, India (Bockeria) National Research Center for Cardiovascular Surgery, Moscow, Russian Federation (Chen) Guangdong Provincial People's Hospital, Guangdong, China (Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e Saude, Sao Paulo, Brazil (Picard) Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States (Chaitman) St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St Louis, MO, United States (Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States (Boden) Boston University School of Medicine, Boston, MA, United States (White) Auckland City Hospital Green Lane Cardiovascular Services and University of Auckland, Auckland, New Zealand (Fremes) University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Rosenberg) National Heart, Lung, and Blood Institute, Washington, DC, United States (Spertus) Saint Luke's Mid America Heart Institute and the University of Missouri, Kansas City, Kansas City, MO, United States (Maron) Department of Medicine, Stanford School of Medicine, Stanford, CA, United States Publisher Elsevier Inc. Abstract Background: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients undergoing an invasive (INV) compared with a conservative (CON) management strategy has not been reported. <br/>Objective(s): Among patients with chronic coronary disease without prior coronary artery bypass grafting randomized to INV vs CON management in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, we examined the following: 1) the outcomes of ACR and FCR compared with incomplete revascularization; and 2) the potential impact of achieving CR in all INV patients compared with CON management. <br/>Method(s): ACR and FCR in the INV group were assessed at an independent core laboratory. Multivariable-adjusted outcomes of CR were examined in INV patients. Inverse probability weighted modeling was then performed to estimate the treatment effect had CR been achieved in all INV patients compared with CON management. <br/>Result(s): ACR and FCR were achieved in 43.4% and 58.4% of 1,824 INV patients. ACR was associated with reduced 4-year rates of cardiovascular death or MI compared with incomplete revascularization. By inverse probability weighted modeling, ACR in all 2,296 INV patients compared with 2,498 CON patients was associated with a lower 4-year rate of cardiovascular death or MI (difference -3.5; 95% CI: -7.2% to 0.0%). In comparison, the event rate difference of cardiovascular death or MI for INV minus CON in the overall ISCHEMIA trial was -2.4%. Results were similar but less pronounced with FCR. <br/>Conclusion(s): The outcomes of an INV strategy may be improved if CR (especially ACR) is achieved. (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches [ISCHEMIA]; NCT01471522)<br/>Copyright © 2023 American College of Cardiology Foundation <94> Accession Number 2047594957 Title Artificial Intelligence for Predicting Perioperative Outcomes in Cardiac Surgery: A Systematic Review. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 21(3) (pp 210-216), 2026. Date of Publication: 01 May 2026. Author Ha J.; Vohra H.A. Institution (Ha, Vohra) University of Bristol, United Kingdom Publisher SAGE Publications Ltd Abstract Objective: Cardiac surgery carries a significant risk of complications and mortality. Artificial intelligence (AI), particularly machine learning (ML), is increasingly being explored to enhance perioperative risk prediction and support clinical decision-making. This systematic review evaluates the clinical applications, predictive performance, and limitations of AI models in cardiac surgery. <br/>Method(s): PubMed and Embase were searched for studies published between January 2020 and July 2025. Of 939 records identified, 178 studies met the inclusion criteria following screening and full-text review. Included studies applied AI to predict clinical outcomes in patients undergoing cardiac surgery. Key outcomes assessed were model performance metrics and their clinical utility. <br/>Result(s): Among the 178 included studies, 114 (64%) were conducted in the United States or China. Most studies (n = 168, 94%) used retrospective designs and focused on adult populations. Random forest (n = 82, 46%), logistic regression (n = 82, 46%), and eXtreme Gradient Boosting (n = 70, 39%) were the most frequently used algorithms. AI applications primarily targeted the prediction of postoperative complications (n = 102, 57%) and mortality (n = 70, 39%), with common outcomes including acute kidney injury and stroke. ML models consistently outperformed traditional clinical risk scores (n = 39). SHapley Additive exPlanations was the most common interpretability method (n = 66, 37%). Only 26% of studies included external validation, and just 19% adhered to TRIPOD guidelines. <br/>Conclusion(s): AI models demonstrate superior predictive performance in cardiac surgery compared with traditional risk scores, but concerns regarding validation, transparency, and generalizability must be addressed to enable implementation.<br/>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). <95> Accession Number 2046095918 Title Randomized trial of tricuspid flexible band versus rigid ring in patients with moderate tricuspid regurgitation or greater: results of the JPH2019 trial. Source Journal of Thoracic and Cardiovascular Surgery. 172(3) (pp 547-555.e10), 2026. Date of Publication: 01 Sep 2026. Author Xu X.; Gu J.; Liu H.; Du J.; Gu W.; Ni B.; Shao Y. Institution (Xu, Gu, Liu, Du, Gu, Ni, Shao) Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, Nanjing, China Publisher Elsevier Inc. Abstract Objective: To compare the efficacy and clinical outcomes of flexible band versus rigid ring annuloplasty for the correction of moderate tricuspid regurgitation (TR) or greater. <br/>Method(s): In this single-center randomized trial, adult patients with moderate or greater TR were assigned to receive either a flexible band or a rigid ring. The primary outcome was recurrent TR during follow-up. Secondary outcomes included death, permanent pacemaker implantation, and other adverse events. <br/>Result(s): In total, 400 patients were randomized with a 1:1 ratio, and 321 were included in the final analysis (flexible band, n = 156; rigid ring, n = 165). Baseline characteristics were balanced between arms. At discharge, recurrent TR was significantly greater in the flexible band arm than the rigid ring arm (10.1% vs 3.8%, P =. 03). However, the significance was no longer significant during follow-up (6.1%/patient-years vs 4.7%/ patient-years, P =. 21). Multivariable analysis identified female sex (subdistribution hazard ratio [sHR], 2.16, 95% CI, 1.1-4.22, P =. 025), preoperative severe TR (sHR, 2.09; 95% CI, 1.06-4.11, P =. 033) and massive TR (sHR, 4.63; 95% CI, 1.29-16.61, P =. 019), and preoperative permanent pacemaker implantation (sHR, 3.69; 95% CI, 1.35-10.09, P =. 011) as independent risk factors for recurrent TR. Subgroup analyses based on these factors showed no significant between-arm difference in the primary outcome. secondary outcomes were also comparable between the arms during follow-up. <br/>Conclusion(s): Both annuloplasty devices provided acceptable TR correction with similar adverse event rates over a median 3-year follow-up.<br/>Copyright © 2026 The American Association for Thoracic Surgery <96> Accession Number 2048939471 Title Robot-assisted versus manual percutaneous vascular interventions across vascular territories: a systematic review and meta-analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 964. Date of Publication: 01 Dec 2026. Author Wu X.; Guo S.; Zhang Y.; Zhang X.; Li Y.; Lin X.; Cui S.; Xing Z.; Zhang L.; Li X.; Sun Y.; Luo J.; Qin M.; Jiao L.; Liu S.; Wang T. Institution (Wu, Guo, Zhang, Lin, Cui, Xing, Li, Sun, Luo, Jiao, Wang) Department of Neurosurgery, China International Neuroscience Institute, National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Ave, Xicheng District, Beijing, China (Zhang) Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Li) Department of Urology, Qilu Hospital, Shandong University, Shandong, Jinan, China (Zhang, Liu) Institute of Automation, Chinese Academy of Sciences, 95 Zhongguancun East Road, Haidian District, Beijing, China (Qin) Department of Emergency Medicine, The Affiliated Hospital of Shandong Second Medical University, Shandong, Weifang, China (Jiao) Department of Interventional Neuroradiology, China International Neuroscience Institute, National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Ave, Xicheng District, Beijing, China Publisher Springer Nature Abstract Robot-assisted percutaneous vascular intervention (R-PVI) has expanded beyond coronary procedures, but previous reviews were largely coronary-focused and observational. Recent randomized controlled trials (RCTs) warrant broader reassessment of R-PVI versus manual percutaneous vascular intervention (M-PVI) across vascular territories. PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from database inception to January 31, 2026, following PRISMA guidelines. RCTs and observational studies including >=10 adult patients in total were eligible. Comparative studies informed primary analyses, while single-arm studies provided supportive evidence. Primary outcomes were clinical success rate and major adverse cardiovascular/cerebrovascular events (MACE) rate. Secondary outcomes included mortality rate, technical success rate, procedural time metrics, contrast volume, and radiation exposure. Random-effects models were used. Forty studies were included: 3 RCTs, 10 comparative observational studies, and 27 single-arm observational studies, comprising 3,870 patients undergoing R-PVI and 1,142 undergoing M-PVI. Comparative analyses showed similar clinical success rates (RR 1.00, P = 0.46), MACE rates (RR 0.72, P = 0.43), and mortality. Single-arm pooled estimates for clinical and technical success were 98.76% and 96.09%, respectively. R-PVI prolonged total procedure time overall (MD 15.92 min, P = 0.01), with consistent increases in the neurovascular, RCT, and non-RCT subgroups. Fluoroscopy time was also longer (MD 1.91 min, P = 0.04), mainly in the RCT subgroup (MD 2.83 min, P = 0.001). In contrast, intravascular intervention time was unchanged overall and in RCTs, but was prolonged in non-RCTs (MD 8.72 min, P = 0.006). Operator radiation exposure was markedly reduced (MD -33.97 muSv, P < 0.001), whereas patient radiation exposure and contrast volume were similar. R-PVI appears feasible and safe across selected vascular procedures. Its clearest benefit is reduced operator radiation exposure, whereas lower whole-procedure efficiency remains its main limitation.<br/>Copyright © The Author(s) 2026. <97> Accession Number 2046550893 Title Machine learning vs. traditional methods for predicting postoperative cardiac complications after non-cardiac surgery: a systematic review and Bayesian network meta-analysis. Source Anaesthesia. 81(10) (pp 1415-1427), 2026. Date of Publication: 01 Oct 2026. Author Dhaliwal S.; Chen S.; Papas C.; Hughes I.; Cavalucci D.; O'Rourke N. Institution (Dhaliwal, Hughes) Gold Coast Hospital and Health Service, Southport, QLD, Australia (Chen, Papas) Goulburn Valley Health, Shepparton, VIC, Australia (Cavalucci, O'Rourke) The Wesley Hospital, Auchenflower, QLD, Australia Publisher John Wiley and Sons Inc Abstract Introduction: Accurate prediction of peri-operative cardiac complications is critical to optimise pre-operative decision-making. Traditional risk prediction scores, such as the Revised Cardiac Risk Index, show only modest discrimination. Machine learning can model complex, non-linear relationships but their predictive performance compared with traditional scores remains unclear. <br/>Method(s): We performed a systematic review and Bayesian network meta-analysis. The primary outcome was postoperative adverse cardiac events following non-cardiac surgery. Prediction models were assessed relative to the Revised Cardiac Risk Index. As many studies evaluated multiple versions of each model type, the highest performing ('best version') and lowest performing ('worst version') results were analysed. Models were ranked using the surface under the cumulative ranking curve (SUCRA). <br/>Result(s): Thirteen studies evaluating 54 models and 927,113 patients were included. Machine learning approaches generally outperformed traditional risk scores. Automated machine learning ranked highest (SUCRA 96.6) showed the greatest improvement in the best version analysis (mean difference (MD) 0.28 (95%CrI 0.16-0.40)) and remained superior in the sensitivity analysis (MD 0.30 (95%CrI 0.14-0.45)). Gradient boosting models showed superior performance over the Revised Cardiac Risk Index across analysis (best version: MD 0.20 (95%CrI 0.14-0.26), worst version: MD 0.18 (95%CrI 0.12-0.25), SUCRA 82.4). The Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest score outperformed the Revised Cardiac Risk Index in the best version analysis (MD 0.16 (95%CrI 0.01-0.32)). Between-study heterogeneity was low. None of the included studies externally validated their machine learning models and only six were judged to be at low risk of bias. <br/>Discussion(s): Most machine learning models showed better discrimination than traditional risk scores, with automated machine learning and gradient boosting models ranking highest. However, study quality, calibration reporting and absence of external validation limit immediate clinical adoption. Prospective, multicentre evaluation is required before integration of these models into peri-operative practice.<br/>Copyright © 2026 Association of Anaesthetists. <98> Accession Number 2047784468 Title Acute normovolaemic haemodilution after cardiac surgery: failed diffusion or clinical re-invention? Comment on Br J Anaesth 2026; 136: 836a"46. Source British Journal of Anaesthesia. 137(4) (pp 1249-1251), 2026. Date of Publication: 01 Oct 2026. Author Tanaka K.; Alhamami R.; Butt A.L.; Stewart K.E. Institution (Tanaka, Butt, Stewart) Department of Anaesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Alhamami) College of Medicine, University of Oklahoma Health, Oklahoma City, OK, United States (Stewart) Department of Surgery, University of Oklahoma Health, Oklahoma City, OK, United States Publisher Elsevier Ltd <99> Accession Number 2048657236 Title Comment on "Impact of Left and Right Bundle Branch Block on Left Ventricular Systolic Function and Myocardial Mechanics Assessed by Speckle-Tracking Echocardiography and Cardiac Magnetic Resonance Feature Tracking: A Systematic Review and Meta-Analysis". Source Echocardiography. 43(9) (no pagination), 2026. Article Number: e70601. Date of Publication: 01 Sep 2026. Author Kumar A.; Roy R.; Sajjan P.; Bhatt A.; Paul J.R. Institution (Kumar) Department of Psychiatry, School of Medical Sciences and Research, Sharda University, Greater Noida, India (Roy) Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be-University), Maharashtra, Pune, India (Sajjan) Department of Public Health, Malla Reddy Institute of Dental Sceinces, Malla Reddy Vishwavidyapeeth (Deemed to be University), Telangana, Hyderabad, India (Bhatt) Faculty of Pharmaceutical Sciences, Graphic Era Hill University, Dehradun, India (Bhatt) Centre for Promotion of Research, Graphic Era Deemed University, Dehradun, India (Paul) Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Publisher John Wiley and Sons Inc <100> Accession Number 2049050227 Title A Reassessment of Prophylactic Antibiotics in Low-Infection-Risk Electrophysiology Procedures. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Sileshi R.M.; Mathes K.; Kosuri S.; Gupta A.; Phillips N.; Pimentel R.; Emert M.; Soma S.; Ramirez R.; Dendi R.; Reddy M.; Sheldon S.H.; Atrouni W.E.; Baddour L.M.; Noheria A. Institution (Sileshi, Gupta, Phillips, Pimentel, Emert, Soma, Ramirez, Dendi, Reddy, Sheldon, Noheria) Department of Cardiovascular Medicine, The University of Kansas Medical Center, Kansas City, KS, United States (Mathes) The University of Kansas School of Medicine, Kansas City, KS, United States (Kosuri) Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS, United States (Atrouni) Division of Infectious Diseases, The University of Kansas Medical Center, Kansas City, KS, United States (Baddour) Departments of Medicine and Cardiovascular Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States Publisher John Wiley and Sons Inc Abstract Certain electrophysiology (EP) procedures are associated with minimal tissue disruption and do not involve permanent transvenous leads. As a result, these interventions carry a lower risk of device- or procedure-related infection. These procedures include placement of implantable cardiac monitors, leadless pacemakers, and left atrial appendage occlusion devices, as well as catheter ablation procedures in patients with preexisting cardiac implantable electronic device or prosthetic valve. Due to lack of clear guidelines regarding the use of prophylactic antibiotics in these procedures, clinical practice is variable. Therefore, we conducted a review of literature to evaluate the practice of prophylactic antibiotic administration and infection rates in low-infection-risk EP procedures. Available data indicate that periprocedural infection rates are low regardless of antibiotic use. Due to their observational design and limited power, existing studies are, however, insufficient to determine the benefit of routine antibiotic administration. At the same time, unnecessary antibiotic use may contribute to antimicrobial resistance and disrupt the patient's gut microbiome. Adequately powered randomized controlled trials are needed to determine whether routine prophylactic antibiotic administration is justified for low-infection-risk EP procedures.<br/>Copyright © 2026 The Author(s). Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC. <101> Accession Number 2048830496 Title Clinical efficacy of video double-lumen tube for one-lung ventilation in thoracic surgery: a meta-analysis of randomized controlled trials. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1819031. Date of Publication: 2026. Author Jiang L.; Wu X.; Yuan Y.; Li Y.; Yang G.; Zhang D. Institution (Jiang, Wu, Yuan, Li, Yang, Zhang) Department of Anesthesiology, Hebei General Hospital, Hebei, Shijiazhuang, China Publisher Frontiers Media SA Abstract Background - Double-lumen tube (DLT) is generally regarded as the gold standard for one-lung ventilation during thoracic surgery. Compared with DLT, video double-lumen tube (VDLT) has an integrated camera, allowing continuous visualization of its position in the trachea. However, the clinical efficacy of VDLT for one-lung ventilation in thoracic surgery is unclear. This meta-analysis aims to evaluate the clinical efficacy of VDLT for one-lung ventilation in thoracic surgery. Methods - The PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, WanFang, and CBM databases were searched for relevant studies from inception to July 2025. This meta-analysis used RevMan and Stata software to implement statistical analysis. The primary outcome was the intubation time. Sensitivity analysis and Egger's test were performed to evaluate the stability of the results and the publication bias. Results - Eighteen studies involving 1, 332 patients were included. For the primary outcome intubation time, extreme and unexplained between-study heterogeneity was observed (I2 =99%). A random-effects model was applied, and the pooled result suggested a trend toward shorter intubation time in the VDLT group (MD=-102.68 [95% CI: -123.71 to -81.66], p<0.00001). Meta-analysis also revealed that the VDLT group exerted a higher first-attempt success rate (OR=8.04, 95% CI [2.17 to 29.74], p=0.002), lower mean arterial pressure (MD=-16.85 [95% CI: -21.67 to -12.02], p<0.00001) and heart rate (MD=-11.32 [95% CI: -19.80 to -2.85], p=0.009) after intubation, a shorter repositioning time after dislodgement (MD=-50.91 [95% CI: -67.30 to -34.52], p<0.00001), and a lower incidence of sore throat (OR=0.62, 95% CI [0.39 to 0.98], p=0.04). No significant differences regarding the incidence of dislodgement during positioning and surgery, quality of lung collapse, or the incidence of hoarseness after surgery were noted between the 2 group. Conclusion - Compared with the DLT, VDLT may provide modest clinical advantages of a shorter intubation time, higher first-attempt success rate, lower mean arterial pressure and heart rate after intubation, shorter repositioning time after dislodgement, and lower incidence of sore throat. However, the primary outcome of intubation time is limited by extreme between-study heterogeneity that could not be explained. Standardized multicenter international randomized trials are warranted to confirm the clinical efficacy of VDLT. Systematic review registration - , Identifier: CRD420251138139.