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Total documents retrieved: 144 Results Generated From: Embase <1980 to 2026 Week 46> Embase Weekly Updates (updates since 2026-11-06) - (144 records) <1> Accession Number 2021608192 Title A Clinical Mathematical Model Estimating Postoperative Urine Output in Children Underwent Cardiopulmonary Bypass for Congenital Heart Surgery. Source Journal of Pediatric Intensive Care. (no pagination), 2022. Date of Publication: 2022. Author Baloglu O.; Ryan S.D.; Onder A.M.; Rosen D.; Mullett C.J.; Munther D.S. Institution (Baloglu) Department of Pediatric Critical Care Medicine, Cleveland Clinic Children's, Cleveland Clinic, Cleveland, OH, United States (Baloglu) Cleveland Clinic Children's Center for Artificial Intelligence (C4AI), Cleveland Clinic, Cleveland, OH, United States (Ryan, Munther) Department of Mathematics and Statistics, Cleveland State University, Cleveland, OH, United States (Onder) Division of Pediatric Nephrology, Nemours Children's Hospital, Wilmington, DE, United States (Rosen) Division of Pediatric Cardiothoracic Anesthesiology, West Virginia University, School of Medicine, Morgantown, WV, United States (Mullett) Division of Pediatric Critical Care Medicine, Department of Pediatrics, West Virginia University, School of Medicine, Morgantown, WV, United States Publisher Georg Thieme Verlag Abstract Objectives Our objective was to build a proof of concept of the clinical mathematical model estimating postoperative urine output (UOP) utilizing preoperative, intraoperative, and immediate postoperative variables in children who underwent cardiopulmonary bypass (CPB) for congenital heart surgery. Methods This was a single-center, retrospective cohort study in a university-affiliated children's hospital. Patients younger than 21 years old who underwent CPB for congenital heart surgery and were postoperatively admitted to West Virginia University Children's Hospital's pediatric intensive care unit (PICU) between September 1, 2007 and June 31, 2013 were included in the study. Body surface area, CPB duration, first measured hematocrit, serum pH, central venous pressure, and vasoactive-inotropic score in the PICU were used to build the mathematical model. A randomly selected 50% of the dataset was used to calculate model parameters. A cross-validation was used to assess model performance. Results A total of 256 patients met the inclusion criteria. The model was able to achieve mean absolute error of 1.065 mL/kg/h (95% confidence interval (CI): 1.062-1.067 mL/kg/h), root mean squared error of 1.80 mL/kg/h (95% CI: 1.799-1.804 mL/kg/h), and R 2 of 0.648 (95% CI: 0.646-0.650) in estimating UOP in the first 32 hours of postoperative period. Conclusions The mathematical model utilizing preoperative, intraoperative, and immediate postoperative variables may be a potentially useful clinical tool in estimating UOP in the first 32 hours postoperative period. Copyright © 2022. Thieme. All rights reserved. <2> Accession Number 637507990 Title Veno-Arterial Partial Pressure of Carbon Dioxide Difference as a Metric of Systemic Oxygen Delivery: Insights from a Correlative Meta-Analysis. Source Journal of Pediatric Intensive Care. 13(4) (pp 372-378), 2022. Date of Publication: 22 Nov 2024. Author Loomba R.S.; Farias J.S.; Savorgnan F.; Acosta S.; Flores S.; Villarreal E.G. Institution (Loomba) Division of Cardiology, Advocate Children's Hospital, Chicago, IL, United States (Loomba) Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, IL, United States (Farias, Villarreal) Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX, United States (Savorgnan, Acosta, Flores) Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States (Savorgnan, Acosta, Flores) Tecnologico de Monterrey, School of Medicine and Health Sciences, Nuevo Leon, Monterrey, Mexico Publisher Georg Thieme Verlag Abstract The assessment of cardiac output and adequacy of systemic oxygen delivery in children after cardiac surgery require the use of an aggregate of hemodynamic monitors and blood tests. There are previously published data regarding the utility of the veno-arterial partial pressure of carbon dioxide difference (AVDco2) to help with this. This study pooled data on the correlation of AVDco2 with other metrics of cardiac output and systemic oxygen delivery such as arteriovenous oxygen saturation difference, venous saturation, and serum lactate. A systematic review of the literature was done to identify studies analyzing the correlation of AVDco2 with other hemodynamic and laboratory values. Data were extracted, and correlation coefficients were pooled for each specific comparison to create a point estimate for the overall correlation. A total of four studies with 350 patients and 809 paired blood gases were pooled. Adequate data were available to assess the correlation of AVDco2 with arteriovenous oxygen saturation difference, venous saturation, and serum lactate. There was a significant, moderate correlation with arteriovenous oxygen saturation difference and venous saturation. A significant, weak correlation with serum lactate was found. The AVDco2 has significant, moderate correlations with other metrics of the adequacy of systemic oxygen delivery such as arteriovenous oxygen saturation difference and venous saturation. There was a significant but only weak correlation with serum lactate. AVDco2 may be complementary to assess the adequacy of cardiac output and systemic oxygen delivery. Copyright © 2022. Thieme. All rights reserved. <3> Accession Number 2040584798 Title A randomised clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: five-year and ten-year follow-up for neurodevelopmental outcomes in children with functional single ventricle. Source Cardiology in the Young. 35(10) (pp 2030-2036), 2025. Date of Publication: 01 Oct 2025. Author Wolschendorf R.M.; Smith-Parrish M.; Peterson A.; Yu S.; Ohye R.G.; Bove E.; Best M.; Goldberg C.S. Institution (Wolschendorf, Yu, Goldberg) Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States (Smith-Parrish) Division of Pediatric Cardiology, Department of Pediatrics, Vanderbilt University, Nashville, TN, United States (Ohye, Bove) Section of Pediatric Cardiovascular Surgery, Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI, United States (Peterson) Department of Neurology, Vanderbilt University, Nashville, TN, United States (Best) Pediatric Neuropsychology Clinic, Yale University, New Haven, CT, United States Publisher Cambridge University Press Abstract Objective: - This study aimed to evaluate school-age neurodevelopmental outcomes among children with single ventricle heart disease who underwent neonatal Norwood operation with regional cerebral perfusion compared to deep hypothermic circulatory arrest. Additionally, we aimed to identify predictors of school-age development, including early developmental measures. Study design: - Patients enrolled in a prospective randomised trial of infants with single ventricle heart disease undergoing the Norwood operation with either regional cerebral perfusion or deep hypothermic circulatory arrest were included. For the same cohort of patients, this study performed neurodevelopmental testing at 5 years and 10 years of age. At 5 years, a comprehensive neuropsychological evaluation was performed. At 10 years, parent report instruments were used to measure participants' behaviour and executive function. Result(s): - Forty-one patients at 5 years of age and 33 patients at 10 years of age completed neurodevelopmental evaluation. There were no significant differences in neurodevelopmental scores between the regional cerebral perfusion and deep hypothermic circulatory arrest groups at either 5 or 10 years. At 5 years of age, the average full scale intelligence quotient (IQ) was 93.4 +/- SD18.8. The Bayley Scale of Infant Development Psychomotor Developmental Index (r = 0.68, p < .0001) and mental developmental index (r = 0.64, p < .0001) at 1 year positively correlated with the full scale IQ at 5 years. Conclusion(s): - Neurodevelopment is delayed in patients with single ventricle heart disease. Neurodevelopmental outcomes at school age did not differ based on the perfusion strategy for the Norwood operation. Mental and psychomotor developmental indices at 1 year are predictive of early school-age measures. Copyright © The Author(s), 2025. Published by Cambridge University Press <4> Accession Number 2050131848 Title Intraoperative hemoadsorption and postoperative inflammatory biomarkers in patients undergoing cardiac surgery, a meta-analysis of randomized controlled trials. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 46. Date of Publication: 01 Dec 2026. Author Motawea K.R.; Makky E.; Amer A.E.; Ibrahim M.; Abouainain L.; Almaraihah R.A.; Abdelkader Y.; Pelletier M.; Diasty M.E.; Elgudin Y.; Abu-Omar Y. Institution (Motawea, Diasty, Elgudin, Abu-Omar) Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States (Makky, Abdelkader) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Amer) Pulmonary and Critical Care Department, Tufts Medical Center, Boston, MA, United States (Ibrahim) Banner University Medical Center, Phoenix, AZ, United States (Abouainain) Faculty of Medicine, University of Jordan, Amman, Jordan (Almaraihah) University College London Hospitals, London, United Kingdom (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Aim: We aimed to perform a meta-analysis to evaluate the effect of intraoperative hemoadsorption (HA) with cardiopulmonary bypass (CPB) on postoperative inflammatory biomarkers in patients undergoing cardiac surgery. Method(s): We searched PubMed, Web of Science, and Scopus databases for randomized controlled trials (RCTs) that compared intraoperative HA with CPB versus CPB without intraoperative HA in patients undergoing cardiac surgery in terms of postoperative inflammatory biomarkers. Result(s): Twelve RCTs involving 830 patients (420 in HA group and 410 control group) were included. HA was associated with significantly lower interleukin-6 (IL-6) levels at 6 h (SMD = - 3.33, 95% CI - 6.55 to - 0.11; p = 0.04). However, no significant differences were observed in IL-6 at end of CPB, 24 h, or 48 h. Tumor necrosis factor-alpha (TNF-alpha) levels did not differ significantly between groups at end of CPB (SMD = - 0.29, 95% CI - 0.77 to 0.20; p = 0.25), 6 h (SMD = - 0.22, 95% CI - 0.55 to 0.12; p = 0.21), 24 h (SMD = - 0.22, 95% CI - 0.53 to 0.10; p = 0.17), or 48 h (SMD = 0.02, 95% CI - 0.29 to 0.34; p = 0.89). Similarly, no significant between-group differences were found in interleukin-8, interleukin-10, C-reactive protein, procalcitonin, or leukocyte counts at the assessed postoperative time points. Conclusion(s): Our study shows that intraoperative HA in cardiac surgery has no clear evidence of reducing the postoperative inflammatory response. Further clinical research, particularly large-scale clinical trials with more standardized management protocols, is required to guide further use of HA in cardiac surgery. Copyright © The Author(s) 2026. <5> Accession Number 2051273233 Title Effect of omeprazole on platelet reactivity in patients with diabetes mellitus and coronary artery disease receiving aspirin and clopidogrel: a randomised, placebo-controlled crossover trial (POC-DM). Source Open Heart. 13(2) (no pagination), 2026. Article Number: e004409. Date of Publication: 01 Jul 2026. Author Thungthienthong M.; Kluntang S.; Khopanlert W.; Kaewkan P.; Meemook K.; Likittanasombut K.; Chandanamattha P.; Vathesatogkit P. Institution (Thungthienthong, Kluntang, Meemook, Likittanasombut, Chandanamattha) Cardiovascular Unit, Mahidol University Faculty of Medicine Ramathibodi Hospital Department of Medicine, Bangkok, Thailand (Khopanlert) Anatomical Pathology Unit, Division of Pathology, Prince of Songkla University Faculty of Medicine, Hat Yai, Thailand (Kaewkan) Department of Pharmacy, Mahidol University Ramathibodi Hospital, Bangkok, Thailand (Vathesatogkit) Division of Cardiology, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand Publisher BMJ Publishing Group Abstract Background: Proton pump inhibitors are often prescribed with aspirin and clopidogrel to reduce gastrointestinal bleeding risk. However, the European Society of Cardiology diabetes guidelines recommend avoiding concomitant use of omeprazole and clopidogrel due to potential drug-drug interactions. Evidence in patients with diabetes mellitus (DM), who have a higher prevalence of high on-treatment platelet reactivity, remains limited. In Thailand, where omeprazole is the only reimbursed PPI, this potential interaction has important clinical implications. We aimed to evaluate the effect of omeprazole on platelet reactivity, measured as P2Y12 reaction units (PRU), in patients with DM and coronary artery disease (CAD) receiving aspirin and clopidogrel. Method(s): This double-blind, randomised, placebo-controlled crossover trial enrolled patients with DM and CAD receiving aspirin 81 mg/day and clopidogrel 75 mg/day. Participants received omeprazole 20 mg or a matching placebo for 2 weeks, followed by crossover to the alternate treatment. Platelet reactivity was assessed using the VerifyNow P2Y12 assay. The primary outcome was the change in PRU following omeprazole coadministration compared with both baseline and placebo. Secondary outcomes included changes in clopidogrel responder status (PRU >208) before and after omeprazole treatment and PRU values in each treatment period. Result(s): 50 patients were enrolled (median age 67 years; 58% male). Omeprazole significantly increased PRU by a mean difference of 20.57 units versus baseline (p=0.002) and 16.14 units versus placebo (p=0.006). The proportion of clopidogrel non-responders increased from 44% to 56%, with 25% of baseline responders converting to non-responders. Conclusion(s): Omeprazole significantly attenuated clopidogrel's antiplatelet effect in patients with diabetes and CAD. Concomitant use may be avoided, especially in those with high thrombotic risk. Trial registration number: TCTR20260714003. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <6> Accession Number 2051042710 Title Neuroprotective Effects of Dexmedetomidine in Pediatric Open-heart Surgery with Cardiopulmonary Bypass: A Randomized Controlled Study using Near-Infrared Spectroscopy and S-100B. Source Open Anesthesia Journal. 20 (no pagination), 2026. Article Number: e258964583987. Date of Publication: 2026. Author Sasmita D.N.; Perdana A.; Heriwardito A.; Adeline M. Institution (Sasmita, Perdana, Heriwardito, Adeline) Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia (Sasmita, Perdana, Heriwardito) Department of Anesthesiology and Intensive Care, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia Publisher Bentham Science Publishers Abstract Introduction: Cardiopulmonary Bypass (CPB) during pediatric congenital heart surgery is associated with a risk of perioperative neurological injury. This study aimed to evaluate whether intra-CPB administration of dexmedetomidine reduces neuronal injury, as assessed by serum S-100B levels and regional cerebral oxygen saturation (rSO<inf>2</inf>) monitored with near-infrared spectroscopy (NIRS). Method(s): This double-blind randomized controlled trial included 36 children aged 0-18 years; 32 patients were included in the final analysis (16 per group) undergoing open-heart surgery with CPB. Patients were randomized to receive either dexmedetomidine or placebo, with 16 patients in each group. In the dexmedetomidine group, 0.5 microg/kg dexmedetomidine was added to the CPB priming solution, followed by a continuous infusion of 0.25 microg/kg/h into the CPB reservoir during bypass. Serum S-100B levels were measured before CPB and 6-12 hours postoperatively. Cerebral rSO<inf>2</inf> was monitored at predefined perioperative time points. Secondary outcomes included duration of mechanical ventilation, cardiac intensive care unit length of stay, and 7-day mortality. Result(s): Baseline pre-CPB S-100B levels did not differ significantly between the control and dexmedetomidine groups [8.76 (3.04-14.70) vs. 11.89 (3.93-14.20) pg/mL; p = 0.127]. Post-CPB S-100B levels were significantly higher in the control group than in the dexmedetomidine group (33.97 vs. 9.39 pg/mL; p = 0.019). The change in S-100B levels also differed significantly between groups, with an increase in the control group and a decrease in the dexmedetomidine group (+14.62 vs. -4.53 pg/mL; p = 0.001). Cerebral rSO<inf>2</inf> showed similar temporal trends in both groups, with no statistically significant between-group differences at any measurement time point. Duration of mechanical ventilation, cardiac intensive care unit length of stay, and 7-day mortality were comparable between groups. Discussion(s): Intra-CPB dexmedetomidine was associated with lower postoperative S-100B levels, suggesting a potential reduction in biochemical evidence of neuronal injury during pediatric cardiac surgery with CPB. However, this biochemical effect was not accompanied by measurable differences in cerebral oxygenation or short-term clinical outcomes, indicating that its clinical significance remains uncertain. Conclusion(s): Intra-CPB dexmedetomidine administration was associated with lower postoperative S-100B levels in pediatric patients undergoing open-heart surgery with CPB. Larger studies incorporating serial biomarker measurements and long-term neurodevelopmental follow-up are warranted to determine whether this biochemical effect translates into clinically meaningful neuroprotection. Clinical Study Trial Number: TCTR20260317004. Copyright © 2026 The Author(s). Published by Bentham Open., 2026. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. <7> Accession Number 2047687886 Title Measuring patient disability in the peri-operative period using the WHODAS 2.0 questionnaire: a systematic review. Source Anaesthesia. 81(11) (pp 1569-1580), 2026. Date of Publication: 01 Nov 2026. Author Boerlage R.M.; van Dartel D.; Vernooij J.E.M.; Koning N.J.; Posthuma L.M.; Kalkman C.J.; Doggen C.J.M.; Preckel B. Institution (Boerlage, Vernooij, Koning) Department of Anaesthesiology and Pain Medicine, Rijnstate Hospital, Arnhem, Netherlands (Boerlage, Doggen) Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands (Boerlage, Doggen) Clinical Research Center, Rijnstate Hospital, Arnhem, Netherlands (Boerlage, Preckel) Department of Anaesthesiology, Amsterdam UMC location AMC, Amsterdam, Netherlands (van Dartel) Department of Intensive Care, Gelre ziekenhuizen, Apeldoorn, Netherlands (Posthuma) Department of Intensive Care, Albert Schweitzer Hospital, Dordrecht, Netherlands (Kalkman) Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht, Netherlands (Preckel) Amsterdam Public Health, Quality of Care Research Institute, Amsterdam, Netherlands (Preckel) Amsterdam Cardiovascular Science Research Institute, Amsterdam, Netherlands Publisher John Wiley and Sons Inc Abstract Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is recommended by peri-operative core outcome sets as a measure of disability. Despite its growing use, the effect of different surgical procedures on disability measured by WHODAS 2.0 remains poorly understood and heterogeneous reporting across studies limits direct comparison. Method(s): We conducted a systematic review to assess the effect of different surgical procedures on disability measured by WHODAS 2.0, and the reporting of disability endpoints in peri-operative medicine. The primary outcome was the difference in WHODAS 2.0 summary score before and after surgery. Disability scores were calculated as a metric between 0% (no disability) and 100% (complete disability). Result(s): Thirty-nine studies were included. Pre-operative disability ranged from 2% to 61%. In 21 studies, disability increased by 1% to 17% within 3 months of surgery, with little change between 6 and 12 months (0% to -2%). Studies of orthopaedic surgery generally reported high pre-operative disability (> 35%) but also reductions in disability (10-37% reduction) within 3 months of surgery. In contrast, studies evaluating cancer surgery (n = 12) generally reported lower pre-operative disability (< 20%) but small increases (1-8%) within 3 months of surgery. Cardiovascular surgical studies displayed pre-operative disability between 4% and 17% with a difference in disability of -8% to +3% 3 months after surgery. Three different thresholds to define disability and 13 different WHODAS 2.0 endpoints were used, measured at eight different time-points after surgery. Discussion(s): The effect of surgical procedures on postoperative disability as measured by WHODAS 2.0 is influenced by the type of surgery. Orthopaedic surgery may decrease disability, whereas cancer surgery may be associated with persistent increases. Standardised reporting of disability endpoints is needed to enhance the quality and comparability of future studies using WHODAS 2.0. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <8> Accession Number 2051037488 Title Modified frailty index versus risk analysis index for 30-day mortality after noncardiac surgery: a systematic review and meta-analysis. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1885620. Date of Publication: 09 Oct 2026. Author Yin X.; Du S. Institution (Yin) Department of Anesthesiology, Aerospace Center Hospital, Beijing, China (Du) Department of VIP Dental Service, Peking University Stomatological Hospital, Beijing, China Publisher Frontiers Media SA Abstract Background - mFI and RAI are widely used in noncardiac surgical risk stratification, but they differ in content and data requirements. Because construct validity and outcome discrimination are distinct, we evaluated their prognostic discrimination for 30-day all-cause mortality without treating either instrument as a criterion-standard multidimensional frailty measure. Methods - This PRISMA-aligned, prospectively registered systematic review used two complementary evidence levels: tool-specific random-effects meta-analyses across independent cohorts and direct within-study comparison. Standalone AUCs were pooled on the logit scale using REML with Hartung-Knapp inference and 95% prediction intervals. Risk of bias was assessed with QUIPS. CFS was analyzed post hoc as secondary exploratory evidence. Results - Seventy-seven studies were included. For mFI, 39 independent cohorts yielded a pooled AUC of 0.634 (95% CI, 0.618-0.649; 95% prediction interval, 0.551-0.709). For RAI, 30 independent cohorts yielded 0.767 (95% CI, 0.737-0.795; 95% prediction interval, 0.579-0.888). Among 29 dual-tool studies, 21 had source-valid numeric comparisons in which RAI was higher, none had a source-valid numeric comparison in which mFI was higher, 2 supported RAI only qualitatively, and 6 could not be numerically classified; no paired meta-analysis was conducted because within-study covariance or delta-AUC standard errors were unavailable. Fourteen CFS studies were identified; 6 source-confirmed 30-day AUC cohorts yielded a post hoc exploratory AUC of 0.757 (95% CI, 0.618-0.857). Conclusions - RAI showed higher average prognostic discrimination than mFI, a pattern also observed in most directly comparative studies. Separate pooled AUCs are not a formal superiority test because case mix differs across studies. The analysis does not establish construct validity, and CFS evidence remains exploratory. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420261378778, identifier PROSPERO, CRD420261378778. Copyright © 2026 Yin and Du. <9> Accession Number 2049277114 Title Landscape of Biomarker Use in Critically Ill Patients: Systematic Evidence Map of Acute Kidney Injury and Implications for Practice. Source Critical Care Medicine. 54(11) (pp 2935-2943), 2026. Date of Publication: 01 Nov 2026. Author Kane-Gill S.L.; Boyer K.M.; Akcan Arikan A.; Barreto E.F.; Belcher J.M.; Lumlertgul N.; Kellum J.A. Institution (Kane-Gill) Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States (Boyer) Society of Critical Care Medicine, Mt. Prospect, IL, United States (Akcan Arikan) Divisions of Critical Care Medicine and Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States (Barreto) Department of Pharmacy, Mayo Clinic, Rochester, MN, United States (Belcher) Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States (Lumlertgul) Centre of Excellence in Critical Care Nephrology and Excellence Centre in Critical Care Nephrology, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand (Kellum) The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States Publisher Lippincott Williams and Wilkins Abstract OBJECTIVES: - Create systematic evidence maps of novel biomarkers of kidney injury from a mapping review to guide future implementation in patient care. DATA SOURCES: - PubMed/MEDLINE and Embase. STUDY SELECTION: - Systematic evidence maps included clinical trials and observational studies in critically ill patients, investigating novel kidney biomarkers for acute kidney injury (AKI). DATA EXTRACTION: - Six thousand eight hundred five records were screened, and 1116 studies were included that related to one or more novel biomarkers and AKI. DATA SYNTHESIS: - Adult populations accounted for 78.6% of the studies, and 93.3% used a cohort design to investigate AKI biomarkers. Mixed critically ill populations, cardiac surgery, and sepsis were identified as the most frequently studied clinical contexts in 69.5% of the studies. Systematic evidence maps were synthesized for biomarker studies to predict AKI (n = 944), prognosticate clinical outcomes (n = 647), diagnose AKI etiology (n = 109), enrich clinical trials (n = 6), and manage AKI (n = 12). Implementation strategies for patient care included surveilling patients at risk of AKI, including patients undergoing surgery and those exposed to multiple nephrotoxic drugs. CONCLUSION(S): - Substantial clinical evidence assessing the accuracy of biomarkers compared with diagnosis of AKI exists, with fewer practical trials in clinical use. Still, guidance on implementation approaches can be gleaned from evaluations using biomarkers for the management of critically ill patients, particularly in surgical and nephrotoxin-exposed populations where evidence is available. This review identifies the landscape of current evidence and highlights priorities for future management and enrichment trials needed to bridge the gap between predictive accuracy and clinical decision-making. Copyright © 2026 by the Society of Critical Care Medicine and Wolters Kluwer Health, LLC. All Rights Reserved. <10> Accession Number 2046104354 Title Effect of Breathing Exercises to Prevent Pulmonary Complications in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Pilot Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(12) (pp 4004-4013), 2026. Date of Publication: 01 Dec 2026. Author Li C.; Huo C.; Li H.; Ding R.; Zhang P. Institution (Li, Huo, Li, Ding, Zhang) Xuanwu Hospital Capital Medical University, Beijing, China Publisher W.B. Saunders Abstract Objective: To explore the impact of perioperative breathing exercises on postoperative pulmonary complications (PPCs) in patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery. Design(s): A single-center, randomized controlled pilot study. Setting(s): The inpatient unit of a tertiary hospital affiliated with a university in Beijing, China. Participant(s): A total of 154 eligible elective OPCABG patients were randomized 1:1 to the intervention group (perioperative breathing exercises plus standard care, n = 77) or control group (standard care only, n = 77). Intervention(s): Breathing exercises (balloon-blowing, deep breathing, and coughing) performed for at least 5 days before surgery, in addition to standard perioperative care. Measurements and Main Results: PPC incidence was significantly lower in the intervention group (15.6% v 42.9%, p < 0.001). Postoperative PaO<inf>2</inf> was higher (p < 0.05) and 6-minute walk test distance was longer (327.01 +/- 41.07 m v 319.94 +/- 29.08 m, p = 0.03). Short Form-36 scores for physical functioning and social functioning were better in the intervention group at 1 month (p < 0.01). Conclusion(s): Perioperative breathing exercises may reduce PPC incidence, preserve arterial oxygenation, and improve functional capacity and the quality of life in OPCABG patients. Larger multicenter studies are warranted to confirm these preliminary findings. Copyright © 2026 The Authors <11> Accession Number 2051218366 Title Quantitative Flow Ratio- vs Angiography-Guided Percutaneous Coronary Intervention: A Secondary Analysis of the FAVOR III China Trial. Source JAMA Network Open. 9(10) (no pagination), 2026. Article Number: e2639926. Date of Publication: 22 Oct 2026. Author Zhang H.; Shi Y.; Guan C.; Cui J.; Wu X.; Chen L.; Shen C.; Yang J.; Liu X.; Jin Y.; Wang L.; Su X.; Yang Q.; Shen Z.; Zhao Y.; Dou K.; Yang W.; Wang J.; Wu Y.; Fearon W.F.; Tu S.; Escaned J.; Qiao S.; Song L.; Stone G.W.; Jin Z.; Yu B.; Fu G.; Zhou Y.; Chen Y.; Pu J.; Qu X.; Guo L.; Zhang Y.; Zhang Q.; Pan H.; Mi J.; Ye F.; Cheng X.; Huang R.; Guo N.; Xu B.; Leon M.B.; Kirtane A.J.; Serruys P.W.; Wijns W.; Windecker S. Institution (Zhang, Shi, Guan, Cui, Dou, Yang, Wu, Qiao, Song) Department of Cardiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Wu) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Chen) Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China (Shen) Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (Yang) Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Liu) Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China (Jin) Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China (Wang) Department of Cardiology, Jiangsu Provincial People's Hospital, Nanjing, China (Su) Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China (Yang) Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China (Shen) Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Zhao) Medical Research and Biometrics Centre, National Center for Cardiovascular Diseases, Beijing, China (Wang) Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Fearon) Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States (Tu) Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (Escaned) Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fearon) Cardiology Section, VA Palo Alto Health Care System, Palo Alto, CA, United States (Jin) Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Yu) The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Fu) Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Zhou) Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Chen) The Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (Pu) Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Qu) Huadong Hospital Affiliated to Fudan University, Shanghai, China (Guo) Peking University Third Hospital, Beijing, China (Zhang) Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China (Zhang) Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (Pan) Hunan Provincial People's Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, China (Mi) The First Hospital of Shijiazhuang, Shijiazhuang, China (Ye) Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Cheng) Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Huang) Beijing Friendship Hospital, Capital Medical University, Beijing, China (Guo) The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Xu) Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China (Leon, Kirtane) NewYork-Presbyterian Hospital, Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States (Serruys) NHLI, Imperial College London, London, United Kingdom (Serruys) Department of Cardiology, National University of Ireland, Galway, Ireland (Wijns) The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, Ireland (Windecker) Bern University Hospital, Bern, Switzerland Publisher American Medical Association Abstract Importance: Whether the association of quantitative flow ratio (QFR)-guided percutaneous coronary intervention (PCI) with long-term outcomes differs according to multivessel disease (MVD) status is uncertain. Objective(s): To assess the association of QFR-guided vs angiography-guided PCI with 3-year outcomes according to MVD status. Design, Setting, and Participant(s): In this prespecified secondary analysis of the FAVOR III China randomized clinical trial, patients were screened across 26 centers in China from December 25, 2018, to January 19, 2020. Eligible participants were adults undergoing PCI for stable or unstable angina or for myocardial infarction (MI) occurring at least 72 hours before screening who had at least 1 lesion with 50% to 90% diameter stenosis in a vessel of 2.5 mm or larger. The analysis compared QFR-guided with angiography-guided PCI according to MVD status. MVD was defined by involvement of at least 2 epicardial vessels or the left main coronary artery. The primary analyses of the current prespecified secondary analysis were completed in October 2024. Intervention(s): Randomization 1:1 to QFR-guided PCI or angiography-guided PCI. Main Outcomes and Measures: The primary end point of the FAVOR III China randomized clinical trial was 1-year major adverse cardiac events (MACE), defined as a composite of all-cause death, MI, and ischemia-driven revascularization. The current analysis evaluated 3-year MACE. Result(s): Among 3825 patients in the intention-to-treat population (mean [SD] age, 62.7 [10.0] years; 2699 [70.6%] male), 2066 (54.0%) had MVD. In the MVD cohort, MACE occurred in 124 of 1023 patients (12.1%) in the QFR-guided group and 188 of 1043 patients (18.1%) in the angiography-guided group (hazard ratio, 0.65; 95% CI, 0.52-0.81; P <.001), driven by lower rates of MI and revascularization. In the non-MVD cohort, MACE occurred in 76 of 890 patients (8.6%) and 95 of 869 patients (11.0%), respectively (hazard ratio, 0.77; 95% CI, 0.57-1.04; P =.09). The treatment x MVD interaction was not statistically significant (P for interaction =.35). The findings of landmark, per-protocol, competing-risk, sensitivity, and hierarchical win-ratio analyses were directionally consistent with the main findings. Conclusions and Relevance: In this prespecified secondary analysis of a randomized clinical trial of patients undergoing PCI, QFR-guided PCI was associated with a lower 3-year MACE rate among patients with MVD; however, no significant interaction was observed between treatment effect and MVD status. These findings provide longer-term randomized evidence supporting QFR-guided PCI across MVD strata and warrant further confirmation. Copyright © 2026 Zhang H et al. <12> Accession Number 2048327115 Title Methodological considerations in evaluating time-dependent outcomes after Magmaris implantation. Source Acta Cardiologica. 81(8) (pp 974-975), 2026. Date of Publication: 2026. Author Wu J. Institution (Wu) Department of Cardiology, Jinjiang Hospital of Traditional Chinese Medicine, Quanzhou, China Publisher Taylor and Francis Ltd. <13> Accession Number 2046987101 Title Robot-Assisted Coronary Artery Bypass Versus Percutaneous Coronary Intervention in Patients With Coronary Artery Disease: A Meta-Analysis. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 21(4) (pp 319-331), 2026. Date of Publication: 01 Jul 2026. Author Doma M.; Bertoli E.D.; Rovari G.; Ramadan A.; Seferasi L.; Kritya M.; Sanadgol G.; Kamel I.; Lingamsetty S.S.P.; Karara Y.; Bendaham L.C.A.R.; Hosseini M.; Geirsson A.; Brown C.R.; Goldsweig A.M. Institution (Doma, Ramadan, Sanadgol) Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Bertoli) Department of Internal Medicine, Marieta Konder Bornhausen Hospital and Maternity, Itajai, Brazil (Rovari) Hospital Universitario Antonio Pedro/Federal Fluminense University, Niteroi, Brazil (Ramadan, Kamel) Department of Internal Medicine, Boston Medical Center, MA, United States (Seferasi) Faculty of Medicine, University of Tirana, Albania (Kritya) DeBakey Heart and Vascular Institute, Houston Methodist, TX, United States (Sanadgol) General Surgery Department, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States (Lingamsetty) Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Karara) Division of Cardiovascular Medicine, Alexandria Faculty of Medicine, Egypt (Bendaham) Faculty of Medicine, Federal University of Roraima, Boa Vista, Brazil (Hosseini) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Geirsson) Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Columbia University, New York, NY, United States (Brown) Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center, Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States Publisher SAGE Publications Ltd Abstract Objective: As alternatives to conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG) and percutaneous coronary intervention (PCI) offer less invasive treatments for coronary artery disease (CAD). However, data comparing outcomes of R-CABG versus PCI are limited. Method(s): Databases were systematically searched for studies comparing R-CABG versus PCI. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), both overall and stratified by left main or multivessel (LM+MV) or isolated left anterior descending artery (LAD) disease. Kaplan-Meier curves were digitally extracted to reconstruct individual participant data (IPD), from which hazard ratios (HRs) were estimated for survival analyses. Result(s): Six retrospective studies, including 1,896 patients (R-CABG: 894, 47.1%), were analyzed. The mean age was 63.8 +/- 11.3 years, and 78.7% were male patients. Follow-up ranged from 2 to 8 years. Overall, R-CABG was associated with a lower odds of target vessel revascularization (TVR; OR = 0.50, 95% CI: 0.27 to 0.93, P = 0.03) and myocardial infarction (MI; OR = 0.44, 95% CI: 0.26 to 0.76, P < 0.01), with no significant difference in all-cause mortality. Among patients with LM+MV disease, R-CABG reduced TVR and MI. In LAD lesions, R-CABG significantly lowered the likelihood of MI (OR = 0.18, 95% CI: 0.04 to 0.71) as well as major adverse cardiovascular events (MACE; OR = 0.51, 95% CI: 0.28 to 0.93). Time-to-event analysis from reconstructed IPD demonstrated significantly improved freedom from reintervention (HR = 0.31, 95% CI: 0.16 to 0.60) and MACE (HR = 0.24, 95% CI: 0.15 to 0.60) with R-CABG, whereas no significant difference was found for all-cause mortality. Conclusion(s): R-CABG was associated with less TVR and MI compared with PCI in CAD patients, with no difference in all-cause mortality. Copyright © The Author(s) 2026 <14> 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. 40(12) (pp 3922-3929), 2026. Date of Publication: 01 Dec 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). Design(s): Prospective, open-label, randomized, parallel-group comparative study. Setting(s): Department of Cardiac Anaesthesiology and Critical Care at a tertiary-level cardiac surgical center. 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. 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. 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). 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. Copyright © 2026 Elsevier Inc. <15> Accession Number 2050834372 Title Cold and Room-Temperature Platelets in Cardiac Surgery: The CHIPS Randomized Clinical Trial. Source JAMA. 336(14) (pp 1216-1227), 2026. Date of Publication: 13 Oct 2026. Author Spinella P.C.; Zantek N.D.; VanBuren J.M.; Nicolson S.C.; Khanna A.K.; Klompas A.M.; Boisen M.L.; Williams T.M.; Monteleone M.; Bashir D.A.; Pavey W.; Smith B.B.; Ahmed M.I.; Niebler R.A.; Jeng E.; Flynn B.C.; Joshi R.V.; Preuss J.F.; Goswami D.; Yamada C.; Lewis C.; Cohn C.S.; Tint H.; Kwak J.; Sodha N.; Simon E.R.; Van P.Y.; Greilich P.E.; Booth F.V.McL.; Carter C.P.; Keegan A.; Cap A.P.; Matuk J.; McGlothlin A.; Berry N.S.; Lewis R.J.; Steiner M.E.; Hu P.; Hawkins J.; Jobes D.R.; Fadeyi E.A.; Reynolds A.M.A.; Bel C.G.; Smith M.M.; Gandhi M.J.; Montonye B.; Kaplan A.; Serna-Gallegos D.; Sultan I.; Kinney S.; Molony K.; Hensch L.; Resheidat A.; Malivers M.; Hahn R.; Le Viellez A.; Pepperell D.; Lu Q.; Downey F.X.; Haeger K.N.; Baltagi S.A.; Jaquiss R.D.B.; Noland D.K.; Cole R.; Duffin A.; Scott J.P.; Zeng L.; Ballew A.; Webb C.; Jessen M.; Hopson E.; Mickle P.; Kavanagh S.; Matzelle S.; Crowe L.; Mennie C.; Davenport R.; Chlebeck T.; Zenk E.; Lotz D.T.; Choi W.; Hobbs R.; Baptise A.; DeChristopher P.; Schoenecker N.; Rodheim D.; Connor J.; Griese D.J.; McGuire E.; VanSandt M.; Sera V.; O'Donovan J.; Marks D.; Johnson L.; Viele K.; Cholette J.M.; Levy J.H.; Selke F.; Silverman T.; Shea S.; Yazer M.; Young P.; Ness P.; Strandenes G.; Dean J.M.; Shaz B.; Stubbs J. Institution (Spinella) University of Pittsburgh, 3250 Fifth Ave, Ste 500, Pittsburgh, PA, United States (Spinella) Departments of Surgery and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States (Zantek, Cohn) Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, University of Minnesota, Minneapolis, United States (VanBuren, Carter) Department of Pediatrics, Division of Critical Care, University of Utah, Salt Lake City, United States (Nicolson) Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Khanna) Department of Anesthesiology, Division of Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States (Khanna) Outcomes Research Consortium, Houston, TX, United States (Klompas) Departments of Anesthesiology & Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States (Boisen) Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesiology, University of Pittsburgh, Pittsburgh, PA, United States (Williams) Department of Anesthesiology & Perioperative Medicine, Division of Cardiothoracic Anesthesiology, UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States (Monteleone) Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States (Bashir) Department of Pediatrics, Division of Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, United States (Pavey) Department of Anaesthesia and Perioperative Medicine, Division of Cardiothoracic Anaesthesia, Fiona Stanley Hospital, Perth, WA, Australia (Smith) Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Phoenix, AZ, United States (Ahmed) Department of Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, United States (Niebler) Department of Pediatrics, Medical College of Wisconsin and Herma Heart Institute, Children's Wisconsin, Milwaukee, United States (Jeng) Department of Surgery, Division of Cardiovascular Surgery, University of Florida, Gainesville, United States (Flynn) Department of Anesthesiology, Division of Critical Care, University of Kansas Medical Center, Kansas City, United States (Joshi, Greilich) Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, William P. Clements Jr University Hospital, Dallas, United States (Preuss) Department of Anesthesia, Sir Charles Gairdner Hospital, The University of Western Australia, Perth, WA, Australia (Goswami) Department of Anesthesia and Critical Care Medicine, Division of Pediatric Cardiac Critical Care and Anesthesia, Johns Hopkins Medical Center, Baltimore, MD, United States (Yamada) Department of Pathology, Division of Transfusion Medicine, University of Michigan, Ann Arbor, United States (Lewis) Department of Anesthesiology and Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Tint) Department of Pathology and Laboratory Medicine, Hemotherapy & Transfusion Medicine, University of Texas Health Science Center, Memorial Hermann Health System, Houston, United States (Kwak) Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesiology, Loyola University Medical Center, Maywood, IL, United States (Sodha) Department of Surgery, Division of Cardiac Surgery, Rhode Island Hospital, Providence, United States (Simon) Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, University of Wisconsin School of Medicine and Public Health, Madison, United States (Van) Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, United States (Booth) HoustonTXUnited States (Keegan) Department of Hematology, King Edward Memorial Hospital, PathWest Laboratory Medicine, Perth, WA, Australia (Cap) Department of Medicine, Uniformed Services University, Bethesda, MD, United States (Matuk) School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States (McGlothlin, Berry, Lewis) Berry Consultants, Austin, TX, United States (Steiner) Department of Pediatrics, Divisions of Hematology/Oncology and Critical Care, University of Minnesota, Minneapolis, United States (Hu, Hawkins, Jobes) Children's Hospital of Philadelphia, Philadelphia, PA, United States (Fadeyi, Reynolds, Bel) Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States (Smith, Gandhi, Montonye) Mayo Clinic, Rochester, MN, United States (Kaplan, Serna-Gallegos, Sultan) University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Kinney, Molony) University of Cincinnati, Cincinnati, OH, United States (Hensch, Resheidat, Malivers) Texas Children's Hospital, Baylor, Houston, TX, United States (Hahn, Le Viellez, Pepperell) Fiona Stanley Children's Hospital, Perth, WA, Australia (Lu, Downey, Haeger) Mayo Clinic, Phoenix, AZ, United States (Baltagi, Jaquiss, Noland) University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX, United States (Cole, Duffin, Scott) Children's Hospital of Wisconsin, Milwaukee, WI, United States (Zeng, Ballew) University of Kansas Medical Center, Kansas City, KS, United States (Webb, Jessen, Hopson) University of Texas Southwestern Clements Hospital, Dallas, TX, United States (Mickle, Kavanagh, Matzelle) Sir Charles Gairdner Hospital, Perth, WA, Australia (Crowe, Mennie) Johns Hopkins Medical Center, Baltimore, MD, United States (Davenport) University of Michigan, Ann Arbor, MI, United States (Chlebeck, Zenk, Lotz) University of Minnesota, Minneapolis, MN, United States (Choi, Hobbs, Baptise) Memorial Herman Health System, Houston, TX, United States (DeChristopher, Schoenecker, Rodheim) Loyola University Medical Center, Maywood, IL, United States (Connor, Griese, McGuire) University of Wisconsin School of Medicine and Public Health, Madison, WI, United States (VanSandt, Sera) Oregon Health & Science University, Portland, OR, United States (O'Donovan, Marks, Johnson) Australian Red Cross Lifeblood West, Melbourne, VIC, Australia (Viele) Berry Consultants, LLC, Austin, TX, United States (Cholette) CHIPS Steering Committee, Rochester, NY, United States (Levy, Shaz) CHIPS Steering Committee, Durham, NC, United States (Selke) CHIPS Steering Committee, Providence, RI, United States (Silverman) CHIPS Steering Committee, Bethesda, MD, United States (Shea, Yazer) CHIPS Steering Committee, Pittsburgh, PA, United States (Young) CHIPS Steering Committee, Nashville, TN, United States (Ness) CHIPS Steering Committee, Baltimore, MD, United States (Strandenes) CHIPS Steering Committee, Bergen, Norway (Dean) CHIPS Steering Committee, Salt Lake City, UT, United States (Stubbs) CHIPS Steering Committee, Jacksonville, FL, United States Publisher American Medical Association Abstract IMPORTANCE Patients undergoing cardiac surgery with cardiopulmonary bypass often require platelet transfusions for bleeding. Platelets are routinely stored at room temperature (20-24 degreeC) for up to 5 to 7 days; however, cold storage (1-6 degreeC) may allow for increased storage duration without loss of hemostatic function. OBJECTIVE To determine the maximum cold-storage duration, up to 21 days, for which cold-stored platelets (CSPs) are noninferior or superior in hemostatic efficacy to room-temperature platelets (RTPs) when transfused in actively bleeding patients undergoing cardiac surgery with cardiopulmonary bypass. DESIGN, SETTING, AND PARTICIPANTS A phase 3, multicenter, randomized, partially blinded, adaptive, noninferiority, storage duration-ranging trial conducted in pediatric and adult patients undergoing cardiac surgery with planned cardiopulmonary bypass at 27 sites in the US and Australia from December 2021 to March 2025. Statistical analysis was conducted from September 9 to October 3, 2025. INTERVENTION Patients were randomized 2:1 to receive CSPs with a maximum of 21 days of storage vs RTPs with a maximum of 7 days of storage. MAIN OUTCOMES AND MEASURES The primary outcome was a hemostatic efficacy score with values ranging from 1 to 5 and higher values indicating greater bleeding. The noninferiority margin was 1 point. The success criterion was met if at least 1 cold-storage duration of 7 days or more had a posterior probability of noninferiority of at least 97.5%. The secondary outcome was 24-hour chest tube output. RESULTS Of the 1000 patients who underwent platelet transfusion, 989 were included in the primary analysis (650 CSPs and 339 RTPs). The cohort had a mean (SD) age of 42.1 (30.1) years and 67.8% were male. CSPs were noninferior to RTPs for the primary outcome, with a probability of greater than 99.9% for all cold-storage durations. Pooled across storage durations, CSPs had a mean difference from RTPs of 0.09 (95% credible interval, -0.06 to 0.23). Median (IQR) chest tube output at 24 hours (8.9 mL/kg [5.2-15.4] for CSPs vs 8.4 mL/kg [5.5-15.9] for RTPs; difference in medians, 0.4 [95% CI, -1.0 to 1.5]) was not statistically different between study groups. In a post hoc analysis, as all storage durations were noninferior, considering the CSPs as a single group, the hemostatic efficacy score was similar between both groups: mean (SD) of 3.08 (1.15) CSPs vs 2.99 (1.10) RTPs. There were no differences in venous or arterial thrombotic events, transfusion-associated adverse events, acute respiratory distress syndrome, kidney failure, septic shock, and mortality between the study groups, except for increased reexploration rates in the CSP group. CONCLUSIONS AND RELEVANCE For patients undergoing cardiac surgery, CSPs stored up to 21 days are noninferior to RTPs for the control of active surgical bleeding. Use of CSPs may allow for increased availability of platelets by reducing wastage and shortages and may allow for incorporation of platelets into inventory at locations where platelets cannot be maintained due to the 5- to 7-day shelf life of RTPs. Copyright © 2026 American Medical Association. All rights reserved. <16> Accession Number 2051066364 Title Timeless therapeutics: cardiac indications for vitamin K antagonists in clinical practice. Source Heart. 112(22) (pp 1237-1247), 2026. Date of Publication: 01 Nov 2026. Author Kempers E.K.; Acampo - de Jong M.J.J.; ten Cate H.; De Caterina R.; Kruip M.J.H.A. Institution (Kempers, Kruip) Erasmus Medical Center, Rotterdam, Netherlands (Acampo - de Jong) Vascular Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands (ten Cate) Thrombosis Expert Centre, Maastricht UMC+, Maastricht, Netherlands (De Caterina) School of Medicine and Surgery, University of Pisa, Pisa, Italy Publisher BMJ Publishing Group <17> Accession Number 2049788249 Title Locally Estimated Scatterplot Smoothing for Censored Survival Data. Source Statistics in Medicine. 45(23-24) (no pagination), 2026. Article Number: e70783. Date of Publication: 01 Oct 2026. Author van Klaveren D.; Austin P.C.; Serruys P.W.; van Calster B.; Harrell F.E. Institution (van Klaveren) Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands (van Klaveren) Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States (Austin) ICES, Toronto, ON, Canada (Austin) Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada (Austin) Sunnybrook Research Institute, Toronto, ON, Canada (Serruys) CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland (van Calster) Department of Development and Regeneration, KU Leuven, Leuven, Belgium (van Calster) Leuven Unit for Health Technology Assessment Research (LUHTAR), KU Leuven, Leuven, Belgium (van Calster) Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands (Harrell) Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, United States Publisher John Wiley and Sons Ltd Abstract In the absence of censoring, locally estimated scatterplot smoothing (LOESS) is a powerful tool to estimate the relationship between a continuous covariate and the probability of an event and is often used to visually assess calibration of prognostic models. Since follow-up in prognostic studies is often incomplete, we aimed to study the extension of LOESS to right-censored data. In line with other work, we first obtained inverse-probability-of-censoring (IPC) weights through Kaplan-Meier estimation. When censoring varied by covariate levels, we used Cox regression with a spline function of the covariate to obtain IPC weights. We then applied LOESS to the weighted event indicators to estimate the relationship between the covariate and the probability of an event within a specific time horizon. We illustrated the application of LOESS for censored data (LOESScd) using patients with complex coronary artery disease. We used the LOESScd to estimate the association between continuous predictors and the probability of death within 10 years. LOESScd estimates closely followed grouped Kaplan-Meier estimates, especially in case of weak smoothing. Covariate-dependent IPC weights improved LOESScd when censoring varied by covariate levels. We then examined the finite-sample behavior of LOESScd in simulations motivated by four typical prognostic model validation scenarios. In 2000 samples of 1800 patients, bias was limited and coverage was close to nominal. In conclusion, LOESScd is a promising estimator of the relationship of a continuous covariate with the probability of an event in the presence of right-censoring. LOESScd is especially useful for estimating calibration curves when validating prognostic models. Copyright © 2026 The Author(s). Statistics in Medicine published by John Wiley & Sons Ltd. <18> Accession Number 637379347 Title Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the Magic Number?. Source Journal of Pediatric Intensive Care. 11(2) (pp 83-90), 2022. Date of Publication: 20 Jun 2022. Author Loomba R.S.; Farias J.S.; Villarreal E.G.; Flores S. Institution (Loomba) Division Of Pediatric Cardiac Critical Care, Advocate Children's Hospital, Oak Lawn, IL, United States (Loomba) Department Of Pediatrics, Chicago Medical School, Rosalind Franklin University Of Medicine And Science, Chicago, IL, United States (Farias, Villarreal) Tecnologico De Monterrey, School Of Medicine And Health Sciences, Nuevo Leon, Monterrey, Mexico (Flores) Section Of Critical Care Medicine And Cardiology, Texas Children's Hospital, Houston, TX, United States (Flores) Department Of Pediatrics, Baylor College Of Medicine, Houston, TX, United States Publisher Georg Thieme Verlag Abstract The primary objective of this study was to determine if serum lactate level at the time of hospital admission can predict mortality in pediatric patients. A systematic review was conducted to identify studies that assessed the utility of serum lactate at the time of admission to predict mortality in pediatric patients. The areas under the curve from the receiver operator curve analyses were utilized to determine the pooled area under the curve. Additionally, standardized mean difference was compared between those who survived to discharge and those who did not. A total of 12 studies with 2,099 patients were included. Out of these, 357 (17%) experienced mortality. The pooled area under the curve for all patients was 0.74 (0.67-0.80, p < 0.01). The pooled analyses for all admissions were higher in those who experienced mortality (6.5 vs. 3.3 mmol/L) with a standardized mean difference of 2.60 (1.74-3.51, p < 0.01). The pooled area under the curve for cardiac surgery patients was 0.63 (0.53-0.72, p < 0.01). The levels for cardiac surgery patients were higher in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a standardized mean difference of 1.80 (0.05-3.56, p = 0.04). Serum lactate at the time of admission can be valuable in identifying pediatric patients at greater risk for inpatient mortality. This remained the case when only cardiac surgery patients were included. Copyright © 2020. Thieme. All rights reserved. <19> Accession Number 2049776971 Title Atrial cardiomyopathy: from knowledge gaps to clinical impact: The role of the EmbRACE Network. Source Netherlands Heart Journal. 34(11) (pp 399-406), 2026. Date of Publication: 01 Nov 2026. Author van Vreeswijk N.L.; Habibi Z.; van Doorn S.; de Groot J.R.; Stoll M.; Pijnappels D.A.; Heijman J.; Tieleman R.G.; Pisters R.; Hemels M.E.W.; Tjong F.V.Y.; Schotten U.; Rienstra M.; Geersing G.-J.; Himmelreich J.C.L. Institution (van Vreeswijk, Tieleman, Rienstra) Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands (Habibi) Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands (Habibi, Schotten) Department of Cardiology, Maastricht UMC+, Maastricht, Netherlands (van Doorn, Geersing) Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands (de Groot, Tjong) Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands (Stoll) Department of Biochemistry, Maastricht University, Maastricht, Netherlands (Stoll) Department of Genetic Epidemiology, Institute of Human Genetics, University of Munster, Munster, Germany (Pijnappels) Laboratory of Experimental Cardiology, Department of Cardiology, Heart Lung Centre Leiden, Leiden University Medical Centre, Leiden, Netherlands (Heijman) Gottfried Schatz Research Center, Division of Medical Physics and Biophysics, Medical University of Graz, Graz, Austria (Tieleman) Department of Cardiology, Martini Hospital, Groningen, Netherlands (Pisters, Hemels) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands (Hemels) Department of Cardiology, Radboud University Medical Centre, Radboud University, Nijmegen, Netherlands (Tjong) Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam UMC, Amsterdam, Netherlands (Himmelreich) Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands (Himmelreich) Amsterdam Public Health, Personalized Medicine, Amsterdam, Netherlands Publisher Bohn Stafleu van Loghum Abstract Background: Atrial cardiomyopathy (AtCM) is increasingly recognised as an underlying atrial substrate contributing to atrial fibrillation (AF), heart failure (HF), and cardio-embolic stroke. However, diagnostic criteria, disease thresholds, and targeted treatment strategies remain poorly defined. Objective(s): To describe the rationale, structure, and translational strategy of the EmbRACE (Electro-Molecular Basis and the theRapeutic management of Atrial Cardiomyopathy, fibrillation and associated outcomEs) network, a national consortium established to address key knowledge gaps in AtCM. Method(s): EmbRACE integrates mechanistic research, computational modelling, clinical trials, and implementation science within seven interconnected work packages. Human atrial tissue biobanking and deep phenotyping (WP1) enable molecular profiling of candidate pathways (WP2), which are validated in experimental models (WP3). Computational modelling and artificial intelligence (WP4) integrate multimodal clinical and biological data to derive composite AtCM phenotypes and severity frameworks. Substrate-targeting clinical trials evaluate AF ablation (RACE X; WP5), weight reduction using GLP-1 agonists (DUTCH-WAIST; WP6), and optimised rate control using calcium channel antagonists (SMART-VERAPAF; WP6). Implementation science (WP7) focuses on guideline integration, decision-support tools, and governance of AI-based risk models. EmbRACE establishes a translational pipeline from mechanistic discovery to clinical application. By integrating tissue-level insights with multimodal risk modelling and interventional trials, the consortium aims to define clinically meaningful AtCM thresholds, to validate indirect markers, and to determine whether targeted treatment modifies disease progression and clinical outcomes. Conclusion(s): EmbRACE provides a multidisciplinary framework to transform AtCM from a theoretical construct into a clinically actionable entity, enabling earlier detection, improved risk stratification, and AtCM-directed therapy in cardiovascular prevention. Copyright © The Author(s) 2026. <20> Accession Number 2051242573 Title Efficacy and Safety of Evogliptin in Mild to Moderate Calcific Aortic Valve Stenosis: The EVOID-AS Trial Rationale and Study Design. Source Mayo Clinic Proceedings. 101(11) (pp 2034-2046), 2026. Date of Publication: 01 Nov 2026. Author Padang R.; Hodara R.; Jan M.F.; Jain R.; Postalian A.; Zweig B.M.; Naqvi T.Z.; Levine R.A.; Dal-Bianco J.P.; Argulian E.; Pressman G.S.; Sengupta P.P.; Abbas A.E.; Cheng W.; Patel A.K.; Bhave N.M.; Chung E.S.; Sanchecirf C.E.; Barrett T.C.; Kort S.; Sohn J.; Pollak P.; Ali M.T.; Chadderdon S.; Zhao Q.; Gill E.; El Sakr F.; Pereira N.L.; Vella A.; Schulte P.J.; Bailey K.R.; Song J.-K.; Oh J.K. Institution (Padang, Pereira, Oh) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Vella) Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Mayo Clinic, Rochester, MN, United States (Schulte, Bailey) Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States (Hodara) Department of Cardiovascular Medicine, UPMC Heart and Vascular Institute, Harrisburg, PA, United States (Jan, Jain) Department of Cardiovascular Medicine, Advocate Aurora, Milwaukee, WI, United States (Postalian) Department of Cardiology, The Texas Heart Institute, Houston, TX, United States (Zweig) Heart and Vascular Institute, Division of Cardiovascular Diseases, Department of Medicine, Henry Ford Hospital, Detroit, MI, United States (Naqvi) Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ, United States (Levine, Dal-Bianco) Cardiology Division, Massachusetts General Hospital, Boston, MA, United States (Argulian) Division of Cardiology, Mt Sinai Morningside Hospital, New York, NY, United States (Pressman) Division of Cardiovascular Diseases, Jefferson Einstein Philadelphia Hospital, Thomas Jefferson University, Philadelphia, PA, United States (Sengupta) Department of Cardiology, Mayo Clinic Health System, Eau Claire, WI, United States (Abbas) Division of Cardiovascular Medicine, Corewell Health East, William Beaumont University Hospital, Royal Oak, MI, United States (Cheng) Department of Cardiovascular Diseases, BayCare Medical Group, Dunedin, FL, United States (Patel) Section of Cardiology, Hackensack University Medical Center, Hackensack, NJ, United States (Bhave) Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health and University of Michigan Medical School, Ann Arbor, United States (Chung) The Lindner Research Center at The Christ Hospital, Cincinnati, OH, United States (Sanchecirf) Heart and Vascular Division, Ohio Health-Riverside Methodist Hospital, Columbus, United States (Barrett) Department of Cardiovascular Disease, University of Vermont Medical Center, South Burlington, United States (Kort) Division of Cardiovascular Medicine, Department of Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, United States (Sohn) Division of Cardiovascular Medicine, Keck School of Medicine of USC, Los Angeles, CA, United States (Pollak, Ali) Division of Cardiology, Department of Medicine, Mayo Clinic, Jacksonville, FL, United States (Chadderdon) Knight Cardiovascular Institute, Oregon Health and Science University, Portland, United States (Zhao) Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital, Cardiac Diagnostics, Fairfax, VA, United States (Gill) Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, United States (El Sakr) Northside Hospital Heart Institute, Northside Hospital, Atlanta, GA, United States (Song) Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Publisher Elsevier Ltd Abstract The only treatment of severe aortic stenosis (AS) is aortic valve replacement. No medical therapy has been proven effective for preventing or delaying AS progression despite several clinical trials. The EVOID-AS trial is designed to evaluate the efficacy of evogliptin, a dipeptidyl peptidase 4 inhibitor, at retarding the progression of aortic valve calcification and AS hemodynamic severity in patients with mild to moderate AS. In this trial, 580 patients with mild or moderate native calcific AS at 40+ clinical sites across the United States and Canada will be randomized in a 1:1 allocation to receive either evogliptin 10 mg or placebo once daily orally for 2 years. Clinical follow-up visits are scheduled at 3-month intervals; transthoracic echocardiography, aortic valve computed tomography calcium score, and laboratory testing are obtained at baseline, 1-year, and 2-year study visits. The primary end point is change in aortic valve calcification as measured by cardiac computed tomography at 2 years of therapy. Secondary end points are progression of AS hemodynamic severity by echocardiography during 2 years of therapy and time to aortic valve intervention. Secondary safety end points include incidence and severity of treatment-emergent or serious adverse events. Enrollment began in June 2022, and the study is expected to be completed in 2028. EVOID-AS is a double-blind, placebo-controlled, randomized medical trial to modify the progression of calcific AS. This trial will contribute to the critical unmet clinical need of identifying an effective medical therapy to prevent or to delay the progression of AS. Trial Registration: ClinicalTrials.gov identifier: NCT05143177. Copyright © 2026 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <21> [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.; 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.; 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.; Events C.; 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.; Testing S.; 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.; 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.; 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.; Lopez-Sendon J.; 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) Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Alpejska 42, Warsaw, Poland (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 (Jeffries) ISCHEMIA Clinical Coordinating Center (CCC), United States (Chan, Cobb, Contreras, Cukali, Ferket, Gabriel, Hansen) Clinical Research Associates, United States (Roberts, Chang, Islam, Wayser, Yakubov, Yee) Clinical Trial Assistants (Setang, Xavier) Statistical and Data Coordinating Center (SDCC), United States (Alexander) 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 (Jones, Nugent, Wang) ISCHEMIA Imaging Coordinating Center (ICC), United States (Shaw, Oliver, Phillips, Goyal, Hetrick) Nuclear Core Lab (Berman, Hayes, Friedman, James Gerlach, Hyun, Miranda-Peats, Slomka, Thomson) CMR Core Lab (Friedrich, Kwong, Mongeon) Steven 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 (Jiang, Dai, Feng, Li, Li, Liu, Xie, Zhang, Zhang, Zhang, Zhang, Zhang, Zhong) Estudios Clinicos Latino America (ECLA), Argentina (Diaz, Escobar, Martin, Pascual) Foundation for Biomedical Research of La Paz University Hospital (FIBHULP), 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. 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. 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. 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. Copyright © 2024 American Heart Association, Inc. <22> Accession Number 2047459672 Title A scoping review of the evidence supporting antiarrhythmic use after paediatric cardiac surgery. Source Cardiology in the Young. 36(6) (pp 1131-1148), 2026. Date of Publication: 01 Jun 2026. Author Sullenger R.D.; Kohlmann T.; Kilborn A.G.; Commander S.J.; Foote H.P.; Zimmerman K.O.; Hill K.D.; Hornik C.; Thompson E.J. Institution (Sullenger, Kohlmann) Duke University School of Medicine, Durham, NC, United States (Kohlmann, Kilborn, Commander, Foote, Zimmerman, Hill, Hornik, Thompson) Duke Clinical Research Institute, Durham, NC, United States (Foote, Zimmerman, Hill, Hornik, Thompson) Pediatrics, Duke University School of Medicine, Duke University Medical Center, Durham, NC, United States Publisher Cambridge University Press Abstract Background: - Arrhythmias after paediatric cardiac surgery occur frequently and contribute to postoperative morbidity and mortality. There is limited literature assessing the safety and efficacy of common antiarrhythmics administered in this population. Method(s): - We systematically searched PubMed and EMBASE for literature on antiarrhythmic use in children <18 years of age after cardiac surgery from 2000 to 2024. Two reviewers independently screened abstracts and then reviewed full-text manuscripts to determine eligibility. Result(s): - We identified 28 studies of 3,752 patients across 11 different antiarrhythmics: flecainide, procainamide, esmolol, landiolol, propranolol, amiodarone, sotalol, dexmedetomidine, digoxin, ivabradine, and magnesium. Most studies were small, with 17 enrolling fewer than 100 children. Only eight studies were randomised, 16 were retrospective, 12 were prospective, and one was multicenter. Safety and efficacy endpoints varied widely, limiting our ability to combine data for meta-analysis. Overall, evidence supporting the use of these drugs in children after cardiac surgery was limited. Conclusion(s): - Although antiarrhythmics are commonly used in children after cardiac surgery, randomised trials with standardised endpoints to guide choice of therapy are lacking. Pragmatic trials to generate real-world data should be considered to further evaluate the safety and efficacy of various antiarrhythmics in this population. Copyright © The Author(s), 2026. Published by Cambridge University Press <23> Accession Number 2050131403 Title Deep learning versus conventional risk scores for postoperative mortality prediction in adult cardiac surgery: a systematic review. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 47. Date of Publication: 01 Dec 2026. Author Shuaibu I.I.; Mahmoud A.Y.A.; Aaroud I.; Abazid A.R.; Abdelsalaam M.H.M.; Gazge N.N.; Alabed M.M.S.; Eltayeb S.; Zadeh S.P. Institution (Shuaibu) Department of Health Care Management, Bahcesehir Cyprus University, Nicosia, North Cyprus, Turkey (Mahmoud) NicosiaCyprus (Aaroud, Abazid, Abdelsalaam, Gazge, Alabed, Eltayeb, Zadeh) Faculty of Medicine, Near East University, Nicosia, Cyprus Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Earlier reviews of machine learning for mortality after cardiac surgery pooled deep learning (DL) with shallow and non-neural methods. We asked whether models meeting an explicit definition of DL discriminate short-term mortality better than EuroSCORE II, the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) or logistic regression in the same patients. Method(s): This re-conducted review (PROSPERO CRD420261354546) supersedes an earlier preprint. MEDLINE, Europe PMC, Lens.org and IEEE Xplore were searched on 27-28 September 2026, with backward citation searching; Embase, CINAHL and CENTRAL were not searched, and forward citation searching was not performed. DL required at least two hidden layers, or a named architecture of established depth, shown in the source. A large language model pre-screened records and extracted data; two reviewers verified every decision and value. Risk of bias was assessed with PROBAST + AI, and results were synthesised without meta-analysis as within-cohort differences in the area under the curve (AUC). Result(s): Of 1,845 records identified, 515 duplicates were removed and 1,330 were screened; of 76 reports sought, 54 were assessed in full and 22 could not be retrieved. Four studies (five cohort-level comparisons) met all criteria. A chest-radiograph convolutional network had lower AUCs than STS-PROM in temporal (0.829 vs. 0.884) and external (0.738 vs. 0.803) cohorts with about two dozen deaths each; two-hidden-layer perceptrons did not outperform logistic regression (0.761 vs. 0.762; 0.77 vs. 0.80); one study reported AUCs only graphically. All four studies had high or unclear risk of bias. Fifteen reports described networks of undetermined depth, including a tabular transformer that outperformed EuroSCORE II internally (0.834 vs. 0.807); in the 12 with extractable comparisons, the network had a higher AUC than the best comparator in 4 and lower in 8 (median difference - 0.004). Conclusion(s): Evidence that DL improves on established scores for short-term mortality after adult cardiac surgery is sparse, inconsistent and at high or unclear risk of bias, and the search was incomplete relative to the registered protocol. Differences in discrimination were small or absent, and calibration and clinical utility were rarely evaluated. Superiority cannot be established. PROSPERO registration: This review was registered on PROSPERO, the International Prospective Register of Systematic Reviews, on 29 March 2026 (CRD420261354546; https://www.crd.york.ac.uk/prospero/). At registration, the record stated that searching and screening for an earlier version of the review had been completed and that data extraction had not started. That earlier version was posted as a preprint on 31 March 2026 (Preprints.org, doi:10.20944/preprints202603.2465.v1); it is superseded by this report. Its withdrawal was requested from Preprints.org on 18 October 2026 and had not been confirmed at the time of resubmission. The review reported here was re-conducted in full after registration: the searches were run on 27-28 September 2026, and screening, data extraction and risk-of-bias assessment followed. The registered eligibility criteria were not changed in substance; the registered deep-learning criterion was operationalised before full-text assessment and, after peer review, applied more strictly (a post hoc change reported in the manuscript). The search sources, risk-of-bias tool and synthesis method differ from the registered protocol. Every difference, with its timing and reason, is reported in Table 1 of the manuscript, and an amendment describing them has been submitted to PROSPERO. Copyright © The Author(s) 2026. <24> Accession Number 2050164184 Title Updated Meta-Analysis of Left Atrial Appendage Closure Versus Oral Anticoagulation to Prevent Stroke in Atrial Fibrillation. Source Stroke. 57(11) (pp 3233-3244), 2026. Date of Publication: 01 Oct 2026. Author Pekyi-Boateng P.K.; Mahadevan A.; Frimpong S.K.; Kanishka L.; Gbekor S.; Abimbilla H.; Villafuerte Trisolini B.J.; Blankson G.A.; Pekyi-Boateng P.D.; Nguyen D.Y.; Shoraka O.; Wold J.; Shoskes A.; Lyden S.; Vijayaraman P.; Dolia J.; Majersik J.J.; Tandar A.; Budohoski K.P.; Grandhi R. Institution (Pekyi-Boateng) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Mahadevan) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Frimpong) Department of Internal Medicine (S.K.F.), Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Panama (Kanishka) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Gbekor) Department of Internal Medicine, UNC Health Blue Ridge Hospital, Morganton, New Caledonia (Abimbilla) Department of Internal Medicine, St. Patrick's Hospital, Offinso, Ghana (Villafuerte Trisolini) Department of Neurology, HCA Florida Kendall Hospital, Miami (Blankson) Department of Internal Medicine, Case Western Reserve University/University Hospitals Cleveland Medical Center, OH, United States (Pekyi-Boateng) School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana (Nguyen) Department of Neurosurgery, UCHealth, Colorado Springs, Colombia (Shoraka) Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City (Wold) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Shoskes) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Lyden) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Vijayaraman) Department of Cardiac Electrophysiology (P.V.), Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Panama (Dolia) Department of Neurology, Emory University School of Medicine/Grady Memorial Hospital (Marcus Stroke and Neuroscience Center), Atlanta, Gabon (Majersik) Department of Neurology (P.K.P.-B, A.M, L.K, J.W, A.S, S.L, J.J.M.), University of Utah School of Medicine, Salt Lake City (Tandar) Division of Cardiovascular Medicine, Department of Internal Medicine (A.T.), University of Utah School of Medicine, Salt Lake City (Budohoski) Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City (Grandhi) Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City Publisher Wolters Kluwer Health Abstract BACKGROUND: Ninety percent of left atrial thrombi in nonvalvular atrial fibrillation arise in the left atrial appendage, which can be occluded percutaneously (left atrial appendage closure [LAAC]). Two 2026 trials (CHAMPION-AF [Watchman Flx Versus Non-Vitamin K Antagonist Oral Anticoagulant for Embolic Protection in the Management of Patients With Non-Valvular Atrial Fibrillation] and CLOSURE-AF [Left Atrial Appendage Closure in Patients With Atrial Fibrillation Compared to Medical Therapy]) more than doubled the available randomized evidence comparing LAAC with oral anticoagulation. We evaluated pooled effects of LAAC on stroke, bleeding, and mortality by bleeding risk, anticoagulation eligibility, and comparator. METHOD(S): In this systematic review and meta-analysis, we searched PubMed, Scopus, and Embase from inception to April 15, 2026, for randomized controlled trials comparing percutaneous LAAC with oral anticoagulation in nonvalvular atrial fibrillation. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool. Cumulative-incidence outcomes were pooled as odds ratios using random-effects models, with prediction intervals, prespecified subgroups, and trial sequential analysis. RESULT(S): Six randomized controlled trials (2014-2026; 358 sites in North America, Europe, and Asia; 7028 patients) compared LAAC with warfarin (2 trials) or a direct oral anticoagulant (4 trials); populations were predominantly anticoagulation-eligible with low prior-stroke prevalence, plus 2 high-bleeding-risk and 1 postablation trial. Overall stroke rates were similar between arms (odds ratio, 1.10 [95% CI, 0.78-1.56]). Ischemic stroke was more frequent with LAAC (odds ratio, 1.41 [95% CI, 1.07-1.86]) but did not reach the required information size. Nonprocedural bleeding was lower with LAAC (odds ratio, 0.58 [95% CI, 0.35-0.96]), the only outcome reaching a sufficient information size, in standard-risk and postablation but not high-bleeding-risk patients. CONCLUSION(S): LAAC is best positioned to reduce nonprocedural bleeding in anticoagulation-eligible patients at standard-to-moderate bleeding risk, rather than as a stroke-equivalent substitute for oral anticoagulation. REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD420261370546. Copyright © 2026 American Heart Association, Inc. <25> Accession Number 2047527849 Title Advanced organ protection strategies in aortic arch surgery: A narrative review. Source Perfusion (United Kingdom). 