<br/>Copyright © 2026 Jiang, Wu, Yuan, Li, Yang and Zhang. <102> Accession Number 2042143982 Title Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. Source JAMA. 335(7) (pp 600-608), 2026. Date of Publication: 17 Feb 2026. Author Reade M.C.; Marks D.C.; Howe B.D.; Bailey M.J.; Bannon P.G.; Eastwood G.M.; French C.J.; Gattas D.J.; Higgins A.M.; Holley A.D.; Hu R.T.; Irving D.O.; Johnson L.; Mcguinness S.P.; Mcquilten Z.K.; Royse A.G.; Smith J.A.; Weinberg L.; Wood E.M.; Buckland M.; Bedaton G.; Neylan A.; Robertshaw S.; Tran H.; Ueoka M.; Wallace S.; Bickerton T.; Kavadias P.; Macfarlane C.; Shackles J.; Veljanovski T.; Webb A.; Baulch S.; Bellomo R.; Claxton G.; Eastwood G.; Harris S.; Hu R.; Makar T.; Peck L.; Sidiropoulos S.; Young H.; Ambanloc S.; Banchi S.; Banks L.; Davies A.; Gao Y.; Gazelle R.; Hogan C.; Kannesan D.; Kelly S.; Kolar D.; Leong C.; Masuku P.; Napoles R.; Ng J.; Oldenburger C.; Rodrigues C.; Saberi M.; Tran K.; Uson M.; Wilkes A.-M.; McCullough J.; Gough M.; Houbert M.; Pitman J.; Tallott M.; Betts C.; McMahon S.; O'Loughlin Q.; Weng A.; Aneman A.; Coupland L.; Le T.; Miller J.; O'Regan W.; Pancholi A.; Shaw D.; Dhir V.; Matta L.; Moyo N.; Royse A.; Balcos P.; Boggett S.; Royse C.; Williams Z.; Wu J.; Bisignano M.; Haeusler M.; Neander E.; Nguyen V.; Pham N.; Smith K.; Snowdon M.; Gattas D.; Beattie L.; Buhr H.; Cartwright B.; Coles J.; Evangelisti O.; Liang Y.; Oostveen C.; Turner L.; Ackermann L.; Anwar Z.; Flinn H.; Lee R.; Pulanco C.; Skidmore J.; Teevan J.; Slater B.; Corcoran P.; Fernandez A.; Hall K.; Pappas P.; Scott D.; Cole-Sinclair M.; Crockett R.; Morris K.; Walter C.; Pearse B.; O'Brien D.; Amerio E.; Boyd M.; De Waard C.; Mehta A.; Vincent B.; Whiteside J.; Win A.; Baker-Pearson I.; Senthuran S.; Brown C.; Gofton C.; Kempshall L.; Lakh S.; McCormack S.; Marshall H.; Mills W.; Patane M.; Rice T.; Sawyer N.; Shucksmith M.; Smith J.; Hulley A.; Kim M.; Warwarek S.; Fossaert L.; Juliana J.; Hu S.; Koralegedara K.; Papasimeon V.; Reid S.; Santamaria M.; Singh H.; Sreng C.; Dieleman J.; Lei L.; Ali F.; Clark-Mackay E.; Cope J.; Hinks P.; Hussain S.; Crew J.M.; Medalla H.; Mungai T.N.; Pasalic L.; Shaktour T.; van de Vorstenbosch E.; Wentworth A.; Bailey M.; Paul E.; Tan S. Institution (Reade, Holley) Medical School, University of Queensland, Brisbane, QLD, Australia (Reade, Holley) Joint Health Command, Australian Defence Force, Canberra, ACT, Australia (Marks, Irving, Johnson, Tan) Australian Red Cross Lifeblood, Alexandria, NSW, Australia (Howe, Bailey, French, Higgins) Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (Bannon, Gattas) Royal Prince Alfred Hospital, Sydney, NSW, Australia (Bannon, Gattas) Sydney Medical School, Sydney, NSW, Australia (Eastwood, Hu, Weinberg) Austin Hospital, Melbourne, VIC, Australia (Eastwood, Hu, Royse, Weinberg) University of Melbourne, Melbourne, VIC, Australia (French) Western Hospital, Melbourne, VIC, Australia (Mcguinness) Cardiothoracic and Vascular Intensive Care, High Dependency Unit, Auckland, New Zealand (Mcquilten) School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Royse) Royal Melbourne Hospital, Melbourne, VIC, Australia (Royse) Australian Army, Melbourne, VIC, Australia (Smith, Hulley, Kim, Warwarek, Fossaert, Juliana, Hu, Koralegedara, Papasimeon, Reid, Santamaria, Singh, Sreng) Victorian Heart Hospital, Melbourne, VIC, Australia (Smith) Monash University, Melbourne, VIC, Australia (Wood) Transfusion Research Unit, Monash University, Melbourne, VIC, Australia (Buckland, Bedaton, Neylan, Robertshaw, Tran, Ueoka, Wallace, Bickerton, Kavadias, Macfarlane, Shackles, Veljanovski, Webb) The Alfred Hospital, Melbourne, VIC, Australia (Weinberg, Baulch, Bellomo, Claxton, Eastwood, Harris, Hu, Makar, Peck, Sidiropoulos, Young, Ambanloc, Banchi, Banks, Davies, Gao, Gazelle, Hogan, Kannesan, Kelly, Kolar, Leong, Masuku, Napoles, Ng, Oldenburger, Rodrigues, Saberi, Tran, Uson, Wilkes) Austin Hospital, Heidelberg, VIC, Australia (McCullough, Gough, Houbert, Pitman, Tallott, Betts, McMahon, O'Loughlin, Weng) Gold Coast University Hospital, Southport, QLD, Australia (Aneman, Coupland, Le, Miller, O'Regan, Pancholi, Shaw, Dhir, Matta, Moyo) Liverpool Hospital, Liverpool, NSW, Australia (Royse, Balcos, Boggett, Royse, Williams, Wu, Bisignano, Haeusler, Neander, Nguyen, Pham, Smith, Snowdon) Royal Melbourne Hospital, Parkville, VIC, Australia (Gattas, Beattie, Buhr, Cartwright, Coles, Evangelisti, Liang, Oostveen, Turner, Ackermann, Anwar, Flinn, Lee, Pulanco, Skidmore, Teevan) Royal Prince Alfred Hospital, Camperdown, NSW, Australia (Slater, Corcoran, Fernandez, Hall, Pappas, Scott, Cole-Sinclair, Crockett, Morris, Walter, Pearse) St Vincent's Hospital Fitzroy, Melbourne, Australia (O'Brien, Amerio, Boyd, De Waard, Mehta, Vincent, Whiteside) Applied Science The Prince Charles Hospital, Chermside, QLD, Australia (Win, Baker-Pearson, Senthuran, Brown, Gofton, Kempshall, Lakh, McCormack, Marshall, Mills, Patane, Rice, Sawyer, Shucksmith, Smith) Townsville University Hospital, Douglas, QLD, Australia (Bailey, Paul) Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Dieleman, Lei, Ali, Clark-Mackay, Cope, Hinks, Hussain, Crew, Medalla, Mungai, Pasalic, Shaktour, van de Vorstenbosch, Wentworth) Westmead Hospital, Westmead, NSW, Australia Publisher American Medical Association Abstract Importance: Liquid-stored platelets have a shelf-life of 5 to 7 days, limiting availability and resulting in wastage. <br/>Objective(s): To assess the effectiveness and safety of dimethyl sulfoxide-cryopreserved platelets, which have a shelf-life of 2 years, as a treatment for cardiac surgery bleeding. <br/>Design, Setting, and Participant(s): The Cryopreserved vs Liquid Platelets II (CLIP-II) trial was a multicenter, randomized, double-blind, parallel-group noninferiority trial, which enrolled patients between August 2021 and April 2024 at 11 Australian tertiary hospitals, with follow-up completed in July 2024. Patients at high risk of platelet transfusion were eligible. Patients were excluded if they had a history of deep vein thrombosis or pulmonary embolism, were coagulopathic, or were females aged 18 to 55 years who were rhesus D (RhD) negative or of unknown RhD status. Of 879 patients meeting inclusion criteria, 182 were excluded and 285 did not consent, leaving 412. Of these, 388 were randomized and 202 received study platelets. <br/>Intervention(s): Patients received up to 3 units of either group O cryopreserved platelets or conventional liquid-stored platelets, commencing intraoperatively or in the first 24 postoperative hours. <br/>Main Outcomes and Measures: The primary outcome was postsurgical chest drain bleeding within the first 24 hours following intensive care unit admission. Noninferiority was defined prospectively as less than 20% greater bleeding in this period. Five secondary and 42 tertiary outcomes were defined a priori. <br/>Result(s): Of the 202 transfused patients (mean [SD] age, 64.4 [13] years; 75.7% male), 61 (30.2%) underwent nonelective surgery. The primary outcome did not differ between groups (605 mL in cryopreserved platelet group vs 535 mL in liquid-stored platelet group; ratio of geometric means [cryopreserved to liquid ratio], 1.13 [95% CI, 0.96-1.34]; P =.07). As the confidence interval includes bleeding exceeding the noninferiority margin, noninferiority was not established. Cryopreserved platelet transfusion was associated with higher intraoperative and total perioperative blood loss (ratio of geometric means [cryopreserved to liquid ratio], 1.42 [95% CI, 1.12-1.80]; 1.31 [95% CI, 1.07-1.60], respectively), and increased red cell, plasma, and cryoprecipitate transfusion. While there were no differences in the incidence of prespecified adverse events, patients receiving cryopreserved platelets experienced longer times to extubation and intensive care unit/hospital discharge (median [IQR] duration of ventilation, 25.5 hours [16.1-77.3] vs 23.6 hours [13.1-52.8]; median [IQR] intensive care unit length of stay, 3.8 days [2.0-6.0] vs 3.0 days [1.9-4.9]; median hospital length of stay, 10.9 days [7.87-17.0] vs 9.1 [6.9-14.9]). <br/>Conclusions and Relevance: Cryopreserved platelets did not meet the predefined threshold for noninferiority in hemostatic effectiveness at 24 hours after ICU admission. Additional predefined end points consistently indicated diminished hemostatic effectiveness, although prespecified adverse events were comparable.<br/>Copyright © 2026 American Medical Association. <103> Accession Number 652212581 Title Exercise-based cardiac rehabilitation for coronary heart disease. Source The Cochrane database of systematic reviews. 9 (pp CD001800), 2026. Date of Publication: 18 Sep 2026. Author Dibben G.; de Vries F.B.; Faulkner J.; Oldridge N.; Rees K.; Stens N.A.; Thijssen D.; Thompson D.R.; Zwisler A.-D.; Taylor R.S. Institution (Dibben, Taylor) School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom (de Vries, Stens, Thijssen) Department of Medical BioSciences, Cardiovascular Physiology, Radboud University Medical Centre, Nijmegen, Netherlands (Faulkner) Primary Care Research Centre, Faculty of Medicine, University of Southhampton, United Kingdom (Oldridge) College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States (Rees) Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Stens) Department of Cardiology, Radboud University Medical Centre, Nijmegen, United Kingdom (Thijssen) Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (Thompson) School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom (Zwisler) Clinic for Palliative Medicine, Rehabilitation and Patient-centered Care, Rigshospitalet, Denmark (Zwisler) Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Taylor) Robertson Centre for Biostatistics, School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom (Taylor) National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark Abstract RATIONALE: Coronary heart disease (CHD) is the leading cause of death globally. CHD mortality rates remain steady in low- and middle-income countries but are declining in high-income countries, meaning more people are living with CHD and need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health outcomes of people with CHD. <br/>OBJECTIVE(S): To assess the clinical and cost-effectiveness of exercise-based CR (exercise training alone or combined with psychosocial/educational interventions) compared with 'no exercise' control, on mortality, morbidity and health-related quality of life (HRQoL) in people with CHD. <br/>SEARCH METHOD(S): We updated searches from the previous Cochrane review, searching CENTRAL, MEDLINE, Embase, Web of Science, CINAHL, and two clinical trials registers in March 2026. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) of exercise-based CR, compared with 'no exercise' control, with follow-up of six months or longer, in adults with CHD. <br/>OUTCOME(S): Primary outcomes included mortality (all-cause and cardiovascular), fatal and non-fatal myocardial infarction (MI), revascularisation (coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI)), and hospitalisation (all-cause and cardiovascular). Secondary outcomes included HRQoL and cost-effectiveness. We categorised follow-up as short-term (6 to 12 months), medium-term (> 12 to 36 months), and long-term (> 36 months). RISK OF BIAS: We assessed risk of bias with the Cochrane Risk of bias 1 tool (RoB 1). SYNTHESIS METHODS: We synthesised results for each outcome using meta-analysis where possible, using random-effects models to calculate risk ratios (RR) and 95% confidence intervals (CI) for dichotomous outcomes, and mean differences (MD) for continuous outcomes. We stratified meta-analyses by follow-up duration and used univariable meta-regression to explore potential sources of between-study heterogeneity. Where meta-analysis was not possible, we narratively synthesised results. We used GRADE to assess certainty of evidence for primary outcomes at short-term follow-up (the most common time point). INCLUDED STUDIES: This review included 107 trials (26,886 adults with CHD). This update identified 22 new trials (3456 participants). Most participants were post-MI or post-revascularisation; their mean age ranged from 47 to 81 years. Although 78% of trials included women, they represented only 17% of the participants overall. Most trials were conducted in high-income settings in Europe (51/107, 48%), Asia (28/107, 26%) and North America (14/107, 13%). Twenty-six trials (11 in this update) were undertaken in low- and middle-income countries (LMICs). Overall, trial reporting was poor, although there was evidence of an improvement in quality over the last decade. SYNTHESIS OF RESULTS: Short-term follow-up (6 to 12 months) Compared to no structured exercise, exercise-based CR likely reduces all-cause mortality (RR 0.86, 95% CI 0.74 to 1.00; 30 trials, 10,391 participants; number needed to treat for an additional beneficial outcome (NNTB) 125, 95% CI 75 to ; moderate-certainty evidence) and may reduce cardiovascular mortality (RR 0.87, 95% CI 0.68 to 1.11; 20 trials, 7277 participants; NNTB 200, 95% CI 82 to number needed for an additional harmful outcome (NNTH) 238; moderate-certainty evidence). It results in a large reduction in MI (RR 0.72, 95% CI 0.54 to 0.95; 25 trials, 8584 participants; NNTB 71, 95% CI 47 to 435; high-certainty evidence). It makes little to no difference in risk of CABG (RR 1.00, 95% CI 0.78 to 1.28; 21 trials, 4532 participants; high-certainty evidence), and likely little to no difference in PCI (RR 0.86, 95% CI 0.65 to 1.13; 13 trials, 3465 participants; moderate-certainty evidence). It likely reduces all-cause hospital admissions (RR 0.65, 95% CI 0.51 to 0.82; 21 trials, 3868 participants; NNTB 17, 95% CI 12 to 32; moderate-certainty evidence) but we are uncertain about its effects on cardiovascular hospitalisation (RR 0.80, 95% CI 0.35 to 1.82; 6 trials, 1550 participants; low-certainty evidence), with substantial heterogeneity (I2 = 59%). We detected small-study bias for all-cause hospitalisation, but not for other outcomes. Evidence indicated clinically meaningful increases in HRQoL with exercise-based CR across several outcome domains, including SF-36 subscales (physical component, mental component, physical functioning, physical performance, general health, vitality, and social functioning scores) and EQ-5D scores up to 12 months' follow-up. Eight economic evaluation studies consistently showed exercise-based CR to be cost-effective in terms of quality-adjusted life years gained. Meta-regression showed that most study-level characteristics did not explain heterogeneity, though some variation was seen by intervention setting and study sample size. Certainty of evidence ranged from low to high. We downgraded due to imprecision (wide 95% CIs), possible publication bias, and heterogeneity across studies. We judged several studies at high risk of bias in some domains, primarily due to incomplete reporting or study-level attrition. For clinical outcomes, we considered that the impact of this risk of bias on effect estimates was limited. Around a quarter of included trials were conducted in earlier eras of cardiac care, prior to the widespread adoption of contemporary optimal medical therapy. AUTHORS' <br/>CONCLUSION(S): Compared with no exercise, exercise-based CR improves outcomes for people with CHD, including significantly reduced risk of MI and hospitalisation, a likely small reduction in all-cause and cardiovascular mortality, and improved HRQoL up to 12 months' follow-up. Over longer-term follow-up (> 12-months), exercise-based CR is associated with reduced cardiovascular mortality and MI. CR for people with CHD was also shown to be cost-effective. Recent trials have increased inclusion of women, used alternative models of CR delivery (home and digitally supported) and have been undertaken in LMICs, increasing the global generalisability of findings. FUNDING: Internal sources: University of Glasgow, UK - funding support for the time of GD and RST. Radboud University Medical Centre, NL - funding support for the time of FdV, DT and NS. External sources: past NIHR Cochrane Infrastructure funding to Cochrane Heart. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health and Social Care. REGISTRATION: Previous versions available via doi.org/10.1002/14651858.CD001800.pub4; doi.org/10.1002/14651858.CD001800.pub3; doi.org/10.1002/14651858.CD001800.pub2; doi.org/10.1002/14651858.CD001800; DOI 10.1016/j.amjmed.2004.01.009.<br/>Copyright © 2026 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. <104> Accession Number 2049095674 Title Ten-year survival after stenting the proximal left anterior descending coronary artery with new-generation drug-eluting stents. Source Cardiovascular Intervention and Therapeutics. (no pagination), 2026. Date of Publication: 2026. Author van Vliet D.; Dayal A.; Ploumen E.H.; Pinxterhuis T.H.; Buiten R.A.; Kok M.M.; Zocca P.; van Houwelingen K.G.; Hartmann M.; de Man F.H.A.F.; Voortman M.; Linssen G.C.M.; Doggen C.J.M.; von Birgelen C. Institution (van Vliet, Dayal, Ploumen, Pinxterhuis, Buiten, Kok, Zocca, van Houwelingen, Hartmann, de Man, Voortman, von Birgelen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede, Netherlands (van Vliet, Voortman, Doggen, von Birgelen) Department of Health Technology and Services Research, Faculty Faculty Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands (Linssen) Department of Cardiology, Ziekenhuisgroep Twente, Almelo and Hengelo, Netherlands Publisher Springer Abstract Percutaneous coronary intervention (PCI) of the proximal left anterior descending artery (p-LAD) is often considered a high-risk procedure, as the LAD supplies a substantial proportion of the myocardium. For most chronic coronary syndrome (CCS) patients with p-LAD target lesions, guidelines do not favor PCI over CABG, or vice versa. Long-term clinical data is lacking in new-generation drug-eluting stents (DES) used in p-LAD lesions. Therefore, we aimed to assess 10-year survival following PCI of the p-LAD versus other segments. We assessed patient-level data of consecutive all-comers, treated at Thoraxcentrum Twente with new-generation DES in the TWENTE I-III trials. Previous CABG or left main treatment were excluded. The primary endpoint was 10-year survival. Additionally, 5-year clinical events were assessed, including composite endpoints target lesion failure (TLF) and patient-oriented composite endpoint (POCE). Of all 4,467 patients, 1,244(27.8%) were treated for p-LAD lesions, while 3,223(72.2%) were treated exclusively for non-p-LAD lesions. After 10 years, all-cause mortality showed a numerically higher incidence in the p-LAD group, which was not statistically significant (24.0% vs. 22.3%; adjusted HR:1.05 95%CI 0.91-1.21, p=0.52). Furthermore, similar 5-year TLF and POCE rates were observed for both groups. In CCS patients, subgroup analyses showed no differences in 10-year survival by lesion location. Yet, the p-LAD group showed significantly lower 5-year repeat revascularization rates. P-LAD lesion location may not independently influence 10-year survival after PCI, both in all-comers and CCS patients. Yet, among CCS patients, 5-year repeat revascularization rates were lower in those treated for p-LAD lesions.<br/>Copyright © The Author(s) 2026. <105> Accession Number 2049568276 Title Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data and GRADE Assessment. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Yassin M.N.; Elfeqi K.; Abdelmaksoud A.; Hanna F.; El-Helbawy A.; Elkasaby M.H.; Mohsen A.; Frishman W.H.; Aronow W.S. Institution (Yassin, Elfeqi, Hanna) Department of Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt (Abdelmaksoud) Department of Internal Medicine, University of California, Riverside, CA, United States (El-Helbawy) Department of Medicine, Faculty of Medicine, Capital University (formerly Helwan University), Cairo, Egypt (Elkasaby) Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Mohsen) Department of Medicine, Division of Cardiology, Loma Linda University, Loma Linda, CA, United States (Frishman, Aronow) Departments of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Publisher Lippincott Williams and Wilkins Abstract Coronary artery disease coexists in approximately 50% of transcatheter aortic valve implantation candidates, yet the role of percutaneous coronary intervention (PCI) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing PCI with conservative management or deferral in transcatheter aortic valve implantation candidates with coronary artery disease. We searched 4 databases from inception to June 19, 2026. Odds ratios (ORs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Individual patient data were reconstructed from published Kaplan-Meier curves. Risk of bias and certainty of evidence were assessed. Three randomized controlled trials (n = 1156 patients) were included. PCI showed no significant reductions in all-cause death (OR 0.88; 95% confidence interval [CI], 0.62-1.25; I<sup>2</sup> = 0%), cardiovascular death (OR 0.72; 95% CI, 0.40-1.29; I<sup>2</sup> = 0%), or myocardial infarction (OR 0.85; 95% CI, 0.17-4.18; I<sup>2</sup> = 51.8%). Stroke was significantly reduced with PCI (OR 0.68; 95% CI, 0.48-0.95; I<sup>2</sup> = 0%). PCI was associated with a trend toward increased any bleeding (OR 2.26; 95% CI, 0.81-6.29; I<sup>2</sup> = 69.8%) and major bleeding (OR 1.70; 95% CI, 0.63-4.60; I<sup>2</sup> = 35.9%).