41(8) (pp 1347-1363), 2026. Date of Publication: 01 Nov 2026. Author Husen T.F.; Lotfalla A.; Schreurs R.; Korver E.; Verheule S.; Schurgers L.; Jacobs M.; Lorusso R.; Heuts S.; Bidar E. Institution (Husen, Lotfalla, Schreurs, Korver, Lorusso, Heuts, Bidar) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Husen) Faculty of Medicine, University of Indonesia, Jakarta, Indonesia (Lotfalla, Schreurs, Korver, Verheule, Schurgers, Jacobs, Lorusso, Heuts, Bidar) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands (Jacobs) Department of Vascular Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands Publisher SAGE Publications Ltd Abstract Objective: Aortic arch surgery remains a complex procedure associated with significant morbidity and mortality. This review aims to provide insights into the current concepts and evidence regarding organ protection during this procedure. Method(s): A non-systematic approach was used to identify relevant literature across three databases. Inclusion criteria comprised case reports/series, observational cohorts, or randomized controlled trials investigating perfusion strategies and other factors that influence clinical outcomes in aortic arch surgery, as well as experimental studies and key reviews pertinent to the topic. Result(s): Although hypothermic circulatory arrest (HCA) remains the current gold standard, interest in using higher temperatures in aortic arch surgery is increasing. To enable this, cerebral, myocardial, and visceral protection remain crucial, prompting the development of several strategies to facilitate higher-temperature surgery. A growing body of predominantly observational, single-center evidence has explored warmer, continuous multi-organ perfusion strategies. These emerging approaches have been associated with favorable outcomes in selected cohorts but have not been validated against the guideline-concordant standard. Conclusion(s): Advancements in cardiopulmonary bypass and perfusion techniques have driven an evolving interest in continuous normothermic organ perfusion as an emerging strategy rather than an established alternative to HCA in selected cases. Continuous normothermic multi-organ perfusion represents an intriguing and potentially important direction, but its adoption should remain selective until comparative clinical evidence becomes stronger. 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). <26> Accession Number 2048461914 Title CRT and CABG Improve Survival and Reduce Readmissions in Ischemic Heart Failure: A Systematic Review and Meta-Analysis. Source PACE - Pacing and Clinical Electrophysiology. 49(11) (pp 1762-1771), 2026. Date of Publication: 01 Nov 2026. Author Zanati Saeed T.; Mohamed A.A.; Hanna M.; Badawy E.Y.; Mohamed B.; Azzawi M.A.D.A.; Rashwan I.; Alhussaini M. Institution (Zanati Saeed) Faculty of Medicine, Assiut University, Assiut, Egypt (Mohamed) Faculty of Medicine, Zagazig University, Zagazig, Egypt (Hanna) Cardiovascular section, Department of Internal Medicine, University of Oklahoma Health Science Center, OK, United States (Badawy) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Mohamed) Department of Public Health and Community Medicine, Faculty of Medicine, Benha University, Benha, Egypt (Azzawi) Faculty of Medicine, The National Ribat University, Khartoum, Sudan (Rashwan) Cardiothoracic Surgery Department, Misr University for Science and Technology, Cairo, Egypt (Alhussaini) Department of Cardiothoracic Surgery, Assiut University, Assiut, Egypt Publisher John Wiley and Sons Inc Abstract Introduction: Heart failure (HF) continues to be the leading cause of death and rehospitalization among cardiomyopathic patients undergoing coronary artery bypass grafting (CABG). Objective(s): To systematically evaluate the effect of adding cardiac resynchronization therapy (CRT) to CABG versus CABG alone for patients with concomitant ischemic cardiomyopathy and electromechanical dyssynchrony. (PROSPERO ID: CRD420251006918). Method(s): A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus to identify clinical trials and cohort studies evaluating the impact of inserting a CRT device during CABG surgery on survival and rehospitalization outcomes. A total of 3 studies involving 300 patients were included: 150 underwent CABG alone, and 150 received both CABG and CRT. Result(s): The meta-analysis of two studies (n = 200) showed that adding CRT during CABG was associated with lowering the probability of HF readmission (RR = 0.25, 95% CI [0.13-0.49], P < 0.0001) and of all-cause mortality (RR = 0.44, 95% CI [0.25-0.78], p = 0.0048) in the targeted patient population. Analyses according to study design demonstrated consistent treatment effects across randomized and observational evidence, with no significant subgroup differences. Conclusion(s): In patients with ischemic cardiomyopathy and electromechanical dyssynchrony undergoing CABG, perioperative epicardial CRT implantation may be associated with decreased HF rehospitalization and all-cause mortality rates. However, given the limited number of included studies and small cumulative sample size, these findings should be considered hypothesis-generating, and large-scale confirmatory randomized trials are warranted. Registration: The study protocol was prospectively registered in PROSPERO. (CRID: CRD420251006918). Copyright © 2026 Wiley Periodicals LLC. <27> Accession Number 2048497603 Title Deep versus moderate hypothermia in pediatric cardiac surgery: Systematic review and meta-analysis of early postoperative outcomes. Source Perfusion (United Kingdom). 41(8) (pp 1335-1346), 2026. Date of Publication: 01 Nov 2026. Author Zoupas I.; Covell J.M.; Cruz Naranjo J.; Podgorsek B.; Chen P.C.; LaPar D.J.; Greenleaf C.E. Institution (Zoupas, Covell, Cruz Naranjo, Chen, LaPar, Greenleaf) Division of Pediatric and Congenital Cardiac Surgery, Department of Cardiothoracic and Vascular Surgery, Children's Memorial Hermann Hospital, The University of Texas Health Science Center at Houston, Houston, TX, United States (Podgorsek) Department of Cardiothoracic and Vascular Surgery, Memorial Hermann Hospital, The University of Texas Health Science Center at Houston, Houston, TX, United States Publisher SAGE Publications Ltd Abstract Introduction: Deep hypothermia (DH) has been widely adopted for cerebral and visceral protection during pediatric cardiac surgery, but concerns about perioperative complications remain. This meta-analysis aims to evaluate the impact of DH compared to moderate hypothermia (MH) on outcomes in pediatric cardiac surgery patients. Method(s): Following a PRISMA-compliant systematic search in PubMed, Cochrane, and Embase, eligible studies comparing DH (<22degreeC) with MH (22-30degreeC) in pediatric cardiac surgery were assessed. Risk of bias was evaluated using the ROBINS-I tool. Result(s): Five comparative studies with 448 patients (250 in the MH group and 198 in the DH group) were included. Baseline characteristics were similar between groups, with the majority of patients undergoing aortic arch repairs. Perioperative variables were also similar, except for cross-clamp time, which was significantly longer in the DH group (p = 0.02), and circulatory arrest was more frequently used in DH patients (p = 0.01). No significant differences were found in overall postoperative complication rates, acute kidney injury, 24-h chest drainage volume, or in-hospital mortality. However, the incidence of early postoperative neurological complications was significantly higher in the DH group (p < 0.001). Conclusion(s): Moderate hypothermia may be associated with a significantly lower incidence of postoperative neurological complications compared to deep hypothermia, while overall in-hospital mortality and morbidity rates remained similar between the two groups. Taken together, these findings support moderate hypothermia with regional perfusion as a clinically feasible and well-tolerated alternative to deep hypothermia in pediatric cardiac surgery. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <28> Accession Number 2047027471 Title Safety and efficacy of transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement (SAVR) in patients with bicuspid aortic stenosis: A Systematic review and meta-analysis. Source Perfusion (United Kingdom). 41(8) (pp 1376-1391), 2026. Date of Publication: 01 Nov 2026. Author Gadelmawla A.F.; Mansour A.; Elbataa A.; Asiri O.H.; Alharbi A.A.; Alquraish F.A.; Al-Ibrahim F.S.; AlHasani A.F.; Alharbi T.N.; Al Murayyi R.M.; Alotaibi A.G.; Abdul-Hafez H.A.; Suliman I. Institution (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Mansour, Elbataa) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Asiri, Al Murayyi) College of Medicine, King Khalid University, Abha, Saudi Arabia (Alharbi) College of Medicine and Surgery, Taibah University, Medina, Saudi Arabia (Alquraish, Al-Ibrahim) College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (AlHasani) College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia (Alharbi) College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia (Alotaibi) Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia (Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Suliman) King Abdulaziz Medical City, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia Publisher SAGE Publications Ltd Abstract Background: Bicuspid aortic valve (BAV) disease is a leading cause of aortic stenosis (AS). Surgical aortic valve replacement (SAVR) has traditionally been regarded as the best therapeutic option for bicuspid AS. However, the distinctive anatomical characteristics of BAV make the treatment with transcatheter aortic valve replacement (TAVR) challenging, so this population was often excluded from the trials. We aimed to compare TAVR and SAVR in terms of safety and efficacy in the population with bicuspid AS. Method(s): We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, searched from PubMed, Cochrane, Scopus, and Web of Science (from inception until September 2025). Dichotomous outcomes were pooled as risk ratios (RRs), and continuous outcomes as mean differences (MDs), each with 95% confidence intervals (CIs). Result(s): A total of 78,677 patients were included in one RCT, 12 retrospective cohort studies, and one prospective cohort study. TAVR, compared to SAVR, was associated with significantly higher rates of permanent pacemaker implantation (PPI) (O.R. = 2.29, 95% C.I. [1.51, 3.47], P < 0.01) and shorter length of hospital stay (M.D. = -2.24, 95% C.I. [-3.96, -0.52], P = 0.01) and lower bleeding rates (O.R. = 0.31, 95% C.I. [0.14, 0.69], P < 0.01). However, there were no significant differences in all-cause mortality (ACM) (P = 0.948), acute kidney injury (AKI) (P = 0.28), stroke incidence (P = 0.475), and vascular complications (P = 0.31). The PPI and stroke rate results were consistent during in-hospital and short-term follow-ups. However, subgroup analysis by follow-up duration revealed that long-term stroke incidence was significantly higher in the TAVI group. Conclusion(s): TAVR offers benefit by minimizing significant bleeding and hospital length of stay. However, the benefits should be balanced against the considerably increased risk of PPI and PVL. Further RCTs are needed to confirm these findings. Copyright © The Author(s) 2026 <29> Accession Number 2038748993 Title Paravertebral analgesia versus wound infiltration in children recovering from cardiac surgery: a randomized controlled trial. Source Regional Anesthesia and Pain Medicine. 51(5) (pp 584-590), 2026. Date of Publication: 01 May 2026. Author Guo J.; Jia Y.; Tian L.; Kang W.; Zhao Y.; Yuan S.; Sessler D.I. Institution (Guo, Jia, Tian, Kang, Zhao, Yuan) Fuwai Hospital, Beijing, China (Sessler) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States Publisher BMJ Publishing Group Abstract Introduction: Optimal analgesia for thoracotomies remains unclear. Paravertebral blocks are more complex than local anesthetic infiltration but may be more effective. We therefore tested the hypothesis that paravertebral blocks provide better postoperative analgesia than local anesthetic infiltration in children recovering from cardiac surgery thoracotomies. Method(s): This was a single-center randomized double-blind trial. We recruited children aged 6-14 years with atrial or ventricular septal defects scheduled for cardiac surgery with cardiopulmonary bypass via thoracotomy were recruited. 100 patients were enrolled and randomized to either postoperative paravertebral blocks (n=50) or local anesthetic wound infiltration (n=50). We recorded opioid consumption during the initial 24 hours after surgery, along with pain scores at 6 hour intervals. Complications including postoperative nausea and vomiting and respiratory failure were also recorded. Result(s): 100 patients (mean 7 years, 43% male) were included in the analysis. The only postoperative opioid used was sufentanil. Total sufentanil consumption in the first 24 hours postsurgery was 0.3+/-0.4 microg/kg for those receiving paravertebral blocks, significantly lower than the 0.6+/-0.5 microg/kg for wound infiltration (p=0.002). Faces Pain Scale-Revised pain scores were consistently lower in the paravertebral block group across all measured time points (6, 12, 18, and 24 hours), with the most pronounced difference observed at 6 hours postoperatively (1.7+/-2.2 vs 3.3+/-2.2; p<0.001). Postoperative mechanical ventilation time, ICU stay, hospitalization, and incidence of postoperative nausea and vomiting were comparable. Conclusion(s): Paravertebral blocks reduced opioid consumption and pain during the first postoperative day in pediatric cardiac thoracotomies but did not accelerate recovery. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <30> Accession Number 2050497829 Title Impact of heparin-to-bivalirudin bridging time on hospitalization and safety outcomes in PCI for acute coronary syndrome. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1752565. Date of Publication: 2026. Author Wang G.; Yang B.; Zhang R.; Liu X. Institution (Wang, Liu) Tangshan Gongren Hospital, Hebei, Tangshan, China (Yang, Zhang) Global Health Research Center, Duke Kunshan University, Jiangsu, Kunshan, China Publisher Frontiers Media SA Abstract Background - Bivalirudin is increasingly used during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), but the optimal interval between discontinuing unfractionated heparin (UFH) and initiating bivalirudin remains unclear. This study examined the association between heparin-to-bivalirudin bridging time and clinical outcomes. Methods - This retrospective cohort included 197 ACS patients undergoing PCI. Bridging intervals were evaluated using two predefined thresholds: Scenario A (<=30 vs. >30 min) and Scenario B (<=20 vs. >20 min). Clinical, laboratory, and procedural data were collected. Outcomes included bleeding events, cardiovascular events, rehospitalization, and composite adverse outcomes. Multivariable logistic regression and binomial regression with generalized estimating equations were performed, and restricted cubic spline analyses assessed non-linear associations. Results - In Scenario A, hospitalization occurred significantly less frequently in the <=30-min group compared with the >30-min group (8.9% vs. 21.6%). After adjustment, longer intervals were associated with higher hospitalization risk (OR = 3.20, 95% CI: 1.20-8.54; RR = 2.55, 95% CI: 1.15-5.66). No differences were observed for bleeding, cardiovascular events, or composite outcomes. In Scenario B, no significant associations were identified for any outcomes. Spline analyses revealed no dose-response relationship between bridging time and clinical outcomes. Conclusions - A heparin-to-bivalirudin bridging interval of <=30 min may reduce hospitalization without increasing bleeding or cardiovascular events, whereas a 20-min threshold offers no clinical advantage. Bridging time may represent a modifiable procedural parameter that warrants further evaluation in prospective randomized trials. Clinical Trial Registration - ChiCTR2400089671. Copyright © 2026 Wang, Yang, Zhang and Liu. <31> Accession Number 2049175843 Title Clinical outcomes of early vs. late extubation following cardiac surgery: a systematic review and meta-analysis. Source Frontiers in Medicine. 13 (pp 1-15), 2026. Article Number: 1913348. Date of Publication: 26 Aug 2026. Author Dairi M.S.; Thalib H.I.; Khan S.; Jamal A.; Alghamdi S.M.; Aldhahir A.M.; Alqarni A.A.; Oyelade T.; Khalid I.; Bawazeer S.S.; Aziz A.; Alwafi H. Institution (Dairi) Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia (Thalib, Khan, Jamal) Batterjee Medical College, Jeddah, Saudi Arabia (Alghamdi) Respiratory Care Program, Clinical Technology Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia (Aldhahir) Respiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia (Alqarni) Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia (Oyelade) School of Medicine, Keele University, Stoke-on-Trent, Keele, United Kingdom (Oyelade) Division of Medicine, University College London, London, United Kingdom (Khalid) Alfaisal University, Riyadh, Saudi Arabia (Khalid) King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia (Bawazeer) Department of Surgery, College of Medicine, Al-Qunfudah, Umm Al-Qura University, Makkah, Saudi Arabia (Aziz) Health Informatics Specialist Digitization Department Dallah Health Co, Riyadh, Saudi Arabia (Alwafi) Department of Pharmacology and Toxicology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia Publisher Frontiers Media SA Abstract Objective - This systematic review and meta-analysis evaluated clinical outcomes associated with earlier vs. later extubation in adults undergoing cardiac surgery. Methods - A systematic review and meta-analysis were conducted following PRISMA guidelines, with the study registered in PROSPERO. We searched PubMed, Scopus, Web of Science, CENTRAL, and EBSCO from inception until April 2025. Two reviewers independently screened studies. We included observational and interventional studies comparing early vs. late extubation following cardiac surgery in adult patients. Primary outcomes were all-cause mortality, length of intensive care unit (ICU) stay, length of hospital stay, reintubation, postoperative pneumonia, and postoperative renal failure requiring continuous renal replacement therapy (CRRT). Secondary outcomes included mediastinal bleeding requiring re-exploration, tracheostomy, and hospital or ICU readmission. Risk of bias in randomized trials was assessed using the Cochrane Risk of Bias tool, while the Newcastle-Ottawa Scale (NOS) was used for observational studies. Data synthesis was performed using Review Manager version 5.4. For continuous outcomes, pooled effect estimates were expressed as mean differences (MDs). For dichotomous outcomes, pooled odds ratios (ORs) with corresponding 95% CIs were calculated. Random-effects models were used as the primary analysis. A subgroup analysis based on extubation threshold ( <= 6 h or >6 h) was conducted. Statistical heterogeneity was assessed using the Chi-square test and the I 2 statistic. Results - A total of 237 records were identified, of which only 19 studies (18 observational and one randomized trial) were included in this meta-analysis. Earlier extubation was associated with lower odds of mortality (OR 0.09, 95% CI 0.04-0.23), reintubation (OR 0.22, 95% CI 0.07-0.70), postoperative pneumonia (OR 0.20, 95% CI 0.09-0.45), renal failure requiring CRRT (OR 0.10, 95% CI 0.06-0.17), postoperative tracheostomy (OR 0.01, 95% CI: 0.00-0.03), and hospital or ICU readmission (OR 0.25, 95% CI 0.07-0.86). Conclusions - In adults undergoing cardiac surgery, earlier extubation was associated with favorable postoperative outcomes including lower mortality, shorter ICU and hospital stays, and lower rates of reintubation, postoperative pneumonia, tracheostomy, CRRT, and hospital or ICU readmission. However, future randomized trials and prospective studies are warranted as the available evidence was predominantly observational and clinically heterogeneous. Systematic review registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420261361735, identifier: CRD420261361735. Copyright © 2026 Dairi, Thalib, Khan, Jamal, Alghamdi, Aldhahir, Alqarni, Oyelade, Khalid, Bawazeer, Aziz and Alwafi. <32> Accession Number 2050089527 Title Effects of CytoSorb hemoadsorption therapy on serum myoglobin and creatine kinase levels in severe rhabdomyolysis: a systematic review and meta-analysis. Source BMC Nephrology. 27(1) (no pagination), 2026. Article Number: 640. Date of Publication: 01 Dec 2026. Author Reynolds A.; Scharf C.; Forni L.G.; Koo T.Y.; Buttner S.; Humbert V.; Kielstein J.; Kindgen-Milles D.; Meiser A.; Mitzner S.; Molnar Z.; Premuzic V.; Taborda-Kupper M.S.; Weidhase L.; Kribben A. Institution (Reynolds, Forni) Critical Care Unit, Royal Surrey County Hospital, Surrey, Guildford, United Kingdom (Scharf) Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistrase 15, Munich, Germany (Forni) School of Medicine, Kate Granger Building, University of Surrey, Egerton Rd, Guildford, United Kingdom (Koo) Department of Nephrology, Korea University Anam Hospital, Seoul, South Korea (Buttner) Medical Clinic I - Cardiology, Pulmonology, Nephrology and Intensive Care Medicine, Klinikum Aschaffenburg-Alzenau, Academic Teaching Hospital of Julius-Maximilians-University Wurzburg, Am Hasenkopf 1, Aschaffenburg, Germany (Humbert, Taborda-Kupper) Medical Affairs, CytoSorbents Europe GmbH, Muggelseedamm 131, Berlin, Germany (Kielstein) Medical Clinic V, Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Naumburgstrase 15, Braunschweig, Germany (Kindgen-Milles) Department of Anesthesiology, University Hospital Duesseldorf, Heinrich- Heine University, Moorenstr.5, Duesseldorf, Germany (Meiser) Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University Hospital, Homburg, Germany (Mitzner) Division of Nephrology, University Hospital Rostock, Ernst-Heydemann-Str. 7, Rostock, Germany (Mitzner) 2-Fraunhofer IZI Rostock, Schillingallee 68, Rostock, Germany (Molnar) Department of Anesthesiology and Intensive Therapy, Semmelweis University, Ulloi ut 78, Budapest, Hungary (Molnar) Department of Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, 49 Przybyszewskiego St, Poznan, Poland (Premuzic) Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, School of Medicine, Catholic University of Zagreb, Zagreb, Croatia (Weidhase) Medical Intensive Care Unit, University Hospital Leipzig, Liebigstrase 20, Leipzig, Germany (Kribben) University Hospital Essen, University Duisburg Essen, Essen, Germany Publisher BioMed Central Ltd Abstract Background: In patients with severe rhabdomyolysis, active myoglobin elimination employing extracorporeal hemoadsorption has been used as a potentially beneficial adjunctive measure. However, data remains scarce regarding the biochemical and clinical effects of this approach. Our aim was to summarize the currently available literature as well as examine the available data on myoglobin and creatine kinase (CK) concentrations in patients with severe rhabdomyolysis before-and-after the use of extracorporeal hemoadsorption. Method(s): A systematic literature search was performed on 6th February 2025. Where data was available analyses were conducted to assess changes in plasma myoglobin and CK concentrations before-and-after CytoSorb (CS) hemoadsorption. Non-controlled studies and case reports were analysed via a pooled data analysis comparing myoglobin and CK concentrations before-and-after CS treatment. Controlled studies were analysed via a random-effects meta-analysis to assess CS intervention effect compared to standard treatment. Result(s): A systematic review of literature highlighted 18 publications on the use of CS hemoadsorption in patients with rhabdomyolysis. 14 publications were included in a pooled data analysis; all reported data on myoglobin concentrations (n = 75) and 10 included measurements for CK concentration (n = 71) pre-and-post CS therapy. There was a median absolute myoglobin reduction of 6975 [IQR 1089-18,381] microg/L, resulting in a median 31.04% decrease [IQR 4.68-47.41] following CS use. CK was associated with a median absolute reduction of 380 [IQR - 2682-2720] U/L and a median 12.44% decrease [IQR: -28.08-32.89] after CS therapy. Four controlled studies were identified and included for meta-analysis, of which all included data on myoglobin concentrations (n = 107) and 3 included CK concentrations pre-and-post use of CS therapy (n = 88). CS treatment was associated with a statistically significant post-treatment myoglobin concentration that was - 5062 microg/L (95% CI: -9438 to -687; p = 0.02) lower than that observed with standard treatment. Although CK concentrations decreased in both groups, the final post-treatment CK concentration was 4703 U/L (95% CI: -171 to 9577; p = 0.06) higher in the CS group than in the standard treatment group. Conclusion(s): Based on current limited evidence, this study suggests that CS therapy may be associated with reductions in circulating myoglobin concentrations in patients with severe rhabdomyolysis. However, the certainty of evidence is low, the effect on CK is unclear, and it remains to be determined if biochemical reductions in CK or myoglobin translate to improved clinical outcomes. Copyright © The Author(s) 2026. <33> Accession Number 2048098803 Title Efficacy and Safety of CETP Inhibitors in Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Journal of Cardiovascular Pharmacology. 88(4) (pp 290-298), 2026. Date of Publication: 01 Oct 2026. Author Rodriguez Milan R.; Jimenez Castellanos M.S.; Doniz Viveros A.D.; Yusufzai M.O.; Espinoza E.E.C.; Estela Fernandez C.A.; Machado D.A.; Sharjeel Abbas M.; Sah H.; Altamirano A.A.; Mahajan K. Institution (Rodriguez Milan, Altamirano) Universidad Autonoma Metropolitana, Unidad Xochimilco, Departamento de Atencion a la Salud, Ciudad de Mexico, Mexico (Jimenez Castellanos) Facultad de Medicina Humana, Universidad Autonoma de Chiapas, Tuxtla Gutierrez, Mexico (Doniz Viveros) Facultad Mexicana de Medicina, Universidad La Salle, Departamento de Medicina y Salud, Ciudad de Mexico, Mexico (Yusufzai) Bacha Khan Medical College, Mardan, Pakistan (Espinoza) Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru (Estela Fernandez) Universidad Cientifica del Sur, Lima, Peru (Machado) Universidad Catolica, Santa Cruz, Bolivia (Sharjeel Abbas) Goma Medical College, Khyber Medical University, Peshawar, Pakistan (Sah) Bahcesehir University Medical Park Goztepe, Istanbul, Turkey (Mahajan) Himachal Heart Institute, Mandi, India Publisher Lippincott Williams and Wilkins Abstract Atherosclerotic cardiovascular disease remains a leading cause of death globally. Cholesteryl ester transfer protein (CETP) inhibitors have been proposed as a novel strategy for cardiovascular risk reduction, yet evidence remains inconsistent. PubMed, EMBASE, and Scopus were searched for randomized controlled trials comparing CETP inhibitors with placebo in patients with atherosclerotic cardiovascular disease. Random-effects models were used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Statistical analysis was performed using R software version 4.3.3. We included 5 RCTs involving 62, 565 participants, of whom 31, 698 (50.7%) received CETP inhibitors. Compared with placebo, CETP inhibitors showed no significant reduction in death from coronary heart disease (RR: 0.91; 95% CI, 0.82 to 1.01), unplanned coronary revascularization (RR: 0.91; 95% CI, 0.79-1.05), nonfatal myocardial infarction (RR: 0.94; 95% CI, 0.87-1.02), and stroke (RR: 1.02; 95% CI, 0.93-1.12). In addition, no excess risk of adverse events was observed (RR: 1.00; 95% CI, 0.99-1.02). Conversely, HDL-C (MD: +130.82%; 95% CI, 121.49-140.15), LDL-C (MD: -32.68%; 95% CI, -40.73 to -24.63), ApoA1 (MD: +45.04%; 95% CI, 40.51-49.57), and Apo B (MD: -17.26%; 95% CI, -20.51 to -14.00) showed significant improvement. CETP inhibitors produce substantial lipid modifications but do not reduce major adverse cardiovascular events, underscoring the limitations of surrogate lipid markers and the need for outcome-based validation of lipid-modifying therapies. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <34> Accession Number 2049612393 Title Trial Of Pathogen-reduced Cryoprecipitate vs. cryoprecipitated AHF to Lower Operative Transfusions (TOP-CLOT): a single center, prospective, cluster randomized trial in cardiovascular surgery. Source Journal of Clinical Anesthesia. 116 (no pagination), 2027. Article Number: 112335. Date of Publication: 01 Jan 2027. Author Cushing M.M.; Cohen T.; Girardi N.I.; Jimenez A.; Andy C.; Milewski A.R.; Fitzgerald M.M.; Chen D.; Parra P.; Rand S.; Sinfort A.; Lau C.; Keltner N.; Corash L.; Mack C.; DeSimone R.A. Institution (Cushing, Cohen, Jimenez) Weill Cornell Medicine, Pathology and Laboratory Medicine, 1300 York Avenue, New York, NY, United States (Girardi, Fitzgerald) Weill Cornell Medicine, Clinical Anesthesiology, 1300 York Avenue, New York, NY, United States (Andy) Weill Cornell Medicine, Population Health Sciences, Division of Biostatistics, 1300 York Avenue, New York, NY, United States (Milewski) Weill Cornell Medicine, Anesthesiology, 1300 York Avenue, New York, NY, United States (Chen, Parra) NewYork-Presbyterian Hospital, Transfusion Medicine, 525 East 68th Street, New York, NY, United States (Rand) Weill Cornell Medicine, 1300 York Avenue, New York, NY, United States (Sinfort) Columbia University Vagelos College of Physicians and Surgeons, 630 W 168th St, New York, NY, United States (Lau, Mack) Weill Cornell Medicine, Cardiothoracic Surgery, 1300 York Avenue, New York, NY, United States (Keltner) Cerus Corporation, Clinical Strategy and Education, 1220 Concord Ave Suite 600, Concord, CA, United States (Corash) Cerus Corporation, 1220 Concord Ave Suite 600, Concord, CA, United States (DeSimone) Weill Cornell Medicine, Clinical Pathology and Laboratory Medicine, 1300 York Avenue, New York, NY, United States Publisher Elsevier Inc. Abstract Background Low perioperative fibrinogen levels potentiate hemorrhage and increase transfusions in cardiac surgery patients. Cryoprecipitated anti-hemophilic factor (Cryo) requires on-demand thawing, often delaying fibrinogen supplementation; its short post-thaw shelf life limits pre-emptive availability. In contrast, Pathogen Reduced Cryoprecipitated Fibrinogen Complex (PR CRYO) can be stored post-thaw at room temperature for up to five days, allowing immediate availability without the need for on-demand thawing. This single-center, randomized trial compared PR CRYO to Cryo in cardiac surgery patients with suspected hypofibrinogenemia to determine whether PR CRYO reduces transfusions. Methods Cryoprecipitate orders were cluster-randomized by month to PR CRYO or Cryo. Bleeding cardiac surgery patients receiving intraoperative cryoprecipitate were included. The primary outcome was number of allogeneic blood components transfused within 30 days. Multivariable mixed effects regression was used to evaluate outcomes. Results The trial stopped early for futility after 170 of 502 planned patients (84 PR CRYO, 86 Cryo; conditional power 8.2%). Baseline characteristics were similar; valve/CABG procedures were most common (51%), followed by aneurysm (38%), and aortic arch repair (11%). Total blood component utilization was identical (6 units, IQR 3-12, both groups; p > 0.9). PR CRYO was issued 19 min faster (12 vs. 31 min; p < 0.001) and transfusion began 16 min sooner (46 vs. 62 min; p = 0.008). Adverse events and 3-day transfusions were similar. Conclusions PR CRYO was available earlier for bleeding patients in this first clinical trial of the product. No reduction in 30 day transfusions was demonstrated in this underpowered, single-center superiority trial. Safety and efficacy outcomes were numerically similar between groups; however, the trial was not designed to assess noninferiority, and therefore equivalence cannot be formally concluded. Copyright © 2026. Published by Elsevier Inc. <35> Accession Number 2051132663 Title Incidence and predictors of major arrhythmic events after acute myocarditis complicated by ventricular arrhythmias: A systematic review and meta-analysis. Source Heart Rhythm. 23(9) (pp e2141-e2150), 2026. Date of Publication: 01 Sep 2026. Author M'Rabet S.; Kabore E.G.; Rav-Acha M.; Ng C.Y.; Gentile P.; Merlo M.; Pinnacchio G.; Deville L.; Benali K.; Narducci M.L.; Guenancia C. Institution (M'Rabet, Guenancia) Cardiology Department, Dijon University Hospital, Dijon, France (M'Rabet, Guenancia) PEC 2 EA 7460, UFR Sciences de Sante, Universite Bourgogne Europe, Dijon, France (Kabore) Cardiology Department, Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso (Rav-Acha) Integrated Heart Center, Shaare Zedek Hospital, Hebrew University, Jerusalem, Israel (Ng) Cardiac Arrhythmia Center, Massachusetts General Hospital, Harvard University, Boston, MA, United States (Gentile) De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, Milan, Italy (Gentile) School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy (Merlo) Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Member of the ERN GUARD-Heart, University of Trieste, Trieste, Italy (Pinnacchio, Narducci) Cardiovascular and Thoracic Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (Deville, Benali) Cardiology Department, Jean Monnet University Hospital, Saint-Etienne, France Publisher Elsevier B.V. Abstract BACKGROUND Acute myocarditis (AM) complicated by ventricular arrhythmias (VAs) carries an uncertain risk of VA recurrence after discharge. Predictors are poorly defined, complicating risk stratification and implantable cardioverter-defibrillator (ICD) decision making. OBJECTIVE This study aimed to assess recurrence rates and identify predictors of major arrhythmic events (MAEs) after AM complicated by sustained VA. METHODS This systematic review and meta-analysis was registered in PROSPERO (CRD420250594422). PubMed, Web of Science, and Cochrane Library were searched up to December 2024 for studies reporting postdischarge VA recurrence in patients with AM complicated by VA in the acute phase. Unpublished data were obtained from study authors to restrict analysis to sustained ventricular tachycardia and ventricular fibrillation. The primary outcome was MAE at follow-up (documented sustained VA, appropriate ICD therapy, or sudden cardiac death). Pooled recurrence rates and predictors were assessed using random-effects models. RESULTS 8 observational studies (n 5 355) were analyzed. MAE occurred in 46.4% (95% confidence interval, 38.1-54.9; I2 5 50.0) during a mean pooled follow-up of 3.8 years (95% confidence interval, 2.7-5.1). Neither demographic factors (age and sex), comorbidities, cardiovascular risk factors, nor ICD implantation before discharge was associated with MAE at follow-up. Reduced left ventricular ejection fraction and the presence or localization of late gadolinium enhancement on cardiac magnetic resonance were also not predictive. CONCLUSION MAE recurrences after AM affect nearly half of patients with sustained VA during the acute phase. No consistent predictors emerged. These findings are consistent with the European Society of Cardiology guidelines and call for refined risk stratification from large, multicenter cohorts with standardized criteria. Copyright © 2026 Heart Rhythm Society. All rights are reserved. <36> Accession Number 2051025810 Title Closing the diagnostic gap in transthyretin cardiac amyloidosis: red flags, modern imaging, and emerging therapies. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1935800. Date of Publication: 29 Sep 2026. Author Yi Z.; Li P.; Wang X. Institution (Yi, Wang) Department of Cardiovascular Medicine, Fuling People's Hospital of Chongqing, Chongqing, China (Li) Department of Cardiovascular Medicine, Meishan People's Hospital, Meishan, China Publisher Frontiers Media SA Abstract Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized, treatable, and still underdiagnosed cause of heart failure with preserved ejection fraction (HFpEF) and unexplained left ventricular hypertrophy in older adults, with a typical diagnostic delay of several years. We conducted a narrative review with a systematic literature search of PubMed and Embase (January 2000 to June 2026) using database-specific controlled vocabulary and free-text terms related to ATTR cardiomyopathy, clinical red flags, bone scintigraphy, monoclonal protein testing, cardiac magnetic resonance, tafamidis, acoramidis, vutrisiran, and emerging TTR-directed therapies. Two authors screened titles and abstracts, resolved disagreements by consensus, and prioritized multicenter cohorts, clinical trials, meta-analyses, systematic reviews, and guideline or consensus documents. Sixty-two references were included. Three practice points emerge from the literature. First, suspicion should be triggered by red flags such as bilateral carpal tunnel syndrome, lumbar spinal stenosis, spontaneous distal biceps tendon rupture, and the combination of increased ventricular wall thickness with low or normal QRS voltage. Second, the contemporary diagnostic pathway requires parallel bone scintigraphy and complete monoclonal protein screening; grade 2-3 myocardial uptake supports non-biopsy diagnosis of ATTR-CM only when monoclonal screening is negative and myocardial uptake is confirmed, preferably by SPECT or SPECT/CT. Third, treatment options now extend beyond tafamidis to acoramidis and vutrisiran, with amyloid-depleting antibodies under active investigation. We propose a pragmatic, resource-stratified diagnostic framework for targeted case-finding rather than population-level screening. Copyright © 2026 Yi, Li and Wang. <37> Accession Number 2049608134 Title Impact of Evolocumab on LDL-Cholesterol and Cardiovascular Outcomes in Patients With Established CVD: Systematic Review and Meta-Analysis. Source Endocrinology, Diabetes and Metabolism. 9(6) (no pagination), 2026. Article Number: e70355. Date of Publication: 01 Nov 2026. Author Goel A.; Naveed M.A.; Tandel H.; Mahmood A.; Mukhlis M.; Reddy K.S.V.; Maloth A.K.; Chauhan A.; Ashwara A.; Verma A.; Tahir H.B. Institution (Goel, Reddy, Maloth) Kakatiya Medical College, Telangana, Warangal, India (Naveed) Dow Medical College, Karachi, Pakistan (Tandel) C U Shah Medical College, Gujarat, Surendranagar, India (Mahmood) Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Punjab, Lahore, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Pakistan (Chauhan) Maulana Azad Medical College, New Delhi, India (Ashwara) Department of Medicine, An-Najah National University, Nablus, Palestine (Verma) SR Sanjeevani Hospital, Siraha, Nepal (Verma) Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be-University), Maharashtra, Pune, India (Verma) Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be-University), Maharashtra, Pune, India (Tahir) Lahore General Hospital, Lahore, Pakistan Publisher John Wiley and Sons Inc Abstract Background: Atherosclerotic cardiovascular disease is a leading cause of morbidity and mortality, and many high-risk patients fail to reach LDL-cholesterol (LDL-C) targets on statins alone. Evolocumab, a PCSK9 inhibitor, offers potent LDL-C lowering, but a synthesis of its lipid and clinical benefits in secondary prevention is needed. Method(s): We conducted a systematic review and meta-analysis of randomised controlled trials evaluating evolocumab in adults with established cardiovascular disease. PubMed, Embase, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were searched through April 2025. Outcomes included lipid parameters, major adverse cardiovascular events (MACE), individual cardiovascular endpoints, and safety, with pooled risk ratios (RR) and mean differences calculated using random-effects models. Result(s): Nine trials enrolling 67,662 patients were included. Evolocumab significantly reduced LDL-C (mean difference -57.73 mg/dL), total cholesterol (-52.27 mg/dL), triglycerides (-21.21 mg/dL), and lipoprotein(a) (-10.99 mg/dL), while increasing HDL-cholesterol (3.69 mg/dL). Evolocumab was associated with lower MACE (RR 0.53; 95% CI 0.40-0.71), though this estimate should be interpreted cautiously given heterogeneity in endpoint definitions and study designs. Myocardial infarction (RR 0.74) and coronary revascularisation (RR 0.80) were significantly reduced, while cardiovascular mortality and stroke showed no statistically definitive reduction. Serious adverse events and neurocognitive effects were comparable between groups, though injection-site reactions were more frequent with evolocumab. Conclusion(s): In patients with established cardiovascular disease, evolocumab provides substantial lipid lowering and reduces ischemic events without major safety concerns, supporting its use as an adjunct to statin therapy in secondary prevention. Copyright © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. <38> Accession Number 2050366470 Title Liposomal bupivacaine in thoracic surgery: a comprehensive review of current evidence and clinical implications. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1917255. Date of Publication: 2026. Author Huang L.; He J.; Wei J.; Huang X.; Chen X.; Yang Q.; Zhong Y. Institution (Huang, Yang) School of Nursing, Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, Nanning, China (Huang, He, Wei, Huang, Chen, Zhong) Department of Thoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Guangxi Zhuang Autonomous Region, Nanning, China (Yang) Nursing Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Guangxi Zhuang Autonomous Region, Nanning, China Publisher Frontiers Media SA Abstract Liposomal bupivacaine (LB) is a prolonged-release formulation designed to provide postoperative analgesia for up to 72-96 h after a single injection. This comprehensive review evaluates the current evidence on LB in thoracic surgery, focusing on acute pain control, opioid consumption, hospital length of stay (LOS), functional recovery, comparative effectiveness across regional techniques, integration into Enhanced Recovery After Surgery (ERAS) protocols, chronic postsurgical pain (CPSP) reduction, and safety/cost considerations. The core critical finding of this review is that although meta-analyses show statistically significant reductions in pain scores and opioid consumption with LB, the clinical significance of these reductions is questionable-for example, the opioid-sparing effect at 24 h (-1.83 MME) is far below the threshold generally considered clinically meaningful (10-15 MME). Results vary by block type; benefits are more consistent with serratus anterior, erector spinae, and paravertebral blocks, while intercostal nerve block data are mixed. LB appears most effective when incorporated into ERAS protocols, although the independent contribution of LB within these multimodal pathways remains difficult to isolate. Emerging evidence suggests LB may reduce CPSP incidence by 30-58%, but these findings are preliminary and require confirmation in larger studies with longer follow-up. Safety profiles are favorable, with peak plasma concentrations well below toxicity thresholds. Methodological limitations of the existing evidence include small sample sizes, lack of blinding, and and heterogeneity across studies. Future large-scale RCTs with long-term follow-up are warranted. Copyright © 2026 Huang, He, Wei, Huang, Chen, Yang and Zhong. <39> Accession Number 2038632729 Title ANATOMICAL PROXIMITY OF THE LEFT CIRCUMFLEX CORONARY ARTERY TO THE MITRAL VALVE ANNULUS AND ITS IMPLICATIONS FOR MITRAL VALVE SURGERY: A SYSTEMATIC REVIEW. Source International Journal of Medicine and Public Health. 16(3) (pp 3214-3219), 2026. Date of Publication: 01 Jul 2026. Author Sreekanth C.; Sameer P.A.; Krishna Kishore G.; Periyasamy V.; Showri R. Institution (Sreekanth, Showri) Department of Anatomy, PES University Institute of Medical Sciences and Research, Karnataka, Bangalore, India (Sameer) Department of Anatomy, Sri Devraj Urs Medical College, Karnataka, Kolar, India (Krishna Kishore, Periyasamy) Shridevi institute of Medical Sciences and Research Hospital, Karnataka, Tumakuru, India Publisher Pink Petals Publications Pvt Ltd Abstract Background: Anatomical proximity between the left circumflex coronary artery (LCx) and the mitral valve annulus (MVA) presents a risk of iatrogenic coronary compromise during mitral valve (MV) operations and transcatheter interventions. This systematic review evaluated spatial LCx-MVA distances across annular sectors, coronary dominance patterns, and their surgical implications. Material(s) and Method(s): Following PRISMA 2020 guidelines (PROSPERO: CRD42026849201), MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library were searched (2015-2026) for multidetector CT (MDCT), 3D-TEE, and cadaveric studies evaluating LCx-to-annulus proximity. Result(s): Fourteen studies (n=1,842) were included. Overall mean LCx-to-annulus distance was 4.8+/-2.1" mm". The anterolateral commissure (P1/A1 sector) exhibited the closest proximity (3.2+/-1.4" mm" ), whereas the posteromedial sector (P3/A3) was furthest (8.4+/-2.3" mm" ). Critical proximity (<2" mm" ) occurred in 13.8% of patients (95%" CI: " 10.2%-17.4%), primarily localized to the P1/A1 zone (78%). Left-dominant coronary systems demonstrated significantly shorter distances (2.3+/-0.9" mm" ) and a >3-fold higher rate of critical proximity (28.4%) compared to right-dominant systems (9.1%). Surgical LCx injury (0.4%-1.8% incidence) was predominantly driven by direct suture transfixion (62%) and dynamic traction (28%). Conclusion(s): The LCx courses in close proximity to the MVA, with the anterolateral commissure representing the highest-risk zone. Left-dominant circulation markedly increases susceptibility to iatrogenic compromise. Routine pre-procedural MDCT/3D-TEE mapping and intraoperative TEE Doppler interrogation of LCx flow are essential for injury prevention. Copyright © 2026, Pink Petals Publications Pvt Ltd. All rights reserved. <40> Accession Number 2051032142 Title Direct oral anticoagulants vs dual antiplatelet therapy following left atrial appendage closure in atrial fibrillation. Source Heart Rhythm. 23(9) (pp e1947-e1957), 2026. Date of Publication: 01 Sep 2026. Author Kaisaier W.; Xu Z.; Ye M.; Wu Z.; Dong Y.; He J.; Liu C.; Chen Y.; Lip G.Y.H.; Zhu W. Institution (Kaisaier, Ye, Wu, Dong, He, Liu, Chen, Zhu) Department of Cardiology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China (Xu) Department of Emergency, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (Lip) Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (Lip) Department of Cardiology, Lipidology and Internal Medicine, Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok, Poland Publisher Elsevier B.V. Abstract Background Percutaneous left atrial appendage closure (LAAC) is an established alternative to oral anticoagulants for preventing thromboembolic events for selected patients with atrial fibrillation (AF). However, optimal post-procedural antithrombotic therapy remains uncertain, particularly regarding the use of direct oral anticoagulants (DOACs) vs dual antiplatelet therapy (DAPT). Objective This meta-analysis aimed to compare the efficacy and safety outcomes of DOACs vs DAPT in the early post-implant period following LAAC in patients with AF. Methods We systematically searched PubMed and Embase until November 2025 to identify randomized controlled trials (RCTs) that compared DOACs with DAPT after LAAC. Efficacy outcomes included device-related thrombosis (DRT), stroke, and all-cause mortality, whereas safety outcomes encompassed major and minor bleeding. Pooled effect estimates were calculated as odds ratios (ORs) with 95% confidence intervals (CIs). Where appropriate, fixed- or random-effects models were applied according to between-study heterogeneity. Results 3 RCTs (ADRIFT, ADALA, ANDES) involving 704 patients (mean age 75.8-78.4 years; 65% males) were included, with 368 assigned to DOAC and 336 to DAPT. Baseline thromboembolic and bleeding risk were high (mean CHA<inf>2</inf>DS<inf>2</inf>-VASc 4.0-4.7; mean HAS-BLED 3.5-3.8). Clinical outcomes were evaluated at 2-3 months. Compared with DAPT, DOACs were associated with significantly lower risks of DRT (OR = 0.16; 95% CI: 0.05-0.57), major bleeding (OR = 0.46; 95% CI: 0.26-0.81) and minor bleeding (OR = 0.59; 95% CI: 0.38-0.92). No significant differences were observed in stroke (OR = 0.46; 95% CI: 0.07-3.13) and all-cause mortality (OR = 0.60; 95% CI: 0.23-1.54). Conclusion In randomized trials of patients with AF undergoing LAAC, short-term DOAC-based regimens were associated with lower rates of DRT and fewer bleeding events than DAPT, without differences in stroke or mortality. These findings support DOACs as a favorable short-term antithrombotic option after LAAC in selected patients. Copyright © 2026 Published by Elsevier Inc. on behalf of Heart Rhythm Society. <41> Accession Number 2051034928 Title Helicobacter pylori in solid organ transplantation: Challenges and treatment strategies. Source World Journal of Gastroenterology. 32(46) (no pagination), 2026. Article Number: 122731. Date of Publication: 14 Dec 2026. Author Fang X.-H.; Xie M.; Rao W. Institution (Fang) Division of Ultrasound, The Affiliated Hospital of Qingdao University, Shandong Province, Qingdao, China (Xie) Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Shandong Province, Qingdao, China (Rao) Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Shandong Province, Qingdao, China Publisher Baishideng Publishing Group Inc Abstract It has been reported that the incidence of de novo gastric cancer is significantly increased in solid organ transplantation (SOT) recipients. At least 90% of non-cardia gastric cancers are related to Helicobacter pylori (H. pylori) infection. This article aims to assess the prevalence and sequelae of H. pylori infection in SOT recipients, and to evaluate the efficacy of eradication therapy. A systematic search of the literature was conducted to elucidate the prevalence and impact of H. pylori in SOT recipients and to summarize the outcome of eradication regimens. This study demonstrated an estimated prevalence of H. pylori in SOT recipients of 33%, but the research showed significant heterogeneity, which may be related to the detection methods used. Overall, the prevalence of H. pylori infection in SOT recipients is generally lower than that observed in the general population. Studies indicate that H. pylori infection plays a significant role in the development of gastrointestinal complications, particularly among SOT recipients. However, other studies have found no evidence that H. pylori infection increases the risk of postoperative gastrointestinal complications. Although H. pylori infection is less common in SOT recipients than in the general population, eradication therapy is still advised on diagnosis. Copyright © 2026 Baishideng Publishing Group Inc. All rights reserved. <42> Accession Number 2051031363 Title COMPARISON OF EFFICACY AND SAFETY OF SUGAMMADEX VS NEOSTIGMINE AS A REVERSAL AGENT IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA UNDERGOING MAJOR ABDOMINAL AND THORACIC SURGERIES - A PROSPECTIVE RANDOMIZED CONTROL STUDY. Source International Journal of Academic Medicine and Pharmacy. 8(5) (pp 735-739), 2026. Date of Publication: 2026. Author Moturi P.K.; Subhalakshmi S.; Tungana S.; Dhivakaran A. Institution (Moturi) Department of Anesthesiology, Andhra Medical College, India (Subhalakshmi) JR Medical College and Hospital, Andhra Medical College, India (Tungana) Andhra Medical College, India (Dhivakaran) Department of Anaesthesiology, Andhra Medical College, India Publisher Society for Healthcare and Research Development Abstract Background: Patients with obstructive sleep apnoea (OSA) face a heightened risk of postoperative respiratory complications. Residual neuromuscular blockade (rNMB) significantly contributes to airway obstruction and hypoventilation during the perioperative period. While Neostigmine, the traditional reversal agent, shows variable efficacy and is linked to cholinergic side effects, Sugammadex offers a rapid and predictable reversal of steroidal neuromuscular blockade, potentially improving postoperative respiratory outcomes. Objective(s): This study aims to compare the safety and efficacy of Sugammadex and Neostigmine regarding neuromuscular blockade recovery, postoperative pulmonary complications, adverse events, and recovery profile in OSA patients undergoing significant abdominal and thoracic surgeries. Material(s) and Method(s): In a prospective randomized controlled study, approved by the Institutional ethics committee, 120 adult patients with OSA undergoing major abdominal and thoracic surgeries under general anaesthesia were assigned to receive either Sugammadex (n=60) or Neostigmine with an anticholinergic (Glycopyrrolate) (n=60) for the reversal of Vecuronium-induced neuromuscular blockade. Quantitative train-of-four (TOF) monitoring was employed. The primary outcome was the time to achieve a TOF ratio of >=0.9. Secondary outcomes included postoperative pulmonary complications, adverse events, extubation time, and PACU stay. Result(s): The time to reach TOF >=0.9 was significantly shorter with Sugammadex (2.3 +/- 0.9 min) compared to Neostigmine (11.2 +/- 4.1 min) (p < 0.001). Composite pulmonary complications were observed in 10% of the Sugammadex group versus 28.3% in the Neostigmine group (p = 0.01). Adverse events were significantly fewer with Sugammadex (11.7% vs 40%, p < 0.001). Both PACU stay and extubation time were notably reduced. Conclusion(s): Sugammadex offers a faster and more reliable reversal of neuromuscular blockade and is linked to fewer respiratory and cholinergic complications compared to Neostigmine in OSA patients. Its preferential use in this high-risk group is clinically advantageous. Copyright © 2026, Society for Healthcare and Research Development. All rights reserved. <43> Accession Number 2050366650 Title Edoxaban antithrombotic therapy in diabetic patients with atrial fibrillation and stable coronary artery disease: the EPIC-CAD trial. Source Europace. 28(10) (no pagination), 2026. Article Number: euag247. Date of Publication: 01 Oct 2026. Author Lee S.; Cho M.S.; Kang D.-Y.; Ahn J.-M.; Lee J.-B.; Park H.-S.; An S.Y.; Wee S.-B.; Seo K.-W.; Oh Y.-S.; Lee C.H.; Choi E.-K.; Lee J.H.; Kwon C.H.; Park G.-M.; Choi H.O.; Park K.-H.; Park K.-M.; Hwang J.; Yoo K.-D.; Cho Y.-R.; Kim J.H.; Hwang K.W.; Jin E.S.; Kwon O.; Kim K.-H.; Park S.-J.; Nam G.-B.; Park D.-W. Institution (Lee, Cho, Kang, Ahn, Park, An, Wee, Seo, Park, Nam, Park) Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea (Lee) Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (Oh) Cardiovascular Center and Cardiology Division, St. Mary's Hospital, Seoul, South Korea (Lee) Division of Cardiology, Veterans' Health Service Medical Center, Seoul, South Korea (Choi) Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea (Lee) Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea (Kwon) Division of Cardiology, Konkuk University Medical Center, Seoul, South Korea (Park) Division of Cardiology, Ulsan University Hospital, Ulsan, South Korea (Choi) Division of Cardiology, Soon Chun Hyang University Hospital Bucheon, Bucheon, South Korea (Park) Division of Cardiology, Hallym University Medical Center, Anyang, South Korea (Park) Division of Cardiology, Samsung Medical Center, Seoul, South Korea (Hwang) Division of Cardiology, Keimyung University Dongsan Hospital, Daegu, South Korea (Yoo) Division of Cardiology, St. Vincent's Hospital, Suwon, South Korea (Cho) Division of Cardiology, Dong-A University Hospital, Pusan, South Korea (Kim) Division of Cardiology, Dongguk University Hospital, Goyang, South Korea (Hwang) Division of Cardiology, Pusan National University Yangsan Hospital, Yangsan, South Korea (Jin) Division of Cardiology, Kyung Hee University Hospital at Gangdong, Suwon, South Korea (Kwon) Cardiovascular Center and Cardiology Division, Eunpyeong St. Vincent's Hospital, Seoul, South Korea (Kim) Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea Publisher Oxford University Press Abstract Aims: The appropriate antithrombotic regimen for diabetic patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) who are at high atherothrombotic risk remains uncertain. We evaluated whether the effects of different antithrombotic strategies differ according to diabetes status. Methods and Results: The EPIC-CAD (Edoxaban versus Edoxaban with Antiplatelet Agent in Patients with Atrial Fibrillation and Chronic Stable Coronary Artery Disease) was a randomized trial comparing edoxaban monotherapy with dual antithrombotic therapy (edoxaban plus a single antiplatelet agent) in patients with AF and stable CAD. The primary outcome was a composite of death from any cause, myocardial infarction, stroke, systemic embolism, unplanned urgent revascularization, and major or clinically relevant non-major bleeding at 12 months. Among 1040 randomized patients, 421 (40.5%) had diabetes. There were no differences in the incidence of the primary outcome between diabetic and non-diabetic patients [9.7% vs. 11.6%; hazard ratio (HR) 0.82; 95% confidence interval (CI) 0.56-1.20; P = 0.30]. The incidence of the primary outcome at 12 months was significantly lower with edoxaban monotherapy than with dual antithrombotic therapy in both diabetic (6.3% vs. 13.7%; HR 0.44; 95% CI 0.23-0.83; P = 0.01) and non-diabetic patients (6.7% vs. 16.3%; HR 0.39; 95% CI 0.23-0.65; P < 0.001), with no significant interaction between diabetic status and randomized treatment strategy (P for interaction = 0.78). Conclusion(s): The risk of primary outcome was similar between diabetic and non-diabetic patients with AF and CAD. Irrespective of diabetes status, edoxaban monotherapy led to a lower risk of a primary outcome at 12 months than dual antithrombotic therapy. Clinical trial registration: EPIC-CAD ClinicalTrials.gov number: NCT03718559. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. <44> Accession Number 2048168842 Title The Effectiveness of Perioperative Respiratory Muscle Exercise in Elderly Cardiac Surgery Patients: A Randomized Controlled Trial. Source Archives of Physical Medicine and Rehabilitation. 107(11) (pp 3196-3204), 2026. Date of Publication: 01 Nov 2026. Author Wang Q.; Shao J.; Peng Y.; Li S.; Chen L.; Lin Y. Institution (Wang, Shao, Peng, Lin) Department of Nursing, Fujian Medical University Union Hospital, Fujian, Fuzhou, China (Wang, Li, Chen, Lin) Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fujian, Fuzhou, China (Wang) School of Nursing, Fujian Medical University, Fujian, Fuzhou, China Publisher W.B. Saunders Abstract Objective: This study aimed to evaluate the impact of perioperative respiratory muscle training on respiratory muscle strength, pulmonary function, functional capacity, and prognostic outcomes in patients undergoing surgery. Design(s): A randomized controlled trial. Setting(s): Cardiac surgery ward and cardiac surgery intensive care unit of a tertiary Grade A hospital in Fuzhou, China. Participant(s): Eighty-two participants. Intervention(s): Perioperative respiratory muscle exercise. Main Outcome Measure(s): Eighty-two patients were randomly assigned to either the intervention group (n=42), who performed perioperative respiratory muscle training, or the control group (n=40). The intervention group completed respiratory muscle exercise from admission to discharge (except during mechanical ventilation). Respiratory muscle strength was assessed upon admission, the day before surgery, on the third day postintensive care unit transfer, and at discharge. Each patient underwent a lung function test, a 6-minute walk test, a self-efficacy for exercise scale, an anxiety and depression test, and a quality of life questionnaire, before and after intervention. Result(s): Compared to the control group, the intervention group showed significantly greater improvements in maximal inspiratory pressure (57.69+/-10.85 cmH<inf>2</inf>O vs 48.28+/-10.30 cmH<inf>2</inf>O), pulmonary function, functional capacity, postoperative pulmonary complications (38.1% vs 65.0%), inspiratory muscle weakness (42.9% vs 85.0%), duration of mechanical ventilation and intensive care unit stay, level of anxiety and depression, quality of life, and length of postoperative hospitalization. In addition, the incidence of postoperative pulmonary (9.5% vs 22.5%) and rehospitalization within 6 months (9.5% vs 17.5%) was reduced, though not statistically significant. Conclusion(s): Perioperative respiratory muscle training could contribute to improved respiratory muscle strength, pulmonary function, functional capacity, prognostic outcomes, and quality of life in elderly cardiac surgery patients. Continuous activation of the respiratory muscles could provide multiple benefits for these individuals. Copyright © 2026 American Congress of Rehabilitation Medicine <45> Accession Number 2049967645 Title Infectious Complications in Adults Receiving Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis of Nosocomial and Bloodstream Infection, Prevalence, Risk Factors, and Clinical Outcomes. Source Medical sciences. 14(6) (no pagination), 2026. Article Number: 653. Date of Publication: 01 Oct 2026. Author Alzibdeh A.; Alamami A.; Zara S.; Aljabri M.; Tawel R.; Hashim S.; Elbuzidi A.; Abdelhadi H.; Shehatta A.L.; Kharma N.; Ibrahim A.S.; Hassan I.F.; Almaslamani M. Institution (Alzibdeh, Zara, Aljabri, Hashim, Abdelhadi, Almaslamani) Department of Infectious Diseases, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar (Alamami, Tawel, Elbuzidi, Shehatta, Kharma, Ibrahim, Hassan) Department of Medical Intensive Care, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar (Abdelhadi) Medical College, Qatar University, P.O. Box 2713, Doha, Qatar Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Reported infection rates during extracorporeal membrane oxygenation (ECMO) vary widely, partly because case definitions are applied inconsistently. We synthesized the prevalence and prognostic association of nosocomial and bloodstream infection (BSI) acquired during adult ECMO. Method(s): PubMed/MEDLINE, Embase, Scopus and CENTRAL were searched through December 2025 for observational studies of at least 10 adults on ECMO with an explicit infection definition. We classified case definitions by the criteria actually applied. We pooled crude mortality odds ratios (ORs) and patient-level BSI prevalence in studies applying laboratory-confirmed criteria, assessed risk of bias with ROBINS-I and the JBI checklist, and rated certainty with GRADE. Result(s): Forty-seven reports (46 cohorts; 11,573 patients) were included. Pooled BSI prevalence was 25.8% (95% CI 17.3-36.5%; 7 studies, 1193 patients), 18.2% in pre-pandemic and 39.2% in COVID-19 cohorts (post hoc). Infection was associated with higher crude odds of death (OR 1.65, 1.33-2.04; prediction interval 0.95-2.85; 24 studies), but analyses modeling infection as time-varying were inconsistent, including no association in a multistate model (adjusted hazard ratio 1.00, 0.79-1.26), and small-study effects were suggested. Certainty was very low for both outcomes. Conclusion(s): Roughly one in four adults on ECMO developed laboratory-confirmed BSI, more often in COVID-19 cohorts. Whether infection acquired on ECMO increases mortality remains uncertain. Copyright © 2026 by the authors. <46> Accession Number 2046785117 Title A Trends Analysis and Scoping Review: Minimal Invasive Extracorporeal Circulation. Source Cardiovascular Engineering and Technology. 17(5) (pp 637-653), 2026. Date of Publication: 01 Oct 2026. Author Hemsinli D.; Karakisi S.O.; Kilic H. Institution (Hemsinli, Karakisi) Faculty of Medicine, Department of Cardiovascular Surgery, Recep Tayyip Erdogan University, Rize, Turkey (Kilic) Faculty of Medicine, Department of Medical Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey Publisher Springer Abstract Purpose: The minimal invasive extracorporeal circulation (MiECC) was developed as abiocompatible alternative to conventional cardiopulmonary bypass (cCPB), intending to mitigate haemodilution, lessen the systemic inflammatory response, and enhance organ protection. AQ2 Although the evidence base has grown over the past 30 years, there has been no systematic mappingof the evolution of research activity and its results. Method(s): The objectives are to perform a detailed analysis of the temporal, geographical, methodological, and clinical trends within MiECC research published between 1990 and 2025. Studies involving original human clinical data (randomized controlled trials, cohort studies, observational reports, methodological or protocol papers) that reported perioperative or clinical outcomes of MiECC were included. Exclusion criteria comprised reviews, meta-analyses, editorials, letters, guidelines, animal studies, and conference abstracts lacking full text. A comprehensive search of PubMed/MEDLINE, Web of Science, Scopus, and Cochrane databases was conducted up to September 2025 to gather evidence. Reference lists of included articles and relevant reviews were also screened. Data were extracted on publication year, country, sample size, study design, surgical procedure, and reported outcomes. Two reviewers independently charted the data, and discrepancies were resolved by a third reviewer. Result(s): A total of 151 studies were identified, of which 128 met eligibility criteria. Publication activity increased substantially after 2002 and peaked in 2021, with major contributions from European centres (Germany, Italy, Switzerland, Greece, and the Netherlands). Methodological/protocol papers and Randomize Controlled Trials (RCT) predominated (respectively, n = 37, n = 36). Most studies focused on coronary artery bypass grafting (CABG), while valve surgery and paediatric populations were underrepresented. Reported outcomes shifted over time: early studies emphasised transfusion and inflammatory markers, whereas more recent investigations increasingly examined renal function, neurological complications, and survival. Subgroup analyses suggested notable benefits in elderly patients, those with renal dysfunction, and individuals with low ejection fraction (EF). Conclusion(s): MiECC research has progressed from feasibility series to large multicentre trials, generating evidence for reduced transfusion requirements, attenuated inflammatory response, and better organ protection, though no clear mortality benefit has been demonstrated. Copyright © The Author(s) 2026. <47> Accession Number 2050090708 Title The impact of leaflet thrombosis on transcatheter aortic valve degeneration: a narrative review. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author van Nuland P.J.A.; Overduin D.C.; van Ginkel D.J.; Jacobsen M.R.; Swaans M.J.; Timmers L.; Rensing B.J.W.M.; Geisler T.; ten Berg J.M. Institution (van Nuland, Overduin, van Ginkel, Swaans, Timmers, Rensing, ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands (Jacobsen) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Geisler) Department of Cardiology and Angiology, University Hospital Tubingen, Eberhard Karls University of Tubingen, Tubingen, Germany (ten Berg) Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands (ten Berg) Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands Publisher Springer Abstract Transcatheter aortic valve implantation (TAVI) has expanded into younger and lower-risk patients, making long-term valve durability increasingly important. Leaflet thrombosis, most commonly identified on computed tomography as hypoattenuated leaflet thickening (HALT), is common after TAVI. Whether leaflet thrombosis contributes to structural valve deterioration (SVD) remains incompletely understood. To summarize the current evidence on the relationship between leaflet thrombosis and SVD after TAVI, with a focus on clinical outcomes, imaging findings, antithrombotic therapy, and pathophysiological mechanisms. This narrative review synthesizes available clinical, imaging, mechanistic, histopathological and antithrombotic literature addressing leaflet thrombosis and valve durability after TAVI. CT studies show that leaflet thrombosis occurs in 13-32% of patients within the first post-procedural year. Although some lesions resolve spontaneously, longitudinal imaging studies demonstrate persistence in a substantial proportion of patients, supporting the presence of an underlying valve-related substrate. HALT has not consistently been associated with adverse valve hemodynamics during the first year after implantation. Long-term TAVI durability studies report low rates of severe SVD (0.8-1.5% up to 10 years), although outcomes vary according to valve generation and study population. The 10-year NOTION and PARTNER 2A data provide important long-term durability information, but neither study included systematic longitudinal CT assessment of leaflet thrombosis. Observational studies linking early HALT to subsequent hemodynamic valve deterioration have yielded conflicting results. Indirect evidence from anticoagulation studies and histopathological investigations supports biological plausibility for a relationship between leaflet thrombosis and progressive leaflet injury, but does not establish causality. Leaflet thrombosis is a frequent imaging finding after TAVI and may persist over time, but its contribution to long-term SVD remains uncertain. Current evidence supports a potential biological relationship between leaflet thrombosis and valve degeneration but does not demonstrate that HALT is a causal precursor of clinically relevant SVD. Prospective studies combining serial CT imaging with long-term, standardized assessment of structural valve outcomes are required to resolve this question. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <48> Accession Number 2050115849 Title Aortic valve replacement and concomitant coronary artery bypass grafting: technical considerations in the era of sutureless and rapid-deployment aortic valves. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Karangelis D.; Stougiannou T.M. Institution (Karangelis, Stougiannou) Department of Cardiothoracic Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece Publisher Taylor and Francis Ltd. Abstract Introduction: Coexistence of severe aortic stenosis (AS) and coronary artery disease (CAD) is frequently encountered in contemporary practice, particularly amongst elderly patients with multiple comorbidities. Although transcatheter aortic valve implantation (TAVI) combined with percutaneous coronary intervention (PCI) has emerged as an alternative strategy, surgical aortic valve replacement (SAVR) with concomitant coronary artery bypass grafting (CABG) remains the reference treatment for these patient groups. The introduction of sutureless and rapid-deployment aortic valves (RDAV) has considerably expanded the surgical armamentarium by facilitating implantation and reducing cardiopulmonary bypass (CPB) and aortic cross-clamp times. Appropriate application of these technologies requires specific technical considerations that ultimately influence operative planning and execution. Areas covered: This review summarizes contemporary evidence associated with the use of sutureless and RDAVs in combined CABG and SAVR procedures. To ensure relevant literature is included, a literature search across PubMed and ScienceDirect has been carried out, spanning the last 20 years, utilizing relevant medical subject headings (MeSH) terms and keywords. Expert opinion: As evidence on sutureless and RDAVs technologies continues to accumulate, with associated advancements in perioperative planning, these valves are expected to become valuable adjuncts in combined procedures, by minimizing operative burden while also allowing for robust, aortic valve pathology correction. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <49> Accession Number 2051140156 Title Evolution of diagnostic reference levels in paediatric cardiac interventional procedures: a narrative review. Source Applied Radiation and Isotopes. 239 (no pagination), 2027. Article Number: 113057. Date of Publication: 01 Jan 2027. Author Ubeda C.; Cabanas A.; Nocetti D.; Cubillos Y.; Miranda P.; Franco M.C.; Donoso-Aguirre S. Institution (Ubeda, Nocetti, Donoso-Aguirre) Medical Technology Department, Health Sciences Faculty, LABODOP, Universidad de Tarapaca, Arica, Chile (Cabanas) Physics Department, Faculty of Medicine, Universidad de Tarapaca, Arica, Chile (Cubillos) Library System, Universidad de Tarapaca, Arica, Chile (Miranda) Dr. Luis Calvo Mackenna Children's Hospital, Antonio Varas 360, Santiago, Chile (Franco) Department of Pediatric Cardiology, Zambrano Hellion Hospital, Tecnologico de Monterrey, School of Medicine and Health Sciences, Nuevo Leon, Monterrey, Mexico Publisher Elsevier Ltd Abstract The goal of this narrative review was to identify and synthesise publications reporting radiation dose values for paediatric cardiac interventional procedures (PCIP), organised according to four DRL-related benchmarking levels used in this review: typical values, local DRLs, national DRLs and regional DRLs. These procedures can deliver high radiation doses to markedly radiosensitive patients. DRLs are an important tool for optimising these exposures. Publications from 2010 to 2025 were searched, and twenty-five studies met the eligibility criteria, with reported kerma-area product (P<inf>KA</inf>) taken as a common comparator. Reported P<inf>KA</inf> spanned more than two orders of magnitude, from below 1 Gy cm2 in patients under 5 kg to above 100 Gy cm2 for complex therapeutic procedures in larger children. Within a single DRL category, procedural complexity alone drove differences exceeding one order of magnitude, while procedure-specific stratification converged on a narrow 1-5 Gy cm2 band in the youngest patients. National DRLs showed the widest inter-study dispersion and regional DRLs the narrowest. The variability in reported dose values was primarily driven by differences in categorisation schemes and procedural complexity rather than by inconsistencies in the DRL concept itself. The available evidence reflects an evolution from early local initiatives towards national and regional frameworks characterised by increasing methodological maturity and international collaboration. Future developments are expected to move towards complexity-based DRLs supported by large multicentre datasets, automated dose monitoring and artificial intelligence for real-time optimisation, while coordinated regional initiatives and shared registries may enable continuous DRL updating and stronger radiation protection for PCIP. Copyright © 2026 Elsevier Ltd <50> Accession Number 2050056379 Title The effect of virtual reality glasses used during chest tube removal following open-heart surgery on pain and hemodynamic parameters: a randomized controlled trial. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 993. Date of Publication: 01 Dec 2026. Author Yanik T.C.; Gulsen M.; Ugras G.A.; Arslan S.; Ozdemir F.E. Institution (Yanik) Faculty of Nursing, Surgical Nursing Department, Mersin University, Mersin, Turkey (Gulsen) Faculty of Health Sciences, Surgical Nursing Department, Cukurova University, Adana, Turkey (Ugras) Faculty of Nursing, Surgical Nursing Department, Professor, Mersin University, Mersin, Turkey (Arslan) Faculty of Health Sciences, Surgical Nursing Department, Professor, Cukurova University, Adana, Turkey (Ozdemir) Cardiovascular Surgery Intensive Care Unit, Mersin University Hospital, Mersin, Turkey Publisher BioMed Central Ltd Abstract Background: Chest tube removal (CTR) following open-heart surgery is a painful procedure that may adversely affect patients' hemodynamic parameters. Purpose(s): This study aimed to determine the effect of virtual reality glasses (VRG) used during chest tube removal after open-heart surgery on pain levels and hemodynamic parameters. Method(s): This prospective, two-arm (1:1), randomized controlled trial included 82 patients undergoing open-heart surgery. Patients in the VRG group (n = 41) were exposed to relaxing forest-walk-themed virtual reality content starting five minutes before CTR and continuing for five minutes after the procedure. The control group (n = 41) received routine care without any additional intervention. Pain levels were assessed using the Visual Analog Scale (VAS), and hemodynamic parameters-systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO2)-were recorded before CTR, immediately after, and at 5, 15, and 30 min post-procedure. Result(s): A significant group x time interaction was observed for pain (p = 0.003). After adjustment for baseline pain and multiple comparisons, pain was significantly lower in the VRG group than in the control group immediately after CTR (adjusted mean difference [VRG - Control]: -1.26, 95% CI: -1.85 to - 0.68; adjusted p < 0.001), whereas no significant between-group differences were observed at 5, 15, or 30 min. A significant group x time interaction was also observed for SpO2 (p < 0.001), with significantly higher SpO2 in the VRG group immediately after CTR (adjusted mean difference: 2.70, 95% CI: 1.88 to 3.53; adjusted p < 0.001). No significant group x time interactions were observed for SBP, DBP, HR, or RR. Conclusion(s): VRG use during CTR was associated with lower pain immediately after the procedure and higher SpO2 immediately after CTR. No significant effects were observed for SBP, DBP, HR, or RR. These findings suggest that VRG may be a useful non-pharmacological adjunct for short-term pain management during CTR following open-heart surgery. Further studies are needed to confirm its effects on oxygenation and other hemodynamic parameters. Trial registration: ClinicalTrials.gov (NCT05585853) first submitted on October 12, 2022, and first posted on October 19, 2022. Copyright © The Author(s) 2026. <51> Accession Number 2050055067 Title Utilization of Microaxial Mechanical Circulatory Support Among the Pediatric Population: A Systematic Review. Source Artificial Organs. (no pagination), 2026. Date of Publication: 2026. Author Jones A.J.; Rahimov D.; Smoot D.; Mustafa M.; Mallur K.; Rajab T.K.; Hoopes C.W.; Tchantchaleishvili V. Institution (Jones, Rahimov, Mustafa, Mallur, Hoopes, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States (Smoot) Drexel University College of Medicine, Philadelphia, PA, United States (Rajab) Department of Cardiovascular Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, United States Publisher John Wiley and Sons Inc Abstract Background: Utilization of microaxial pumps for temporary mechanical circulatory support in children has increased in recent years. However, data on patient selection, implantation techniques, and outcomes remain limited. Method(s): A systematic literature search was conducted in July 2025 to identify case reports and case series reporting the use of microaxial pumps in patients aged 18 years or less. Forty-four studies comprising 100 patients were identified, and patient-level data were extracted for analysis. Result(s): The median age of the patients was 14 [IQR, 11.5-16] years, with a median weight of 52 [40-73] kg and median body surface area of 1.59 [1.35-1.85] m2. The most common diagnoses were cardiomyopathy (29%), heart allograft rejection (26%), and myocarditis (21%). Impella CP was the most frequently used device (48%), followed by Impella 2.5 and Impella 5.5 (each 21%). Access was predominantly obtained via the femoral artery (47%). Percutaneous implantation was performed in 47% of patients. Patients were weaned from microaxial support for cardiac recovery (42%) or heart transplantation (31%). Fourteen patients (14%) died prior to discharge, with significantly higher mortality among patients supported with ECPella (29%) compared with microaxial pump alone (6%; p = 0.01). The median duration of support was 6 [4-13] days. At the median follow-up of 119 [23-180] days overall survival was 84%. Conclusion(s): Microaxial pumps represent an important addition to temporary mechanical circulatory support in pediatric patients and can serve as an alternative to VA-ECMO in selected cases. Outcomes were less favorable when used in tandem configurations such as ECPella, reflecting the greater severity of illness in these patients. Copyright © 2026 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. <52> Accession Number 2048116583 Title Effect of a Nurse Practitioner-Led Bundled Care on Postoperative Recovery in Cardiac Surgery Patients: A Randomized Controlled Trial. Source Research in Nursing and Health. 