<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <106> Accession Number 2049276241 Title Rethinking Transfusion Strategies in CABG: Acute Normovolaemic Haemodilution versus Conventional Transfusion: A Systematic Review. Source Journal of the College of Physicians and Surgeons Pakistan. 36(9) (pp 1181-1186), 2026. Date of Publication: 01 Sep 2026. Author Muhammad D.; Ali T.A.; Khan M.A.; Khan A.; Shah S.; Iqbal I. Institution (Muhammad, Ali, Iqbal) Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan (Khan) Department of Biochemistry, Khyber Medical College, Peshawar, Pakistan (Khan) Department of Internal Medicine, Aneurin Bevan University Health Board, Newport, United Kingdom (Shah) Department of Internal Medicine, DHQ Teaching Hospital, Kohat, Pakistan Publisher College of Physicians and Surgeons Pakistan Abstract Coronary artery bypass grafting (CABG) is among the most commonly performed cardiac surgical procedures worldwide and frequently requires perioperative blood transfusion. Acute normovolaemic haemodilution (ANH) is a simple and economical strategy that aims to reduce the need for allogeneic blood transfusion. A systematic review was conducted between October 2024 and August 2025 and analysed randomised controlled trials comparing ANH with conventional transfusion practices in patients undergoing coronary bypass surgery. Eighteen studies were evaluated for outcomes such as transfusion rates, blood loss, coagulation profiles, myocardial protection, postoperative complications, and cost-effectiveness. ANH reduced the need for allogeneic blood transfusion without affecting haemodynamic stability or postoperative recovery. Moderate improvements were observed in coagulation preservation and myocardial protection, although the certainty of evidence varied across outcomes. Further large-scale trials are required to establish standardised ANH protocols and clarify long-term clinical outcomes.<br/>Copyright © 2026 College of Physicians and Surgeons Pakistan. All rights reserved. <107> Accession Number 652211607 Title Incidence and risk factors of persistent postoperative pain after cardiac surgery: a systematic review and meta-analysis. Source BMC anesthesiology. 26(1) (no pagination), 2026. Date of Publication: 06 Aug 2026. Author Yang Y.; Liu F.; Yao H. Institution (Yang) School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (Yang) Third People's Hospital of Chengdu, Chengdu, Sichuan, China (Liu) Department of Emergency division, Municipal Hospital, Qingdao, Shandong, China (Yao) Department of Intensive Care Unit, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China Abstract BACKGROUND: Persistent postoperative pain after cardiac surgery (PPPCS) is a prevalent complication. This paper aims to appraise the incidence of PPPCS and analyze its related risk factors through systematic evaluation and Meta-analysis. <br/>METHOD(S): According to PRISMA guidelines, two researchers independently searched seven databases (PubMed, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang Database and China Biomedical Database) until October 5, 2024. Finally, 40 eligible studies were included. The quality of the included articles was evaluated by Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality Agency Scale. The random-effect model was selected for Meta-analysis. Meta-regression analysis was conducted to test whether the publication time affected the incidence of PPPCS. <br/>RESULT(S): The incidence of PPPCS changed at different times after operation: 31.7% (27.2%, 36.2%) at 3 to 6 months, 25.1% (19.5%, 30.7%) at 6 to 12 months, 24.4% (18.1%, 30.7%) at 12 to 24 months, and 13.1% (7.6%, 18.6%) at more than 24 months. Meta-regression revealed that longer postoperative follow-up (12-24 months and beyond 24 months) was associated with a lower overall incidence of PPPCS.Significant risk factors included females, age < 69 years old, BMI>=28 kg/m2, poor wound healing, intraoperative remifentanil infusion, chronic pain history, and moderate-severe pain (day 0-5). <br/>CONCLUSION(S): The incidence of PPPCS ranged from 13.1% to 31.7%. Female sex, younger age, elevated BMI, poor wound healing, intraoperative remifentanil use, history of chronic pain, and severe acute postoperative pain were associated with higher odds of PPPCS. However, given the observational nature of the included studies, variable confounder adjustment, small numbers of studies for certain risk factors, and high heterogeneity, these associations should be interpreted cautiously and require confirmation in prospective studies with standardized definitions and more comprehensive adjustment. The identified factors may guide risk stratification but should not yet be regarded as definitively established causal determinants of PPPCS.<br/>Copyright © 2026. The Author(s). <108> Accession Number 2049410094 Title Continuous Ultrasound-guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoracotomy. Source Clinical Journal of Pain. 42(10) (no pagination), 2026. Article Number: e1399. Date of Publication: 01 Oct 2026. Author Habeeb R.M.; Sultan W.A.; Basune M.E.; Safan A.G. Institution (Habeeb, Sultan, Basune, Safan) Anesthesia and Intensive Care Department, Faculty of Medicine, Menoufia University, Egypt Publisher Lippincott Williams and Wilkins Abstract Objectives: - To compare postoperative analgesia using continuous ultrasound-guided erector spinae plane block (ESPB) versus thoracic paravertebral block (TPVB), with dynamic visual analog 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, postanesthesia care unit stay, time to first ambulation, and patient satisfaction. <br/>Method(s): - The study included 40 cases scheduled for elective thoracotomy admitted to the cardiothoracic surgery unit of Menoufia University Hospital. Patients were equally randomized into 2 groups, 20 patients each receiving either ultrasound-guided ESPB or 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. <br/>Result(s): - Dynamic visual analogue pain 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. <br/>Discussion(s): - The utilization of continuous ultrasound-guided ESPB demonstrated better postoperative visual analogue pain scale scores and a significant decrease in opioid consumption, with fewer side effects than TPVB.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <109> Accession Number 2049586763 Title Research progress in the application of double-lumen endobronchial tubes and bronchial blockers in thoracic surgery. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1849170. Date of Publication: 10 Aug 2026. Author Liu D.; Zhao Q. Institution (Liu, Zhao) Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China Publisher Frontiers Media SA Abstract With the rapid development of thoracic surgery toward minimally invasive and precise approaches, as well as the popularization of video-assisted thoracic surgery (VATS) and robot-assisted video-assisted thoracic surgery (RAVATS), higher requirements have been put forward for one-lung ventilation (OLV) technology during anesthesia. An ideal lung isolation technique not only needs to provide a good surgical field of view but also should minimize the incidence of airway injury, hypoxemia, and postoperative pulmonary complications (PPCs). Currently, double-lumen endobronchial tubes (DLTs) and bronchial blockers (BBs) are the two main tools for achieving OLV. This narrative review summarizes the development status and main surgical types of thoracic surgery in recent years, and analyzes the application of DLTs and BBs in operations such as pneumonectomy, esophageal surgery, and mediastinal surgery. Through a comprehensive comparison of high-quality randomized controlled trials and retrospective studies, the differences between the two airway management devices in terms of lung collapse quality, positioning time, incidence of airway injury, and postoperative recovery indicators are explored. Studies have shown that DLTs have advantages in lung isolation speed and bronchial suction efficiency, while BBs exhibit unique value in difficult airway management, reducing postoperative sore throat, and isolating specific lobes. Moreover, retrospective studies suggest a potential association between BBs use and lower PPCs rates, but this finding requires confirmation by high-quality randomized trials. This article aims to provide evidence-based airway management strategy references for thoracic surgeons and anesthesiologists when facing different surgical types and specific patients.<br/>Copyright © 2026 Liu and Zhao. <110> Accession Number 2049094432 Title Effect of phenylephrine versus ephedrine on the incidence of postoperative delirium in elderly patients undergoing non-cardiac and non-neurosurgical procedures: protocol for a multicentre, double-blind, randomized, controlled trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2732555. Date of Publication: 2026. Author Xu X.; Wang G.; Li X.; Peng K.; Liu H.; Ji F.; Shan X.; Wang Y. Institution (Xu, Wang, Li, Peng, Ji, Shan, Wang) Department of Anesthesiology, First Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China (Xu, Wang, Li, Peng, Ji, Shan, Wang) Institute of Anesthesiology, Soochow University, Jiangsu, Suzhou, China (Xu) Department of Anesthesiology, The Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, China (Liu) Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, United States Publisher Taylor and Francis Ltd. Abstract Background: Whether ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium remains uncertain. This study aims to determine whether the intraoperative management of hypotension with ephedrine, compared with phenylephrine, reduces the incidence of postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. <br/>Method(s): This multicentre, randomized, double-blind, controlled trial will enrol 1,084 elderly patients scheduled for elective non-cardiac and non-neurosurgical major surgeries under general anaesthesia at seven hospitals in China. Participants will be randomized in a 1:1 ratio, stratified by study centre, to receive continuous intravenous infusion of either phenylephrine or ephedrine to maintain mean arterial pressure within 20% of the baseline value. The primary outcome is the incidence of postoperative delirium within 7 days after surgery. Secondary outcomes include severity of postoperative delirium, numeric rating scale pain scores at rest and during activity at 24, 48 and 72 h postoperatively, intensive care unit (ICU) admission rate and length of ICU stay, length of postoperative hospital stay, incidence of in-hospital major adverse cardiovascular and cerebrovascular events (myocardial infarction, arrhythmia, heart failure, and stroke), and 30-day all-cause mortality. <br/>Discussion(s): We hypothesize that ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. The findings of this study may provide high-quality evidence for optimizing the management of intraoperative hypotension in this vulnerable population. Trial registration: Chinese Clinical Trial Registry (ChiCTR2500115385).<br/>Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <111> Accession Number 2048940564 Title Pulmonary artery catheters or central venous catheters for cardiac surgery: the PUMA Pilot randomised clinical trial. Source Anaesthesia. 81(10) (pp 1358-1366), 2026. Date of Publication: 01 Oct 2026. Author Perry L.A.; Segal R.; Larobina M.; Bellomo R.; Smith J.A.; Sin J.; Danial K.; McLean A.R.D.; Rong L.Q.; Gaudino M.; Schwann T.; Palumbo M.; O'Halloran L.; Chee B.; Patel J.; Silvers A.; Bennetts J.; Marasco S.; Coulson T.G.; Royse A.; See E.; Miles L.F. Institution (Perry, Sin, Danial, Chee, Patel) Victorian Cardiac Anaesthesia Research Laboratory, Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia (Perry, Sin, Danial, Palumbo, O'Halloran, Chee, Patel, Silvers) Department of Anaesthesia and Perioperative Medicine, Victorian Heart Hospital, Melbourne, VIC, Australia (Perry, Coulson, See, Miles) Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia (Segal) Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia (Larobina, Smith, Bennetts) Department of Cardiothoracic Surgery, Victorian Heart Hospital, Monash Health, Melbourne, VIC, Australia (Smith, Marasco) Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia (McLean) Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia (McLean) MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia (Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Schwann) Department of Cardiovascular Surgery, Corewell Health, Royal Oak, MI, United States (Marasco) Cardiothoracic Unit, The Alfred, Melbourne, VIC, Australia (Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, VIC, Australia (Royse) Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia (See) Departments of Intensive Care and Nephrology, The Royal Melbourne Hospital, Melbourne, VIC, Australia (Miles) Department of Anaesthesia, Austin Health, Melbourne, VIC, Australia Publisher John Wiley and Sons Inc Abstract Introduction: Pulmonary artery catheters are used widely in cardiac surgery despite observed associations with worse outcomes and guidelines that recommend against their routine use. No adequately powered randomised trials are available. <br/>Method(s): The PUMA Pilot was a multicentre, randomised, parallel assignment, open-label, pilot and feasibility trial conducted at three tertiary cardiac surgery centres. Eligible patients were adults undergoing coronary artery bypass grafting, aortic valve replacement or surgery on the aortic root or ascending aorta with or without aortic valve replacement, with a predicted surgical mortality of < 2%. Patients were allocated randomly to receive a pulmonary artery catheter or a central venous catheter inserted immediately before surgery. The primary feasibility outcome was protocol compliance, defined as receiving the assigned intervention without crossover. Secondary feasibility outcomes were eligibility rate; recruitment proportion and rate; data completeness; and rate of clinician refusal. <br/>Result(s): We screened 480 patients and 206 (43%) were eligible; 150/203 (74%) approached provided informed consent. Three of 206 (1%) eligible patients were not included due to clinician refusal. Of 149 patients who were randomised, 76 were assigned to the pulmonary artery catheter group and 73 to the central venous catheter group. For the primary feasibility outcome, 147 patients (99%) received the allocated intervention. Data were complete for 144 (97%) patients. Median (IQR [range]) days alive and at home at 30 days was 23.7 (21.9-24.7 [7.0-26.0]) in the pulmonary artery catheter group and 22.9 (20.8-23.9 [8.6-25.8]) in the central venous catheter group. Acute kidney injury occurred in 26/76 (34%) patients in the pulmonary artery catheter group and 14/73 (19%) in the central venous catheter group. <br/>Discussion(s): A randomised trial of pulmonary artery catheters compared with central venous catheters in low-risk cardiac surgery is feasible. Such a trial would address significant practice variability and inform international guidelines.<br/>Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <112> Accession Number 2049534968 Title Application of the combined technique of novel transseptal puncture guidewire and steerable sheath in left atrial appendage occlusion: a preliminary feasibility case series. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1908230. Date of Publication: 03 Sep 2026. Author Liang M.; Wang W.J.; Wang P.Y.; Gu Q. Institution (Liang, Wang, Gu) Department of Cardiology, The First People's Hospital of Yuxi City, Yuxi, China (Wang) Faculty of Engineering, Data Science at the University of Bristol, Bristol, United Kingdom Publisher Frontiers Media SA Abstract Objective - Transseptal puncture (TSP) is a critical step in left atrial appendage occlusion (LAAO) but presents certain technical challenges. Conventional puncture needles, due to their inherent rigidity, often cause unpredictable needle tip "bouncing" or upward migration at the moment of septal puncture, resulting in a high or suboptimal puncture site, which subsequently compromises the coaxial alignment between the sheath and the left atrial appendage (LAA). This study aims to evaluate the safety and feasibility of the novel transseptal puncture guidewire AccusafeTM used in combination with a steerable sheath NavigoTM. Methods - In this case series, 20 consecutive patients undergoing a one-stop procedure (LAAO combined with atrial fibrillation ablation) were enrolled. The first 10 patients underwent conventional transseptal puncture, while the latter 10 underwent transseptal puncture using AccusafeTM. The primary endpoints included first-pass puncture success rate, incidence of post-puncture site migration, and coaxiality assessed by the angle between the delivery sheath and the central axis of the LAA on angiography. Results - Transseptal puncture was successfully performed in all patients. The application of AccusafeTM in combination with a steerable sheath significantly reduced sheath migration, achieving a first-pass puncture success rate of 100%. Furthermore, AccusafeTM significantly improved sheath-LAA coaxiality, effectively simplified the occluder delivery and deployment process, shortened procedure time, and ensured an ideal occlusion outcome. Conclusion - Transseptal puncture via the AccusafeTM guidewire with steerable sheath improves first-pass puncture success rate, enhances puncture site accuracy, and optimizes sheath-LAA central axis coaxiality, thereby improving procedural efficiency and occlusion efficacy. These findings support further validation of its clinical value in larger, randomized controlled studies.<br/>Copyright © 2026 Liang, Wang, Wang and Gu. <113> Accession Number 2049110750 Title Erector Spinae Plane Block vs. Intercostal Nerve Block for Pain Management in Thoracic Surgeries and Chest Wall Traumas: A Meta-Analysis. Source Current Pain and Headache Reports. 30(1) (no pagination), 2026. Article Number: 124. Date of Publication: 01 Dec 2026. Author Duplechin M.O.; Mashaw S.A.; Schwab S.J.; Mira A.J.; Serio M.A.; Ahmadzadeh S.; Miller B.C.; Shekoohi S.; Kaye A.D. Institution (Duplechin, Mashaw, Schwab, Mira, Serio) School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States (Ahmadzadeh, Miller, Shekoohi, Kaye) Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States Publisher Springer Abstract Background: Thoracic surgeries and chest wall traumas often result in severe postoperative pain, leading to significant morbidity and prolonged hospital stays. Intercostal nerve blocks have been a common strategy for managing this pain. In this regard, the ESPB is being utilized increasingly as a promising alternative as it offers more extensive pain relief and has a better safety profile. <br/>Objective(s): A meta-analysis comparing analgesic efficacy, measured by pain scores and opioid consumption, as well as hospital length of stay and time spent under analgesia, between ESPB and ICNB in patients undergoing thoracic surgeries and chest wall trauma was performed. <br/>Method(s): A systematic literature search was conducted across three databases, identifying 2,141 potential studies. After eliminating duplicates (n = 728), the remaining studies were screened in two stages: initially by reviewing abstracts and titles (n = 1,413), followed by a full-text review of the remaining studies (n = 10). These selected studies assessed postoperative pain scores and opioid consumption. Pain was measured using the Numeric Rating Scale (NRS) and Visual Analog Scale (VAS) at 1 h, 24 h, and 48 h postoperatively, while opioid consumption was quantified in intravenous morphine milligram equivalents at 24 and 48 h. <br/>Result(s): The ESPB demonstrated significantly lower pain scores at 1 h (P < 0.00001), 24 h (P < 0.00001), and 48 h (P = 0.0008) postoperatively compared to the ICNB. Postoperative opioid consumption, measured in intravenous morphine milligram equivalents at 24 h (P = 0.10) and 48 h (P = 0.20) showed no significant difference between the two groups. Additionally, there were no significant differences observed in hospital stay duration (P = 0.06) or time spent under analgesia (P = 0.33). <br/>Conclusion(s): While ESPB provides superior pain relief at all measured time points postoperatively, there were no significant differences in postoperative opioid consumption, hospital stay, or time under analgesia between ESPB and ICNB. Both techniques effectively manage thoracic pain, but ESPB offers enhanced analgesic effects. Further research is necessary to refine these techniques and establish clearer guidelines for their use in specific clinical contexts.