49(6) (pp 845-855), 2026. Date of Publication: 01 Dec 2026. Author Paul D.; Kanagaraj P.; Pappaiya P. Institution (Paul) Narayana Institute of Cardiac Sciences, Narayana Health City, Karnataka, Bangalore, India (Kanagaraj) Department of Nursing, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia (Pappaiya) Narayana Hrudayalaya College of Nursing, Narayana Health City, Karnataka, Bangalore, India Publisher John Wiley and Sons Inc Abstract Postoperative delirium, pain, and sleep disturbances prolong recovery after cardiac surgery. Evidence for multicomponent, nurse practitioner-led interventions is limited, especially in resource-constrained settings. This study evaluated their effect on delirium, pain, sleep quality, and hospital stay. In a single-blinded, post-test only RCT at a tertiary cardiac hospital in India, 100 adults undergoing elective coronary artery bypass graft, mitral valve replacement, or aortic valve replacement were randomized to nurse practitioner-led bundled care (n = 50) or routine care (n = 50). The intervention included preoperative orientation, early mobilization, cognitive reorientation, family engagement, relaxation, and sleep promotion. Outcomes-delirium (CAM-ICU), pain (VAS), and sleep quality (RCSQ) and length of stay were analyzed using chi-square/Fisher's exact tests, repeated-measures ANOVA, GLM, and Mann-Whitney U tests. All 100 participants completed the study (n = 50 per group) with comparable baseline demographics and clinical profiles. The intervention group showed significantly lower postoperative delirium (Day 2: 6% vs. 32%, p = 0.001; GLM group x time interaction p = 0.009), reduced pain scores across Days 1-3 (F<inf>1,98</inf> = 72.18, p < 0.001), and improved sleep quality across Days 2-4 (F<inf>1,98</inf> = 233.35, p < 0.001; group x time interaction p < 0.001) compared with controls. Recovery was faster, with shorter ICU stay (median 3 vs. 3-4 days, p = 0.006), ward stay (5 vs. 6 days, p = 0.002), and total hospital stay (8 vs. 10 days, p < 0.001). Nurse practitioner-led bundled care reduces delirium, improves pain and sleep, and shortens recovery, providing a feasible, low-cost approach for cardiac surgery patients. Trial Registration: CTRI/2023/06/054180 Dated 6/19/2023. Copyright © 2026 Wiley Periodicals LLC. <53> Accession Number 2049877146 Title 5-Year Follow-Up of Transcatheter Aortic Valve Replacement With Self-Expanding Intra-Annular Versus Commercially Available Valves. Source JACC: Cardiovascular Interventions. 19(21) (pp 2821-2833), 2026. Date of Publication: 09 Nov 2026. Author Makkar R.R.; Cheng W.; Waksman R.; Chakravarty T.; Satler L.F.; Groh M.; Abernethy W.; Russo M.J.; Heimansohn D.; Hermiller J.; Worthley S.; Chehab B.M.; Matthews R.; Ramana R.K.; Yong G.; Chen C.; Asch F.M.; Nakamura M.; Jilaihawi H.; Sharma R.; Patel D.; Kapadia S.; Reardon M.J.; Bhatt D.L.; Fontana G.P. Institution (Makkar, Cheng, Chakravarty, Nakamura, Jilaihawi, Patel) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Waksman, Satler) Washington Hospital Center, Washington, DC, United States (Groh, Abernethy) Mission Health and Hospitals, Asheville, NC, United States (Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Chen) Newark Beth Israel Medical Center, Newark, NY, United States (Heimansohn, Hermiller) St Vincent Heart Center, Indianapolis, IN, United States (Worthley) Royal Adelaide Hospital, Adelaide, SA, Australia (Worthley) Genesis Care, Sydney, NSW, Australia (Chehab) Ascension Via Christi Hospital, University of Kansas, Wichita, KS, United States (Matthews) University of Southern California, Los Angeles, CA, United States (Ramana) Advocate Christ Medical Center, Oak Lawn, IL, United States (Ramana, Yong) Heart Care Centers of Illinois, Palos Park, IL, United States (Asch) MedStar Health Research Institute, Washington, DC, United States (Sharma) Stanford University Medical Center, Stanford, CA, United States (Kapadia) Cleveland Clinic, Cleveland, OH, United States (Reardon) Houston Methodist Hospital, Houston, TX, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fontana) Cardiovascular Institute, Los Robles Regional Medical Center, Thousand Oaks, CA, United States Publisher Elsevier Inc. Abstract Background Long-term outcomes of the self-expanding intra-annular Portico transcatheter aortic valve are not known. Objectives This study aimed to report the 5-year outcomes of the PORTICO IDE randomized controlled trial. Methods This multicenter trial randomized (1:1) patients with severe symptomatic aortic stenosis at high/extreme surgical risk to transcatheter aortic valve replacement (TAVR) with the self-expanding intra-annular valve (study valve) or Food and Drug Administration-approved commercially available valves (CAVs; balloon-expandable or self-expanding supra-annular platforms). Assessments of the primary safety endpoint (30 days) and the primary efficacy endpoint (1 year) have been previously reported. Prespecified clinical outcomes and hemodynamic valve parameters are presented through 5 years. Results We randomized 750 eligible patients (mean age: 83 years, 52.7% female) to the study valve (n = 381) or CAV (n = 369). Compared with CAV, the study valve showed similar 5-year all-cause mortality or stroke (55.6% vs 51.3%, P = 0.42). Cardiovascular mortality was numerically higher in the study valve group compared with the CAV group (33.4% vs 25.8%; P = 0.06). Naive permanent pacemaker implantation was higher in the study valve group (36.6%) than the CAV group (20.3%; P < 0.0001) at 5 years. At 5 years, the study valve showed a lower mean transvalvular gradient (7.2 +/- 3.0 vs 9.5 +/- 6.5 mm Hg, P = 0.008), but similar valve area (1.78 +/- 0.45 vs 1.71 +/- 0.51 cm2, P = 0.40) compared to CAV. Conclusions In patients at high or extreme surgical risk, TAVR with the self-expanding intra-annular transcatheter heart valve had similar 5-year overall survival, stroke rates, and valve function compared with commercially available valves. Copyright © 2026 The Authors. <54> Accession Number 2045458723 Title The link between atrial fibrosis and postoperative atrial fibrillation after cardiac surgery: A systematic review. Source Trends in Cardiovascular Medicine. 36(8) (pp 515-523), 2026. Date of Publication: 01 Nov 2026. Author Nawaz A.; Sohpal A.; Mitra R.; Abu-Omar Y.; Elsebaie A.; El-Diasty M. Institution (Nawaz, Sohpal) School of Medicine, Case Western Reserve University, Cleveland, OH, United States (Mitra) Case School of Engineering, Case Western Reserve University, Cleveland, OH, United States (Abu-Omar, El-Diasty) Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Elsebaie) Department of Medicine, Queen's University, Kingston, ON, Canada (El-Diasty) Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada Publisher Elsevier Inc. Abstract Postoperative atrial fibrillation (POAF) is a common complication that can affect up to 20-44% of patients undergoing cardiac surgery. Evidence suggests that atrial fibrosis is a key factor in the development of POAF due to the disruption of the myocardial electric properties. This systematic review examines the correlation between pre-existing atrial fibrosis and the development of POAF after cardiac surgery. A systematic literature search was conducted in MEDLINE, Embase, and Google Scholar (2000 to March 2025) to identify studies that conducted comparative analysis of atrial fibrosis levels between those who did and did not develop POAF, using histological assessment methods. Extracted data, included study characteristics, histopathological staining methods and analysis findings, fibrosis quantification methods, and overall POAF incidence. Thirteen studies met the inclusion criteria, resulting in a total of 1222 patients, primarily undergoing coronary artery bypass surgery. The incidence of POAF ranged from 14%-42.4% (median 31.6%). In more than half of the studies (7/13), patients who developed POAF demonstrated statistically significant higher degrees of atrial fibrosis compared to those that remained in sinus rhythm postoperatively (four exhibited p < 0.001). Of the eight studies that conducted multivariate analyses, three identified atrial fibrosis as an independent POAF predictor. High heterogeneity precluded pooling of results into a meta-analysis. The current evidence examining the link between pre-existing atrial fibrosis and the development of POAF is restricted by methodological heterogeneity and inconsistent findings. Further efforts to standardize fibrosis quantification methods and POAF definitions are warranted before histopathological assessments can reliably inform POAF risk before cardiac surgery. Copyright © 2026 The Author(s) <55> 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. 8(11) (pp 1579-1591), 2026. Date of Publication: 01 Nov 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. 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). 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). 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. Copyright © 2026 <56> Accession Number 2038049344 Title Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial. Source BMJ. 388 (no pagination), 2025. Article Number: e082104. Date of Publication: 2025. Author Han J.; Zhai W.; Wu Z.; Zhang Z.; Wang T.; Ren M.; Liu Z.; Sessler D.I.; Guo Z.; Meng L. Institution (Han, Zhai, Zhang, Wang) Department of Anesthesiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China (Wu) Department of Critical Care, Tianjin Chest Hospital, Tianjin University, Tianjin, China (Ren) Tianjin Research Institute of Cardiovascular Disease, Tianjin, China (Liu) Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indiana University, Indianapolis, IN, United States (Sessler) Department of Anesthesiology and Center for Outcomes Research, UTHealth, Houston, TX, United States (Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China (Meng) Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, United States Publisher BMJ Publishing Group Abstract Objective: To assess whether perioperative management guided by near-infrared spectroscopy to determine tissue oxygen saturation and haemodynamic monitoring reduces postoperative complications after off-pump coronary artery bypass grafting. Design(s): Assessor blinded, single centre, randomised controlled trial (Bottomline-CS trial). Setting(s): A tertiary teaching hospital in China. Participant(s): 1960 patients aged 60 years or older who were scheduled for elective off-pump coronary artery bypass grafting. Intervention(s): All patients had multisite monitoring of tissue oxygen saturation (bilateral forehead and unilateral forearm brachioradialis) and haemodynamic monitoring. Both groups received usual care, including arterial blood pressure, central venous pressure, electrocardiography, and transoesophageal echocardiography when indicated. Guided care aimed to maintain tissue oxygenation within 10% above or below preoperative baseline values, established 24-48 hours before surgery, from the start of anaesthesia until extubation or for up to 24 hours postoperatively. In the usual care group, tissue oximetry and haemodynamic data were concealed, and care was routine. Main Outcome Measure(s): The primary outcome was the incidence of a composite of 30 day postoperative complications, which were cerebral, cardiac, respiratory, renal, infectious, and mortality complications. Secondary outcomes included the individual components of the composite outcome, new-onset atrial fibrillation, and hospital length of stay. Result(s): Of 1960 patients randomly assigned, data from 967 guided care and 974 usual care patients were analysed. During anaesthesia, the area under the curve for tissue oxygen saturation measurements outside the plus and minus 10% baseline range was significantly smaller with guided care than only usual care: left forehead 32.4 versus 57.6 (%xmin, P<0.001), right forehead 37.9 versus 62.6 (P<0.001), and forearm 14.8 versus 44.7 (P<0.001). The primary composite outcome occurred in 457/967 (47.3%) patients in the guided care group and 466/974 (47.8%) patients in the usual care group (unadjusted risk ratio 0.99 (95% confidence interval 0.90 to 1.08), P=0.83). No secondary outcomes differed significantly between groups. The largest observed difference was in incidence of pneumonia, which was less frequent in the guided care group (88/967, 9.1%) than in the usual care group (121/974, 12.4%) and not statistically significant after adjusting for multiple comparisons. Conclusion(s): Guided care by use of multisite near-infrared spectroscopy and haemodynamic monitoring effectively maintained tissue oxygenation near baseline levels compared with usual care. However, no clear evidence was noted that this approach reduced the incidence of major postoperative complications. These findings do not support the routine use of near-infrared spectroscopy and haemodynamic monitoring to maintain tissue oxygenation during off-pump coronary artery bypass grafting. Trial registration: ClinicalTrials.gov NCT04896736. Copyright © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. <57> Accession Number 2047633683 Title Aortocoronary Versus Composite Grafting Strategies in Coronary Artery Bypass Surgery: A Network Meta-analysis. Source Canadian Journal of Cardiology. 42(11) (pp 2744-2755), 2026. Date of Publication: 01 Nov 2026. Author Gupta A.K.; Zaka A.; Tyagi D.; Chang S.; Burton E.; Munir L.; Mutahar D.; Ren J.; Stretton B.; Kovoor J.G.; Bacchi S.; Edwards S.; Kovoor P.; Maddern G.J.; Bennetts J.S.; Vallely M.P. Institution (Gupta, Stretton, Kovoor, Bacchi, Edwards, Maddern) School of Medicine, University of Adelaide, Adelaide, SA, Australia (Gupta, Zaka, Mutahar) Department of Surgery, Gold Coast University Hospital, Southport, QLD, Australia (Tyagi) School of Medicine, University of Newcastle, Newcastle, NSW, Australia (Chang, Munir) School of Medicine, Griffith University, Southport, QLD, Australia (Burton, Kovoor, Bacchi) Department of Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia (Ren) Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, VIC, Australia (Kovoor) Department of Cardiology, Westmead Hospital, Westmead, New Soth Wales, Australia (Maddern) Royal Australasian College of Surgeons, Adelaide, SA, Australia (Bennetts) Department of Cardiothoracic Surgery, Flinders Medical Centre, Adelaide, SA, Australia (Bennetts) School of Medicine, Flinders University, Adelaide, SA, Australia (Vallely) Department of Cardiothoracic Surgery, St George Hospital, Sydney, NSW, Australia Publisher Elsevier Inc. Abstract Coronary artery bypass graft surgery (CABG) has traditionally used an in situ left internal mammary artery (LIMA) graft to the left anterior descending artery (LAD), in addition to aortocoronary anastomoses to graft non-LAD target vessels. Composite grafting provides an opportunity to avoid aortic anastomoses by using nonaortic anastomoses to provide greater efficiency in the use of conduits for improved all-cause mortality and reduced aortic manipulation to lower the incidence of postoperative stroke. In this study we performed a network meta-analysis (NMA) to compare aortocoronary and various composite grafting strategies for CABG. A systematic search of 6 electronic databases identified all publications reporting outcomes of CABG with aortocoronary or composite grafting strategies. The primary outcome was in-hospital or 30-day all-cause mortality, and studies that reported these were included in our NMA. The study protocol was registered with PROSPERO (CRD42023402665) and conformed with PRISMA 2020 and MOOSE guidelines. A systematic search of 6 electronic databases identified all publications reporting outcomes of the included operations. A total of 6656 articles were screened, 24 of which (8 RCTs and 16 observational studies) were included with a total of 9692 patients. There was no difference in conventional aortocoronary anastomosis and composite grafting for the outcome of in-hospital or 30-day all-cause mortality ( P = 0.387). There was also no difference in rates of stroke ( P = 0.277), myocardial infarction ( P = 0.09), reoperation for bleeding ( P = 0.500), postoperative atrial fibrillation ( P = 0.219), and deep sternal wound infection ( P = 0.549). This Bayesian NMA of 9692 patients demonstrated that composite grafting CABG can be performed as safely as conventional aortocoronary CABG. Prospero Registration CRD42023402665. Copyright © 2026 The Authors. <58> Accession Number 2050064887 Title Chlorhexidine within a standardized oral-care bundle for the prevention of ventilator-associated pneumonia: a pragmatic cluster-randomized crossover trial in six medical intensive care units. Source Critical Care. 30(1) (no pagination), 2026. Article Number: 553. Date of Publication: 01 Dec 2026. Author Anushapreethi S.; Chhotray P.; Samal S.; Panda S.; Patnaik R.; Mishra S.B. Institution (Anushapreethi, Samal, Panda, Mishra) Department of Critical Care Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Odisha, Bhubaneswar, India (Chhotray) Department of Respiratory Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Odisha, Bhubaneswar, India (Patnaik) Department of Critical Care Medicine, Medeor 24x7 Hospital, Abu Dhabi, United Arab Emirates Publisher BioMed Central Ltd Abstract Background: Chlorhexidine (CHX) has been a long-standing component of oral-care bundles for preventing ventilator-associated pneumonia (VAP), but recent evidence has questioned its benefit in non-cardiac-surgery ICU. We evaluated whether adding 0.12% CHX to standardized oral-care bundle provides incremental benefit in a mixed medical ICU. Method(s): We conducted a prospective, pragmatic cluster-randomized crossover (AB/BA) trial in six adult medical ICUs of a single tertiary-care academic hospital in Bhubaneswar, India. ICUs were randomized as three ICUs of two Period of 9 months with the multicomponent oral-care bundle without chlorhexidine and three with the same bundle plus 0.12% chlorhexidine with a 1-month wash-in and re-training interval. Consecutive adults ventilated for >= 48 h were included. The primary outcome was VAP incidence density (Clinical Pulmonary Infection Score (CPIS) > 6) as per 1,000 ventilator-days. Secondary outcomes were 28-day all-cause mortality, duration of mechanical ventilation, ICU length of stay, 28- day ventilator-free days, Beck Oral Assessment Scale (BOAS) and Critical-Care Pain Observation Tool (CPOT) scores. The primary model was a population-averaged Poisson generalized estimating equation (GEE) and adjustment for treatment, period, sequence, age, sex, APACHE II, and SOFA. Result(s): A total of 1,035 patients (637 No CHX, 398 CHX) accrued 10,024 ventilator-days (5,918 vs. 4,106). Groups were well balanced at baseline (mean age = 55 years; APACHE II = 19.6; SOFA = 13.4). VAP occurred in 100/5,918 ventilator-days (16.9 per 1,000) vs. 77/4,106 (18.8 per 1,000) (No CHX vs. CHX). The adjusted Poisson incidence rate ratio was 1.08 (95% CI 0.84-1.38; p = 0.56). 28-day mortality was 28.7% vs. 26.4% (no CHX vs. CHX) (adjusted OR 0.87, 95% CI 0.65-1.15; p = 0.33). ICU length of stay was longer in the CHX arm (adjusted mean difference + 0.89 days, 95% CI + 0.19 to + 1.58; p = 0.013). BOAS and CPOT scores did not differ. Conclusion(s): In this trial, adding 0.12% chlorhexidine to a standardized oral-care bundle did not reduce VAP incidence density or 28-day mortality and was associated with a modest increase in ICU length of stay. Routine CHX use provided no clear incremental benefit in a mixed medical ICU population. Trial registration: Clinical Trials Regisrty- India (CTRI) identifier [CTRI/2024/02/062201], registered [01 February 2024]. Copyright © The Author(s) 2026. <59> Accession Number 2050092116 Title Elevated Lipoprotein(a) Predicts Recurrent Myocardial Infarction in Diabetic Patients Following Acute Coronary Syndromes. Source Clinical Cardiology. 49(11) (no pagination), 2026. Article Number: e70480. Date of Publication: 01 Nov 2026. Author Echeverria-Ortegon E.; Torres-Chavez M.C.; Tejeda A.P.-T.; Caballero-Osorno P.; Pastor-Cervantes J.; Laviada-Molina H. Institution (Echeverria-Ortegon, Caballero-Osorno, Laviada-Molina) School of Health Sciences, Universidad Marista de Merida, Yucatan, Merida, Mexico (Torres-Chavez) Facultad de Medicina Mexicali, Universidad Autonoma de Baja California, Baja California, Mexicali, Mexico (Tejeda) Memorial Healthcare System, Hollywood, FL, United States (Pastor-Cervantes) Department of Cardiovascular Disease, Memorial Healthcare System, Hollywood, FL, United States Publisher John Wiley and Sons Inc Abstract Background: Patients with type 2 diabetes mellitus (T2DM) who experience acute coronary syndromes (ACS) remain at high risk for recurrent ischemic events despite secondary prevention. Lipoprotein(a) [Lp(a)] contributes to residual cardiovascular risk, but its prognostic impact on recurrent myocardial infarction (MI) and repeat revascularization in diabetic patients after ACS or percutaneous coronary intervention (PCI) remains unclear. Hypothesis: We hypothesized that elevated Lp(a) is associated with increased risk of recurrent MI and repeat coronary revascularization in patients with diabetes after ACS or PCI. Method(s): We conducted a PRISMA-guided systematic review and meta-analysis. PubMed, EBSCOhost, and Cochrane Library were searched for studies evaluating Lp(a) and recurrent cardiovascular outcomes in patients with diabetes after ACS or PCI. Observational studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) were included. Pooled HRs were calculated using random-effects models. Result(s): Seven studies comprising 7887 patients with diabetes and prior ACS or PCI were included. Elevated Lp(a) was associated with increased risk of recurrent MI (pooled HR 2.17, 95% CI 1.02-4.62; I2 = 75%) but not repeat coronary revascularization (pooled HR 1.68, 95% CI 0.79-3.57; I2 = 78%). Conclusion(s): Elevated Lp(a) was associated with increased risk of recurrent MI in patients with diabetes after ACS or PCI. Findings should be interpreted considering the observational study designs, substantial heterogeneity, and limited evidence for repeat revascularization. These findings support Lp(a) as a contributor to residual cardiovascular risk and its potential role in post-ACS risk stratification. Trial Registration: This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD420261296821). Copyright © 2026 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC. <60> Accession Number 2047849201 Title Multimodality Intravascular Imaging Guidance (NIRS-IVUS-OCT) Compared to Angiography-Guided Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction: The NIRVUS Trial. Source Catheterization and Cardiovascular Interventions. 108(4) (pp 1322-1336), 2026. Date of Publication: 01 Oct 2026. Author Noori M.; Hougaard M.; Maehara A.; Troan J.; Hansen K.N.; Junker A.; Hansen H.S.; Veien K.; Ellert J.; Lassen J.F.; Jensen L.O. Institution (Noori, Hougaard, Troan, Hansen, Junker, Hansen, Veien, Ellert, Lassen, Jensen) Department of Cardiology, Odense University Hospital, Odense, Denmark (Maehara) Department of Cardiology, Columbia University Medical Center and Cardiovascular Research Foundation, NY, United States Publisher John Wiley and Sons Inc Abstract Background: Imaging-guided percutaneous coronary intervention (PCI) improves outcomes, but the clinical utility of near-infrared spectroscopy (NIRS) remains unclear. Aim(s): The aim of the study was to evaluate whether multimodality imaging with NIRS, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) would improve stent strut coverage compared with angiography-guided PCI in patients with acute myocardial infarction (MI) and further to assess the impact of lipid-rich plaque (LRP) on vascular healing. Method(s): A total of 104 patients with MI were randomized to imaging- or angiography-guided PCI. NIRS-IVUS imaging was performed pre- and post-PCI, and OCT post-PCI and at 6-month follow-up. Maximum lipid core burden index in a 4-mm segment (maxLCBI<inf>4 mm</inf>) was measured. The primary endpoint was percentage of covered stent struts (OCT) at 6-month follow-up. Result(s): Pre-PCI maxLCBI<inf>4 mm</inf> was similar in the two groups (441 [239, 565] vs. 333 [242, 517], p = 0.19). Imaging guidance resulted in a larger minimal stent area (7.3 +/- 2.4 mm2 vs. 6.5 +/- 1.7 mm2, p = 0.04). At 6-month follow-up, stent strut coverage was higher in the imaging group (86.9% [77.7, 93.7] vs. 74.4% [53.8, 81.8], p < 0.001). Segment-level analyses showed that LRP without superficial attenuation and suboptimal stent expansion was associated with higher percentage of intima hyperplasia (23.4% [20.5, 25.9] vs. 13.9% [10.6, 16.0], p < 0.001) compared to optimal stent expansion, whereas LRP with attenuation and suboptimal stent expansion was associated with higher rates of late-acquired stent malapposition (81.8% vs. 30.0%, p = 0.02) compared to optimal stent expansion. Conclusion(s): Imaging-guided PCI improved stent strut coverage. LRP phenotypes were associated with different healing patterns. Clinical Trial Registration Information: Clinical Trial Registration Information: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04460482. Copyright © 2026 Wiley Periodicals LLC. <61> Accession Number 2050569823 Title Comment on "Rationale and design of a pilot randomized control trial of permissive hypotension after cardiac surgery: The PHACS trial". Source American Heart Journal Plus: Cardiology Research and Practice. 71 (no pagination), 2026. Article Number: 100948. Date of Publication: 01 Nov 2026. Author Kalpana T.; Silpa C.; Manukonda M.; Ponmani A. Institution (Kalpana) College of Nursing, Sri Padmavati Mahila Visvavidyalayam Women's University, Tirupati, India (Silpa) Department of Community Health Nursing, Apollo College of Nursing, Chittoor, India (Manukonda) (Ponmani) Vikram College of Nursing, Madurai, India Publisher Elsevier Inc. <62> Accession Number 2051225556 Title Remimazolam Versus Propofol for Anesthesia Induction and Maintenance in Adult Cardiac Surgical Patients: A PRISMA-Compliant Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Yao Y.-T.; Huang S.; Wang H.-B.; Chao M.; More A.; Allafy L.; Liu K.-X.; Gao S.-S. Institution (Yao, Huang, Wang, Liu, Gao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Yao, Huang, Liu, Gao) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Yao, Chao, More, Allafy) Center for Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Yao, Chao, More, Allafy) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To compare remimazolam-based with propofol-based anesthesia for induction and maintenance in adult cardiac surgery. Design(s): Systematic review and meta-analysis of randomized controlled trials. Setting(s): Cardiovascular centers. Participant(s): Adults undergoing cardiac surgery. Intervention(s): Remimazolam-based versus propofol-based general anesthesia for induction and maintenance. Measurements and Main Results: Fourteen reports describing randomized trials, including three theses, contributed 1,773 reported participants to the primary synthesis. All were conducted in China, and no key pooled result was supported exclusively by results at low risk of bias. One terminated European registry-results trial (23 treated patients) was included as supplementary sensitivity evidence. Data on major postoperative morbidity and mortality were too sparse to pool. Remimazolam was associated with fewer trial-defined intraoperative hypotension events (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.20-0.47; p < 0.001; I2 = 0%) and fewer bradycardia events (OR, 0.20; 95% CI, 0.12-0.34; p < 0.001; I2 = 0%). It was also associated with shorter mechanical ventilation duration (mean difference [MD], -1.84 hours; 95% CI, -2.34 to -1.35 hours; p < 0.001; I2 = 71%). Hospital length of stay crossed the line of no effect (MD, -0.48 days; 95% CI, -0.99 to 0.02 days; p = 0.06; I2 = 37%). Certainty of evidence was very low for the hemodynamic and mechanical ventilation findings. Conclusion(s): Across the cardiac surgical populations represented in the included trials, remimazolam was associated with fewer trial-defined intraoperative hypotension and bradycardia events and shorter mechanical ventilation duration. The certainty of evidence for these associations was very low. The evidence does not establish improved major morbidity or mortality. Future multicenter confirmation is required. Copyright © 2026 Elsevier Inc. <63> Accession Number 2051099375 Title Effects of Pharmacological and Surgical Treatments on Mitral Regurgitation Regression and Left Heart Structures: A Meta-Analysis. Source Cardiovascular Innovations and Applications. 11(Supplement 1) (no pagination), 2026. Article Number: 37. Date of Publication: 2026. Author Li H.; Wang S.; Liu W.; Liu J.; Peng Y.; Chen Q. Institution (Li, Wang) Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China (Chen, Liu, Peng) Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China (Liu) Department of Cardiology, Guangdong Second Provincial General Hospital, Guangzhou, China (Chen) Department of Cardiology, Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China Publisher Compuscript Ltd Abstract Background: An integrated evaluation of medical therapy and surgical intervention for mitral regurgitation (MR) regression is necessary. Method(s): Eligible studies in five electronic databases were screened by two independent reviewers. Relative risk (RR) was calculated for an echocardiographic MR grade <= 2+, and the standard mean difference (SMD) was calculated for the percentage change in MR severity and left ventricular/atrial volume with random-effects models. Result(s): A total of 24 RCTs including 3711 patients were collected. Overall medical therapy decreased MR area (SMD = -1.13) and volume (SMD = -0.76), whereas angiotensin receptor and neprilysin inhibitors (SMD = -0.49) and sodium glucose cotransporter-2 inhibitors (SMD = -0.70) had better performance, on the basis of decreased left atrial volume. Transcatheter mitral valve repair (TMVr) performed similarly to mitral valve surgery (MVS) (RR = 0.99) but better than nonsurgical controls (RR = 3.02), according to 12-month MR grade <= 2+. The addition of MVS to coronary artery bypass grafting was associated with more <= 2+ MR (RR = 1.66) and lower left ventricular volume (SMD = -0.49) (all P < 0.05). A network meta-analysis supported the 12-month benefits of TMVr and MVS for nonrecurrent MR. Conclusion(s): TMVr and MVS were associated with nonrecurrent MR, and medical therapy also decreased MR. The combination of medication and surgery might potentially be beneficial to reduce left heart size and to preserve its output. Copyright © 2026 The Authors <64> Accession Number 2049925274 Title Effect of Preoperative Intranasal Dexmedetomidine on Postoperative Myocardial Injury in Patients Undergoing Coronary Artery Bypass Grafting. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 644667. Date of Publication: 2026. Author Li Q.; Hu S.; Fu Y.; Shen L.; Xiong B.; Qi D. Institution (Li, Hu, Fu, Shen, Xiong, Qi) Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Jiangsu, Xuzhou, China (Li, Hu, Fu, Shen, Xiong, Qi) Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, Xuzhou, China Publisher Dove Medical Press Ltd Abstract Purpose: To evaluate the effects of preoperative intranasal dexmedetomidine on postoperative myocardial injury biomarkers in patients undergoing on-pump coronary artery bypass grafting (CABG). Patients and Methods: In this randomized, double-blind, placebo-controlled trial, 70 patients undergoing on-pump CABG were assigned to receive intranasal dexmedetomidine (1 mug/kg) or saline 30 min before bedtime on the night before surgery and again 30 min before anesthesia induction. The primary outcome was serum high-sensitivity cardiac troponin T (hs-cTnT) at 24 h after surgery. Secondary outcomes included perioperative cardiac biomarkers, preoperative sleep quality, postoperative delirium, and adverse events. Result(s): For the prespecified primary outcome, hs-cTnT concentrations at 24 h after surgery were significantly lower in the dexmedetomidine group than in the control group (estimated marginal means, 170.29 vs 357.29 ng/L; P < 0.001). Postoperative creatine kinase-MB (CK-MB) concentrations were also lower in the dexmedetomidine group (all P < 0.05). N-terminal pro-B-type natriuretic peptide showed a significant group-by-time interaction (P = 0.030), although between-group differences at individual postoperative time points were not significant. The dexmedetomidine group had higher Leeds Sleep Evaluation Questionnaire scores (62 [60-64] vs 44 [41-50]; P < 0.001) and a lower incidence of postoperative delirium (14.3% vs 37.1%; P = 0.029). Adverse events, mechanical ventilation duration, and intensive care unit (ICU) length of stay did not differ significantly between groups. Conclusion(s): In this single-center trial, two-dose preoperative intranasal dexmedetomidine was associated with lower postoperative hs-cTnT and CK-MB concentrations, better subjective preoperative sleep quality, and a lower observed incidence of postoperative delirium. These findings are preliminary and require confirmation in larger, adequately powered multicenter randomized trials to determine whether the biomarker reductions translate into clinically meaningful cardiovascular benefits. Trial Registration: Chinese Clinical Trial Registry, ChiCTR2500111431. Copyright © 2026 Li et al. <65> Accession Number 2047415205 Title Screening and Treatment Using a Risk-Based Approach With NT-proBNP Guidance in Diabetes Mellitus. Source JACC: Heart Failure. 14(10) (no pagination), 2026. Article Number: 103153. Date of Publication: 01 Oct 2026. Author Subramanian V.; Patel K.V.; Suh J.M.; Willett D.; Kannan V.; Sadek A.; Vaduganathan M.; Butler J.; Bayes-Genis A.; Wang T.; Pandey A. Institution (Subramanian, Suh, Willett, Kannan, Sadek, Pandey) University of Texas Southwestern Medical Center, Department of Internal Medicine, Dallas, TX, United States (Patel) Houston Methodist DeBakey Heart & Vascular Center, Department of Cardiology, Houston, TX, United States (Vaduganathan) Brigham and Women's Hospital Heart and Vascular Center, Department of Medicine, Harvard Medical School, Boston, MA, United States (Butler) Baylor Scott and White Research Institute, Dallas, TX, United States (Butler) Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States (Bayes-Genis) Heart Institute, University Hospital Germans Trias i Pujol, CIBERCV, Badalona, Spain (Bayes-Genis) Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain (Wang) University of Michigan School of Medicine, Ann Arbor, MI, United States Publisher Elsevier Inc. Abstract Background Adults with type 2 diabetes mellitus (T2DM) have an elevated risk for developing heart failure (HF), but prescription rates of preventive therapies remain low. Objectives The purpose of this study was to evaluate the feasibility and effectiveness of a virtual cardio-kidney-metabolic (CKM) prevention strategy, including risk assessment and consultation for individuals with high risk of developing HF, to guide the prescription of preventive therapies. Methods The study included patients with T2DM and no history of HF who were seen by a participating primary care physician (PCP) and matched control patients. The intervention included PCP education, electronic health record-based recommendations for N-terminal pro-B-type natriuretic peptide (NT-proBNP) screening, and virtual CKM consultations among patients with high risk of developing HF based on the WATCH-DM score (>=12) or NT-proBNP (>=125 pg/mL). Key outcomes included prescription rate of CKM therapies (sodium-glucose cotransporter 2 inhibitors, glucagon-like-peptide-1 receptor agonists, or finerenone) during the 6-month follow-up period that were compared between the intervention and matched (age, sex, race, CKM risk factors, CKM therapies) control group identified retrospectively from the cohort of patients seen during the same study period by nonparticipating PCPs within the same practices. Results Among 545 patients (62.4% women; 33.6% Black), PCPs ordered NT-proBNP screening in 93.4% of patients, and 36.9% were identified as high risk for developing HF. NT-proBNP screening identified 16.7% additional patients as high-risk for HF who were deemed low risk based on WATCH-DM. Over the 180-day median follow-up, the intervention (vs matched control) group had significantly greater new prescriptions of sodium-glucose cotransporter 2 inhibitors (20.3% vs 5.8%; P < 0.001) and finerenone (4.1% vs 0.2%; P < 0.001), with no significant difference in glucagon-like-peptide-1 receptor agonists initiation. Overall, the intervention group demonstrated a 3-fold higher rate of initiating any CKM therapy (4.33 vs 1.43 new prescriptions/100-person-months; incidence rate ratios [IRRs]: 3.03; 95% CI: 2.18-4.31; P < 0.001). The greater uptake of CKM therapies in the intervention compared with control group was driven by greater prescriptions among high-risk (IRR: 5.03; 95% CI: 3.06-8.77) vs low-risk patients (IRR: 1.82; 95% CI: 1.15-2.96; P interaction = 0.005). Conclusions Among adults with T2DM and high risk for developing HF, a virtual CKM prevention strategy was feasible and increased prescription rates of preventive therapies. This virtual CKM prevention strategy should be evaluated further in a randomized clinical trial. Copyright © 2026 American College of Cardiology Foundation. <66> Accession Number 2051240000 Title Long-Term Clinical Outcomes of Left Atrial Appendage Closure Versus Oral Anticoagulation in Atrial Fibrillation: An Updated Meta-Analysis and Trial Sequential Analysis. Source Critical Pathways in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Farooq F.; Fatima S.I.; Maaz Amjad M.; Amir Malik A.; Qazi T.I.; Khan H.W.; Niazi H.; Kotak P.; Rahat A.; Khan A.H.; Bashir M.S.; Abbas A.; Riaz Malik M.H.; Wahab L.; Muzamil Shaikh M.; Memon W.; Khan S.; Batool A.; Huzaifa Khattak M.; Khan B.W. Institution (Farooq, Fatima, Rahat, Bashir) Department of Medicine, Rawalpindi Medical University, Punjab, Rawalpindi, Pakistan (Maaz Amjad, Qazi, Khan, Huzaifa Khattak, Khan) Department of Medicine, Khyber Medical College, KPK, Peshawar, Pakistan (Amir Malik) Department of Medicine, United Medical and Dental College, Sindh, Karachi, Pakistan (Khan) Department of Medicine, King Edward Medical University, Punjab, Lahore, Pakistan (Niazi) Department of Medicine, Pak-Austria Fachhochschule Institute of Applied Sciences and Technology, KPK, Haripur, Pakistan (Kotak, Muzamil Shaikh, Memon) Department of Medicine, Liaquat University of Medical and Health Sciences, Sindh, Jamshoro, Pakistan (Khan) Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan (Abbas) Department of Medicine, Allama Iqbal Medical College, Punjab, Lahore, Pakistan (Riaz Malik) Department of Medicine, Narowal Medical College, Punjab, Narowal, Pakistan (Wahab) Department of Medicine, Dow Medical College, Sindh, Karachi, Pakistan (Batool) Department of Medicine, Sir Syed College of Medical Sciences, Sindh, Karachi, Pakistan Publisher Lippincott Williams and Wilkins Abstract Left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF), particularly among individuals at increased risk of bleeding. We performed an updated systematic review and meta-analysis of randomized controlled trials comparing the efficacy and safety of LAAC versus OAC in AF. PubMed, Embase, and Scopus were searched through May 2026. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model, and trial sequential analysis (TSA) was conducted to evaluate the sufficiency of cumulative evidence. Six randomized trials involving 7,004 patients were included. Compared with OAC, LAAC demonstrated similar risks of stroke, systemic embolism, cardiovascular death, all-cause mortality, and transient ischemic attack. LAAC showed a nominally higher risk of ischemic stroke or systemic embolization (RR 1.36, 95% CI 1.04-1.79), although this finding was not robust to sensitivity analysis, with a borderline increase in ischemic stroke. In contrast, LAAC significantly reduced non-procedural clinically relevant bleeding (RR 0.49, 95% CI 0.42-0.58), while major bleeding and hemorrhagic stroke were comparable between groups. TSA confirmed sufficient evidence supporting the reduction in bleeding outcomes but indicated that current evidence remains insufficient to establish definitive conclusions regarding thromboembolic efficacy. Overall, LAAC was not associated with statistically significant differences in several thromboembolic and mortality outcomes compared with OAC, while providing a substantial reduction in non-procedural clinically relevant bleeding. However, the potential signal toward increased ischemic events warrants further investigation in adequately powered randomized trials, particularly against contemporary DOAC-based therapy. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <67> Accession Number 2051136130 Title Intravenous and intra-arterial thrombolysis for acute ischemic stroke following interventional cardiac procedures: A systematic review and narrative synthesis. Source Therapeutic Advances in Neurological Disorders. 19 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author D'Anna L.; Prandin G.; Abu-Rumeileh S.; Favruzzo F.; Surcinelli A.; Simonetti R.; Ornello R.; Colantuono P.; Sacco S.; Di Sante F.; Di Pietro M.; Sensi S.L.; Tomassini V.; Strano S.; Toni D.; Miserocchi L.M.; Balducci G.; Piacaglia M.G.; Otto M.; Simister R.; Caulo M.; Zimarino M.; Meinel T.R.; Korompoki E.; Veltkamp R.; Bax F.; Valente M.; Gigli G.; Merlino G.; Russo M.; Foschi M. Institution (D'Anna, Korompoki, Veltkamp) Department of Brain Sciences, Imperial College London, London, United Kingdom (D'Anna) Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London NHS Healthcare Trust, London, United Kingdom (Prandin) Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Trieste, Italy (Abu-Rumeileh, Otto) Department of Neurology, Martin-Luther-University Halle-Wittenberg, (Saale), Halle, Germany (Favruzzo) Comprehensive Stroke Center, Ospedale dell'Angelo, Azienda ULSS 3 Serenissima, Mestre, Italy (Surcinelli, Miserocchi, Balducci, Piacaglia, Foschi) Department of Neurosciences, Stroke Unit - Neurology Unit, S.Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy (Simonetti) Unidad de Ictus, Hospital Universitario Vall d'Hebron, Barcelona, Spain (Ornello, Colantuono, Sacco) Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy (Di Sante, Di Pietro, Sensi) Department of Neurosciences, Imaging and Clinical Sciences, Institute of Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti-Pescara, Chieti, Italy (Tomassini) Department of Neurosciences, Imaging and Clinical Sciences, Centre for Disability, Rehabilitation and Sport Medicine (CARES), Institute of Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti-Pescara, Chieti, Italy (Strano) Department of Internal, Anesthesiological and Cardiovascular Clinical Sciences, Sapienza University, Rome, Italy (Toni) Emergency Department Stroke Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy (Simister) Comprehensive Stroke Service, University College London Hospital, London, United Kingdom (Caulo) Department of Neuroscience and Clinical Sciences, University of Chieti, Chieti, Italy (Zimarino, Russo) Department of Cardiology, SS. Annunziata Hospital, ASL2 Abruzzo, Chieti, Italy (Zimarino) Department of Neuroscience, Imaging and Clinical Sciences, "Gabriele d'Annunzio" University of Chieti-Pescara, Chieti, Italy (Meinel) Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland (Korompoki) Department of Clinical Therapeutics, National and Kapodistrian University of Athens Alexandra Hospital, Athens, Greece (Veltkamp) Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (Veltkamp) Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany (Bax, Valente, Gigli, Merlino) Clinical Neurology, Udine University Hospital, Department of Medicine (DAME), University of Udine, Udine, Italy (Merlino) Department Head, and Neurosciences, SOSD Stroke Unit, Udine University Hospital, Udine, Italy (Russo) Department1 of Cardiology, F. Renzetti Hospital, ASL2 Abruzzo, Lanciano, Italy Publisher SAGE Publications Ltd Abstract Background: Acute ischemic stroke is a rare but potentially devastating complication of interventional cardiac procedures, and evidence on thrombolysis remains limited. Objective(s): To systematically review intravenous and intra-arterial thrombolysis (IVT and IAT) for ischemic stroke during or after cardiac procedures, focusing on neurological, functional, mortality, and haemorrhagic outcomes. Design(s): Systematic review and narrative synthesis. Method(s): The review followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420261287481). PubMed, Scopus, and EMBASE were searched from inception to January 2026. Studies reporting periprocedural ischemic stroke treated with IVT and/or IAT were included. Prespecified outcomes were favourable functional outcome (modified Rankin Scale score 0-2 at approximately 90 days), all-cause mortality, and symptomatic intracranial haemorrhage; neurological improvement/recovery was additionally summarised post hoc. Result(s): Twenty-four studies including 85 thrombolysis-treated patients were included, predominantly case reports and small case series. Exact age was available for 38 patients (median 72 years, IQR 61.3-78.8) and sex for 69 (59.4% male). TAVI/TAVR was the most frequent setting (33/85, 38.8%). Stroke occurred during or immediately after the intervention in 21/38 patients (55.3%) with precise timing; large-vessel occlusion was identified in 33/47 (70.2%) with extractable vascular imaging data. Favourable functional outcome was reported in 11/18 patients (61.1%) with compatible approximately 90-day mRS data. Post-hoc neurological improvement/recovery was separately ascertainable in 43 patients and was reported in 33/43 (76.7%). All-cause mortality occurred in 9/68 (13.2%), major or clinically significant bleeding in 8/85 (9.4%), intracranial haemorrhage/haemorrhagic transformation in 6/85 (7.1%), and symptomatic intracranial haemorrhage in 1/35 (2.9%). Conclusion(s): Thrombolysis has been reported across heterogeneous cardiac procedural settings, but case-report predominance and substantial clinical and outcome heterogeneity preclude reliable estimates of effectiveness and safety. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <68> [Use Link to view the full text] Accession Number 2034995843 Title Effectiveness of Single Chest Tube vs Double Chest Tube Application Postdecortication: Prospective Randomized Controlled Study. Source Journal of the American College of Surgeons. 236(6) (pp 1217-1231), 2023. Date of Publication: 01 Jun 2023. Author Hart J.M.; Hussien A.M.; Tesfaye S.; Nadamo S.M.; Senbu M.F.; Wadaja D.F.; Bacha I.T.; Tebeje H.G. Institution (Hart, Bacha, Tebeje) Department of Surgery, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia (Hussien) Department of Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia (Tesfaye) Department of Surgery, Jimma University Medical Center, Jimma, Ethiopia (Nadamo) Department of Surgery, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia (Senbu, Wadaja) Department of Surgery, Adama Comprehensive Specialized Hospital and Medical College, Adama, Ethiopia Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: Draining the chest cavity with 2 tubes is a common practice among thoracic surgeons. This research was conducted in Addis Ababa from March 2021 to May 2022. A total of 62 patients were included. STUDY DESIGN: This study was conducted to investigate the superiority of either single or double tube insertion after decortication. Patients were randomized in a ratio of 1:1. In group A, 2 tubes were inserted; in group B, single 32F tubes were inserted. Statistical analyses were performed using Statistical Package for Social Sciences version 27.0, Student's t test and Pearson chi-square test. RESULT(S): The age range of patients was 18 to 70 years, with a mean of 44 +/- 14.4434 years; the male to female ratio was 2.9:1. The dominant underlying pathologies were tuberculosis and trauma (45.2% vs 35.5%); the right side was more involved (62.3%). Drain output was 1,465 +/- 1,887.9751 mL in group A vs 1,018 +/- 802.5662 mL in group B (p value = 0.00001); the duration of drains was 7.5498 +/- 11.3137 days in group A vs 3.8730 +/- 1.4142 days in group B (p value = 0.000042). The degree of pain was 2.6458 +/- 4.2426 vs 2.000 +/- 2.1213 in group A and group B, respectively (p value = 0.326757). The length of hospital stay was 21.5818 +/- 11.9791 days in group A vs 13.6091 +/- 6.2048 days in group B (p value = 0.00001). Group A had air leak of 90.3% vs 74.2% in group B; subcutaneous emphysema was 9.7% in group A and 12.9% in group B. There was no fluid recollection, and no patients required tube reinsertion. CONCLUSION(S): The placement of a single tube after decortication is effective in reducing drain output, time of drain, and hospital stay. There was no association with pain, and there was no effect on other endpoints. Copyright © 2023 The Author(s). <69> Accession Number 2051220662 Title Rigid Ring versus Flexible Band for Functional Tricuspid Regurgitation? Long-Term Survival and Tricuspid Regurgitation Recurrence Using Reconstructed Individual Patient Data Time-to-Event Analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Santos K.; Patel N.; Kim J.Y.B.K.; Malt H.H.E.; Comprido J.M.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A.; Sa M.P. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Kim) Faculty of Medical Sciences, Universidad Nacional de Asuncion, Asuncion, Paraguay (Malt) Faculty of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia (Comprido) Federal University of Mato Grosso do Sul Campo Grande, Mato Grosso do Sul, Brazil (Napoli, Brozzi, Navia, Polanco) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute, Cleveland Clinic Florida, Weston, FL, United States (Sa) Department of Surgery, Division of Cardiac Surgery, CHI Creighton University Medical Center Bergan-Mercy, Creighton University School of Medicine, Omaha, NE, United States Publisher W.B. Saunders Abstract Objectives: To compare long-term survival and recurrent tricuspid regurgitation (TR) following tricuspid valve repair (TVr) using flexible bands versus rigid rings for functional TR. Design(s): Systematic review and reconstructed individual patient data (IPD) meta-analysis with parallel study-level random-effects meta-analysis. Setting(s): Meta-analysis of published studies identified through PubMed, Scopus, and the Cochrane Library. Participant(s): A total of 4,407 adult patients from 11 studies undergoing TVr for functional TR; 59% received flexible bands. Intervention(s): Comparison of flexible band versus rigid ring annuloplasty. Time-to-event data were reconstructed from published Kaplan-Meier curves, and pooled hazard ratios were estimated using Cox frailty models. Propensity-matched subgroup analyses were performed. Measurements and Main Results: Primary outcome was long-term survival; secondary outcome was freedom from recurrent TR. Study-level meta-analysis showed no significant difference in survival between device types (HR 0.86; 95% CI 0.72-1.04; p = 0.110). In contrast, reconstructed IPD analysis demonstrated an association between flexible bands and improved long-term survival compared with rigid rings (HR 0.76; 95% CI 0.65-0.89; p < 0.001) and greater freedom from recurrent TR (HR 0.62; 95% CI 0.48-0.80; p < 0.001). No significant differences were observed in propensity-matched cohorts. Conclusion(s): Reconstructed IPD analyses demonstrated associations between flexible bands and improved long-term survival and greater freedom from recurrent TR; however, these associations were not confirmed in study-level or propensity-matched analyses. The available evidence therefore does not establish superiority of either annuloplasty strategy. Copyright © 2026 Elsevier Inc. <70> Accession Number 2050489841 Title Effects of two mechanical ventilation strategies during cardiopulmonary bypass on perioperative mechanical power: a prospective observational study. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1781255. Date of Publication: 30 Apr 2026. Author Akhmadalieva M.; Talih G.; Tuncay A.; Gunes I.; Ulgey A. Institution (Akhmadalieva, Talih, Gunes, Ulgey) Department of Anaesthesiology and Reanimation, Erciyes University Medical Faculty, Kayseri, Turkey (Tuncay) Department of Cardiovascular Surgery, Erciyes University Medical Faculty, Kayseri, Turkey Publisher Frontiers Media SA Abstract Background and aim - Cardiac surgery requiring cardiopulmonary bypass (CPB) is associated with a high rate of postoperative pulmonary complications (PPCs). Mechanical power (MP) represents energy per breath multiplied by respiratory rate and conversion factor (0.098), resulting in J/min. This prospective observational study aimed to investigate the effects of two ventilation strategies applied during CPB on MP and their association with PPCs. Methods - In this prospective observational study, ventilation during CPB was managed according to routine clinical practice. Ventilation was discontinued after full CPB flow in Group 1 (n = 125), while low-tidal volume ventilation (3 mL/kg) was maintained in Group 2 (n = 120). Mechanical power was measured before CPB (T1), after CPB (T2), and in the intensive care unit (T3). Patients were monitored for PPCs for 7 days postoperatively. Results - MP, the primary endpoint of the study, did not differ significantly between the two ventilation strategy groups at any measured time point. In a secondary exploratory analysis, MP values were higher at T2 and T3 in patients who developed PPCs (T2: 8.54 +/- 0.32 vs. 7.78 +/- 0.19 J/min, p = 0.041; T3: 8.67 +/- 0.33 vs. 7.82 +/- 0.19 J/min, p = 0.029). Conclusion - The two ventilation strategies applied during CPB did not significantly affect the primary outcome, mechanical power. Higher post-CPB MP values were observed in patients who developed PPCs, although this finding was exploratory. Copyright © 2026 Akhmadalieva, Talih, Tuncay, Gunes and Ulgey. <71> Accession Number 2050918329 Title Mental Health Factors in Cardiothoracic Surgery Risk Prediction Models: A Systematic Review. Source Journal of the American Heart Association. 15(20) (no pagination), 2026. Article Number: e052512. Date of Publication: 2026. Author Rios-Monterrosa J.; Artunduaga M.C.; Rasheed N.; Aguiar C.; Jr Castro S.; Jaime M.; Lang E.; Woodward A.; Sun L.Y. Institution (Rios-Monterrosa, Rasheed, Jr Castro, Sun) Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Stanford University School of Medicine, Stanford, CA, United States (Artunduaga) Universidad de los Andes, Bogota, Colombia (Aguiar) California Northstate University College of Medicine, Elk Grove, CA, United States (Jaime) Kaiser Permanente Bernard J, Tyson School of Medicine, Pasadena, CA, United States (Lang) University of Central Florida College of Medicine, Orlando, FL, United States (Woodward) Lane Medical Library, Stanford University School of Medicine, Stanford, CA, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Mental health disorders are associated with substantial morbidity and death in cardiovascular disease, yet their role in perioperative risk stratification remains unclear in patients undergoing cardiothoracic surgery. We evaluated how mental health disorders are currently incorporated into cardiothoracic surgery risk prediction models. METHOD(S): We conducted a Preferred Reporting Items for Systemic Reviews and Meta-Analysis-concordant systematic review of PubMed and Embase on September 11, 2025 (International Prospective Register of Systematic Reviews: CRD420251274958). We included studies that developed or validated risk models predicting postoperative outcomes in adults undergoing cardiothoracic surgery that either included a mental health disorder as a covariate or validated a model in patients with such disorders. Model characteristics were extracted using the Checklist for Critical Appraisal and Data Extraction for Systemic Reviews of Prediction Modeling Studies, and risk of bias and applicability were assessed using the Prediction Model Risk of Bias Assessment Tool+Artificial Intelligence. Findings were synthesized qualitatively. RESULT(S): Of 17 986 articles screened, 9 studies met inclusion criteria and described 17 unique models. No study validated a model specifically in patients with mental health disorders. Depression was the most frequently included mental health covariate (8 models). When incorporated, mental health disorders had associations comparable to established clinical risk factors. The most frequently modeled outcomes were hospital readmission and postoperative depression. Three studies had a high risk of bias. Covariate selection and modeled outcomes varied substantially. CONCLUSION(S): Mental health disorders are rarely incorporated into cardiothoracic surgery risk models despite potentially important prognostic associations. Future studies should evaluate their incremental predictive value, validate models in patients with mental health disorders, and examine intersections with sociodemographic risk factors. 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. <72> Accession Number 2050579152 Title Emergency medicine pharmacotherapy literature of 2025. Source American Journal of Emergency Medicine. 110 (pp 612-621), 2026. Date of Publication: 01 Dec 2026. Author Porter B.A.; Faine B.; Zimmerman D.E.; Sarangarm P.; Flack T.; Howington G.T.; Laub J.; Slocum G.W.; Zepeski A.; Santiago R.D.; Woolum J.; Krenz J.R.; Mattson A.E.; Mercer K.; Feldman R. Institution (Porter) Department of Pharmacy, University of Vermont Medical Center, 111 Colchester Ave., Burlington, VT, United States (Faine) Department of Emergency Medicine and Pharmacy Practice, University of Iowa, Iowa City, IA, United States (Zimmerman) Duquesne University School of Pharmacy, University of Pittsburgh Medical Center-Mercy Hospital, Room 311 School of Pharmacy Building, 600 Forbes Avenue, Pittsburgh, PA, United States (Sarangarm) Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, United States (Flack) Department of Pharmacy, IU Health Methodist Hospital, Indianapolis, IN, United States (Howington, Woolum) Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, United States (Laub) Department of Pharmacy, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, United States (Slocum) Departments of Emergency Medicine and Pharmacy, Rush University Medical Center, Chicago, IL, United States (Zepeski) Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States (Santiago, Krenz) Department of Pharmacy, Jackson Memorial Hospital, Miami, FL, United States (Howington, Woolum) Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, United States (Mattson) Departments of Pharmacy and Emergency Medicine, Mayo Clinic, Rochester, MN, United States (Mercer) The University of Texas at Austin College of Pharmacy, Austin, TX, United States (Mercer) Emergency Medicine Pharmacist, HCA Houston Healthcare Kingwood, Kingwood, TX, United States (Mercer) Research Coordinator, UTMB Southeast Texas Poison Center, Galveston, TX, United States (Feldman) Medical College of Wisconsin School of Pharmacy, Froedtert Thedacare and the Medical College of Wisconsin, Wisconsin Poison Center, Milwaukee, WI, United States (Feldman) Department of Emergency Medicine, Medical College of Wisconsin, Wisconsin Poison Center, Milwaukee, WI, United States Publisher W.B. Saunders Abstract The purpose of this article is to summarize pharmacotherapy-related emergency medicine (EM) literature indexed in 2025. Articles were selected using a modified Delphi approach. The table of contents from predetermined journals were reviewed and independently evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system by paired authors. Pharmacotherapy-related publications deemed to be GRADE 1A and 1B were reviewed by the collective group for inclusion in the review. This article synthesizes and evaluates findings from 7 randomized controlled trials, 10 guidelines, clinical policies, position statements, or consensus recommendations, and 11 meta-analyses, providing critical insight into their potential clinical impact. Covered topics include guideline or policy updates on advanced cardiac life support, rapid sequence intubation, tranexamic acid in trauma, acute coronary syndromes, and hypertension. Randomized controlled trials covering sedative use in rapid sequence intubation, treatment of sexually transmitted infections and bacterial vaginosis, sodium bicarbonate for severe acidemia and acute kidney injury in the critically ill, and thrombolytic therapy beyond traditional time windows for ischemic stroke are also reviewed. Additional topics include nebulized and low-dose ketamine for analgesia, erector spinae plane block for renal colic, two-bag versus three-bag acetylcysteine regimens for acetaminophen overdose, QT prolongation in antipsychotic overdose, and naltrexone for opioid dependence. Copyright © 2026 Elsevier Inc. <73> Accession Number 2049994304 Title Dexmedetomidine Versus Dexamethasone in Pediatric Cardiac Surgery with Cardiopulmonary Bypass: An Exploratory Randomized Controlled Trial of Inflammatory Biomarkers and Opioid Consumption. Source Healthcare (Switzerland). 14(20) (no pagination), 2026. Article Number: 3468. Date of Publication: 01 Oct 2026. Author Salama M.A.; Al Dammas F.K.; AlDhuwaihy A.; Alanezi K.; Alshuwaier F.; Almedlej N.; AbdelTwab H.; ElTantawi N.; Sabri R.A.; Alaidy A.; Jamous Y.F. Institution (Salama, Alaidy) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Al Dammas) Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Saudi Arabia (AlDhuwaihy, Alanezi, Alshuwaier, Almedlej) College of Medicine, King Saud University, Riyadh, Saudi Arabia (AbdelTwab) Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt (ElTantawi) Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Sabri) Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Jamous) Wellness and Preventive Medicine Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Cardiopulmonary bypass (CPB) triggers a systemic inflammatory response in children undergoing congenital heart surgery. Although dexmedetomidine has been proposed as an alternative to corticosteroids, the two agents have not previously been directly compared in a pediatric randomized trial. This study aimed to compare the effects of dexmedetomidine and dexamethasone on inflammatory biomarkers and analgesic outcomes in children undergoing congenital heart surgery with CPB. Method(s): In this prospective, randomized, controlled exploratory trial, 50 children aged 6 months to 18 years undergoing elective congenital heart surgery with CPB were randomized 1:1 to dexamethasone (n = 25) or dexmedetomidine (n = 25), using institutional regimens that were not equipotent anti-inflammatory doses. Serum interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured at baseline, immediately after separation from CPB (post-CPB), and 12 h postoperatively. The primary endpoint was IL-6 at the two postoperative time points; IL-8 was a secondary biomarker outcome. Secondary outcomes also included Face, Legs, Activity, Cry, Consolability (FLACC) pain scores, fentanyl consumption, and time to first rescue analgesia. Effect estimates included Hodges-Lehmann (HL) median differences with 95% confidence intervals (CIs); a post hoc baseline-adjusted mixed-effects model of log-transformed concentrations served as a sensitivity analysis. Secondary and exploratory analyses were not adjusted for multiple comparisons. Result(s): All 50 randomized children were analyzed. Median IL-6 was lower in the dexmedetomidine group at 12 h (50 vs. 178 pg/mL; HL difference 86 pg/mL, 95% CI 59 to 144; p < 0.001); the post-CPB difference (46 vs. 77 pg/mL; HL difference 34 pg/mL, 95% CI 0 to 112; p = 0.045) was imprecise and not significant after post hoc Bonferroni correction for the two primary comparisons. In the post hoc baseline-adjusted sensitivity model, the ratio of geometric mean IL-6 concentrations (dexmedetomidine/dexamethasone) was 0.35 (95% CI 0.22 to 0.58; p < 0.001). Among secondary and exploratory outcomes, for which p-values are nominal, IL-8 was also lower post-CPB (159 vs. 381 pg/mL; p = 0.001) and at 12 h (120 vs. 311 pg/mL; p = 0.002). Dexmedetomidine was associated with lower intraoperative (83.0 +/- 30.7 vs. 142.6 +/- 51.7 microg; p < 0.001) and cumulative 24-h fentanyl consumption (53.8 +/- 17.4 vs. 105.4 +/- 32.8 microg; p < 0.001), analyzed in absolute units with incompletely documented intraoperative doses, and a longer time to first rescue analgesia (4.68 +/- 0.73 vs. 1.84 +/- 0.23 h; p < 0.001). Time to extubation did not differ significantly (median 2 vs. 1 h; p = 0.204). Intensive care unit length of stay, an exploratory outcome recorded in days, was distributed toward shorter stays with dexmedetomidine (median 2 [interquartile range 1-2] vs. 2 [2-3] days; p = 0.007). No pre-specified adverse events occurred in either group, although the trial was too small to exclude clinically important safety differences. Conclusion(s): In this exploratory trial of two non-equipotent institutional regimens, dexmedetomidine was associated with lower early postoperative IL-6 and IL-8 concentrations and lower opioid consumption than dexamethasone. These hypothesis-generating biomarker and analgesic signals do not demonstrate therapeutic superiority or patient-centered clinical benefit and require confirmation in larger, adequately powered multicenter trials. Copyright © 2026 by the authors. <74> Accession Number 2050936505 Title Impact of social determinants of health on perioperative and interstage outcomes in congenital heart surgery a systematic review. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1881839. Date of Publication: 2026. Author Sakowitz S.; Nelson J.S.; Robinson J.; Rossi C.S.; Shahian D.M.; Cooke D.T.; Jacobs J.P.; Aughtman S.; Schultz M.; Nathan M.; Beaty C.; Shafer M.; Kozik D.; Pelletier G.J. Institution (Sakowitz) Department of Surgery, University of California, Los Angeles, CA, United States (Nelson) Department of Cardiovascular Services, Nemours Children's Hospital, Orlando, FL, United States (Nelson) Department of Surgery, University of Central Florida College of Medicine, Orlando, FL, United States (Robinson) Division of Cardiothoracic Surgery, University of Maryland School of Medicine, Baltimore, MD, United States (Rossi) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Shahian) Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Cooke) Division of General Thoracic Surgery, University of California, Davis, Sacramento, CA, United States (Jacobs) Division of Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, FL, United States (Aughtman) Department of Surgery, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States (Schultz) Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States (Nathan) Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, United States (Nathan) Department of Surgery, Harvard Medical School, Boston, MA, United States (Beaty) Nemours Children's Health, Delaware Valley, Wilmington, DE, United States (Shafer) Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, UT, United States (Kozik) Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, United States (Pelletier) Department of Cardiothoracic Surgery, Stanford School of Medicine, Stanford, CA, United States Publisher Frontiers Media SA Abstract Importance - Social determinants of health (SDoH)- conditions in which patients live, grow, and age, -are increasingly recognized to influence the health of patients with congenital heart disease (CHD). Objective - To explore the impact of SDoH on short-term mortality and morbidity, interstage outcomes, and resource utilization, among patients following congenital heart surgery. Evidence review - A systematic review was completed according to PRISMA guidelines. Relevant studies evaluating the association of SDoH with surgical outcomes of pediatric and adult CHD patients were identified from five databases queried including PubMed, SCOPUS, CINAHL, PYSCINFO, and Cochrane between January 1999 and February 2024. Inclusion criteria incorporated prior systematic reviews and meta-analyses, secondary analyses of prospectively collected trial data, and prospective or retrospective cohort studies. Subsequent reference searches identified 39 related articles. SDoH included patient and neighborhood level metrics. Two independent reviewers screened studies for full-text review, with data extraction by an expert panel. Findings - Among 1, 224 studies identified, 157 articles underwent full-text review and 121 were ultimately selected for data extraction. Eighty-Five articles did not address acute postoperative outcomes and were excluded. Thirty-six studies focused on acute or interstage outcomes following congenital heart surgery and served as the source information. The remainder were retrospective cohort studies using various databases. The number of study participants ranged from 98 to 174, 352 (median = 6, 979). Factors found to be linked with greater likelihood of in-hospital mortality included Black race, Hispanic/Latino ethnicity, Medicaid insurance, and lower neighborhood socioeconomic status. Both individual and neighborhood level determinants were associated with longer interstage periods, higher complication rates, as well as greater resource utilization and hospital readmissions. Two critical timespans for intervention to reduce inequities in care were the neonatal period and young adulthood. Conclusions and relevance - SDoH impact both acute and interstage outcomes in patients following surgery for CHD. Developing interventions to increase access to and engagement with quality care and out-of-hospital support may improve both short-term outcomes and reduce systems-level financial burden. Systematic Review Registration: Copyright © 2026 Sakowitz, Nelson, Robinson, Rossi, Shahian, Cooke, Jacobs, Aughtman, Schultz, Nathan, Beaty, Shafer, Kozik and Pelletier. <75> Accession Number 2039124818 Title Use of the Ostial Flash Balloon in Aorto-Ostial Chronic Total Occlusion Percutaneous Coronary Intervention. Source Journal of Invasive Cardiology. 37(5) (no pagination), 2025. Date of Publication: 05 Jan 2025. Author Mutlu D.; Strepkos D.; Carvalho P.E.; Alexandrou M.; Al-Ogaili A.; Jalli S.; Alaswad K.; Jaffer F.A.; Davies R.; Poommipanit P.; Frizzel J.; Elbarouni B.; Khatri J.J.; Gorgulu S.; Goktekin O.; Ozdemir R.; Uluganyan M.; ElGuindy A.; Sadek Y.; Ahmad Y.; Basir M.B.; Raj L.; Ybarra L.; Murad B.; Rangan B.V.; Mastrodemos O.C.; Azzalini L.; Sandoval Y.; Burke M.N.; Brilakis E.S. Institution (Mutlu, Strepkos, Carvalho, Alexandrou, Al-Ogaili, Jalli, Murad, Rangan, Mastrodemos, Sandoval, Burke, Brilakis) Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States (Alaswad, Basir) Henry Ford Cardiovascular Division, Detroit, MI, United States (Jaffer) Massachusetts General Hospital, Boston, MA, United States (Davies) WellSpan York Hospital, York, PA, United States (Poommipanit) University Hospitals, Case Western Reserve University, Cleveland, OH, United States (Frizzel) The Christ Hospital, Cincinnati, OH, United States (Elbarouni) St. Boniface General Hospital, Winnipeg, MB, Canada (Khatri) Cleveland Clinic, Cleveland, OH, United States (Gorgulu) Biruni University Medical School, Istanbul, Turkey (Goktekin) Memorial Bahcelievler Hospital, Istanbul, Turkey (Ozdemir, Uluganyan) Bezmialem Vakif University, Istanbul, Turkey (ElGuindy) Aswan Heart Center, Magdi Yacoub Foundation, Egypt (Sadek) National Heart Center, Cairo, Egypt (Ahmad) Yale University, New Haven Hospital, New Haven, CT, United States (Raj) Vanderbilt University, Nashville, TN, United States (Ybarra) Western University, London, ON, Canada (Azzalini) University of Washington, Seattle, WA, United States Publisher Cliggott Publishing Co. Abstract Background. The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI). Methods. The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436). Results. The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.0%). The mean patient age was 65.1 +/- 10.7 and 80.6% were men, with a high prevalence of diabetes mellitus, hypertension, prior PCI, and prior myocardial infarction. The mean occlusion length was 40.5 +/- 25.1 mm, 52.2% had moderate to severe calcification, and the mean Japanese-CTO score was 2.8 +/- 1.1. Lesions treated with the Ostial Flash balloon were more frequently located in the right aorto-ostium (79.6% vs 66.0%, P =.002). In the Ostial Flash group, the most common successful CTO crossing technique was antegrade wiring (46.3%), followed by the retrograde approach (40.7%); intravascular imaging was used in 61.1% of cases. Technical success (92.6% vs 87.9%, P =.300) and the incidence of major adverse cardiac events (MACE) (5.6% vs 3.6%, P =.450) was similar in the Ostial Flash vs non-Ostial Flash patients, respectively. In multivariable analysis, PCI of proximal right coronary artery CTOs was independently associated with use of the Ostial Flash balloon (odds ratio 2.2; 95% CI, 1.1-4.8; P =.036). Conclusions. The Ostial Flash balloon is infrequently used in aorto-ostial CTO PCI. Although there were no differences in MACE with use of the balloon, randomized controlled trials are needed to determine its effectiveness. Copyright © 2025 HMP Global. All Rights Reserved <76> Accession Number 2048310431 Title SCORE-CUT: A Randomized Trial Comparison of Scoring, Cutting, and Non-Compliant Balloon Lesion Preparation Strategies for Drug-Coated Balloon Angioplasty-Rationale and Design. Source Catheterization and Cardiovascular Interventions. 