<br/>Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <114> Accession Number 2049568126 Title Prehospital versus in-hospital unfractionated heparin in ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis. Source European Journal of Emergency Medicine. (no pagination), 2026. Date of Publication: 2026. Author Wu Y.-J.; Lin H.-J.; Lin Y.-H.; Hung C.-S. Institution (Wu) Department of Pharmacy, United States (Lin, Lin, Hung) Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, United States (Hung) Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan (Republic of China) Publisher Lippincott Williams and Wilkins Abstract Background and importance - In patients with ST-segment elevation myocardial infarction (STEMI), myocardial loss continues until coronary reperfusion is achieved. Objective - To evaluate whether prehospital administration of unfractionated heparin (UFH) improves preprocedural infarct-related artery patency and clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI). Design - Systematic review and meta-analysis. Electronic databases (PubMed, EMBASE, CENTRAL, and Web of Science) and clinical trial registries were systematically searched through March 2026. Settings and participants - Patients with STEMI scheduled for primary PCI across seven included studies (two randomized controlled trials and five observational studies), totaling 10 954 participants, with 78.1% male patients. Intervention or exposure - Prehospital UFH administration compared with PCI-capable hospital UFH administration. Outcome measures and analysis - Prespecified endpoints included pre- and postprocedural thrombolysis in myocardial infarction (TIMI) flow grade, 30-day mortality, a composite endpoint of 30-day or in-hospital mortality, and major bleeding events. Main results - Prehospital UFH was associated with a significantly higher rate of preprocedural TIMI 2-3 flow compared with control [odds ratio (OR): 1.49, 95% confidence interval (CI): 1.28-1.74; P < 0.001). Prehospital UFH was not associated with a significant reduction in 30-day all-cause mortality (OR: 0.70, 95% CI: 0.44-1.13; P = 0.141; I<sup>2</sup> = 60.9%), although a significant reduction was observed for the composite endpoint of 30-day or in-hospital mortality across all seven studies (OR: 0.68, 95% CI: 0.49-0.95; P = 0.023). Prehospital UFH was not associated with a significantly increased risk of major bleeding (OR: 0.77, 95% CI: 0.57-1.05; P = 0.099; I<sup>2</sup> = 0%). Conclusion - In patients with STEMI undergoing primary PCI, prehospital UFH was associated with improved preprocedural coronary patency without an apparent increase in major bleeding. However, no statistically significant reduction was observed in 30-day mortality. Large-scale randomized controlled trials adequately powered for clinical endpoints are needed to establish the role of prehospital UFH in contemporary STEMI care.<br/>Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. <115> Accession Number 652202345 Title Metabolic syndrome severity and the effects of intensive blood pressure lowering: Results from the STEP randomized trial. Source Hypertension research : official journal of the Japanese Society of Hypertension. (no pagination), 2026. Date of Publication: 16 Sep 2026. Author Zhao J.; Dong X.; Song Q.; Cai J. Institution (Zhao, Dong) Anzhen Hospital, Capital Medical University, Beijing, China (Song) 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 (Cai) Capital Medical University, Beijing, China Abstract Several clinical trials have shown that intensive systolic blood pressure (SBP) lowering confers cardiovascular benefits. However, whether baseline metabolic syndrome (MetS) severity modifies these benefits and risks remains unclear. This post hoc analysis of the STEP trial included 8231 participants with complete MetS severity data. Baseline MetS severity was quantified using an age-, sex-, and ethnicity-specific MetS scoring model and analyzed as tertiles and continuously. The primary outcome was a composite of stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, and cardiovascular death. Cox models and restricted cubic spline analyses were used to assess treatment-effect heterogeneity. During a median follow-up of 3.32 years, intensive SBP lowering reduced the risk of the primary outcome compared with standard treatment. The absolute incidence of the primary outcome and major adverse cardiac events was highest in the highest MetS tertile. Across MetS tertiles, event rates were lower in the intensive-treatment group, with the largest reduction in the middle tertile for the primary outcome (Q2: HR, 0.66; 95% CI, 0.44-0.99). No significant treatment-by-MetS interaction was observed in tertile-based or spline analyses. For safety outcomes, no significant treatment-by-MetS tertile interaction was observed, although hypotension was numerically more frequent with intensive treatment among participants in the highest MetS tertile. These findings suggest that baseline MetS severity identifies patients with higher absolute cardiovascular risk but does not significantly modify the relative efficacy of intensive SBP lowering. Careful monitoring for treatment-related hypotension may be warranted, particularly among patients with higher metabolic burden.<br/>Copyright © 2026. The Author(s), under exclusive licence to The Japanese Society of Hypertension. <116> Accession Number 2049461197 Title Diagnostic Performance and Clinical Outcomes of Coronary Computed Tomography Angiography Before Valve Surgery: A Systematic Review and Meta-analysis. Source CJC Open. (no pagination), 2026. Date of Publication: 2026. Author Sun C.; Qian Y.C.; Wilson E.; Rezaee A.; Lee G.; Roifman I.; Fremes S.E.; Tam D.Y. Institution (Sun, Qian) Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Wilson) Sunnybrook Library Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Rezaee) Faculty of Health Sciences, University of Western Ontario, London, ON, Canada (Lee, Fremes, Tam) Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada (Roifman) Division of Cardiology, University of Toronto, Toronto, ON, Canada (Roifman, Fremes, Tam) Sunnybrook Research Institute and Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Background: Recently published guidelines recommend coronary computed tomography angiography (CCTA) instead of invasive coronary angiography (ICA) for preoperative coronary evaluation in valve surgery patients with a low to moderate risk of coronary artery disease (CAD). However, evidence supporting the use of CCTA as a first-line preoperative coronary assessment strategy in this population remains uncertain. We performed a systematic review and meta-analysis comparing diagnostic performance and clinical outcomes of CCTA vs ICA. <br/>Method(s): We searched 5 databases through October 2025 for studies comparing preoperative CCTA with ICA in valve surgery patients reporting diagnostic accuracy and/or clinical outcomes. Pooled estimates were calculated. Coprimary outcomes were per-patient diagnostic accuracy and late major adverse cardiovascular events (MACE). <br/>Result(s): Sixteen observational studies were included (5781 total patients). Pooled sensitivity and specificity of CCTA relative to ICA were 86% (95% confidence interval [CI] 0.78-0.91) and 87% (95% CI 0.81-0.91), respectively (area under the curve = 0.93). There was no difference in concomitant coronary artery bypass graft (CABG) (risk difference [RD] -0.10, 95% CI -0.36 to 0.17, P = 0.32) and unplanned CABG (RD -0.00, 95% CI -0.01 to 0.01, P = 0.76) rates between CCTA and ICA. In-hospital/30-day outcomes were similar, including mortality (OR 1.07, 95% CI 0.42-2.70, P = 0.79), myocardial infarction (odds ratio [OR] 0.90, 95% CI 0.11-7.21, P = 0.63), stroke (OR 1.41, 95% CI 0.01-286.87, P = 0.56), acute kidney injury (OR 1.07, 95% CI 0.90-1.26, P = 0.25), and revascularization (RD -0.00, 95% CI -0.00 to 0.00, P = 0.26). Late MACE did not differ (incidence rate ratio 1.16, 95% CI 0.15-8.96, P = 0.52, median follow-up 31.7 months). <br/>Conclusion(s): CCTA may serve as a reasonable rule-out strategy for CAD in appropriately selected elective valve surgery patients. Although no significant differences in clinical outcomes were observed compared with ICA, larger contemporary prospective studies are required.<br/>Copyright © 2026 <117> Accession Number 2049392773 Title Impact of Coronary Diameter Stenosis and Proximal Lesion Location on Outcomes Following PCI in Patients Undergoing TAVI: Prespecified NOTION-3 Substudy. Source Circulation: Cardiovascular Interventions. 19(9) (pp e016286), 2026. Date of Publication: 01 Sep 2026. Author Riihiniemi M.; Marquard J.M.; Piuhola J.; Niemela M.; Glinge C.; Jabbari R.; Sabbah M.; Veien K.T.; Freeman P.; Linder R.; Ioanes D.; Terkelsen C.J.; Kajander O.A.; Koul S.; Savontaus M.; Karjalainen P.; Christiansen E.H.; Eftekhari A.; Holmvang L.; Sorensen R.; Ellert-Gregersen J.; Ruck A.; Angeras O.; Bieliauskas G.; Jorgensen T.H.; Junttila J.; Sondergaard L.; De Backer O.; Engstrom T.; Lonborg J. Institution (Riihiniemi, Piuhola, Niemela, Junttila) Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu, Finland (Piuhola, Niemela, Junttila) Department of Cardiology, Oulu University Hospital, Finland (Marquard, Glinge, Jabbari, Sabbah, Holmvang, Sorensen, Bieliauskas, Jorgensen, De Backer, Engstrom, Lonborg) Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (Veien, Ellert-Gregersen) Department of Cardiology, Odense University Hospital, Denmark (Eftekhari) Department of Cardiology, Aalborg University Hospital, Denmark (Freeman, Linder, Ruck) Department of Medicine, Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institute, Stockholm, Sweden (Ioanes, Angeras) Department of Cardiology, Sahlgrenska University Hospital, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden (Terkelsen, Christiansen) Department of Cardiology, Aarhus University Hospital, Denmark (Kajander) Heart Hospital, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Finland (Koul) Department of Cardiology, Lund University, Skane University Hospital, Sweden (Savontaus) Heart Center, Turku University Hospital, Finland (Karjalainen) Heart and Lung Center, Helsinki University Hospital, Finland (Sondergaard) Abbott, Santa Clara, California, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Optimal treatment of coronary artery disease in patients undergoing transcatheter aortic valve implantation remains debated. Here, our aim was to analyze the impact of the diameter and location of coronary stenosis on outcomes in patients undergoing percutaneous coronary intervention (PCI) with transcatheter aortic valve implantation. <br/>METHOD(S): - This study was a prespecified subanalysis of the NOTION-3 trial (Nordic Aortic Valve Intervention), which randomized patients with severe symptomatic aortic stenosis and physiologically significant stable coronary artery disease to receive either PCI or conservative treatment of coronary artery disease with transcatheter aortic valve implantation. In this substudy, patients were stratified according to diameter stenosis (<90% or >=90%) and stenosis location (proximal or nonproximal). The primary outcome was major adverse cardiovascular event, a composite of all-cause death, myocardial infarction, and urgent revascularization. <br/>RESULT(S): - Of 455 randomized patients, 184 (40%) had diameter stenosis <90% and 271 (60%) >=90%. A total of 294 (65%) patients had at least 1 proximal stenosis, while in 161 (35%) patients stenoses were nonproximal. At a median follow-up of 2 years (interquartile range, 1-4), PCI reduced the absolute risk of major adverse cardiovascular event by 13% in patients with diameter stenosis >=90% (PCI 24% versus conservative treatment 37%; hazard ratio, 0.53 [95% CI, 0.34-0.82]), whereas no benefit was observed in patients with diameter stenosis <90% (31% versus 33%; hazard ratio, 1.04 [95% CI, 0.62-1.73]; P for interaction=0.051). PCI reduced major adverse cardiovascular events in case of proximal stenosis (26% versus 38%; hazard ratio, 0.61 [95% CI, 0.40-0.93]), although the difference in effect remained nonsignificant when compared with patients with nonproximal stenosis (28% versus 32%; hazard ratio, 0.91 [95% CI, 0.52-1.61]; P for interaction=0.27). <br/>CONCLUSION(S): - The beneficial effect of PCI in patients undergoing transcatheter aortic valve implantation with physiologically significant stable coronary artery disease was seemingly pronounced in patients with high-grade stenosis, while stenosis location was not found to modify the outcome despite an almost similar beneficial effect with PCI in patients with proximal stenosis.<br/>Copyright © 2026 American Heart Association, Inc. <118> Accession Number 2049303784 Title Renal near-infrared spectroscopy for predicting acute kidney injury in pediatric cardiac surgery: A systematic review and meta-analysis. Source Heart, Vessels and Transplantation. 10(3) (no pagination), 2026. Date of Publication: 05 Sep 2026. Author Verma A.; Bajpai S.; Taluja A.; Shah P.; Banker K. Institution (Verma, Taluja, Shah, Banker) Department of Cardiac Anesthesia, Civil Hospital Campus, Asarwa, Gujarat, Ahmedabad, India (Bajpai) Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, United States Publisher Bishkek: Center for Scientific Research and Development of Education Abstract Objective: Renal near-infrared spectroscopy (NIRS) is a non-invasive, real-time monitoring technique that measures regional renal oxygen saturation (rSO_2) and may enable early detection of renal hypoperfusion. This systematic review and meta-analysis aimed to evaluate the role of renal NIRS in predicting postoperative acute kidney injury (AKI) in pediatric patients undergoing cardiac surgery. <br/>Method(s): A systemic search of PubMed, Cochrane Library, Google scholar and DOAJ database was conducted to identify relevant studies published between 2010 and 2024. The primary outcome was the pooled incidence of AKI. Secondary outcome included subgroup analyses based on AKI definition, geographic region, monitoring site, timing, side of monitoring and laterality. Heterogeneity was assessed using I<sup>2</sup> and Tau<sup>2</sup> statistics. <br/>Result(s): Eighteen studies comprising 1,330 participants were included. The pooled odds ratio (OR) for AKI was (OR- 0.22; 95% CI (confidence interval): 0.11 to 0.41; I<sup>2</sup>=92.1%; p<0.0001) indicating substantial heterogeneity. In the secondary outcome of subgroup analyses, the pooled odds ratio was higher in studies using KDIGO (Kidney Disease: Improving Global Outcomes) criteria (OR - 0.54; 95% CI: 0.27 to 1.07) than in those using pRIFLE (Pediatric Risk, Injury, Failure, Loss and End) (OR - 0.18; 95%CI: 0.06 to 0.44) criteria. In Asian studies, KDIGO-based estimates was OR - 0.27 (95% CI: 0.20 to 0.35), while intraoperative monitoring estimates - OR - 0.38 (95% CI: 0.15 to 0.96). Cerebral/renal site monitoring was associated with - OR - 0.34; (95% CI: 0.18 to 0.63), and right-sided monitoring estimates - OR - 0.20 (95% CI: 0.07-0.50). <br/>Conclusion(s): Renal NIRS identifies a clinically relevant pooled AKI incidence of 21 (6% approximately in postoperative pediatric cardiac surgery patients, with notable differences by definition, timing, and monitoring approach. Despite heterogeneity, these findings support to renal NIRS as a promising tool for early risk stratification and potential intervention to mitigate AKI.<br/>Copyright © 2026 Heart, Vessels and Transplantation This is an open access article CC-BY-NC-ND 4(0).license <119> Accession Number 652201306 Title Use of tPA-DNase in the management of pleural infection in a tertiary hospital with a dedicated pleural service. Source Irish Journal of Medical Science. Conference: Irish Thoracic Society Annual Scientific Meeting 2025. Galway Ireland. 195(3 Supplement) (pp S253-S254), 2026. Date of Publication: 01 Aug 2026. Author Griffiths S.; Foley E.; Barry D.; Fitzgerald D. Institution (Griffiths, Foley, Barry, Fitzgerald) Tallaght University Hospital, Ireland Publisher Springer Science and Business Media Deutschland GmbH Abstract Introduction: Pleural infection is a common presentation with significant morbidity and mortality, with up to 30% of patients failing initial therapy with antimicrobials and chest drain insertion and requiring surgical intervention. Intra-pleural enzyme therapy for the management of complicated parapneumonic effusions or empyema, with a combination of alteplase (tPA) and dornase alfa (DNase), were proven to reduce the rate of surgical referral and duration of hospital stay in the MIST2 randomised controlled trial. A 'real-life' observational series reported 92.3% of patients treated with tPA/DNase were successfully managed without surgical intervention Methods: We conducted a retrospective, single centre review of the use of tPA/DNase in patients with pleural infection managed under the respiratory department or pleural consult service. A secure Excel database was collated via chart review to analyse demographic data, radiology, laboratory results and follow-up to date for all patients treated from 2022-2025. Outcomes measured include: 1. Nature of patient presentation 2. Pleural intervention performed 3. Initial pleural fluid analysis 4. Length of stay 5. Rate of re-intervention Results: A total of 30 patients were included for analysis, 33.3% (10) female and 66.6% (20) male, with a mean patient age of 64.1 (SD 19.5, range 21-94). Dyspnoea was the most commonly recorded presenting symptom in 76% of patients, with chest pain (67%) and cough (63%) also frequently reported. All patients had a chest drain inserted, with 50% (n=15) by the respiratory team and 43% (n=13) by interventional radiology. One patient was treated for a loculated malignant pleural effusion via indwelling pleural catheter (IPC) and one patient presented with pleural infection post-IPC insertion in another institution. Initial pleural fluid analysis was reported as follows: mean pH 7.07 +/- 0.26 (n=17), mean LDH 999 +/- 613.5U/L (n=25), mean glucose 3.4 +/- 2.46mmol/L (n=19), mean protein 42.6 +/- 8.5g/L (n=27). Microbiological analysis was minimally contributory, with only 10% positive pleural fluid culture. The average time from presentation to chest drain insertion was 4.7 days with an average length of stay of 25.6 days (median 17 days, IQR 18.75). Two patients were discussed with cardiothoracic surgery (CTS), but no patients required surgical intervention. It is worth noting that 2 patients had previously had CTS interventions prior to presentation. The most common starting dose of tPA was 5mg and no patient required escalation to 10mg. tPA and DNase were administered once daily and concurrently. One patient required re-intervention post initial drain insertion, with a repeat diagnostic thoracentesis and chest drain insertion. One patient died during the hospital admission. <br/>Conclusion(s): Early intervention with antimicrobials, chest drain insertion and intra-pleural enzyme therapy is an effective treatment for pleural infection in a broad cohort of patients presenting to a respiratory department with a dedicated pleural consult service. This analysis shows a low rate of referral to cardiothoracic surgery and re-intervention post tPA/DNase. The length of stay is significantly skewed by a small number of prolonged hospital stays, likely reflecting the significant morbidity associated with pleural infection. In appropriately selected patients, tPA/DNase is an effective treatment for pleural infection. <120> Accession Number 652201754 Title Ten-year survival after stenting the proximal left anterior descending coronary artery with new-generation drug-eluting stents. Source Cardiovascular intervention and therapeutics. (no pagination), 2026. Date of Publication: 16 Sep 2026. Author van Vliet D.; Dayal A.; Ploumen E.H.; Pinxterhuis T.H.; Buiten R.A.; Kok M.M.; Zocca P.; van Houwelingen K.G.; Hartmann M.; de Man F.H.A.F.; Voortman M.; Linssen G.C.M.; Doggen C.J.M.; von Birgelen C. Institution (van Vliet, Dayal, Ploumen, Pinxterhuis, Buiten, Kok, Zocca, van Houwelingen, Hartmann, de Man, Voortman) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede, Netherlands (van Vliet, Voortman, Doggen) Department of Health Technology and Services Research, Faculty Faculty Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands (Linssen) Department of Cardiology, Ziekenhuisgroep Twente, Netherlands (von Birgelen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede, Netherlands (von Birgelen) Department of Health Technology and Services Research, Faculty Faculty Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands Abstract Percutaneous coronary intervention (PCI) of the proximal left anterior descending artery (p-LAD) is often considered a high-risk procedure, as the LAD supplies a substantial proportion of the myocardium. For most chronic coronary syndrome (CCS) patients with p-LAD target lesions, guidelines do not favor PCI over CABG, or vice versa. Long-term clinical data is lacking in new-generation drug-eluting stents (DES) used in p-LAD lesions. Therefore, we aimed to assess 10-year survival following PCI of the p-LAD versus other segments. We assessed patient-level data of consecutive all-comers, treated at Thoraxcentrum Twente with new-generation DES in the TWENTE I-III trials. Previous CABG or left main treatment were excluded. The primary endpoint was 10-year survival. Additionally, 5-year clinical events were assessed, including composite endpoints target lesion failure (TLF) and patient-oriented composite endpoint (POCE). Of all 4,467 patients, 1,244(27.8%) were treated for p-LAD lesions, while 3,223(72.2%) were treated exclusively for non-p-LAD lesions. After 10 years, all-cause mortality showed a numerically higher incidence in the p-LAD group, which was not statistically significant (24.0% vs. 22.3%; adjusted HR:1.05 95%CI 0.91-1.21, p=0.52). Furthermore, similar 5-year TLF and POCE rates were observed for both groups. In CCS patients, subgroup analyses showed no differences in 10-year survival by lesion location. Yet, the p-LAD group showed significantly lower 5-year repeat revascularization rates. P-LAD lesion location may not independently influence 10-year survival after PCI, both in all-comers and CCS patients. Yet, among CCS patients, 5-year repeat revascularization rates were lower in those treated for p-LAD lesions.<br/>Copyright © 2026. The Author(s). <121> Accession Number 2049493659 Title Transcatheter vs Surgical Replacement of Degenerated Bioprosthetic Aortic Valve: A Meta-Analysis of Propensity-Score-Matched Studies. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Ebrahimi P.; Taheri M.; Mahalleh M.; Soleimani H.; Taheri H.; Moradi A.; Sattartabar B.; Taebi M.; Bhia I.; Pirdehghan R.; Anafje M.; Alkhouli M.; Tajdini M.; Mohsen A.; Elgendy I.; Siegel R.J.; Mandegar M.H.; Hosseini K. Institution (Ebrahimi) Department of Cardiology, University Hospitals Birmingham, Birmingham, United Kingdom (Ebrahimi, Soleimani) Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom (Taheri) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Mahalleh, Sattartabar, Taebi) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Soleimani) Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Taheri, Siegel) Cedars-Sinai Medical Center, Los Angeles, CA, United States (Moradi) Internal Medicine, Blake Hospital, HCA Florida, University of South Florida, Morsani College of Medicine, Bradenton, FL, United States (Bhia) Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Pirdehghan, Anafje) Rajaei Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Alkhouli) Mayo Clinic Alix School of Medicine, Department of Cardiovascular Medicine, AZ, United States (Tajdini, Mohsen) Johns Hopkins University School of Medicine, Baltimore, MD, United States (Mohsen) Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, United States (Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, United States (Mandegar) Department of Cardiac Surgery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Elsevier Ltd Abstract Introduction: Degeneration of bioprosthetic aortic valves is a common late complication. While redo surgical aortic valve replacement (redo-SAVR) has traditionally been the standard of care, transcatheter valve-in-valve implantation (ViV-TAVR) has emerged as a less invasive alternative. This meta-analysis aimed to compare outcomes between ViV-TAVR and redo-SAVR using propensity-score-matched studies. <br/>Method(s): A systematic search of Cochrane CENTRAL, Scopus, MEDLINE (via PubMed) Embase, and Scopus was conducted from inception through to 1 September 2024. Propensity-score matched cohort studies comparing ViV-TAVR and redo-SAVR were included. Risk ratios (RRs) and mean differences (MDs) or standardised mean differences (SMD), as appropriate, were pooled using a random-effects model. <br/>Result(s): Thirteen propensity score-matched studies encompassing 16,223 patients (8,463 ViV-TAVR; 7,760 redo-SAVR) with a weighted mean follow-up of 16.6 months were included. Compared to redo-SAVR, ViV-TAVR was associated with significantly lower short-term all-cause mortality (RR: 0.47; 95% confidence interval [CI]: 0.34-0.66; p<0.0001), major bleeding (RR: 0.45; 95% CI: 0.33-0.59), acute kidney injury (RR: 0.56; 95% CI: 0.38-0.84), and shorter hospital stay (SMD: -0.79; 95% CI: -1.00 to -0.57). ViV-TAVR was also associated with a significantly lower incidence of new-onset atrial fibrillation (RR: 0.22; 95% CI: 0.13-0.37) but higher post-procedural mean transvalvular gradients (SMD: 0.45; 95% CI: 0.20-0.69). No significant differences were observed in 1- or >=2-year mortality, stroke/transient ischaemic attack, myocardial infarction, permanent pacemaker implantation, or early readmission. Results remained consistent across sensitivity and subgroup analyses. <br/>Conclusion(s): ViV-TAVR offers significant short-term benefits over redo-SAVR, including lower early mortality and shorter hospitalisation. Long-term clinical outcomes remain comparable, while postprocedural mean gradients are higher after ViV-TAVR, underscoring the need for randomised trials and individualised patient selection to guide treatment decisions for degenerated bioprosthetic valves.<br/>Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <122> Accession Number 2049179803 Title Safety and Glycemic Efficacy of Perioperative Liraglutide in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Gamal I.; Elkasaby M.H.; Ewidat O.; Riyad N.; Sadin Z.; Singh Gill A.; Nassar M.; Frishman W.H.; Aronow W.S. Institution (Gamal, Elkasaby) From the Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Ewidat, Riyad) Department of Medicine, An-Najah National University, Nablus, Palestine (Sadin) Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Singh Gill) Department of Medicine, Division of Endocrinology, Champlain Valley Physicians Hospital, Plattsburgh, NY, United States (Nassar) Department of Medicine, Division of Endocrinology and Diabetes, Larner College of Medicine, University of Vermont, Burlington, VT, United States (Frishman, Aronow) Departments of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Publisher Lippincott Williams and Wilkins Abstract Perioperative hyperglycemia in cardiac surgery is associated with wound infection, acute kidney injury, and death, yet the intravenous insulin used to treat it is itself coupled to hypoglycemia. Glucagon-like peptide-1 receptor agonists lower glucose only when glucose is elevated and might therefore separate glycemic control from hypoglycemic risk. We searched PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL through September 2025 for randomized controlled trials of perioperative subcutaneous liraglutide versus placebo or insulin-based usual care in adults undergoing cardiac surgery. Two reviewers screened, extracted data, and applied the Cochrane Risk of Bias 2 tool independently; certainty was graded using GRADE. Effects were pooled by inverse variance, fixed-effect when I<sup>2</sup> was below 50%. Seven reports of 4 trials, enrolling 446 randomized patients, were eligible. Liraglutide did not alter 30-day mortality (1/161 vs 3/160; risk ratio [RR] 0.42, 95% confidence interval [CI], 0.06-2.81), the composite of any postoperative complication (68/129 vs 76/132; RR 0.92; 95% CI, 0.74-1.14), cardiac adverse events (RR 1.08; 95% CI, 0.83-1.40), hypoglycemia (8/165 vs 9/166; RR 0.85; 95% CI, 0.34-2.13), or postoperative nausea and vomiting (RR 3.01; 95% CI, 0.26-35.27).<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <123> Accession Number 2049073443 Title A randomized controlled study on the effects of the T-REX Twente (Thoracic Surgical Rehabilitation Experts Twente) sternal precautions on quality of life and physical activity levels in cardiac surgery patients, compared to standard care in patients following a median sternotomy: the study protocol. Source Trials. 27(1) (no pagination), 2026. Article Number: 571. Date of Publication: 01 Dec 2026. Author Wielens N.; Roerdink K.; Lynch W.; Esau L.; van der Palen J.; Halfwerk F.R. Institution (Wielens, Roerdink, Lynch, Halfwerk) Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Esau) Department of Physiotherapy, Foothills Medical Centre, Alberta Health Services, Calgary, Canada (van der Palen) Department of Epidemiology, Medisch Spectrum Twente, Enschede, Netherlands (van der Palen) Section Cognition, Data and Education, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands (Halfwerk) Cardiac Surgery Innovations Lab, Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands Publisher BioMed Central Ltd Abstract Background: In 2023, a majority (86%) of open-heart surgeries was performed at Thorax Centrum Twente (TCT) via a full median sternotomy. Currently, there is no consensus on postoperative sternal precautions following full median sternotomy. Research from the USA and Canada suggests that existing restrictive sternal precautions may not be necessary. More lenient sternal precautions, such as the "Keep Your Move in the Tube" principle, have shown positive outcomes, with no significant complications. Patients following this approach experienced fewer mobility issues and reported improved quality of life and reduced anxiety. This study explores the potential benefits of fewer restrictions, which could reduce patient anxiety and lead to fewer follow-up visits. This study aims to determine whether the Thoracic Surgical Rehabilitation Experts Twente (T-REX Twente) sternal precautions have a small positive effect on the Modified MacNew Quality of Life after Myocardial Infarction questionnaire (QLMI-2), physical activity, and reduction of movement-related anxiety in patients after full median sternotomy, compared to standard restrictive sternal precautions. It also assesses whether the T-REX sternal precautions result in no negative effects on pain, wound healing, or postoperative complications. <br/>Method(s): This prospective, randomized, controlled, single-blind study will include adult patients undergoing full median sternotomy at TCT between June 2024 and June 2026, all participating in outpatient cardiac rehabilitation. Exclusion criteria include intensive care unit stays over 72 h, delirium, dementia, severe cognitive impairments, language barriers, or treatment by an external referring cardiologist. The control group will adhere to current restrictive sternal precautions, whereas those in the intervention group will follow the T-REX sternal precautions, which allow lifting, pushing, or pulling as long as arm movement remains within a defined "tube." The primary endpoint is the change in QLMI-2 from baseline (T<inf>0</inf>) to start of phase II cardiac rehabilitation (T<inf>4</inf>). <br/>Discussion(s): The T-REX Twente sternal precautions may improve quality of life, physical activity, and reduce movement-related anxiety, supporting the idea that less restrictive postoperative sternal precautions can enhance patient outcomes. Trial registration: CCMO Trial Register NL78107.100.23, registered on 29 February 2024. ClinicalTrials.gov: NCT06115759.<br/>Copyright © The Author(s) 2026. <124> Accession Number 652202884 Title Erector Spinae Plane Block vs. Intercostal Nerve Block for Pain Management in Thoracic Surgeries and Chest Wall Traumas: A Meta-Analysis. Source Current pain and headache reports. 30(1) (no pagination), 2026. Date of Publication: 16 Sep 2026. Author Duplechin M.O.; Mashaw S.A.; Schwab S.J.; Mira A.J.; Serio M.A.; Ahmadzadeh S.; Miller B.C.; Shekoohi S.; Kaye A.D. Institution (Duplechin, Mashaw, Schwab, Mira, Serio) School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States (Ahmadzadeh, Miller, Shekoohi, Kaye) Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States Abstract BACKGROUND: Thoracic surgeries and chest wall traumas often result in severe postoperative pain, leading to significant morbidity and prolonged hospital stays. Intercostal nerve blocks have been a common strategy for managing this pain. In this regard, the ESPB is being utilized increasingly as a promising alternative as it offers more extensive pain relief and has a better safety profile. <br/>OBJECTIVE(S): A meta-analysis comparing analgesic efficacy, measured by pain scores and opioid consumption, as well as hospital length of stay and time spent under analgesia, between ESPB and ICNB in patients undergoing thoracic surgeries and chest wall trauma was performed. <br/>METHOD(S): A systematic literature search was conducted across three databases, identifying 2,141 potential studies. After eliminating duplicates (n = 728), the remaining studies were screened in two stages: initially by reviewing abstracts and titles (n = 1,413), followed by a full-text review of the remaining studies (n = 10). These selected studies assessed postoperative pain scores and opioid consumption. Pain was measured using the Numeric Rating Scale (NRS) and Visual Analog Scale (VAS) at 1 h, 24 h, and 48 h postoperatively, while opioid consumption was quantified in intravenous morphine milligram equivalents at 24 and 48 h. <br/>RESULT(S): The ESPB demonstrated significantly lower pain scores at 1 h (P < 0.00001), 24 h (P < 0.00001), and 48 h (P = 0.0008) postoperatively compared to the ICNB. Postoperative opioid consumption, measured in intravenous morphine milligram equivalents at 24 h (P = 0.10) and 48 h (P = 0.20) showed no significant difference between the two groups. Additionally, there were no significant differences observed in hospital stay duration (P = 0.06) or time spent under analgesia (P = 0.33). <br/>CONCLUSION(S): While ESPB provides superior pain relief at all measured time points postoperatively, there were no significant differences in postoperative opioid consumption, hospital stay, or time under analgesia between ESPB and ICNB. Both techniques effectively manage thoracic pain, but ESPB offers enhanced analgesic effects. Further research is necessary to refine these techniques and establish clearer guidelines for their use in specific clinical contexts.<br/>Copyright © 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. <125> Accession Number 2049557268 Title Comparison of analgesic efficacy of dexamethasone and dexmedetomidine as an adjuvant to local anaesthetic in transversus thoracic muscle plane block in adult patients undergoing median sternotomy: A randomised controlled trial. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102955. Date of Publication: 01 Nov 2026. Author Kumari P.; Jha L.; Sinha C.; Kumar A.; Kumar S.; Kapoor P. Institution (Kumari, Kumar, Sinha, Kumar) Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India (Jha) Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Kumar, Kapoor) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Patna, India Publisher Elsevier Inc. Abstract Background: Post-sternotomy pain contributes significantly to delayed recovery following cardiac surgery. The transversus thoracic muscle plane block (TTPB) is a recently described regional anaesthetic technique that provides analgesia to the anterior chest wall. The addition of adjuvants such as dexamethasone and dexmedetomidine may enhance the analgesic efficacy of TTPB. <br/>Objective(s): This study compared the analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to bupivacaine for TTPB in patients undergoing median sternotomy. <br/>Method(s): 66 adult patients (ASA I-III) scheduled for cardiac surgery via median sternotomy were recruited for this randomised trial. Following induction of anaesthesia, all patients received bilateral TTPB and were allocated to three groups: dexamethasone (0.25 % bupivacaine + 8 mg dexamethasone), dexmedetomidine (0.25 % bupivacaine + 1 microg/kg dexmedetomidine), and a control group (0.25 % bupivacaine alone). The primary outcome was the time to first rescue analgesia following extubation. Secondary outcomes included 24-hour postoperative fentanyl consumption, intraoperative fentanyl requirement, pain scores, extubation time, patient satisfaction, and adverse events. <br/>Result(s): Time to first rescue analgesia was significantly longer in the dexmedetomidine group than in the dexamethasone and control groups (P 0.001). Twenty-four-hour postoperative fentanyl consumption was significantly lower in both adjuvant groups than in the control group (P < 0.001). Pain scores were consistently lower with dexmedetomidine and dexamethasone groups. Extubation time and intraoperative fentanyl consumption were comparable among the three groups (P > 0.05). <br/>Conclusion(s): Both dexamethasone and dexmedetomidine improved TTPB analgesia. Dexmedetomidine significantly prolonged the duration of analgesia, whereas 24-hour postoperative opioid consumption was comparable between the adjuvant groups.<br/>Copyright © 2026 Elsevier Inc. <126> Accession Number 652197085 Title SBUF-SMUF: On the path to the optimum hemofiltration technique in pediatric cardiopulmonary bypass: A randomized clinical trial. Source The journal of extra-corporeal technology. 58(3) (pp 228-236), 2026. Date of Publication: 01 Sep 2026. Author Shadmehr M.; Ali B.; Abdollahzadeh R.; Zarrabi K.; Gerami H.; Butt S.P. Institution (Shadmehr) Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran, Islamic Republic of (Ali) Department of Cardiology and Cardiac Perfusion, Khyber Medical University, PO BOX 25160, Peshawar, Pakistan (Abdollahzadeh) Department of Perfusion, School of Medicine, Isfahan University of Medical Science, PO BOX 7346-81746, Isfahan, Iran, Islamic Republic of (Zarrabi) Department of Cardiovascular Surgery, School of Medicine, Shiraz University of Medical Science, PO BOX 71348-14336 Shiraz, Iran, Islamic Republic of (Gerami) Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran, Islamic Republic of (Butt) Perfusion Services, Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, United Arab Emirates Abstract BACKGROUND: Hemofiltration during pediatric cardiopulmonary bypass (CPB) is essential to mitigate hemodilution, inflammatory responses, and postoperative complications. Conventional ultrafiltration (CUF) is widely practiced, but novel methods such as subzero balanced ultrafiltration combined with simple modified ultrafiltration (SBUF-SMUF) may offer superior outcomes. <br/>OBJECTIVE(S): To compare the clinical efficacy and safety of CUF versus SBUF-SMUF in pediatric patients undergoing open-heart surgery. <br/>METHOD(S): In this prospective randomized, outcome-assessor-blinded clinical trial, 80 pediatric patients with congenital heart disease were allocated to either CUF (n = 40) or SBUF-SMUF (n = 40) during CPB. Baseline demographics, intraoperative characteristics, fluid balance, blood product utilization, and postoperative outcomes were assessed. Statistical analysis was conducted using independent t-tests, Chi-square tests, and Fisher's exact tests. Statistical significance was defined as a two-tailed p-Value of less than 0.05. <br/>RESULT(S): Demographic and preoperative variables were comparable between groups. Mean fluid balance was significantly positive in the CUF group (+192.1 +/- 178.8 mL) but negative in the SBUF-SMUF group (-105.0 +/- 78.9 mL, p < 0.001). The SBUF-SMUF group required significantly less intraoperative PRBC (141.7 +/- 70.2 vs. 261.0 +/- 68.8 mL, p < 0.001) and postoperative FFP transfusion (2% vs. 10%, p = 0.020). Post-bypass hematocrit levels were higher (31.2% vs. 27.3%, p = 0.001) and extubation occurred earlier in the SBUF-SMUF group (1.05 +/- 1.03 vs. 2.27 +/- 2.37 days, p = 0.006). No significant differences were observed in potassium levels or incidence of acute kidney injury. <br/>CONCLUSION(S): The SBUF-SMUF technique is safe, effective, and superior to CUF in optimizing fluid balance, reducing blood product utilization, and facilitating earlier extubation in pediatric cardiac surgery. No additional risk of oliguria or electrolyte imbalance was observed compared to CUF. Its simplicity and reproducibility support its consideration as a standard approach in pediatric CPB.<br/>Copyright © The Author(s), published by EDP Sciences, 2026. <127> Accession Number 652196172 Title Impact of adenosine in controlled aortic root reperfusion on clinical outcomes among patients undergoing valvular heart surgery. Source The journal of extra-corporeal technology. 58(3) (pp 217-222), 2026. Date of Publication: 01 Sep 2026. Author Jalili Shahandashti F.; Kachoueian N.; Fattahi M.; Samaie D.; Ghanbari Garekani M.; Taherkhani A.; Seyedebrahimi S.; Heydari Nia S.; Gorjipour F. Institution (Jalili Shahandashti, Fattahi, Samaie, Ghanbari Garekani, Taherkhani, Heydari Nia) Rajaie Cardiovascular, Medical and Research Center, Tehran, Iran, Islamic Republic of (Kachoueian) Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Seyedebrahimi) Department of Allied Medicine, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Gorjipour) Rajaie Cardiovascular, Medical and Research Center, Tehran, Iran - SUNY Upstate Medical University, Syracuse, NY, USA (Gorjipour) Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of Abstract BACKGROUND: Adenosine is a vital medication in cardiac surgery, particularly in valvular heart procedures. While its use has been linked to improved postoperative cardiac function in some studies, there remains significant uncertainty regarding the adenosine usage in aortic reperfusion phase. This lack of consensus poses challenges for surgeons, perfusionists, and anesthesiologists alike. This study aims to explore the impact of adenosine on clinical outcomes in patients undergoing valvular heart surgery. <br/>METHOD(S): This prospective randomized controlled trial was conducted over a three-month period. Sixty patients undergoing valvular heart surgery were enrolled using a continuous sampling method and randomly allocated into two equal groups of 30 patients each. The intervention group received adenosine-enriched aortic root reperfusion immediately prior to aortic declamping, while the control group underwent standard warm blood aortic root reperfusion. Both groups were matched for demographic and clinical characteristics to ensure comparability. <br/>RESULT(S): Results indicated no significant differences in mean cardiopulmonary bypass (CPB) time, aortic cross-clamping duration, or mechanical ventilation between the intervention and control groups. However, the intervention group that received adenosine had a higher rate of antiarrhythmic agent usage in the operating room (P < 0.05). Inotropic agent usage was similar in both groups during surgery and in the ICU. Additionally, laboratory parameters on the first day of ICU admission were comparable between groups. <br/>CONCLUSION(S): Results in the control group showed more favorable outcomes in terms of anti-arrhythmic drug usage, electroshock application, and arrhythmia prevalence. This study showed advantages for the standard warm blood aortic root reperfusion technique in managing post-operative cardiac rhythm disturbances, in comparison with the trial group.<br/>Copyright © The Author(s), published by EDP Sciences, 2026. <128> Accession Number 652194295 Title Effect of phenylephrine versus ephedrine on the incidence of postoperative delirium in elderly patients undergoing non-cardiac and non-neurosurgical procedures: protocol for a multicentre, double-blind, randomized, controlled trial. Source Annals of medicine. 58(1) (pp 2732555), 2026. Date of Publication: 01 Dec 2026. Author Xu X.; Wang G.; Li X.; Peng K.; Liu H.; Ji F.; Shan X.; Wang Y. Institution (Xu, Wang, Li, Peng, Ji, Shan, Wang) Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (Xu, Wang, Li, Peng, Ji, Shan, Wang) Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, China (Xu) Department of Anesthesiology, Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, China (Liu) Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, United States Abstract BACKGROUND: Whether ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium remains uncertain. This study aims to determine whether the intraoperative management of hypotension with ephedrine, compared with phenylephrine, reduces the incidence of postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. <br/>METHOD(S): This multicentre, randomized, double-blind, controlled trial will enrol 1,084 elderly patients scheduled for elective non-cardiac and non-neurosurgical major surgeries under general anaesthesia at seven hospitals in China. Participants will be randomized in a 1:1 ratio, stratified by study centre, to receive continuous intravenous infusion of either phenylephrine or ephedrine to maintain mean arterial pressure within 20% of the baseline value. The primary outcome is the incidence of postoperative delirium within 7 days after surgery. Secondary outcomes include severity of postoperative delirium, numeric rating scale pain scores at rest and during activity at 24, 48 and 72 h postoperatively, intensive care unit (ICU) admission rate and length of ICU stay, length of postoperative hospital stay, incidence of in-hospital major adverse cardiovascular and cerebrovascular events (myocardial infarction, arrhythmia, heart failure, and stroke), and 30-day all-cause mortality. <br/>DISCUSSION(S): We hypothesize that ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. The findings of this study may provide high-quality evidence for optimizing the management of intraoperative hypotension in this vulnerable population. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2500115385). <129> Accession Number 2049545823 Title BiodEgradable soaked Amiodarone paTch use for the prevention of Atrial Fibrillation after cardiac surgery (The BEAT-AF Trial): Rationale and Design. Source CJC Open. (no pagination), 2026. Date of Publication: 2026. Author Lemma M.; Chao L.; Scorsin M.; Gregg A.C.; Sandner S.; Stone G.W.; Redfors B.; Gaudino M. Institution (Lemma, Chao, Scorsin) Cardiac Surgery Department, Jilin Heart Hospital, Changchun, China (Gregg, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Sandner) Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Redfors) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Redfors) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Redfors) Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States Publisher Elsevier Inc. Abstract Postoperative atrial fibrillation (POAF) remains the most common complication following cardiac surgery and contributes substantially to patient morbidity and healthcare utilization. Although amiodarone is among the most effective pharmacologic agents for the prevention and treatment of POAF, its routine use is limited by systemic toxicity and drug interactions. Localized delivery strategies may achieve therapeutic myocardial concentrations while minimizing systemic exposure, but they have never been tested in appropriately powered trials. Experimental studies have indicated that epicardial and intrapericardial administration of amiodarone can reduce atrial vulnerability to tachyarrhythmias while maintaining low circulating drug levels. Preliminary clinical investigations have suggested a potential reduction in POAF incidence with topical amiodarone; however, studies have yielded inconsistent results, leaving uncertainty regarding clinical efficacy. The BiodEgradable soaked Amiodarone paTch use for the prevention of Atrial Fibrillation after cardiac surgery (BEAT-AF) trial is a single-centre, double-blind, randomized, placebo-controlled trial designed to evaluate the efficacy and safety of topical amiodarone administration for the prevention of POAF following cardiac surgery. A minimum of 500 patients undergoing elective cardiac surgery through median sternotomy will be randomized in a 1:1 ratio to receive either amiodarone-soaked (150 mg/3 mL) or saline-soaked oxidized regenerated cellulose patches applied intra-operatively to the dome of the left atrium and the ostia of the right pulmonary veins immediately prior to sternal closure. The primary outcome is the occurrence of POAF within 5 days postoperatively. This trial will inform use of topical amiodarone as a strategy for POAF prevention in cardiac surgery patients. Clinical Trial Registration: NCT06722196.<br/>Copyright © 2026 The Authors <130> Accession Number 652195588 Title Percutaneous Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Nonvalvular Atrial Fibrillation. Source Trends in cardiovascular medicine. (no pagination), 2026. Date of Publication: 15 Sep 2026. Author Odeh A.; Shubietah A.; Salah M.R.; Itraish J.; Jiao T.; Foy A.J.; Mandrola J.; Ruzieh M. Institution (Odeh) Department of Internal Medicine, Northwestern Memorial Hospital, Chicago, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States (Salah) University of Chicago Medical Center, Chicago, IL, USA; Endeavor Health - NorthShore Hospitals, Evanston, IL, USA (Itraish) Department of Biology, University of Florida, Gainesville, FL, United States (Jiao) Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL, United States (Foy) Beebe Hospital, Lewes, DE, United States (Mandrola) Baptist Health Louisville, Louisville, KY, United States (Ruzieh) Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, USA Abstract Percutaneous left atrial appendage occlusion (pLAAO) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation, yet no individual trial has been powered to detect meaningful differences in ischemic stroke or systemic embolism. We evaluated the comparative efficacy and safety of pLAAO vs OAC in nonvalvular atrial fibrillation using pooled analysis of randomized controlled trials. We searched PubMed, Embase, and Cochrane Central through April 3, 2026. Risk ratios were pooled using a random-effects model. Bayesian and trial sequential analyses were performed to assess non-inferiority using a prespecified margin of RR = 1.40, and power of available evidence. The primary efficacy endpoint was ischemic stroke or systemic embolism; primary safety endpoints were major bleeding and hemorrhagic stroke. Seven RCTs enrolling 7,353 patients were included. Compared with OAC, pLAAO was associated with significantly more ischemic stroke or systemic embolism (3.3% vs 2.0%; RR 1.48, 95% CI 1.06-2.07). Hemorrhagic stroke was numerically lower with pLAAO but non-significant (0.6% vs 0.9%; RR 0.65, 95% CI 0.39 - 1.07). Major bleeding did not differ (8.3% vs 8.1%; RR 0.98, 95% CI 0.84-1.15). Bayesian analysis yielded a posterior probability of non-inferiority of 45.3%, failing the prespecified margin. Trial sequential analysis confirmed insufficient evidence to establish non-inferiority, and the major bleeding Z-curve entered the futility zone. Compared with OAC, pLAAO was not non-inferior for the outcome of ischemic stroke or systemic embolism, and did not significantly reduce major bleeding, though hemorrhagic stroke was numerically lower with pLAAO.<br/>Copyright © 2026 Elsevier Inc. All rights reserved. <131> Accession Number 2038616411 Title Surgical Considerations for Kidney Transplant in Simultaneous Versus Sequential Heart-Kidney Transplant: A Systematic Review. Source Experimental and Clinical Transplantation. 24(8) (pp 579-588), 2026. Date of Publication: 01 Aug 2026. Author Sharma R.; Khan N. Institution (Sharma) Department of Surgery, West Virginia University School of Medicine, Morgantown, WV, United States (Khan) Department of Nephrology, West Virginia University School of Medicine, Morgantown, WV, United States Publisher Baskent University Abstract Objectives: We aimed to answer a key kidney-focused question in simultaneous heart-kidney transplant of whether the kidney should be implanted immediately, staged after short-term stabilization, or deferred to sequential kidney-after-heart transplant. <br/>Material(s) and Method(s): We used PRISMA to guide our systematic review using PubMed as the primary database, with supplementary Embase and Cochrane searches and separate review of current Organ Procurement and Transplant Network policies. PubMed was searched on March 21, 2026, using (((heart-kidney transplant) OR (sequential kidney transplant in heart transplant)) OR (simultaneous heart and kidney transplant)), limited to English, humans, adult: 19+ years, MEDLINE, and January 1, 2006, through March 21, 2026. Our review yielded 303 records; 62 abstracts underwent review, of which 26 were selected for full-text review. Embase search yielded 264 records across 7 targeted searches; 14 studies underwent review, of which 7 were duplicates and 7 unique studies underwent full-text review. No Cochrane record met final inclusion criteria. Two Organ Procurement and Transplant Network policy reports were reviewed separately. Final qualitative synthesis included 35 full-text records. <br/>Result(s): Simultaneous heart-kidney transplant was most consistently supported in dialysis-dependent recipients and in recipients with severe, likely irreversible renal dysfunction. Kidney delayed graft function occurred in approximately one-fourth to one-third of simultaneous heart-kidney transplant recipients and was associated with worse patient and kidney graft survival. Primary nonfunction, early kidney graft loss, and renal allograft futility were highly consequential, especially in hemodynamically fragile and surgically complex recipients. Comparative studies suggested that sequential kidney-after-heart transplant is a reasonable strategy when renal reversibility is uncertain or when the postsurgery heart transplant environment is hostile to renal graft perfusion. <br/>Conclusion(s): Simultaneous allocation should be distinguished from simultaneous implantation. In selected recipients, staged or sequential kidney transplant may better protect kidney outcomes and better align with utility, justice, and organ stewardship.<br/>Copyright © Baskent University 2026 Printed in Turkey. All Rights Reserved. <132> Accession Number 2049079085 Title Balloon Aortic Valvuloplasty as a Bridge Therapy in Acute Valve Syndrome: A Narrative Review of Evidence Gaps and Future Directions. Source Structural Heart. 10(9) (no pagination), 2026. Article Number: 101059. Date of Publication: 01 Sep 2026. Author Saleh O.; Jafar O.; Valle N.; Yasa S.; Mostafa S.; Benza R.L.; Talreja D.R.; Peterson B.D.; Summers M.R. Institution (Saleh, Yasa, Mostafa) Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Eastern Virginia Medical School, Norfolk, VA, United States (Jafar, Valle) Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, United States (Benza) Department of Cardiology, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Eastern Virginia Medical School, Norfolk, VA, United States (Talreja, Summers) Department of Structural Cardiology, Sentara Medical Group, Sentara Health, Virginia Beach, VA, United States (Peterson) Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States Publisher Cardiovascular Research Foundation Abstract Acute valve syndrome represents a high-acuity, decompensated presentation of severe aortic stenosis (AS), often manifesting as acute heart failure, cardiogenic shock, or cardiac arrest. Transcatheter aortic valve replacement (TAVR) remains the only durable therapy for severe AS in patients with prohibitive surgical risk, yet acute valve syndrome patients may be too unstable for standard preprocedural planning. Balloon aortic valvuloplasty (BAV) has re-emerged as a bridge strategy that can provide rapid hemodynamic stabilization and permit subsequent valve replacement. Registry analyses report lower mortality in emergent TAVR compared with BAV, but these comparisons are confounded by procedural indication and unmatched AS severity. Smaller hemodynamically characterized cohorts suggest that selected patients who stabilize after BAV and proceed to TAVR may achieve outcomes comparable to direct TAVR, although these studies remain underpowered for definitive inference. In this narrative review, we evaluate evidence comparing BAV-bridged strategies with emergent TAVR, identify key evidence gaps, and discuss how acute hemodynamic status may inform Heart Team decision-making.<br/>Copyright © 2026 The Author(s). <133> Accession Number 2049241458 Title COGNITIVE IMPAIRMENT AFTER CORONARY ARTERY BYPASS GRAFTING: THE ROLE OF MEDICAL REHABILITATION - A LITERATURE REVIEW. Source Georgian Medical News. 375(6) (pp 63-72), 2026. Date of Publication: 2026. Author Rakhmetullina A.K.; Alimbayeva A.R.; Orekhov A.Yu.; Dairbekov Ye.Ye.; Rakhmetullin A.B. Institution (Rakhmetullina, Alimbayeva, Orekhov, Dairbekov, Rakhmetullin) Semey Medical University, Semey, Kazakhstan Publisher Georgian Association of Business Press Abstract Introduction: Advances in cardiac surgery, extracorporeal circulation techniques, and perioperative care have significantly improved survival following coronary artery bypass grafting (CABG). However, the increasing number of postoperative survivors has led to a growing burden of long-term complications, among which cognitive impairment represents a major yet underrecognized clinical problem. <br/>Objective(s): To critically synthesize current evidence on the prevalence, mechanisms, and clinical significance of cognitive impairment after CABG, as well as to evaluate the role of medical rehabilitation in its prevention and management. <br/>Method(s): A structured literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published within the last five years. Study selection was performed based on predefined inclusion criteria, and elements of the PRISMA framework were applied to enhance transparency. A total of 55 studies were included in the final analysis. <br/>Result(s): Postoperative cognitive impairment remains one of the most common neurological complications following CABG, affecting approximately 30-60% of patients in the early postoperative period, with persistent deficits observed in a substantial proportion of cases. Its pathogenesis is multifactorial and involves preoperative vulnerability, intraoperative cerebral hypoperfusion and microembolization, systemic inflammation, and postoperative complications. Despite its clinical relevance, cognitive impairment is frequently underdiagnosed and insufficiently addressed within standard rehabilitation programs. <br/>Conclusion(s): Current rehabilitation models lack systematic approaches to the assessment and management of cognitive dysfunction after CABG. Integrative strategies combining cognitive training, physical rehabilitation, and multimodal interventions demonstrate promising potential for improving cognitive outcomes and quality of life. Further high-quality studies are required to develop standardized rehabilitation protocols with mandatory inclusion of cognitive endpoints.<br/>Copyright © GMN <134> Accession Number 2049043473 Title The Next Frontiers in Stroke Prevention: Optimizing Left Atrial Appendage Closure in Atrial Fibrillation: Current Devices, Imaging-Guided Strategies, and Emerging Approaches. Source Journal of Clinical Medicine. 15(17) (no pagination), 2026. Article Number: 6526. Date of Publication: 01 Sep 2026. Author Qassim Z.A.-A.M.; Patni M.M.; George B.T.; Kar S.S.; Dube R.; Al Shaibani R.M.S.; Yassin G.H.; Theyabat Y.M.; Alabid I.; Qassim M.M. Institution (Qassim, Al Shaibani, Yassin, Theyabat, Alabid, Qassim) RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, United Arab Emirates (Patni) Department of Community Medicine, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, United Arab Emirates (George) Department of Surgery, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, United Arab Emirates (Kar) Department of Paediatrics, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, United Arab Emirates (Dube) Department of Obstetrics and Gynaecology, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, United Arab Emirates Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with ischemic stroke, systemic thromboembolism, heart failure, and mortality. Although oral anticoagulation (OAC) remains the cornerstone of stroke prevention, long-term therapy may be limited by bleeding risk, contraindications, intolerance, nonadherence, or thromboembolic events despite treatment. Left atrial appendage closure (LAAC) has therefore emerged as a non-pharmacological alternative for selected patients with nonvalvular AF. This review aimed to synthesize current evidence on LAAC, focusing on comparative efficacy versus OAC, device evolution, imaging-guided strategies, antithrombotic management, procedural optimization, unresolved challenges, and emerging technologies. <br/>Method(s): This state-of-the-art narrative review was informed by targeted, non-systematic searches of PubMed and Scopus for publications from January 2009 to June 2026. Evidence was selected purposively to represent clinically relevant guidelines, randomized trials, registries, comparative observational studies, systematic reviews, meta-analyses, imaging studies, device-comparison studies, and reports of emerging technologies. The selected evidence was synthesized narratively; no exhaustive screening process, PRISMA flow diagram, formal risk-of-bias assessment, or quantitative synthesis was performed. <br/>Result(s): Randomized evidence was context dependent. OPTION supported LAAC as an alternative to oral anticoagulation in selected anticoagulation-eligible patients undergoing atrial fibrillation ablation. CHAMPION-AF established noninferiority of Watchman FLX to non-vitamin K antagonist oral anticoagulants for its composite efficacy endpoint in a predominantly moderate-risk, anticoagulation-eligible population and demonstrated less non-procedural bleeding, although ischemic stroke occurred numerically more often after LAAC. In contrast, CLOSURE-AF did not establish noninferiority of LAAC to physician-directed medical therapy in an older population at high risks of both stroke and bleeding. These findings indicate that the comparative value of LAAC depends strongly on patient selection, comparator therapy, endpoint composition, procedural risk, and trial design. Observational, registry, and emerging evidence was considered supportive or hypothesis-generating rather than equivalent to randomized evidence. OPTION enrolled only patients undergoing or recently undergoing AF ablation who were suitable for anticoagulation. CHAMPION-AF included 3000 anticoagulation-eligible patients but had relatively low baseline bleeding risk, while CLOSURE-AF studied 912 substantially older, higher-risk patients and did not meet its noninferiority criterion. <br/>Conclusion(s): LAAC has evolved into a precision-guided intervention integrating patient risk, left atrial appendage anatomy, device choice, imaging, antithrombotic therapy, and structured surveillance. Further studies are needed to optimize patient selection, standardize post-procedural therapy, and clarify its long-term role compared with contemporary direct oral anticoagulant therapy.<br/>Copyright © 2026 by the authors. <135> Accession Number 2038606937 Title Regional anaesthesia for postoperative pain after median sternotomy in cardiac surgery: a scoping review and meta-analysis. Source Acta Anaesthesiologica Belgica. 77(3) (pp 227-235), 2026. Date of Publication: 01 Sep 2026. Author Batonga J.; Tuna T.; Duranteau O. Institution (Batonga, Tuna, Duranteau) Anesthesiology Departement, Hopitaux Universitaires de Bruxelles - Site Erasme, Anderlecht, Belgium (Tuna, Duranteau) Medical School, Universite Libre de Bruxelles, Anderlecht, Belgium Publisher BeSARPP Abstract Introduction: Regional anaesthesia (RA) is an established option for analgesia in cardiac surgery performed via median sternotomy. Despite the growth of minimally invasive approaches, sternotomy remains widely used and is associated with substantial postoperative pain and related complications. Perioperative analgesic management in cardiac surgery is therefore typically multimodal. The primary objective of this study was to evaluate the efficacy and limitations of RA techniques to determine whether RA could serve as a core component of postoperative pain management after sternotomy. <br/>Method(s): We conducted a systematic review of the literature across multiple databases to identify studies reporting postoperative outcomes of RA techniques with respect to reduction of post-sternotomy pain. Six studies in which the primary endpoint was postoperative pain after cardiac surgery met the eligibility criteria and were included in the meta-analysis. <br/>Result(s): Pooled analysis of the six studies indicated that RA was associated with a clinically meaningful reduction in post-sternotomy pain intensity (pooled mean difference approximately -3 points on a 0-10 scale), along with decreased opioid consumption. Considerable between-study heterogeneity was observed (I2 = 99.5%), reflecting variation in RA techniques, comparators, and perioperative protocols; nevertheless, the direction of effect consistently favoured RA. <br/>Conclusion(s): RA appears effective for improving postoperative analgesia after cardiac surgery via median sternotomy and may reduce perioperative opioid requirements. Incorporation of RA into Enhanced Recovery After Cardiac Surgery pathways could support postoperative recovery and mitigate opioid-related adverse effects. Given the substantial heterogeneity across studies, further well-designed trials using standardised analgesic outcomes are warranted to refine indications and optimise technique selection.<br/>Copyright © 2026, BeSARPP. All rights reserved. <136> Accession Number 2049043496 Title Post-Heart Transplant Changes and Perceived Donor-Recipient Correspondences: A Scoping Review. Source Journal of Clinical Medicine. 15(17) (no pagination), 2026. Article Number: 6584. Date of Publication: 01 Sep 2026. Author Nigrelli D.; Lo Monaco M.; Figura M.; Giammarinaro M.R.; Zerilli I.; Ahmad I.; Iacorossi L.; Latina R.; Anastasi G. Institution (Nigrelli, Zerilli, Ahmad) Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (Lo Monaco, Figura, Latina) Department of Maternal and Child Health Promotion, Internal Medicine & Specialties of Excellence "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy (Giammarinaro) Department of Nursing, ARNAS Ospedale Civico di Cristina e Benefratelli, Palermo, Italy (Iacorossi) Department of Life, Health Sciences and Health Professions, Link Campus University, Rome, Italy (Anastasi) Department of Medicine and Surgery, University of Enna "Kore", Enna, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Heart transplantation is a life-saving treatment for advanced cardiac disease, but post-transplant adaptation may involve psychosocial, identity-related, and existential change. Some recipients interpret these changes as corresponding to donor characteristics, although the nature and evidence base of these reports remain unclear. This review mapped post-transplant changes reported by adult heart transplant recipients, perceived donor-recipient correspondences, and the explanatory frameworks proposed for these phenomena. <br/>Method(s): A scoping review was conducted following the Arksey and O'Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR reporting standards. PubMed, Web of Science, Scopus, CINAHL, and PsychINFO were searched in August 2026. Quantitative, qualitative, mixed-methods, conceptual, opinion, and review articles were eligible. Findings were synthesized descriptively. <br/>Result(s): Sixteen sources published between 1992 and 2025 were included. Empirical studies reported changes in preferences, emotional and personality-related experiences, social and physical functioning, sexuality, identity and embodiment, sensory and memory-like experiences, and spirituality. Some changes were attributed by recipients to donor characteristics, whereas correspondences supported by independently obtained donor information were reported in a limited subset of studies. Proposed explanations ranged from psychological, pharmacological, physiological, and sociocultural processes to cellular, molecular, neurocardiac, energetic, and transpersonal hypotheses. Donor-transfer hypotheses were developed in the secondary literature and were not empirically established. Methodological quality varied substantially across sources. <br/>Conclusion(s): Post-transplant changes and perceived donor-recipient correspondences are meaningful phenomena, but current evidence does not support the transfer of donor memory, personality, or identity through the transplanted heart. Future prospective, longitudinal, and methodologically rigorous studies should distinguish reported experience, donor attribution, and proposed explanations.<br/>Copyright © 2026 by the authors. <137> Accession Number 2038603171 Title Effects of Jazz on Postoperative Pain and Stress in Patients Undergoing Elective Hysterectomy. Source Advances in Mind-Body Medicine. 29(1) (pp 6-11), 2015. Date of Publication: 01 Dec 2015. Author Rafer L.; Austin F.; Frey J.; Mulvey C.L.; Vaida S.J.; Prozesky J. Institution (Rafer, Frey, Mulvey, Vaida, Prozesky) Department of Anesthesiology, Penn State College of Medicine, Hershey, PA, United States (Austin) University of Pittsburgh Medical Center, Pittsburgh, PA, United States Publisher Alternative Medicine.com Abstract Context * Anesthesiologists use various medications to provide surgical patients with pain relief in the postoperative period. Other modalities, such as music, could be used in conjunction with opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and lower heart rate and blood pressure. Our hypothesis was that patients listening to jazz in a postanesthesia care unit (PACU) would have lower heart rates and blood pressures and reduced pain and anxiety. Objective * The study objective was to determine if listening to jazz music in the PACU, when compared to wearing noise-canceling headphones with no music playing, would decrease heart rate, blood pressure, pain, or anxiety in patients undergoing a hysterectomy. Design * The research design was a prospective, randomized study. Setting * The study was conducted in the PACU at the Penn State Hershey Medical Center in Hershey, PA, USA. Participants * A total of 56 patients, aged 18-75 y, who were categorized as status 1 or 2 according to the American Society of Anesthesiologists (ASA) Physical Status Classification System, and who were undergoing elective laparoscopic or abdominal hysterectomies, were enrolled in the study. Intervention * Patients were randomly assigned either to listen to jazz music where the beats per min (BPM) was <100 (experimental group, n = 28) or to wear noise-canceling headphones (control group, n = 28) for 30 min while in the PACU after their surgery. Outcome Measures * Heart rate was the primary outcome, and secondary outcomes included systolic and diastolic blood pressure, an anxiety score, and a pain score. All outcome measures were initially recorded at baseline upon the patient's arrival in the PACU. Heart rate and blood pressure were recorded postoperatively every 5 min for the initial 30 min that a patient was in the PACU. Pain was checked every 10 min during the 30-min period; anxiety was checked at 30 min. Results * Heart rates of patients in the noise-cancellation group were significantly lower when compared with baseline (P < .05), at all time points. For patients in the jazz group, heart rates were significantly lower at 15, 20, 25, and 30 min when compared with baseline. The pain scores were significantly lower (P < .05) in the noise-cancellation group compared with the jazz group at 10 min into the recovery period. Conclusion * Overall, the results showed that patients responded not only to music but also to silence in the PACU. Using music and/or noise reduction could decrease opioid administration, promote relaxation, and improve patient satisfaction.<br/>Copyright © 2015, Alternative Medicine.com. All rights reserved. <138> Accession Number 2038603325 Title Outcomes for congenitally corrected transposition of great arteries using various surgical techniques: a systematic review and network meta-analysis. Source Annals of the Royal College of Surgeons of England. 108(7) (pp 510-517), 2026. Date of Publication: 01 Sep 2026. Author Hasan S.U.; Usmani S.U.R.; Ahmed S.H.; Pervez A.; Kamalia M.A.; Shah A.D.; Zubair M.M. Institution (Hasan, Pervez) Nottingham University Hospitals NHS Trust, United Kingdom (Usmani) Dow University of Health Sciences, Karachi, Pakistan (Ahmed) Geisinger Health System, Danville, United States (Kamalia) Medical College of Wisconsin, Milwaukee, United States (Shah) University of Minnesota, Minneapolis, United States (Zubair) Children's Mercy, Kansas City, United States Publisher Royal College of Surgeons of England Abstract Introduction Congenitally corrected transposition of the great arteries (ccTGA) is a rare disorder. Here, we evaluated the effectiveness of physiological, anatomical and Fontan repair techniques for ccTGA. Methods A systematic database search in PubMed, Embase and Cochrane Central Register of Controlled Trials was conducted from inception to 5 June 2023. Random-effects network meta-analysis was performed, comparing mortality, postoperative arrhythmias, reintervention after definitive surgery and transplant-free survival in patients undergoing physiological, anatomical and Fontan repair. Findings A total of 1,209 patients were included from nine studies. Fontan repair was associated with a higher rate of transplant-free survival (absolute risk [AR] 0.999 (+/-0.0101), 95% confidence interval [CI]) and reintervention after definitive surgery (AR 0.098 (+/-0.067), 95% CI), whereas the difference for mortality and postoperative arrhythmias did not reach statistical significance. Conclusions Fontan repair is significantly better than anatomical or physiological repair in terms of transplant-free survival and also had a better rank probability for overall survival and reintervention after definitive surgery.<br/>Copyright © 2026, Royal College of Surgeons of England. All rights reserved. <139> Accession Number 2049032582 Title Perioperative NT-proBNP in Lung Cancer Surgery: A Narrative Review of Mechanisms, Predictive Value, and Clinical Implications. Source Journal of Clinical Medicine. 15(17) (no pagination), 2026. Article Number: 6606. Date of Publication: 01 Sep 2026. Author Butas M.; Popovici S.E.; Ritiu S.A.; Cozma G.V.; Gaborean V.; Crintea I.N.; Sala-Cirtog M.; Buzatu A.R.; Buzas R.; Dinuti M. Institution (Butas, Popovici, Ritiu, Cozma, Gaborean, Crintea, Sala-Cirtog, Buzatu, Dinuti) Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania (Butas, Popovici, Ritiu, Cozma, Gaborean, Crintea) Emergency Municipal Clinical Hospital Timisoara, Timisoara, Romania (Butas, Popovici, Ritiu, Gaborean) Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania (Butas, Popovici, Ritiu) Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania (Cozma, Gaborean) Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania (Cozma, Gaborean) Thoracic Surgery Research Center, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania (Crintea) Department of Surgery I, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041, Timisoara, Romania (Sala-Cirtog, Buzatu, Dinuti) Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, 300041, Timisoara, Romania (Buzas) 1st Medical Semiology, Internal Medicine, Department V, Victor Babes University of Medicine and Pharmacy Timisoara, 300041, Timisoara, Romania (Buzas) Center for Advanced Research in Cardiovascular Pathology and in Hemostaseology, 300041, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: NT-proBNP is a mechanistically grounded biomarker of ventricular wall stress with established prognostic value in cardiac surgery, but its perioperative role in lung cancer resection remains incompletely characterised. Pulmonary resection imposes unique haemodynamic stressors-including one-lung ventilation-induced right ventricular afterload increase, permanent pulmonary vascular bed reduction, and ischaemia-reperfusion injury-that create a distinct biological context for natriuretic peptide elevation not represented in general surgical cohorts. <br/>Method(s): A narrative review of the literature was conducted through systematic searches of PubMed, EMBASE/MEDLINE, and the Cochrane Library (January 2000-June 2026), supplemented by manual reference screening. Approximately 135 articles were included in the final synthesis. <br/>Result(s): Perioperative NT-proBNP elevation predicts postoperative atrial fibrillation, major adverse cardiovascular events, and long-term survival after lung resection, with effect sizes substantially exceeding those reported in general surgical populations. The PRESAGE trial established that NT-proBNP-guided prophylaxis reduces postoperative atrial fibrillation from 40% to 6% in high-risk patients. No thoracic surgery-specific NT-proBNP threshold has been prospectively validated in a multicentre setting, and approximately half the evidence base derives from BNP rather than NT-proBNP assays, precluding direct threshold synthesis. Surgical approach-particularly robot-assisted thoracoscopy-modulates postoperative biomarker elevation through OLV duration rather than inflammatory burden alone. The combination of NT-proBNP with high-sensitivity troponin identifies a dual-elevation subgroup with a MACE rate of 18.4%. <br/>Conclusion(s): NT-proBNP measurement is clinically actionable in thoracic surgery but requires assay-standardised, multicentre validation of population-specific thresholds stratified by resection extent and surgical approach. A dual biomarker strategy combining NT-proBNP with high-sensitivity troponin represents the most evidence-based perioperative risk stratification framework currently available.<br/>Copyright © 2026 by the authors. <140> Accession Number 2049252045 Title Clopidogrel Versus Dual-Antiplatelet Therapy for Long-Term Maintenance After Coronary Stenting in Ischemic and Bleeding Birisk Patients With Acute Coronary Syndromes and Diabetes: A Prespecified Subgroup Analysis of the OPT-BIRISK Trial. Source Journal of the American Heart Association. 15(17) (no pagination), 2026. Article Number: e049178. Date of Publication: 2026. Author Zhang D.; Li Y.; Qiu M.; Zhou Y.; Chen S.; Pei H.; Liu J.; Xu B.; Han Y.; Stone G.W. Institution (Zhang, Li, Qiu, Han) State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Cardiovascular Research Institute, Shenyang, China (Zhou, Liu) Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Chen) Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Pei) The First Affiliated Hospital of Baotou Medical College, Baotou, China (Xu) Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Among patients with acute coronary syndromes at both high bleeding and ischemic risk (birisk), extended clopidogrel monotherapy after 9 to 12months of dual-antiplatelet therapy reduces bleeding without increasing ischemia. Whether this benefit extends to birisk patients with diabetes is unknown. <br/>METHOD(S): This prespecified subgroup analysis of the OPT-BIRISK (Optimal Antiplatelet Therapy for High Bleeding and Ischemic Risk Patients) trial included birisk patients with acute coronary syndrome who had completed 9 to 12months of dual-antiplatelet therapy after percutaneous coronary intervention. Patients were then randomized 1:1 to 9months of clopidogrelplusplacebo versus clopidogrelplusaspirin. Outcomes were compared by diabetes status. The primary end point was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding at 9 months after randomization. The key secondary end point was major adverse cardiac and cerebral events, defined as a composite outcome of all-cause death, myocardial infarction, stroke, or clinically driven revascularization. <br/>RESULT(S): Of 7758 patients, 4072 (52.5%) had diabetes. Clopidogrel monotherapy decreased Bleeding Academic Research Consortium type 2, 3, or 5 bleeding (2.1% versus 3.2%; hazard ratio [HR], 0.66 [95% CI, 0.45-0.97]) with no increase in major adverse cardiac and cerebral events (2.9% versus 3.6%; HR, 0.79 [95% CI, 0.56-1.12]) compared with clopidogrel plus aspirin in patients with diabetes. Outcomes were consistent in patients without diabetes, with no significant interactions by diabetes status. <br/>CONCLUSION(S): In birisk patients with acute coronary syndrome who were stable on dual-antiplatelet therapy with clopidogrel plus aspirin for 9 to 12 months after percutaneous coronary intervention, clopidogrel monotherapy for an additional 9 months reduced clinically relevant bleeding without increasing ischemic events compared with continued dual-antiplatelet therapy, irrespective of diabetes status. REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT03431142.<br/>Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <141> Accession Number 2049253727 Title Redo-Transcatheter Aortic Valve Implantation Versus Surgical Explantation in Patients With Previous Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(17) (no pagination), 2026. Article Number: e048885. Date of Publication: 2026. Author Ktenopoulos N.; Apostolos A.; Terentes-Printzios D.; Drakopoulou M.; Synetos A.; Latsios G.; Xaplanteris P.; Panoulas V.; Baumbach A.; Tsioufis K.; Toutouzas K. Institution (Ktenopoulos, Apostolos, Terentes-Printzios, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) Department of Cardiology, Hippokration General Hospital of Athens, Greece (Ktenopoulos, Apostolos, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece (Apostolos, Panoulas) Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Apostolos) Faculty of Medicine, Imperial College London, London, United Kingdom (Xaplanteris) Department of Cardiology, Centre Hospitalier Universitaire Saint-Pierre, Universite Libre de, Bruxelles, Brussels, Belgium (Panoulas) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Baumbach) Center for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Center, London, United Kingdom (Baumbach) Cleveland Clinic, London, United Kingdom Publisher American Heart Association Inc. Abstract BACKGROUND: As transcatheter aortic valve implantation (TAVI) expands to younger and lower-risk populations, failed transcatheter heart valves are increasingly encountered, yet the optimal reintervention strategy remains uncertain. This meta-analysis aimed to compare the outcomes of redo-TAVI (TAVI-in-TAVI) versus surgical transcatheter heart valve explantation with surgical aortic valve replacement (TAVI-explantation) after transcatheter heart valve failure. <br/>METHOD(S): PubMed/Medline, Scopus and Cochrane Central Register of Controlled Trials were systematically searched from inception to September 10, 2025 for comparative studies. The primary outcome was all-cause mortality (in-hospital, 30-day, and 1-year). Secondary outcomes included cerebrovascular events, major adverse cardiac events, permanent pacemaker implantation, greater-than-mild paravalvular leak, major bleeding, length of stay, and 30-day readmission. As the primary analysis, reconstructed individual patient-level data were analyzed using Firth penalized logistic regression adjusting for study, and complementary random-effects meta-analyses were also used. <br/>RESULT(S): Eight observational studies including 6166 patients (3743 redo-TAVI; 2425 TAVI-explantation) were analyzed. Compared with TAVI-explantation, redo-TAVI was associated with lower in-hospital mortality (odds ratio [OR], 0.20 [95% CI, 0.11-0.35]; P<0.0001), 30-day mortality (OR, 0.28 [95% CI, 0.23-0.34]; P<0.0001), and 1-year mortality (OR, 0.70 [95% CI, 0.62-0.80]; P<0.0001). No significant differences were observed in cerebrovascular events or permanent pacemaker implantation rates. Redo-TAVI was associated with lower major bleeding (OR, 0.35 [95% CI, 0.24-0.50]; P<0.0001), fewer 30-day readmissions (OR, 0.53 [95% CI, 0.30-0.92]; P=0.023), and shorter hospitalization (Mean Difference -6.29days [95% CI, -8.66 to -3.93), but a higher risk of greater-than-mild paravalvular leak (OR, 80.12 [95% CI, 11.30-10153]; P<0.0001). <br/>CONCLUSION(S): Redo-TAVI was associated with lower early and 1-year mortality, reduced bleeding, and shorter hospitalization compared with TAVI-explantation, with similar cerebrovascular event and permanent pacemaker implantation rates but higher paravalvular leak risk. These findings support redo-TAVI as the preferred reintervention strategy in anatomically suitable patients, whereas randomized trials and longer-term follow-up are needed to refine lifetime management strategies after transcatheter heart valve failure.<br/>Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <142> Accession Number 2049341272 Title Comparative Effectiveness of Ivabradine, Carvedilol and its Combination on Post Operative Hemodynamic Stability in Off Pump Coronary Artery Bypass Graft Patients with Low Ejection Fraction. Source International Journal of Current Pharmaceutical Review and Research. 17(12) (pp 2313-2318), 2025. Date of Publication: 2025. Author Mondal C.; Mazumder P.; Kundu S. Institution (Mondal) Department of Anesthesiology, Medical College & Hospital, 88 College Street, Kolkata, India (Mazumder) Department of Cardiac Anesthesiology, Medical College & Hospital, 88 College Street, Kolkata, India (Kundu) Department of Anesthesiology, Medical College & Hospital, 88 College Street, Kolkata, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Introduction: Patients with low left ventricular ejection fraction (LVEF) undergoing off-pump coronary artery bypass graft (OPCAB) surgery are at increased risk of perioperative hemodynamic instability. Although both Ivabradine and Carvedilol have been individually used to optimize perioperative heart rate and hemodynamics, evidence is scarce regarding the comparative effectiveness of Ivabradine, Carvedilol, and their combination in this high-risk population. <br/>Aim(s): To compare the effectiveness of Ivabradine alone, Carvedilol alone, and a combination of Ivabradine + Carvedilol in maintaining post-operative hemodynamic stability in OPCAB patients with pre-existing low LVEF. <br/>Material(s) and Method(s): This prospective, randomized, controlled study included 63 adults (>=18 years) with LVEF <=40% undergoing elective off-pump CABG at the Department of Cardiac Anesthesia, Medical College Hospital, Kolkata. Patients received either carvedilol or ivabradine perioperatively. Demographics were recorded, and heart rate and blood pressure were monitored. Data were analyzed using SPSS; p < 0.05 was considered significant. <br/>Result(s): Baseline demographics, including age, gender, weight, height, and BMI, were comparable across the Ivabradine, Carvedilol, and combination groups, with no statistically significant differences (all p?> 0.05). Mean blood pressure was similar at baseline (p = 0.429) and gradually declined over time in all groups without significant inter-group differences. Baseline heart rate was also comparable (p = 0.633); however, heart rate reduction during follow-up was significantly greater in the combination group from 6 to 48 hours (p <= 0.002), while differences at 3 hours remained non-significant (p = 0.126). <br/>Conclusion(s): In OPCAB patients with low LVEF, combined therapy with Ivabradine and Carvedilol appears more effective than either agent alone in achieving post-operative hemodynamic stability, reducing heart rate, decreasing incidence of arrhythmia, and minimizing inotrope and ventilatory support. This combination may represent an optimal perioperative rate-control strategy in high-risk cardiac surgery patients.<br/>Copyright © This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided original work is properly credited. <143> Accession Number 2048980971 Title Application of Digital Health Interventions in Home Self-Management of Patients Undergoing Transcatheter Aortic Valve Replacement: A Scoping Review and Future Perspectives. Source Nursing Open. 13(9) (no pagination), 2026. Article Number: e70814. Date of Publication: 01 Sep 2026. Author Chen H.; Zou S.; Zheng L. Institution (Chen, Zou, Zheng) The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (Zou) Zhejiang University, Hangzhou, Zhejiang, China Publisher John Wiley and Sons Inc Abstract Aim: To systematically map the application forms, functions, outcomes, and implementation barriers of digital health interventions (DHIs) in home self-management for patients undergoing transcatheter aortic valve replacement (TAVR). <br/>Design(s): Scoping review following the Joanna Briggs Institute methodology with a published a priori protocol. <br/>Data Sources: A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CINAHL, CNKI and Wanfang Databases from inception to 26 August 2026. <br/>Method(s): This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A protocol was prospectively registered on the Open Science Framework. <br/>Result(s): 19 studies were included. DHIs for post-TAVR home self-management covered seven application forms: wearable devices, mobile applications, remote monitoring platforms, AI-powered voice virtual assistants, remote video training platforms, social media platforms and integrated management platforms. Their core functions included remote ECG monitoring, home-based exercise rehabilitation, multi-parameter physiological monitoring, health education and AI-driven follow-up. Current evidence suggests potential positive effects of DHIs on improving exercise capacity, reducing readmission rates, enhancing intervention adherence and increasing patient satisfaction. <br/>Conclusion(s): DHIs for post-TAVR home self-management feature diverse forms and integrated functions, with preliminary evidence suggesting positive effects on multiple outcomes. However, evidence for hard clinical endpoints remains limited, and dedicated health economic evaluations are largely absent. The digital divide remains a key barrier to clinical implementation. Future efforts should optimize technology combinations, improve age-friendly design, promote stratified care and advance reimbursement policies. Implications for the Profession and/or Patient Care: DHIs offer promising support for post-TAVR home management. Addressing accessibility and usability barriers is essential to translate these benefits into routine care. Nurses play a pivotal role in patient education, digital literacy support and remote monitoring coordination. Impact: What is already known? Digital health interventions have been increasingly applied in cardiac surgery, but evidence specifically for TAVR home self-management remains fragmented. What this paper adds? This scoping review systematically maps the application forms, functional modules, outcomes, and implementation barriers of DHIs in post-TAVR home self-management, identifying evidence gaps and highlighting the digital divide as a key implementation challenge. Implications for Practice: Nurses and healthcare providers can leverage DHIs to support post-TAVR patient education, remote monitoring and rehabilitation, but must consider patients' digital literacy and accessibility needs when implementing these technologies. No Patient or Public Contribution: This is a scoping review study. Trial Registration: Open Science Framework (OSF): https://osf.io/kuz7b/overview.<br/>Copyright © 2026 The Author(s). Nursing Open published by John Wiley & Sons Ltd. <144> Accession Number 2049011109 Title Stented vs. stentless in aortic stenosis: a systematic review and meta-analysis. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 694. Date of Publication: 01 Dec 2026. Author Saeed A.; Gerges K.M.; Saeed O.; Alasnag M.; Whitlock R.; Myers P.O.; Balacumaraswami L.; Alesawy A.F.; Abraheem A.; Elraggal D.; Khalleefah D.R.; Elmesherghi A.F.; Fahaid A.; Aljefairi N.; Elhadi M.; Mamas M. Institution (Saeed, Saeed) Faculty of Medicine, Al-Azhar University, Damietta, Egypt (Gerges) Faculty of Medicine, Sohag University, Sohag Governorate, Egypt (Alasnag) Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia (Whitlock) Population Health Research Institute and McMaster University, Hamilton, ON, Canada (Myers) Hopital de La Tour in Geneva, Zurich University Hospital, Zurich, Switzerland (Balacumaraswami) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom (Alesawy) Clinical microbiology and Immunology Department, Benha university, Qalubiya, Egypt (Abraheem) Faculty of Medicine, University of al-azhar, Cairo, Egypt (Elraggal) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Khalleefah) Faculty of Medicine, Sirte University, Sirte, Libyan Arab Jamahiriya (Elmesherghi, Fahaid, Aljefairi, Elhadi) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab Jamahiriya (Elhadi) College of Medicine, Korea University, 145 Anam-ro, Seoul, Seongbuk-gu, South Korea (Mamas) Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom Publisher BioMed Central Ltd Abstract Background: Symptomatic aortic stenosis (AS) is often treated surgically with aortic valve replacement using stented or stentless prostheses. While stentless valves offer potential hemodynamic benefits, a robust synthesis of the evidence regarding clinical outcomes is needed. This systematic review and meta-analysis assessed the effectiveness and safety of both valve types. <br/>Method(s): This study followed the PRISMA guidelines and was prospectively registered in PROSPERO (CRD42025636952). We systematically searched PubMed, Cochrane Library, Scopus, and Web of Science up to December 2024, with a search update in May 2025. We included both randomized and non-randomized studies. The outcomes were early and overall mortality rates, stroke, pacemaker implantation, endocarditis, postoperative atrial fibrillation, total reoperation, severe prosthesis-patient mismatch, hospital stay, cardiopulmonary bypass time, cross-clamp time, and hemodynamic parameters, including postoperative mean aortic valve gradient, left ventricular mass and left ventricular mass index, and left ventricular ejection fraction. A random-effects model with odds ratios (ORs) and mean differences (MDs) was employed. <br/>Result(s): After screening 1,385 records, 20 studies were included, involving 3,940 participants with AS. Studies were first analyzed by design (randomized and non-randomized), and then pooled. There were no significant differences in all-cause mortality rates either early (OR = 1.04, 95% CI: [0.65 to 1.68], p = 0.861) or overall mortality at 1 year (OR = 0.86, 95% CI: [0.28 to 2.63], p = 0.797) and beyond 1 year (OR = 0.95, 95% CI: [0.62 to 1.46], p = 0.820). Postoperative complications showed comparable results between groups, except for pacemaker implantation, which was significantly increased in stentless valves (OR = 1.82, 95% CI: [1.14 to 2.92], p = 0.013). Hemodynamic outcomes showed no significant differences between groups. <br/>Conclusion(s): Our study revealed that the rates of early and overall mortality, postoperative complications, and hemodynamic parameters were comparable between stented and stentless valve groups. However, patients receiving stentless valves exhibited a significantly higher incidence of pacemaker implantation.<br/>Copyright © The Author(s) 2026. <145> Accession Number 652181117 Title Five-Year Follow-Up of Transcatheter Aortic Valve Replacement With Self-Expanding Intra-Annular Versus Commercially Available Valves. Source JACC. Cardiovascular interventions. (no pagination), 2026. Date of Publication: 01 Sep 2026. Author Makkar R.R.; Cheng W.; Waksman R.; Chakravarty T.; Satler L.F.; Groh M.; Abernethy W.; Russo M.J.; Heimansohn D.; Hermiller J.; Worthley S.; Chehab B.M.; Matthews R.; Ramana R.K.; Yong G.; Chen C.; Asch F.M.; Nakamura M.; Jilaihawi H.; Sharma R.; Patel D.; Kapadia S.; Reardon M.J.; Bhatt D.L.; Fontana G.P. Institution (Makkar, Cheng, Chakravarty, Nakamura, Jilaihawi, Patel) Cedars-Sinai Medical Center, Los Angeles, CA, United States (Waksman, Satler) Washington Hospital Center, WA, United States (Groh, Abernethy) Mission Health and Hospitals, Asheville, NC, United States (Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Heimansohn, Hermiller) St Vincent Heart Center, Indianapolis, IN, United States (Worthley) Royal Adelaide Hospital, Adelaide, South Australia, Australia; Genesis Care, Sydney, New South Wales, Australia (Chehab) University of Kansas, Ascension Via Christi Hospital, Wichita, United States (Matthews) University of Southern California, Los Angeles, CA, United States (Ramana) Advocate Christ Medical Center, Oak Lawn, Illinois, USA; Heart Care Centers of Illinois, Palos Park, Illinois, USA (Yong) Heart Care Centers of Illinois, Palos Park, IL, United States (Chen) Newark Beth Israel Medical Center, Newark, NY, United States (Asch) MedStar Health Research Institute, WA, United States (Sharma) Stanford University Medical Center, Stanford, CA, United States (Kapadia) Cleveland Clinic, Cleveland, OH, United States (Reardon) Houston Methodist Hospital, Houston, TX, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, NY, United States (Fontana) Cardiovascular Institute, Los Robles Regional Medical Center, Thousand Oaks, CA, United States Abstract BACKGROUND: Long-term outcomes of the self-expanding intra-annular Portico transcatheter aortic valve are not known. <br/>OBJECTIVE(S): This study aimed to report the 5-year outcomes of the PORTICO IDE randomized controlled trial. <br/>METHOD(S): This multicenter trial randomized (1:1) patients with severe symptomatic aortic stenosis at high/extreme surgical risk to transcatheter aortic valve replacement (TAVR) with the self-expanding intra-annular valve (study valve) or Food and Drug Administration-approved commercially available valves (CAVs; balloon-expandable or self-expanding supra-annular platforms). Assessments of the primary safety endpoint (30 days) and the primary efficacy endpoint (1 year) have been previously reported. Prespecified clinical outcomes and hemodynamic valve parameters are presented through 5 years. <br/>RESULT(S): We randomized 750 eligible patients (mean age: 83 years, 52.7% female) to the study valve (n = 381) or CAV (n = 369). Compared with CAV, the study valve showed similar 5-year all-cause mortality or stroke (55.6% vs 51.3%, P = 0.42). Cardiovascular mortality was numerically higher in the study valve group compared with the CAV group (33.4% vs 25.8%; P = 0.06). Naive permanent pacemaker implantation was higher in the study valve group (36.6%) than the CAV group (20.3%; P < 0.0001) at 5 years. At 5 years, the study valve showed a lower mean transvalvular gradient (7.2 +/- 3.0 vs 9.5 +/- 6.5 mm Hg, P = 0.008), but similar valve area (1.78 +/- 0.45 vs 1.71 +/- 0.51 cm2, P = 0.40) compared to CAV. <br/>CONCLUSION(S): In patients at high or extreme surgical risk, TAVR with the self-expanding intra-annular transcatheter heart valve had similar 5-year overall survival, stroke rates, and valve function compared with commercially available valves.<br/>Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved. <146> Accession Number 2049280112 Title Minimally invasive versus conventional extracorporeal circulation in cardiac surgery: A meta-analysis of 41 randomized controlled trials. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Motawea K.R.; Ahmed M.S.; Khalil M.; Ibrahim M.; Abdelkader Y.; Pelletier M.; El Diasty M.; Elgudin Y.; Sabik J.F.; Abu-Omar Y. Institution (Motawea, El Diasty, Elgudin, Sabik, Abu-Omar) Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Ahmed, Abdelkader) Alexandria University, Alexandria, Egypt (Khalil) Department of Internal Medicine, UConn Health, Farmington, CT, United States (Ibrahim) Department of Cardiovascular Medicine, Banner University Medical Center, Phoenix, AZ, United States (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher SAGE Publications Ltd Abstract Objective: We aimed to compare postoperative clinical outcomes between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) in patients undergoing cardiac surgery. <br/>Method(s): We performed a meta-analysis of randomized controlled trials comparing MiECC and CECC in adult cardiac surgery. A literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane library databases from inception to July 2026 to identify relevant studies. Primary outcomes included mortality, myocardial infarction, atrial fibrillation, stroke, acute kidney injury, delirium, transfusion requirements, ICU length of stay, ventilation duration, and hospital length of stay. <br/>Result(s): Forty-one RCTs with a total of 5215 patients (2652 in MiECC group, and 2563 in CECC group) were included. MiECC was associated with decreased myocardial infarction (RR = 0.50, 95% CI [0.34, 0.73], p-value = 0.0004), atrial fibrillation (RR = 0.82, 95% CI [0.72, 0.93], p-value = 0.002), stroke (RR = 0.50, 95% CI [0.27, 0.93], p-value = 0.03), delirium (RR = 0.42, 95% CI [0.24, 0.73], p-value = 0.002), chest tube drainage (RR = -123.27, 95% CI [-165.41, -81.13], p-value <0.00001), units of transfused RBC (MD = -0.67, 95% CI [-0.84, 0.49], p-value <0.00001), ICU length of stay (MD = -0.99, 95% CI [-1.42, 0.56], p-value <0.00001), hospital length of stay (MD = -0.61, 95% CI [-1.09, -0.12], p-value = 0.01) and ventilation duration (MD = -2.71, 95% CI [-3.72, -1.69], p-value <0.00001) compared to CECC. However, no significant differences were observed between both groups in terms of mortality, transient ischemic attack, acute kidney injury, reoperation for bleeding, and platelet transfusions. <br/>Conclusion(s): MiECC may provide myocardial and neurological protection, better hemostasis, and faster early postoperative recovery compared to CECC, supporting its adoption as a preferred perfusion strategy in cardiac surgery.<br/>Copyright © The Author(s) 2026 <147> Accession Number 2049280602 Title Experiences of surgeons and perfusionists using del Nido cardioplegia in paediatric cardiac surgery: A qualitative sub-study of the DESTINY trial. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Wilson K.L.; Holmes F.E.; Drury N.E. Institution (Wilson, Drury) Department of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom (Wilson, Holmes, Drury) Bristol Medical School, University of Bristol, Bristol, United Kingdom (Drury) Department of Cardiovascular Sciences, School of Medical Sciences, College of Medicine and Health, University of Birmingham, Birmingham, United Kingdom Publisher SAGE Publications Ltd Abstract Introduction: del Nido cardioplegia had not been commercially available in the United Kingdom prior to the DESTINY trial, a multi-centre individually randomised controlled trial to evaluate whether del Nido or St Thomas' blood cardioplegia provides better myocardial protection in children of all ages. In this sub-study, we explored the experiences of surgeons and perfusionists using del Nido in the trial, to support implementation of del Nido in the United Kingdom and identify any practical or safety concerns. <br/>Method(s): We conducted qualitative, semi-structured interviews with surgeons and perfusionists who had completed at least three cases with del Nido cardioplegia in the trial. Interviews were conducted face-to-face or via Zoom, digitally audio-recorded, transcribed, and analysed using a hybrid thematic approach, according to the Consolidated Framework for Implementation Research domains. Trial registration: ISRCTN13638147, registered July 2021. <br/>Result(s): Twelve participants were interviewed, six surgeons and six perfusionists from all four paediatric cardiac surgical centres participating in the trial. Four key themes emerged: (1) attitudes towards the use of del Nido cardioplegia; (2) practical aspects of delivering del Nido cardioplegia; (3) blood conservation techniques; and (4) adopting del Nido cardioplegia into routine clinical use beyond the trial. <br/>Conclusion(s): Surgeons and perfusionists reported that they found del Nido cardioplegia to have practical benefits over St Thomas' blood cardioplegia but felt that further research on the optimal cooling temperature, blood conservation, and dosing for paediatric use are required to support the development of a best practice guideline and guide national implementation beyond the trial.<br/>Copyright © The Author(s) 2026 �
Saturday, September 26, 2026
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