108(4) (pp 1558-1563), 2026. Date of Publication: 01 Oct 2026. Author Khandkar C.; Khialani B.; Ravindran J.; Jain P.; Kurup R.; Ekmejian A.; Touma G.; Cosgrove C.; Asrress K.; Selvakumar D.; Hallani H.; Liou K.; Ford T.; Wong B.; Fairley S.; Harding S.; Yong A.; Ada C. Institution (Khandkar, Ravindran, Yong, Ada) Concord Repatriation General Hospital, Concord, NSW, Australia (Khandkar, Jain, Cosgrove) Royal Prince Alfred Hospital, Camperdown, NSW, Australia (Khandkar, Ravindran, Jain, Yong) University of Sydney, Camperdown, NSW, Australia (Khialani) Tan Tock Seng Hospital (TTSH), National Healthcare Group, Novena, Singapore (Jain, Asrress, Yong, Ada) Macquarie University Hospital, Macquarie, NSW, Australia (Kurup) Campbelltown Hospital, Campbelltown, NSW, Australia (Ekmejian) Royal North Shore Hospital, St Leonards, NSW, Australia (Touma) Hurstville Private Hospital, Hurstville, NSW, Australia (Asrress, Liou) Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia (Selvakumar) Westmead Public Hospital, Westmead, NSW, Australia (Selvakumar, Hallani) Nepean Hospital, Penrith, NSW, Australia (Liou) Prince of Wales Public Hospital, Kensington, NSW, Australia (Ford) Gosford Public Hospital, Gosford, NSW, Australia (Wong) North Shore Hospital, Auckland, New Zealand (Fairley, Harding) Wellington Regional Hospital, Wellington, New Zealand Publisher John Wiley and Sons Inc Abstract Background: Drug-coated balloons (DCB) provide a "metal-free" alternative to drug-eluting stents, yet their success is highly dependent on optimal lesion preparation for effective drug transfer and to minimize acute recoil. While scoring balloons (SB) and cutting balloons (CB) are hypothesized to achieve superior plaque modification versus non-compliant balloons (NCBs) through controlled micro-dissections, high-quality randomized evidence in de-novo coronary lesions remains sparse. Aim(s): SCORE-CUT aims to determine the optimal lesion-preparation strategy prior to DCB angioplasty by directly comparing the efficacy of pre-dilation with NCB, SB, and CB. Method(s): This is a prospective, multi-center, randomized trial conducted across sites in Australia, New Zealand, and Singapore (ACTRN12625001349437). A total of 198 patients with de-novo lesions (2.0-4.0 mm diameter on angiography) are randomized 1:1:1 to undergo lesion preparation with NCB, SB, or CB. Intravascular ultrasound (IVUS) imaging is performed both before and after lesion preparation. The primary endpoint is absolute minimum lumen area (MLA) gain (mm2) on IVUS after lesion preparation, analyzed by an independent, blinded core laboratory. Secondary endpoints include percentage MLA gain, frequency of flow-limiting dissections, and rates of bailout stenting. The study is powered to detect a 0.8 mm2 difference in absolute MLA gain, with statistical significance at p < 0.05. Enrollment has commenced (n = 4) and the study is expected to complete enrollment by the end of 2026. Conclusion(s): SCORE-CUT is the first randomized trial to provide a head-to-head comparison of NCB, SB, and CB using IVUS-derived primary endpoints in de-novo disease. By utilizing intravascular imaging, the trial will provide robust evidence to standardize vessel preparation in DCB angioplasty. Copyright © 2026 Wiley Periodicals LLC. <77> Accession Number 2038667742 Title Estimating the True MACE Benefits From Tirzepatide in SURPASS-CVOT Using an Imputed Placebo Analysis of REWIND. Source Diabetes Care. 49(10) (pp 1771-1778), 2026. Date of Publication: 01 Oct 2026. Author Sattar N.; Gerstein H.C.; D'alessio D.; Bhatt D.L.; Buse J.B.; Prato S.D.; Kahn S.E.; Lincoff A.M.; McGuire D.K.; Nauck M.A.; Nissen S.E.; Zinman B.; Zoungas S.; Bartee A.; Miller D.; Nishiyama H.; Qu Y.; Weerakkody G.; Wiese R.J.; Pavo I.; Nicholls S.J. Institution (Sattar) School of Cardiovascular Medicine and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Gerstein) Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D'alessio) Duke University Medical Center, Durham, NC, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Buse) University of North Carolina at Chapel Hill, Chapel Hill, NC, United States (Prato) Interdisciplinary Research Center "Health Science", Sant'Anna School of Advanced Studies, Pisa, Italy (Kahn) Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA, United States (Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States (McGuire) University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX, United States (Nauck) Diabetes, Endocrinology and Metabolism Section, Department of Medicine, St. Josef-Hospital, Katholisches Klinikum Bochum gGmbH, Ruhr University of Bochum, Bochum, Germany (Nissen) Cleveland Clinic Coordinating Center for Clinical Research and Department of Medicine, Cleveland Clinic, Cleveland, OH, United States (Zinman) University of Toronto, Lunenfeld-Tanenbaum Research Institute and Mount Sinai Hospital, Toronto, ON, Canada (Zoungas) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Bartee, Miller, Nishiyama, Qu, Weerakkody, Wiese, Pavo) Eli Lilly and Company, Indianapolis, IN, United States (Nicholls) Victorian Heart Institute, Monash University, Melbourne, Australia Publisher American Diabetes Association Inc. Abstract OBJECTIVE In prespecified analyses, the treatment effect for major adverse cardiovascular event (MACE) of tirzepatide compared with imputed placebo was estimated using SURPASS-Cardiovascular Outcomes Trial (SURPASS-CVOT) and Researching Cardiovascular Events With a Weekly Incretin in Diabetes (REWIND) trial data. RESEARCH DESIGN AND METHODS The indirect comparison with placebo was conducted for primary (MACE-3) and secondary outcomes of SURPASS-CVOT. The analysis included data from REWIND participants who would have been eligible for SURPASS-CVOT and all participants from SURPASS-CVOT. Propensity score estimation was used to adjust for differences in participant characteristics between studies. The indirect analysis of the treatment effect was derived by multiplying the hazard ratio (HR) for MACE-3 between tirzepatide and dulaglutide in SURPASS-CVOT by the HR for dulaglutide versus placebo in REWIND. Sensitivity analyses were performed using unadjusted analyses, including both the selected REWIND and the entire REWIND populations, and adjusted analysis in the entire REWIND population. Post hoc sensitivity analyses used data from a recent glucagon-like peptide 1 receptor agonist (GLP-1RA) meta-analysis that included REWIND. RESULTS Analyses included 2,055 of 9,901 participants from REWIND and all 13,165 participants from SURPASS-CVOT. In indirect treatment effect comparisons, tirzepatide versus placebo was associated with lower MACE-3 (HR 0.72; 95% CI 0.55, 0.94), death from CV cause or heart failure events (HR 0.70; 95% CI 0.51, 0.96), and all-cause death (HR 0.61; 95% CI 0.45, 0.82). Sensitivity analyses, including nonadjusted or the entire REWIND cohort data or meta-analysis data for GLP-1RAs, were generally consistent. CONCLUSIONS In this indirect prespecified exploratory comparison, tirzepatide compared with imputed placebo was associated with reduced CV outcomes and all-cause mortality in participants with type 2 diabetes and established atherosclerotic CV disease. Copyright © 2026, The Author(s). <78> Accession Number 2047503866 Title Current status of various types of ICG contrast imaging in pediatric thoracic surgery. Source Surgery Today. 56(11) (pp 2583-2594), 2026. Date of Publication: 01 Nov 2026. Author Takazawa S.; Konishi K.-I.; Fujiogi M.; Fujishiro J. Institution (Takazawa, Fujiogi, Fujishiro) Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan (Konishi) Department of Pediatric Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan Publisher Springer Abstract Indocyanine green (ICG) fluorescence imaging is an emerging intraoperative navigation tool. However, its application in pediatric thoracic surgery remains to be elucidated. This review evaluates the current status and clinical utility of ICG-based imaging techniques in the field. A narrative review of studies published between January 2015 and February 2026 was conducted using PubMed, Web of Science, and Cochrane Library. Relevant original articles, reviews, and case reports were included. Data were analyzed by focusing on indications, administration methods, and clinical outcomes. Additionally, representative cases of chylothorax and congenital pulmonary airway malformations from our institution were included. Thirty-eight studies were included in this meta-analysis. ICG imaging enables real-time visualization of lymphatic leakage in chylothorax, rapid identification of intersegmental planes in pulmonary resections, and ventilation-based lesion delineation using inhaled ICG. It also supports fistula localization and perfusion assessment in patients with esophageal diseases. In oncology, ICG shows high sensitivity for detecting hepatoblastoma lung metastases, although its specificity is limited. ICG fluorescence imaging improves intraoperative visualization and precision during pediatric thoracic surgery. However, current evidence remains limited, and further standardization and prospective validation are required. Copyright © The Author(s) 2026. <79> Accession Number 2051096091 Title Hemodynamic and biomechanical impact of proximal aortic surgery on the cardiovascular system: a systematic review and meta-analysis. Source Journal of Thoracic Disease. 18(10) (no pagination), 2026. Article Number: 1090. Date of Publication: 01 Oct 2026. Author van Sambeeck P.S.; Hermans B.P.; Nauta F.J.H.; Hasami N.A.; Saouti N.; Verkroost M.W.A.; Trimarchi S.; Czerny M.; Heijmen R.H. Institution (van Sambeeck, Hermans, Nauta, Hasami, Saouti, Verkroost, Heijmen) Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Trimarchi) Department of Clinical and Community Sciences, University of Milan, Milan, Italy (Czerny) Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany Publisher AME Publishing Company Abstract Background: The consequences of proximal aortic (PA) replacement with a stiff vascular prosthesis remain insufficiently understood. This systematic review and meta-analysis aims to consolidate evidence regarding the hemodynamic and biomechanical effects of PA surgery on the cardiovascular system. Method(s): Four databases were searched on April 16th, 2025. Clinical and experimental studies reporting hemodynamic or biomechanical outcomes after PA compliance alterations were included. Exclusion criteria comprised non-original work, computational models, acute procedures, interventions beyond the PA, and PA constriction surgeries. Primary outcomes reflected cardiac functioning, hemodynamics, and aortic biomechanics. Result(s): Thirteen studies (six clinical, seven experimental) were included. Six studies measured changes pre- and post-intervention, seven studies compared changes to a control group. Pulse pressure (investigated in four studies) significantly increased in one experimental study (37.7+/-5.9 vs. 49.2+/-6.9 mmHg, P=0.01). Left ventricular mass (one study) increased significantly following stiff prosthetic replacement versus optimal medical therapy (+3.67+/-4.1 vs. +0.62+/-4.4 g/m^2, P<0.001). Blood flow velocity of the PA (two studies) showed significant increases in both studies. Two (of five) studies reported significant increases in aortic wall mechanics parameters including mean wall shear stress (WSS) (0.31 vs. 0.82 Pa, P=0.04) and maximal WSS (0.55 vs. 1.11 Pa, P=0.04). Meta-analysis (four studies) found increased distensibility [standardized mean change score (SMCC) 0.50, 95% confidence interval (CI): 0.24-0.76, k=3] and circumferential strain (SMCC 0.55, 95% CI: 0.00-1.10, k=3) of the descending aorta. Ejection fraction (SMCC 0.08, 95% CI: -0.29-0.45, k=3) and pulse pressure (SMCC 0.47, 95% CI: -0.36-1.31, k=3) remained unchanged. Certainty of evidence was very low, and risk of bias was moderate. Conclusion(s): PA stiffening due to a vascular prosthesis appears to have limited systemic hemodynamic effects, likely due to compensatory mechanisms (e.g. increased left ventricular mass and distal aortic adaptation). Local distensibility, WSS and flow dynamics are adversely affected. Copyright Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <80> Accession Number 2051095718 Title Percutaneous Coronary Intervention Before Transcatheter Aortic Valve Implantation in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Bacha Z.; Shahbaz H.; Yasir A.; Afridi H.; Rashad A.; Muneer H.; Gohar F.; Khan M.; Chaudhary M.A.; Rehman A.; Abid M.; Afridi M.S.; Naqvi M.; Khan F.M.; Rahat S.; Rafi F.; Hassanabad A.F. Institution (Bacha, Gohar) From the Department of Medicine, Khyber Medical College (KMC), Peshawar, Pakistan (Yasir, Afridi, Rashad, Khan, Khan) Department of Medicine, Khyber Girls Medical College (KGMC), Peshawar, Pakistan (Shahbaz) Department of Medicine, Ayub Medical College (AMC), Abbottabad, Pakistan (Muneer, Rahat) Department of Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan (Rafi) Department of Medicine, Sharif medical and dental college, Lahore, Pakistan (Chaudhary) Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan (Rehman) Department of Medicine, Kabir medical college, Peshawar, Pakistan (Abid, Naqvi) Department of Medicine, Dow Medical College, Karachi, Pakistan (Afridi) Department of Medicine, Pak International Medical College, Peshawar, Pakistan (Hassanabad) Division of Cardiac Surgery, Department of Surgery, Columbia University Irving Medical Center, Columbia University, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract Concomitant coronary artery disease affects 40-75% of patients undergoing transcatheter aortic valve implantation (TAVI). Three recent randomized trials yielded conflicting findings: NOTION-3 demonstrated reduced composite events with pre-TAVI percutaneous coronary intervention (PCI), whereas PRO-TAVI showed non-inferiority of PCI deferral with less bleeding; neither demonstrated mortality benefit. No previous meta-analysis combined all 3 trials with observational evidence, applied design-stratified GRADE certainty, or explored cardiovascular mortality heterogeneity. We performed a systematic review and meta-analysis of 16 studies (3 randomized trials, 13 observational cohorts; 8,207 patients). Ten prespecified outcomes were pooled using Mantel-Haenszel random-effects risk ratios (RRs) with 95% confidence intervals (CIs); 30-day all-cause mortality was primary. GRADE certainty was assessed separately for randomized and observational evidence. Prespecified design-based subgroup and leave-one-out sensitivity analyses were performed. Pre-TAVI PCI was not associated with significant differences in 30-day all-cause mortality (RR 1.26, 95% CI 0.90-1.77; I2 = 32%) or 1-year mortality (RR 1.00, 95% CI 0.87-1.15; I2 = 0%). Major bleeding (RR 1.19, 95% CI 0.98-1.44) and major vascular complications (RR 1.48, 95% CI 0.95-2.30) showed borderline non-significant trends favoring PCI deferral (both I2 = 0%). Excluding Griese et al. 2014, the principal driver of harm and heterogeneity, reduced cardiovascular mortality heterogeneity (RR 0.91; I2 = 24%). No significant differences occurred in stroke, myocardial infarction, acute kidney injury, pacemaker implantation, or rehospitalization. Routine pre-TAVI PCI confers no mortality benefit and may increase bleeding and vascular complications; PCI should be individualized according to coronary complexity, lesion significance, and bleeding risk. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <81> Accession Number 2050385957 Title ESC Guidelines, mechanisms of myocarditis, novel insights into treatment with mineralcorticoid receptor antagonists, cardiac glycosides, and GLP-1 receptor agonists. Source European Heart Journal. 47(38) (pp 5327-5333), 2026. Date of Publication: 07 Oct 2026. Author Crea F. Institution (Crea) Center of Excellence of Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy (Crea) Catholic University of the Sacred Heart, Rome, Italy Publisher Oxford University Press <82> Accession Number 2035544578 Title Prognostic impact of body mass index in acute myocardial infarction complicated by cardiogenic Shock: an ECLS-SHOCK subanalysis. Source Clinical Research in Cardiology. 115(11) (pp 1910-1920), 2026. Date of Publication: 01 Nov 2026. Author Schupp T.; Thiele H.; Rassaf T.; Mahabadi A.A.; Lehmann R.; Eitel I.; Skurk C.; Clemmensen P.; Hennersdorf M.; Voigt I.; Linke A.; Tigges E.; Nordbeck P.; Jung C.; Lauten P.; Feistritzer H.-J.; Buske M.; Poss J.; Ouarrak T.; Schneider S.; Behnes M.; Duerschmied D.; Desch S.; Freund A.; Zeymer U.; Akin I. Institution (Schupp, Behnes, Duerschmied, Zeymer, Akin) Cardiology, Hemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, and German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany (Thiele, Feistritzer, Buske, Poss, Desch, Freund) Heart Center Leipzig at Leipzig University and Leipzig Heart Science, Leipzig, Germany (Rassaf, Mahabadi) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany (Lehmann) Asklepios Clinic Langen, Langen, Germany (Eitel) University Heart Center Lubeck and German Center for Cardiovascular Research, Partner Site Hamburg-Kiel-Lubeck, Greifswald, Lubeck, Germany (Skurk) Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Benjamin Franklin, DZHK partner site Berlin, Berlin, Germany (Clemmensen) University Heart and Vascular Center Hamburg, Center for Population Health Innovation (POINT) and German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Hamburg, Germany (Hennersdorf) SLK Kliniken Heilbronn, Heilbronn, Germany (Voigt) Department of Acute and Emergency Medicine, Elisabeth-Hospital, Essen, Germany (Linke) Technische Universitat Dresden, Heart Center, Dresden, Germany (Tigges) Asklepios Clinic St. Georg, Hamburg, Germany and German Center for Cardiovascular Research, Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany (Nordbeck) University Hospital Wurzburg, Wurzburg, Germany (Jung) Department of Cardiology, Pulmonology and Vascular Medicine and Cardiovascular Research Institute Duesseldorf (CARID), Faculty of Medicine, Heinrich-Heine-University, Dusseldorf, Germany (Lauten) Zentralklinik Bad Berka, Bad Berka, Germany (Ouarrak, Schneider, Zeymer) Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany (Zeymer) University Heart Center Freiburg-Bad Krozingen, Medical Center, University of Freiburg; Faculty of Medicine, University of Freiburg, Freiburg, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: The prognostic impact of overweight and obesity in patients with cardiogenic shock (CS) following acute myocardial infarction (AMI) is still a matter of debate. The present subanalysis of the ECLS-SHOCK trial sought to investigate the association between body mass index (BMI) and outcomes in patients with AMI-CS. Method(s): Patients with AMI-CS enrolled in the multicenter, randomized ECLS-SHOCK trial between 2019 and 2022 were included. The prognostic impact of BMI was investigated stratified by BMI 18.5-24.9 kg/m2, 25.0-29.9 kg/m2 and >= 30.0 kg/m2 with regard to the primary endpoint 30-day all-cause mortality. Result(s): Overall, 407 patients with AMI-CS were included with a median BMI of 27.7 kg/m2 (interquartile range 24.8-30.8 kg/m2). Patients with a BMI >= 30.0 kg/m2 (n = 115) were less likely males, had a higher burden of cardiovascular risk factors and higher rates of TIMI flow 0 before revascularization than patients with lower BMI values. The primary endpoint of all-cause mortality at 30 days occurred in 53.9%, 45.3% and 47.7% of patients with BMI >= 30.0 kg/m2, 25.0-29.9 kg/m2 and 18.5-24.9 kg/m2, respectively. Using patients with a BMI 18.5-24.9 kg/m2 as a reference, neither a BMI >= 30.0 kg/m2 (OR = 1.28; 95% CI 0.76-2.16; p = 0.35) nor a BMI of 25.0-29.9 kg/m2 (OR = 0.91; 95% CI 0.56-1.46; p = 0.68) were associated with an increased risk of all-cause mortality. Similar results were obtained regardless of allocation to extracorporeal life support (ECLS) or medical treatment only for all BMI groups. Safety endpoints did not differ across the different BMI groups. Conclusion(s): In this well-defined cohort of patients with AMI-CS, BMI was not associated with the risk of all-cause mortality, nor were we able to identify BMI subgroups who derived more benefit or less harm from ECLS therapy. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2025. <83> 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. 8(11) (pp 1570-1578), 2026. Date of Publication: 01 Nov 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. Copyright © 2026 The Authors <84> Accession Number 2050372445 Title Bioprosthetic heart valve degeneration: new insights into structural remodeling and calcification. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1941295. Date of Publication: 2026. Author Levy S.; Weiss L.; Cahalane R.; Meuris B.; Aikawa E. Institution (Levy, Weiss, Cahalane, Aikawa) Center for Interdisciplinary Cardiovascular Sciences, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Cahalane) School of Engineering, Bernal Institute, Health Research Institute, University of Limerick, Limerick, Ireland (Meuris) Department of Cardiovascular Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium (Aikawa) Center for Excellence in Vascular Biology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Publisher Frontiers Media SA Abstract Bioprosthetic heart valves (BHVs) are widely used to treat aortic valve disease, and their demand is rising. However, BHV lifespan remains limited by degeneration, with patients often requiring surgical or transcatheter reintervention within a decade. BHVs lack intrinsic remodeling capabilities, and the mechanisms contributing to their failure remain poorly understood. In this review, we summarize current knowledge of BHV degeneration by integrating findings from native aortic valve disease with studies of explanted bioprosthetic valves. We discuss the structural hallmarks of degeneration, including collagen remodeling, calcification, and inflammatory cell accumulation, and examine evidence that circulating blood-derived factors infiltrate BHV tissue and contribute to degeneration progression. Particular emphasis is placed on macrophages, which are consistently identified in explanted BHVs and may promote extracellular matrix (ECM) degradation. We also highlight extracellular vesicles (EVs) as potential mediators of cardiovascular calcification and propose that macrophage-derived EVs may promote ECM remodeling beyond sites of direct cellular accumulation. In addition, we review experimental approaches, including histological imaging, in vitro cell culture models, and proteomic analyses, that may help define molecular pathways underlying degeneration. Together, we hypothesize a model of BHV degeneration driven by interactions among host immune cells, circulating factors, and bioprosthetic tissue. Improved understanding of these mechanisms may facilitate the development of therapeutic strategies to improve BHV durability and long-term clinical outcomes. Copyright © 2026 Levy, Weiss, Cahalane, Meuris and Aikawa. <85> Accession Number 2048182122 Title Coronary Artery Bypass Grafting Based on Computed Tomography-Derived Fractional Flow Reserve vs Angiography (CABG-COREA trial): Early Results. Source Annals of Thoracic Surgery. 122(5) (pp 1233-1241), 2026. Date of Publication: 01 Nov 2026. Author Kim M.-S.; Ryu A.-J.; Kim J.W.; Lee C.H.; Hwang S.W.; Kim K.-B. Institution (Kim, Kim, Lee, Hwang, Kim) Cardiovascular Center, Myongji Hospital, Gyeonggido, South Korea (Kim) Hanyang University College of Medicine, Seoul, South Korea (Ryu) AiMEDiC, Seoul, South Korea Publisher Elsevier Inc. Abstract Background This randomized trial was designed to compare 1-year outcomes in patients who received revascularization on the basis of computed tomography-derived fractional flow reserve (CT-FFR) vs quantitative coronary angiography (QCA). In this early analysis, early angiographic and clinical outcomes were compared. Methods A total of 106 patients were randomized to undergo coronary artery bypass grafting on the basis of CT-FFR (n = 53) or QCA (n = 53). Complete revascularization was achieved for coronary arteries with CT-FFR <=0.78 (CT-FFR group) or those with QCA stenosis (>70% stenosis for left and >=90% stenosis for right coronary artery territories; QCA group). Angiography was performed at median 1 (1-1) postoperative day in all patients. Angiographic findings of graft flow were categorized as perfectly patent, competitive (bidirectionally or unidirectionally competitive), or occluded. Results There were no differences in patient characteristics between the groups. The average number of revascularized coronary arteries per patient was 3.7 +/- 0.8 in the CT-FFR group and 3.5 +/- 0.7 in the QCA group ( P = .089). The median difference in expected anastomosis sites was 2 (1-3). There was no operative mortality and no difference in morbidities between the groups. The number of perfectly patent, bidirectionally competitive, and unidirectionally competitive grafts was 167 (85.2%), 10 (5.1%), and 19 (9.7%), respectively, in the CT-FFR group (n = 196) and 133 (72.7%), 23 (12.6%), and 27 (14.8%), respectively, in the QCA group (n = 183). There was a significant difference in the number of perfectly patent grafts between the groups ( P = .007). Conclusions The average number of distal anastomoses was similar between the groups. However, the number of competitive grafts was significantly reduced in the CT-FFR group compared with the QCA group. Copyright © 2026 The Society of Thoracic Surgeons. <86> Accession Number 2047312795 Title Intracardiac Echocardiography for Procedural Guidance of Left Atrial Appendage Occlusion From Right Atrium: A Subgroup From a Multicenter Randomized Controlled Trial With Two Intracardiac Echocardiography Imaging Systems. Source Journal of Cardiovascular Electrophysiology. 37(10) (pp 2203-2211), 2026. Date of Publication: 01 Oct 2026. Author Huang B.; Hao Z.; Kuang Y.; Wang J.; Chu H.; Ning Z.; Li H.; Ma W.; Zhang X.; He B.; Xu J.; Jiang L. Institution (Huang, Kuang, Wang, He, Xu, Jiang) Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (Hao) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Chu) Department of Cardiology, The First Affiliated Hospital of Ningbo University, Zhejiang, Ningbo, China (Ning) Department of Cardiology, Shanghai Pudong New District Zhoupu Hospital, Shanghai, China (Li) Department of Cardiology, Shenzhen Hospital, The University of Hong Kong, Shenzhen, China (Ma) Department of Cardiology, Peking University First Hospital, Beijing, China (Zhang) Department of Cardiology, Huai'an First People's Hospital, Jiangsu, Huai'an, China Publisher John Wiley and Sons Inc Abstract Background: Intracardiac echocardiography (ICE)-guided left atrial appendage occlusion (LAAO) from left atrium under local anesthesia showed potential advantages over transesophageal echocardiography (TOE). This study sought to demonstrate the intraprocedural efficiency and safety of LAAO with ICE guidance in right atrium. Method(s): In a multicenter randomized controlled trial to assess whether the imaging quality of a novel DynaSight ICE system (SONOSEMI, Shenzhen, China) is noninferior to the SoundStar (Biosense Webster, USA), a sub-group analysis was performed in patients who underwent LAAO under local anesthesia with ICE guidance in right atrium. Result(s): Thirty-three of 66 in the DynaSight group and 30 of 67 in the SoundStar group were performed LAAO with ICE guidance in right atrium. There were no statistical differences between two groups in baseline characteristics including demographics, cardiovascular comorbidities, CHA2DS2-VASc score, and HAS-BLED score. Both ICE systems had similar clear image qualities according to multi-plane assessments for home view, atrial septum and left atrium, and judgments for occluders including displaying location and resolution. There was comparable procedural successful rate for device implantation (100% in the DynaSight group vs. 96.67% in the SoundStar group, p = 0.4762) and occurrence of major peri-procedural complications including tamponade, device embolism, death, major bleeding, and ischemic stroke/transient ischemic attack/systemic embolism (0 of 33 in the DynaSight group vs. 3 of 30 in the SoundStar group, p = 0.1022). Conclusion(s): The DynaSight ICE system has the same clear image quality as the SoundStar, which-guided LAAO with the catheter in right atrium is intraprocedural effective and safe for device implantation. Copyright © 2026 Wiley Periodicals LLC. <87> Accession Number 2045288712 Title Beyond the protocol: adherence to ECPR selection criteria and outcomes after Out-of-Hospital Cardiac Arrest (OHCA)-insights from the German Cardiac Arrest Registry (G-CAR). Source Clinical Research in Cardiology. 115(11) (pp 1983-1992), 2026. Date of Publication: 01 Nov 2026. Author Springer A.; Rossberg M.; Sinning C.; Voigt I.; Freund A.; Hosler N.; Michels G.; Ewen S.; Voss F.; Wohlmuth P.; Thiele H.; Zeymer U.; Poss J.; Tigges E. Institution (Springer, Tigges) Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany (Rossberg, Freund, Hosler, Thiele, Poss) Heart Center Leipzig at Leipzig University and Leipzig Heart Science, Herzzentrum Leipzig, Struempellstrase 39, Leipzig, Germany (Sinning) Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany (Voigt) Contilia Elisabeth-Krankenhaus, Essen, Germany (Michels) Notfallzentrum, Krankenhaus Der Barmherzigen Bruder Trier, Trier, Germany (Ewen) Klinik Fur Innere Medizin III, Schwarzwald-Baar Klinik, Villingen-Schwenningen, Germany (Voss) University Hospital Dusseldorf, Dusseldorf, Germany (Wohlmuth) Asklepios Proresearch, Hamburg, Germany (Zeymer) Institut Fur Herzinfarktforschung, Ludwigshafen, Germany (Ewen, Zeymer) Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential treatment for selected patients with refractory out-of-hospital cardiac arrest (OHCA). Randomized controlled trials (RCTs) emphasize the importance of appropriate patient selection. Expert consensus statements recommend six criteria for ECPR suitability: age <= 75 years, witnessed OHCA, bystander cardiopulmonary resuscitation (CPR), no-flow time <= 5 min (min), low-flow time <= 60 min, and an initial shockable rhythm. Although widely accepted, these items are not supported by robust data and adherence varies greatly. We present an analysis from the German Cardiac Arrest Registry (G-CAR) describing the current state of ECPR across participating centers. Result(s): Of 1,644 patients in G-CAR, 576 patients (34.6%) were admitted with ongoing CPR. Of these, 162 (28.0%) were treated with ECPR. Only 18 patients (11.0%) met all six ECPR criteria, with the majority displaying five (37.0%) or four (25.9%) characteristics. Overall, rates of favorable neurological survival at 30 days did not differ between patients treated with ECPR and those treated conventionally (8.6% vs. 5.6%, p = 0.25). When stratified according to the number of criteria, the probability of survival was higher in patients meeting all six or five compared to those meeting one to four criteria (20.0% vs. 11.9% vs. 1.4%; p = 0.028). A similar gradient in survival according to the number of fulfilled criteria was observed in conventionally treated patients. Conclusion(s): Adherence to proposed ECPR selection criteria was low in this real-world cohort, potentially contributing to lower survival rates compared with results from RCTs. However, when all criteria were fulfilled, survival rates were significantly higher, underscoring the importance of stringent patient selection. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <88> Accession Number 2049657550 Title Preoperative echocardiographic predictors of atrial fibrillation after coronary artery bypass graft surgery (CABG): a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 912. Date of Publication: 01 Dec 2026. Author Teimouri-Jervekani Z.; Samadi-Broujeni N.; Bahrani S.; Soleimani A. Institution (Teimouri-Jervekani, Soleimani) Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Samadi-Broujeni, Soleimani) Chamran Cardiovascular Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Bahrani) Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG), which is associated with increased morbidity, longer hospital stays, and higher healthcare costs. Preoperative echocardiographic parameters may play an important role in predicting the risk of POAF. Objective(s): To identify and evaluate preoperative echocardiographic parameters that can predict the development of POAF in patients undergoing CABG. Method(s): A systematic search was performed from January 2010 to October 2025 in PubMed, Scopus, Embase, and Web of Science. Risk of bias was assessed with ROBINS-I tool for observational studies. Result(s): Twenty-three studies (n = 2,983 patients) were included. POAF incidence ranged from 22% to 40%, with a pooled rate of 28.8% (95% CI: 21%-34%). Meta-analyses showed no significant pooled associations for left atrial volume index (LAVI) (OR 1.31; 95% CI: 0.92-1.87; I2 = 99.9%), peak atrial longitudinal strain (PALS) 0.65 (95% CI: 0.38-1.11); I2 = 99.9%), or LA contraction strain (LASRa) (OR 1.91; 95% CI: 0.83-4.41; I2 = 98.1%). Heterogeneity was substantial across all outcomes. Limited data suggested potential predictive value for right atrial indices and single-study parameters such as LA kinetic energy. Conclusion(s): Current echocardiographic markers including LAVI, PALS, and LASRa, do not demonstrate consistent or robust predictive value for POAF when pooled across heterogeneous studies. Standardized measurement protocols and larger prospective cohorts are needed to clarify the role of atrial structural and functional indices in POAF risk stratification. Copyright © The Author(s) 2026. <89> Accession Number 2051477199 Title Vasopressors to Treat or Prevent Hypotension During and After Major Surgery: A Scoping Review. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Bandilovska I.; McFarlane I.; Chang K.; Brahmanand T.; Perry L.; Coulson T.G.; Miles L.F. Institution (Bandilovska, Brahmanand, Miles) Department of Anaesthesia, Austin Health, Melbourne, Australia (McFarlane, Chang, Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, Australia (Perry) Division of Cardiac Anaesthesia, Victorian Heart Hospital, Monash Health, Melbourne, Australia (Perry, Coulson) Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia (Miles) Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Australia Publisher W.B. Saunders Abstract Perioperative hypotension is common and associated with adverse postoperative outcomes. Vasopressors are central to management, yet the optimal agent and their subsequent impacts on end-organ outcomes remain unclear. This scoping review characterizes the current evidence base and addresses the need for a full systematic review or meta-analysis. A protocol was formulated a priori per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Subsequently, MEDLINE, Embase, and Scopus were searched from January 1, 2000, to July 18, 2025, for studies comparing parenteral vasopressors in adults undergoing major surgery. Randomized controlled trials and observational studies were included. Data on study design, vasopressor strategies, initiation criteria, and postoperative outcomes were extracted and synthesized descriptively. Sixteen studies (n = 6,927) were included. Most were small, single-center, and observational, predominantly in cardiothoracic surgery. Vasopressor initiation criteria were highly variable, with studies divided broadly between hypotension-based triggers and vasoplegic syndrome, the latter inconsistently defined. A variety of vasopressors were evaluated, yet no 2 studies compared identical regimens. Postoperative outcome reporting was heterogeneous, and outcome definitions varied and showed minimal alignment with the Standardised Endpoints in Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care consensus standards. Eight studies reported significant differences in postoperative clinical outcomes between vasopressor strategies; however, effects were inconsistent, and no vasopressor strategy demonstrated a consistent benefit across studies. Overall, the evidence base for vasopressor therapy in perioperative hypotension is fragmented. Variability in initiation criteria, interventions, and outcome definitions limits comparability and precludes meaningful synthesis. Standardized definitions and adequately powered multicenter trials are required to determine optimal vasopressor strategies and their effects on postoperative organ dysfunction. Copyright © 2026 The Authors <90> Accession Number 2051123075 Title Preventing or Minimizing Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement. Source Journal of Invasive Cardiology. 33(1) (pp E32-E39), 2021. Date of Publication: 01 Jan 2021. Author Tandar A.; Sharma V.; Ibrahim M.; Jones T.; Morgan D.; Montzingo C.; Lee J.; Birgenheier N.; Silverton N.; Abraham A.; Welt F.G.P.; Glotzbach J.P. Institution (Tandar, Ibrahim, Jones, Abraham, Welt) Divisions of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States (Sharma, Glotzbach) Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States (Morgan, Montzingo, Lee, Birgenheier, Silverton) Cardiac Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, United States Publisher Cliggott Publishing Co. Abstract Background. Transcatheter aortic valve implantation (TAVI) is now routinely performed in patients with aortic stenosis with low mortality and complication rates. Although periprocedural risks have been substantially minimized, procedure- and contrast-induced acute kidney injury (AKI) remains a major concern. AKI remains a frequent complication of contrast-guided interventional procedures and is associated with a significantly adverse prognosis. We review the currently available clinical data related to AKI, with emphasis on contrast-induced nephropathy (CIN), and discuss a novel, integrated approach aiming to minimize AKI risk in high-risk patients. A stepwise algorithm is also proposed for the management of these complex patients. Copyright © 2026 HMP Global. All Rights Reserved. Cookie Policy Privacy Policy Terms of Use <91> Accession Number 652581858 Title Long-Term Outcomes of Endoscopic or Open Vein Harvesting for Coronary Artery Bypass Grafting: A 10-Year Follow-Up of the REGROUP Randomized Clinical Trial. Source Circulation. (no pagination), 2026. Date of Publication: 02 Nov 2026. Author Schloss M.J.; Young M.; Barrett E.A.; Stock E.M.; DeMatt E.M.; Kousick B.; Tseng E.E.; Bhatt D.L.; Bakaeen F.G.; Ferguson R.E.; Gaziano J.M.; Zenati M.A. Institution (Schloss, Zenati) Division of Cardiac Surgery (M.J.S., Harvard Medical School, Boston, MA, United States (Schloss, Zenati) Brigham and Women's Hospital, Division of Cardiac Surgery, Veterans Affairs Boston Healthcare System (M.J.S., Harvard Medical School, Boston, MA, United States (Young, Barrett, Ferguson, Gaziano) Massachusetts Veterans Epidemiology Research and Information Collaborative, E.A.B., R.E.F. (Stock, DeMatt, Kousick) Cooperative Studies Program Coordinating Center, Office of Research and Development, Department of Veterans Affairs, E.M.D., Perry Point (Tseng) Division of Cardiothoracic Surgery, San Francisco Veterans Affairs Healthcare System (Tseng) Division of Adult Cardiac Surgery and Lung Transplantation, University of California-San Francisco (E.E.T.) (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, NY, United States (Bakaeen) Department of Thoracic and Cardiovascular Surgery, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic (Ferguson) Department of Medicine, Boston University Chobanian and Avedisian School of Medicine (Ferguson) Boston Cooperative Studies Program Coordinating Center, VA Boston Healthcare System (Gaziano) Harvard Medical School, Boston, MA, United States <92> Accession Number 2051384724 Title Discontinuation of renin-angiotensin system inhibitors before non-cardiac surgery: a meta-analysis. Source European Heart Journal. 47(41) (pp 6145-6156), 2026. Date of Publication: 01 Nov 2026. Author Bena Nnang J.Y.; Tembi T.B.T.; Fodop S.G.J.; Mekontso J.G.K.; Esene I.N. Institution (Bena Nnang, Fodop, Esene) Research Division, Winners Foundation, Yaounde, Cameroon (Bena Nnang) Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon (Tembi) Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States (Fodop) School of Health and Medical Sciences, Catholic University, Kumbo, Cameroon (Mekontso) New York City Health + Hospitals, South Brooklyn Health, New York City, NY, United States (Esene) Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon Publisher Oxford University Press Abstract Background and Aims: The best management approach for renin-angiotensin system (RAS) inhibitor use before surgery is controversial. Some studies have suggested that continuation could increase the risk of clinically significant peri-operative hypotension and, thus, organ injury. By contrast, others believe that withholding them significantly increases the risk of severe hypertension and heart failure. To determine the most effective strategy, this systematic review and meta-analysis of randomized controlled trials compared discontinuation vs continuation of RAS inhibitors in patients undergoing non-cardiac and non-vascular surgeries. Method(s): PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for randomized controlled trials that compared discontinuation vs continuation of RAS inhibitors in patients undergoing non-cardiac and non-vascular surgery. Result(s): Five randomized controlled trials (n = 10 773 patients; 5388 randomized to discontinuation) were included. Discontinuation of an RAS inhibitor probaby reduced peri-operative hypotension (27.66% vs 34.06%; risk ratio [RR] 0.81, 95% confidence interval [CI] 0.73-0.89; moderate certainty). The evidence is very uncertain about effects on peri-operative hypertension (9.46% vs 8.05%; RR 1.38, 95% CI 0.66-2.89; very low certainty). For major clinical outcomes, discontinuation suggested little to no difference in acute kidney injury (10.45% vs 10.69%; RR 0.98, 95% CI 0.66-1.45; low certainty), acute heart failure (5.38% vs 5.32%; RR 1.00, 95% CI 0.76-1.31; low certainty), myocardial infarction (1.22% vs 1.00%; RR 1.19, 95% CI 0.60-2.39; low certainty), stroke (0.42% vs 0.40%; RR 1.04, 95% CI 0.56-1.93; low certainty), and arrhythmias (1.80% vs 1.40%; RR 1.28, 95% CI 0.69-2.38; low certainty). Conclusion(s): These findings suggest that discontinuation of RAS inhibitors is likely to reduce peri-operative hypotension in patients undergoing non-cardiac, non-vascular surgery, but the evidence is very uncertain about effects on peri-operative hypertension and major clinical outcomes. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <93> [Use Link to view the full text] Accession Number 2051243191 Title Comparative Estimation of Long-Term Graft Patency Rates After Isolated Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2025. Date of Publication: 2025. Author Fredericks T.; Nasher N.; Pritting C.D.; Rahimov D.; Saxena A.; Slota P.; Ahmad D.; Saran N.; Stulak J.M.; Tchantchaleishvili V. Institution (Fredericks, Nasher, Pritting, Rahimov, Saxena, Slota, Ahmad, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States (Ahmad) Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Saran, Stulak) Department of Cardiac Surgery, Mayo Clinic, Rochester, MN, United States Publisher Lippincott Williams and Wilkins Abstract We sought to characterize the long-term patency of various graft types in patients undergoing coronary artery bypass grafting. A comprehensive literature search identified 139 studies including 56, 827 patients who underwent isolated coronary artery bypass grafting surgery. The mean patient age was 62 years (95% confidence interval: 60-63), and 80% (95% confidence interval: 79-82) were male. Patency outcomes were analyzed for each graft type, and parametric extrapolation was performed based on mean patency and mean follow-up time per conduit. The left internal mammary artery (LIMA) demonstrated the highest mean patency at 96% with a mean follow-up of 3.2 years, followed by the right internal mammary artery (RIMA) at 94% (2.8 years), gastroepiploic artery (GEA) at 93% (1.7 years), and radial artery (RA) at 89% (3.7 years). The saphenous vein graft had the lowest mean patency at 82% with a mean follow-up of 3.5 years. Extrapolated 20-year patency rates were 77% for LIMA, 64% for RIMA, 54% for RA, 42% for GEA, and 33% for saphenous vein graft. Arterial grafts demonstrated superior long-term patency compared to vein grafts. LIMA remains the primary conduit of choice, while RIMA, followed by RA and GEA, may be appropriate secondary arterial conduits depending on patient-specific factors. Vein grafts had the poorest long-term patency. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <94> Accession Number 652581304 Title PCSK9-Targeting Therapies and Mortality: A Systematic Review and Meta-Analysis of Randomized Trials. Source European journal of preventive cardiology. (no pagination), 2026. Date of Publication: 02 Nov 2026. Author Navarese E.P.; Ruscio E.; Zheng H.; Andreotti F.; Aboyans V.; Kubica J.; Grzelakowska K.; Henry T.D.; Brouwer M.; Stone G.W.; Kereiakes D.J. Institution (Navarese, Ruscio) Department of Life and Health Sciences, Link Campus University (Navarese, Kubica, Grzelakowska) Department of Cardiology and Internal Medicine, L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland (Navarese, Henry, Kereiakes) Carl and Edyth Lindner Center for Research and Education, Christ Hospital, Cincinnati, OH, United States (Zheng) Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China (Andreotti) Cardiovascular Science Department, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy (Andreotti) CardioThoracic Department, Catholic University Medical School, Rome, Italy (Aboyans) Department of Cardiology, Princess Grace Hospital, Ave Pasteur, Monaco (Aboyans) Limoges University, France (Brouwer) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (Stone) Icahn School of Medicine at Mount Sinai, NY, United States Abstract AIMS: To evaluate the association of PCSK9-targeting therapies with mortality and cardiovascular events in stable or clinically stabilized randomized trial populations. METHOD(S): We systematically reviewed randomized trials comparing alirocumab, evolocumab or inclisiran with placebo or active control. The review was registered in PROSPERO (CRD420261395609). Treatment effects were pooled as incidence rate ratios (IRRs) using random-effects models. The primary outcome was all-cause mortality. Prespecified subgroup analyses were based on trial-level known atherosclerosis status, as defined by enrollment criteria. RESULT(S): Thirty-two trials enrolled 77,178 participants. Individual atherosclerosis status could not be determined beyond trial-level eligibility criteria. Mortality estimates were predominantly informed by large cardiovascular outcome trials. All-cause mortality was lower with PCSK9-targeting therapy (IRR 0.88, 95% CI 0.82-0.95). Estimates favored PCSK9-targeting treatment in both trials requiring known atherosclerosis for enrollment (IRR 0.90, 95% CI 0.83-0.98) and trials without such an enrollment requirement (IRR 0.78, 95% CI 0.62-0.97; interaction p = 0.21). PCSK9-targeting treatment additionally reduced myocardial infarction, stroke, and coronary revascularization rates. Leave-one-out estimates remained directionally consistent. CONCLUSION(S): PCSK9-targeting therapies were associated with lower all-cause mortality and fewer ischemic events across trial populations. The predominant contribution of large cardiovascular outcome trials enrolling populations with known atherosclerosis and using PCSK9 antibodies limits the ability to infer a survival benefit in populations not selected on the basis of atherosclerosis status and across individual therapies, particularly inclisiran. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <95> Accession Number 2051365505 Title Efficacy and Safety of Routine Postdilation in Balloon-Expandable Transcatheter Aortic Valve Implantation Platform: The DUOTAP Randomized Clinical Trial. Source JAMA Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Autherith M.; Singer K.; Hauptmann L.; Torrefranca C.; Jantsch C.; Koschatko S.; Roglsperger E.-M.; Halavina K.; Heitzinger G.; Dannenberg V.; Palaparti R.; Langle S.; Mahr S.; Demirel C.; Coti I.; Zimpfer D.; Hengstenberg C.; Nitsche C.; Bartko P.E. Institution (Autherith, Singer, Hauptmann, Torrefranca, Jantsch, Koschatko, Roglsperger, Halavina, Heitzinger, Dannenberg, Demirel, Hengstenberg, Nitsche, Bartko) Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria (Palaparti) Department of Cardiology, Aayush Hospitals, Vijayawada, India (Langle, Mahr, Coti, Zimpfer) Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria Publisher American Medical Association Abstract Importance In patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI), asymmetric valve expansion can estimate prosthetic dysfunction and death. Postdilation has shown promising results in optimizing valve geometry in observational studies; however, randomized evidence is currently lacking. Objective To determine the efficacy of routine postdilation on transcatheter heart valve (THV) geometry and hemodynamic performance, and associated safety outcomes. Design, Setting, and Participants DUOTAP was a single-center, single-blinded randomized clinical trial. Recruitment took place from January 2025 to April 2026 and end points were assessed periprocedurally (fluoroscopy) at 30 days (adverse events) and at 3 months (computed tomography [CT]). The trial was conducted at a high-volume tertiary referral center, the Medical University of Vienna, Austria. Included patients had severe AS suitable for transfemoral TAVI with a balloon-expandable THV and without high-risk features on preprocedural CT or coronary angiography and were randomized in a 1:1 ratio, stratified by THV size, to routine postdilation vs no postdilation. These data were analyzed from July 2026 to September 2026. Intervention Routine postdilation using the original delivery balloon at the identical filling volume. A sham procedure was performed in the control group. Main Outcomes and Measures The fluoroscopic THV asymmetry index served as primary end point. Further fluoroscopic and CT-derived measures of valve geometry, hypoattenuated leaflet thickening (HALT), paravalvular leak (PVL), and THV hemodynamics on echocardiography, and freedom from major procedural adverse events served as secondary end points. Results Overall, 148 patients (median [IQR] age, 81 [77-85] years; 69 female [46.6%] and 79 male [53.4%]; median EuroSCORE-II, 2.3%) underwent randomization (n = 74 intervention vs n = 74 control). Intervention yielded a 70% lower THV asymmetry index compared with control (median: 1.2% vs 2.8%; geometric mean ratio: 0.30; 95% CI, 0.18-0.47; P <.001), with consistent effects across prespecified subgroups, induced by frame height reduction across the outer curve. Additionally, intervention yielded numerically larger THV diameters on fluoroscopy and significantly larger THV areas at the inflow, midframe, and outflow level on CT. HALT and mild or worse PVL were significantly less frequent and the Doppler Velocity Index was significantly higher in the intervention group. No differences in procedure-related adverse events between groups were recorded (chi2 test: P =.36). Conclusions and Relevance In this randomized clinical trial, postdilation led to reduced THV asymmetry, optimized geometry, and improved hemodynamic performance, without increasing procedure-related adverse events. These results support the use of routine postdilation to optimize THV geometry and hemodynamics in suitable patients. Copyright © 2027 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <96> Accession Number 2051477163 Title Cardiac lymphatic modulation in myocardial repair: from lymphangiogenesis to microsurgical reconstructive strategies. Source Trends in Cardiovascular Medicine. (no pagination), 2026. Date of Publication: 2026. Author Fabi A.; Melcher S.; Wendelspiess S.R.; Boeddinghaus J.; Salikhanov I.; Kutschka I.; Baraki H.; Mueller C.; Kappos E.A. Institution (Fabi, Melcher, Wendelspiess, Kappos) Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland (Fabi, Wendelspiess, Kappos) Faculty of Medicine, University of Basel, Basel, Switzerland (Boeddinghaus) BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (Boeddinghaus, Mueller) Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland (Salikhanov, Kutschka, Baraki) Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland Publisher Elsevier Inc. Abstract The cardiac lymphatic system is increasingly recognized as a regulator of myocardial fluid homeostasis and tissue remodeling following myocardial injury. Experimental evidence suggests that impaired lymphatic drainage contributes to persistent edema, chronic inflammation and functional deterioration after myocardial infarction and other acute and chronic cardiovascular conditions. However, the translational relevance of pharmacological and microsurgical reconstructive strategies remains largely unexplored. A literature review was performed using PubMed/MEDLINE to identify studies addressing the anatomy, physiology, pathophysiology, and potential therapeutic strategies addressing the cardiac lymphatic system. This study finds that cardiac lymphatics drain myocardial interstitial fluid and immune cells toward mediastinal pathways. Across various disease models, cardiac lymphatic dysfunction contributes to prolonged edema, inflammation, and adverse fibrotic remodeling. In preclinical models, pro-lymphangiogenic strategies have increased lymphatic growth and transport and have been associated with more favorable remodeling. By contrast, lymphovenous anastomosis and vascularized lymph node transfer remain largely untested concepts in cardiac disease; their ability to improve myocardial lymphatic drainage or clinical outcomes has not been demonstrated. Consequently, cardiac lymphatics may become an important therapeutic target in myocardial repair. Preliminary evidence supports the pharmacological promotion of lymphangiogenesis as a promising strategy for myocardial regeneration, but further research is necessary to explore the safety, feasibility and effectiveness of surgical cardiac lymphatic modulation. Copyright © 2026 The Author(s) <97> Accession Number 2051471240 Title Effects of the Sodium Glucose Cotransporter 2 Inhibitor Empagliflozin on Perioperative Endothelial Function in Patients Undergoing Cardiac Surgery: An Exploratory Analysis of MERCURI-1. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Wang M.; Li X.; Snel L.I.P.; Zuurbier C.J.; Stuhldreier C.; Seehaber J.; Hermanides J.; Albrecht M.; Hollmann M.W.; Preckel B.; van Raalte D.H.; Hulst A.H.; Weber N.C. Institution (Wang, Li, Snel, Zuurbier, Stuhldreier, Seehaber, Hermanides, Hollmann, Preckel, van Raalte, Hulst, Weber) Amsterdam University Medical Center, Department of Anesthesiology - Laboratory of Experimental Intensive Care and Anesthesiology-L. E. I. C. A, Amsterdam Cardiovascular Science, Amsterdam, Netherlands (Li) Center for Cell Lineage Research, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China (Stuhldreier, Seehaber, Albrecht) Department of Anesthesiology and Intensive Care Medicine, Universitatsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany Publisher W.B. Saunders Abstract Objective: To investigate whether short-term treatment with empagliflozin (EMPA) is associated with attenuation of endothelial dysfunction and cardiac injury in patients undergoing cardiac surgery. Design(s): An exploratory study using samples from the open-label randomized MERCURI-1 study. Setting(s): Academic university hospital. Participant(s): Adult patients undergoing cardiac surgery with cardiopulmonary bypass. Intervention(s): Patients received 10 mg/d EMPA starting 3 days before surgery and continuing until 2 days postoperatively or received standard perioperative care. Measurements and Main Results: Blood samples were collected at baseline (prior to EMPA therapy), on the day of surgery (before the first incision), and 1 day after surgery. Plasma biomarkers for endothelial activation (endothelin-1), vascular leakage (angiopoietin-2), glycocalyx degradation (syndecan-1), cardiac injury (Troponin I and NT-proBNP), and systemic inflammation (IL-6, IL-8, and CRP) were measured. In vitro, human cardiac microvascular endothelial cells were exposed to patient plasma, and endothelial permeability was assessed. Surgery-induced changes in biomarkers of endothelial activation and vascular leakage did not differ significantly between the EMPA and control groups. The adjusted between-group differences were 0.097 pg/mL for endothelin-1 (95% confidence interval [CI] -0.478 to 0.672, p = 0.735), -465 pg/mL for angiopoietin-2 (95% CI -2,355 to 1,426, p = 0.623), and 19,540 pg/mL for syndecan-1 (95% CI -10,016 to 49,095, p = 0.19). No significant differences were found for cardiac injury or inflammatory biomarkers. In vitro, endothelial resistance did not differ between the EMPA and control groups. Conclusion(s): In this exploratory substudy, no significant differences in endothelial activation, vascular leakage, cardiac injury, or inflammation between were found the EMPA and control groups. Given the limited sample size, smaller treatment effects cannot be excluded. Copyright © 2026 The Author(s) <98> Accession Number 2051473150 Title Digital Versus Face-to-Face Preoperative Physiotherapy Education in Thoracic Surgery: A Pilot Feasibility Randomised Controlled Trial. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Ball J.L.; Baque E.; Boden I.; Linnane M.P.; Mahoney A.; Hay K.; Morris N.R.; Tronstad O. Institution (Ball, Linnane, Mahoney, Morris, Tronstad) Physiotherapy Department, The Prince Charles Hospital, Brisbane, QLD, Australia (Ball, Baque, Linnane, Morris) School of Allied Health, Sport and Social Work, Griffith University, Gold Coast, QLD, Australia (Boden) School of Health Sciences, University of Tasmania, Launceston, TAS, Australia (Boden) Physiotherapy Department, Launceston General Hospital, Launceston, TAS, Australia (Hay) Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia (Hay) QIMR Berghofer, Brisbane, QLD, Australia (Morris) Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, QLD, Australia (Tronstad) Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia Publisher Elsevier Ltd Abstract Aim: This pilot study evaluated the feasibility, acceptability and fidelity of digital video preoperative physiotherapy education compared with face-to-face education for patients undergoing thoracic surgery. It also explored clinical outcomes to inform a future non-inferiority trial of digital education. Method(s): This prospective pilot feasibility randomised controlled trial was conducted at a tertiary centre in Brisbane, Australia. Participants were randomly allocated to receive face-to-face physiotherapy education or watch a 13-minute professionally made digital education video before thoracic surgery. Protocol feasibility was assessed as the percentage of patients receiving allocated education. Acceptability was measured using a pre/postoperative questionnaire and postoperative interviews. Protocol fidelity, defined as recall of receiving education, and treatment fidelity, defined as recall of key information, were assessed during postoperative interviews using a preset 24-point scoring schema. Feasibility measures included recruitment, retention and missing data. Exploratory outcomes included postoperative pulmonary complications, hospital length of stay and efficiency. Result(s): Sixty-four participants were randomised to face-to-face or digital education before thoracic surgery. All received allocated education, demonstrating 100% protocol feasibility. Both education modes were acceptable and perceived to help with information recall (87% vs 81%) and surgical recovery (93% vs 84%), and included the right amount of information (97% vs 84%). Protocol fidelity (83% vs 87%) and treatment fidelity (median 9.5 [interquartile range (IQR) 6-12] vs 9 [IQR 6-15]) were comparable between groups. Study feasibility was confirmed by 100% recruitment and retention and 95% complete datasets. Hospital length of stay and postoperative pulmonary complications were similar. Digital education was more efficient, saving a median of 10 minutes of preoperative physiotherapist time per patient. Conclusion(s): Digital preoperative physiotherapy education for patients undergoing thoracic surgery is feasible, acceptable and efficient, with protocol and treatment fidelity similar to face-to-face education. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <99> Accession Number 2050198184 Title Robotic-assisted versus manual percutaneous coronary intervention after contemporary randomized evidence: An updated systematic review and meta-analysis of patient-level procedural and radiation outcomes. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Razvi K.; Ibrahim M.; Irshad U.; Ishac R.; Shah Z.; Al Taweel A.; Shabaneh B.; Aldeiri M. Institution (Razvi, Ibrahim, Irshad, Shah, Al Taweel, Shabaneh, Aldeiri) University of Houston, HCA Clear Lake, Webster, TX, United States (Ishac) University of Texas MD Anderson Cancer Center, Houston, TX, United States Publisher Elsevier Inc. Abstract Background Robotic-assisted PCI (R-PCI) reduces measured radiation exposure to the primary operator, but procedural and patient-radiation benefits over manual PCI (M-PCI) remain uncertain. Objectives To compare procedural/PCI time, fluoroscopy time, contrast volume, air kerma, and dose-area product between R-PCI and M-PCI after incorporation of randomized evidence. Methods Randomized and nonrandomized comparative studies of adults undergoing PCI were included. Random-effects models used restricted maximum likelihood with modified Hartung-Knapp inference. Mean differences (MDs) were calculated as M-PCI minus R-PCI. Risk of bias was assessed using RoB 2 and ROBINS-I; certainty was assessed using GRADE. Results Twelve studies, including 2 randomized trials, contributed data. No primary pooled outcome differed significantly: procedural/PCI time, MD -3.90 min (95% CI: -16.15 to 8.35); fluoroscopy time, 0.17 min (95% CI: -2.61 to 2.95); contrast volume, 7.79 mL (95% CI: -3.08 to 18.66); air kerma, 232.01 mGy (95% CI: -145.67 to 609.70); and dose-area product, 31.31 dGy.cm2 (95% CI: -49.45 to 112.07). Heterogeneity was substantial (I2 = 72%-93%). A direct-report-only analysis favored R-PCI for contrast volume (MD: 17.76 mL; 95% CI: 4.62-30.90), but other sensitivity analyses did not materially change interpretation. Certainty was very low for all outcomes. Conclusions R-PCI has not shown consistent patient procedural or radiation benefit. Operator protection is supported descriptively but was not pooled; contrast reduction appeared only in sensitivity analysis. Future trials should assess patient benefit and team-wide occupational exposure. Copyright © 2026 Elsevier Inc. <100> Accession Number 2051416143 Title Beyond anticoagulation: defining the role of left atrial appendage closure in stroke prevention for atrial fibrillation. Source Europace. 28(11) (no pagination), 2026. Article Number: euag296. Date of Publication: 01 Nov 2026. Author Camm A.J. Institution (Camm) School of Health & Medical Sciences, City St George's University of London, Tooting Campus, Cranmer Terrace, London, United Kingdom Publisher Oxford University Press Abstract Oral anticoagulation has a very strong evidence base for stroke prevention in patients with atrial fibrillation (AF) at elevated thromboembolic risk. Direct oral anticoagulants have improved the safety and convenience of treatment, yet important limitations remain, including residual ischaemic stroke, major bleeding, treatment discontinuation, and patient refusal. Left atrial appendage closure (LAAC) offers an alternative strategy for selected patients by excluding the principal anatomical source of AF-related cardiac thrombi. However, the appropriate role of LAAC remains controversial, particularly in patients who can and do tolerate anticoagulation. This viewpoint argues for a more individualized approach that distinguishes absolute contraindications from modifiable bleeding risks, treatment refusal or non-persistence, and stroke occurring despite adequate anticoagulation. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <101> Accession Number 2051253399 Title Mechanical Cardiopulmonary Resuscitation - Assisted Percutaneous Coronary Intervention during Cardiac Arrest: Feasibility and Outcomes. Source Acta Cytologica. (pp 1-1), 2026. Date of Publication: 2026. Author Triantafyllis A.S.; Kotoulas S.C.; Aqeel I.; Karapedi E.; Antoniades K.; Pervana A.M.; Sotiris G.; Kolyda A.; Giannakopoulos A.; Poulimenos L.E. Institution (Triantafyllis, Kotoulas, Aqeel, Karapedi, Antoniades, Pervana, Sotiris, Kolyda, Giannakopoulos, Poulimenos) Department of Cardiology, General Hospital Asklepieio Voulas, Athens, Greece Publisher S. Karger AG Abstract Cardiac arrest complicating acute coronary syndromes requires immediate coronary reperfusion; however, performing percutaneous coronary intervention (PCI) during active manual cardiopulmonary resuscitation (CPR) presents significant technical challenges. The Lund University Cardiac Arrest System (LUCAS) provides automated mechanical chest compressions and enables uninterrupted CPR during coronary angiography and PCI. Existing evidence is primarily limited to case reports and small observational studies, mechanical CPR has emerged as a practical adjunct in catheterization laboratories where manual compressions are unsafe or logistically challenging. We report two cases from our center in which LUCAS-assisted PCI was performed during ongoing cardiac arrest in the setting of cardiogenic shock and acute coronary syndromes, alongside a structured narrative synthesis of contemporary literature addressing feasibility, procedural considerations, and clinical outcomes. Mechanical chest compressions allowed uninterrupted angiography and successful revascularization in both cases, with return of spontaneous circulation achieved in 1 patient. Despite procedural success, survival remained poor, reflecting severe global ischemia and metabolic derangement. LUCAS-assisted PCI is a technically feasible strategy that facilitates coronary reperfusion in carefully selected patients. Evidence of survival benefit remains limited and derives predominantly from observational studies and case reports rather than randomized controlled trials. The role of extracorporeal CPR as a complementary or alternative strategy warrants explicit consideration at appropriately resourced centers. Improved patient selection and integration into structured resuscitation pathways may enhance clinical outcomes. Copyright © The Author(s) 2026. Published by S. Karger AG. <102> Accession Number 2051028262 Title Effect of transcutaneous auricular vagus nerve stimulation on perioperative psychological symptoms in patients undergoing elective thoracoscopic lung resection: A randomized controlled trial. Source Chinese Medical Journal. (no pagination), 2026. Article Number: 10.1097/CM9.0000000000004326. Date of Publication: 2026. Author Sun Z.; Zhang S.; Liu H.; Tao M.; Wang Y.; Chen J.; Xiong X.; Deng Q.; Yu Y.; Lin Y.; Ma T.; Zhou M.; Li P.; Guo X.; Liu J.; Hang C.; Wang M.; Han Y.; Zhang H.; Cao J. Institution (Sun, Liu, Tao, Wang, Chen, Xiong, Deng, Yu, Lin, Ma, Zhou, Li, Guo, Liu, Hang, Wang, Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology and Brain Science & Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu, Xuzhou, China (Sun, Tao, Wang, Xiong, Yu, Lin, Ma, Zhou, Li, Guo, Liu, Hang, Wang, Cao) Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, Xuzhou, China (Zhang) Department of Anesthesiology, Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Liu) Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine & Key Laboratory of Anesthesia and Analgesia Application Technology, Huzhou Central Hospital & The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University & The Affiliated Huzhou Hospital, Zhejiang, Huzhou, China (Chen) Department of Anesthesiology, Suzhou Municipal Hospital, Jiangsu, Suzhou, China (Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, China Publisher Lippincott Williams and Wilkins Abstract Background: - Perioperative anxiety is highly prevalent in patients undergoing thoracoscopic lung resection, adversely affecting postoperative recovery. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising noninvasive neuromodulatory intervention with demonstrated efficacy in various psychiatric and stress-related conditions. This study aimed to evaluate the efficacy and safety of taVNS in reducing perioperative anxiety in this population. Method(s): - This single-center, parallel-group, randomized, double-blind, superiority trial was conducted at the Department of Anesthesiology and Thoracic Surgery, the Affiliated Hospital of Xuzhou Medical University between October 10, 2024, and April 30, 2025. A total of 176 eligible patients aged >=18 years with ASA physical status I-III and scheduled for elective thoracoscopic lung resection were enrolled. Patients with neuropsychiatric disorders, auricular lesions, severe cardio-cerebrovascular diseases, implanted electronic devices, Mini-Mental State Examination (MMSE) score <15, long-term psychotropic medication use or postural tachycardia syndrome were excluded. All participants were randomly allocated to receive four sessions of either active taVNS or sham taVNS. Stimulation was delivered via the auricular branch of the vagus nerve at the cymba conchae of the left ear at four predefined perioperative time points: the afternoon before surgery, the morning of surgery, immediately after tracheal extubation, and the afternoon of the first postoperative day. The primary outcome was the incidence of perioperative anxiety, assessed from the initiation of the first taVNS session through 3 days postoperatively. All participants, healthcare providers, outcome assessors and data analysts were blinded to group assignment during the whole study. Result(s): - A total of 176 patients were randomly assigned, with 88 participants in the active taVNS group and 88 in the sham taVNS group. After excluding 2 patients (1 patient from each group) who were transferred to the ICU postoperatively, a total of 174 patients (median age, 58 years; 105 women [60.4%]) completed the study and were analysed for the primary outcome, including 87 patients in each group. The incidence of perioperative anxiety was significantly lower in the active taVNS group than in the sham taVNS group (50.6% vs. 73.6%; relative risk [RR], 0.59; 95% confidence interval [CI], 0.41-0.85; chi2 = 9.76; P = 0.002). Compared with sham stimulation, active taVNS was associated with reductions in anxiety and depression scores, postoperative pain intensity, and physiological stress indices and improvement in sleep quality and overall postoperative recovery. No severe adverse events were observed in either group. The main mild adverse reactions included nausea, vomiting, local tingling, dizziness and headache, and the incidence of adverse events was similar between the two groups. Conclusion(s): - Four perioperative sessions of taVNS applied to the left cymba conchae significantly reduced the incidence of perioperative anxiety in patients undergoing thoracoscopic lung resection and were additionally associated with improvements in depressive symptoms, stress burden, sleep quality, and pain outcomes. Trial registration: - Chinese Clinical Trial Register Identifier: ChiCTR2400090542 (http://www.chictr.org.cn). Copyright © 2026 The Chinese Medical Association, produced by Wolters Kluwer Health, LLC. under the CC-BY-NC-ND license. <103> Accession Number 2051026996 Title Comparative Outcomes of Self-Expanding Versus Balloon-Expandable Valves in Severe Aortic Stenosis: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2026. Article Number: 10.1097/CRD.0000000000001501. Date of Publication: 2026. Author Elazab A.; Ali A.H.G.; Elbataa A.; Mansour A.; Hammad N.; Galal A.; Abdelaziz O.A.; Sayed M.S.; Elkasaby M.H.; Shaaban M.; Hassanin M.S.; Mousa A.I.A.; Elgendy I.Y.; Alharasees M.; Aly A.; Alali A.K.A.; Frishman W.H.; Aronow W.S. Institution (Elazab, Shaaban) Department of Medicine, Faculty of Medicine, Qena University, Qena, Egypt (Ali) Department of Medicine, Institute of Medicine, National Research Mordovia State University, Mordovia, Saransk, Russian Federation (Elbataa, Mansour, Galal, Elkasaby, Hassanin) Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Hammad) Department of Medicine, Faculty of Medicine, Port Said University, Port Said, Egypt (Abdelaziz) Department of Medicine, Faculty of Medicine, Misr University of Science and Technology, Giza, Egypt (Sayed) Department of Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt (Mousa) Department of Pharmacy, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo, Egypt (Elgendy) Department of Medicine, Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, United States (Alharasees) Department of Medicine, Faculty of Medicine, Mutah University, Al-Karak, Jordan (Aly) Department of Medicine, The Ohio State University Wexner Medical Center, The James Comprehensive Cancer Center, Columbus, OH, United States (Alali) Department of Medicine, Faculty of Medicine, Yarmouk University, Irbid, Jordan (Frishman, Aronow) Departments of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY, United States Publisher Lippincott Williams and Wilkins Abstract Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis, with self-expanding valves (SEV) and balloon-expandable valves (BEV) representing the two major platforms. However, their comparative clinical and hemodynamic performance remains uncertain. We systematically searched four electronic databases through August 2026 for studies comparing SEV and BEV in patients undergoing TAVR. The primary outcomes were permanent pacemaker implantation (PPI) and change in mean pressure gradient (MPG), while secondary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), stroke, paravalvular leakage (PVL), heart failure hospitalization, coronary obstruction, and prosthesis-patient mismatch (PPM). Twenty-three studies involving 21,609 patients were included. Compared with BEV, SEV was associated with a significantly greater reduction in MPG (MD -4.48, 95% CI -5.29 to -3.67; P < 0.0001) and lower risks of moderate (RR 0.56, 95% CI 0.42-0.75) and severe PPM (RR 0.33, 95% CI 0.25-0.44). Conversely, SEV was associated with higher risks of PPI (RR 1.40, 95% CI 1.14-1.72; P < 0.0001), moderate-to-severe PVL (RR 2.28, 95% CI 1.65-3.14; P < 0.0001), and a small but significant increase in all-cause mortality. No significant differences were observed in MACE, stroke, heart failure hospitalization, or coronary obstruction.. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <104> Accession Number 2050180640 Title Bibliometric Analysis and Cluster Analysis of Research Trends on Postoperative Cognitive Dysfunction in Elderly Patients After Anesthesia. Source Journal of Perianesthesia Nursing. (no pagination), 2026. Date of Publication: 2026. Author Duan J.; Duan X.; Zhang H.; Chu J. Institution (Duan) Department of Anesthesiology, Sir Run Run Shaw Hospital, affiliated with the Zhejiang University School of Medicine, Hangzhou, China (Duan) Department of Orthopaedic Surgery, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, China (Zhang) Department of Thoracic Surgery, Sir Run Run Shaw Hospital, affiliated with the Zhejiang University School of Medicine, Hangzhou, China (Chu) Department of Thyroid and Head & Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou, China Publisher W.B. Saunders Abstract Purpose The purpose of this study was to analyze research on postoperative cognitive dysfunction in elderly patients after anesthesia and to identify research hotspots and trends. Design A bibliometric analysis. Methods We searched the Web of Science Core Collection for English-language publications on postoperative cognitive dysfunction in elderly patients after anesthesia published from 1988 to 2024. The retrieved data were analyzed using VOSviewer, CiteSpace, and R 4.3.3. Findings A total of 1,119 articles were included in the analysis. Among countries, China had the highest number of publications. Among institutions, Harvard University ranked first, with 165 publications. Among journals, Anesthesiology had the highest total number of citations, with 3,074 citations and an impact factor of 9.1. Among authors, Xie Zhongcong had the largest number of publications, with 24 articles and 1,045 citations. Keyword cluster analysis identified seven major research themes: anesthesia approach, risk, and clinical management; pathophysiological mechanisms and neuroinflammation; cardiovascular surgery and perioperative monitoring; biomarkers and neurodegeneration; anesthetic drugs and assessment tools; outcomes and neurophysiological responses; and recommendations. High-frequency keywords such as "anesthesia," "surgery," and "dysfunction" reflected the main research hotspots and trends in this field. Conclusions This bibliometric study summarizes the research landscape of postoperative cognitive dysfunction in elderly patients after anesthesia and identifies major contributors, research hotspots, and evolving trends. The findings may provide a useful reference for future research in this field. Copyright © 2026 The American Society of PeriAnesthesia Nurses. <105> Accession Number 2050133233 Title Transcutaneous low-level vagus nerve stimulation for the prevention of postoperative atrial fibrillation after cardiac valve surgery with cardiopulmonary bypass: protocol for a randomized controlled trial. Source BMC Complementary Medicine and Therapies. 26(1) (no pagination), 2026. Article Number: 333. Date of Publication: 01 Dec 2026. Author Bian L.; Shi Y.; Liu T.; Zhang Y.; Li J.; Zhang J. Institution (Bian, Liu, Zhang, Zhang) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Zhejiang, Hangzhou, China (Shi) Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Zhejiang, Hangzhou, China (Li) Department of Cardiac Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Zhejiang, Hangzhou, China Publisher BioMed Central Ltd Abstract Background: Atrial fibrillation (AF) is one of the most common complications following cardiac surgery, with reported incidence rates reaching up to 44%. Transcutaneous low-level vagus nerve stimulation (TLL-VNS) has shown potential in reducing the risk of postoperative AF by modulating autonomic nervous system activity, suppressing inflammation, and regulating atrial ganglionic function. Method(s): The Vagus-Heart Trial is a prospective, randomized, double-blind, sham-controlled study designed to evaluate the efficacy of TLL-VNS in preventing postoperative AF. A total of 140 patients undergoing elective cardiac valve surgery with cardiopulmonary bypass (CPB) are randomly assigned to receive either active TLL-VNS or sham stimulation. The primary endpoint is the incidence of AF within the first week after surgery. Secondary endpoints include the duration of AF within the first week after surgery, surgical parameters, vital signs, inflammatory markers, renal function, surgical prognosis, and stress response biomarkers. Discussion(s): This trial is the first large-scale, randomized, sham-controlled study to evaluate TLL-VNS for the prevention of postoperative AF in patients undergoing cardiac valve surgery with CPB. If proven effective, TLL-VNS could represent a novel, non-invasive, and cost-effective strategy to enhance postoperative recovery and reduce the burden of AF in this high-risk population. Trial registration: Chictr.org.cn Identifer: ChiCTR2400080750. Registered on 6 February 2024. Copyright © The Author(s) 2026. <106> Accession Number 2051341133 Title Fissios and postoperative complications (FPoC trial): a multicentre, randomised, controlled clinical trial. Source BMJ Open Respiratory Research. 13(1) (no pagination), 2026. Article Number: e003269. Date of Publication: 2026. Author Fraile Olivero C.A.; Sotillo Valenzuela L.; Albarran Vidal V.; Barcelo Cal J.G.; Alen Villamayor V.; Hernando Trancho F.; Fernandez Martin E.; Calatayud Gastardi J.; Gomez Martinez A.M.; Arribas Manzanal P.D.; Santos P.; Fernandez Blanco R.; Cal Vazquez M.I.; Milla Collado L.; Rodriguez M.; Perna V.; Romero Roman A.; Ordonez C.A.; Jarabo Sarceda J.R. Institution (Fraile Olivero, Sotillo Valenzuela, Albarran Vidal, Barcelo Cal, Alen Villamayor, Hernando Trancho, Fernandez Martin, Calatayud Gastardi, Gomez Martinez, Jarabo Sarceda) Hospital Clinico San Carlos, Madrid, Madrid, Spain (Arribas Manzanal, Santos, Fernandez Blanco) Hospital Clinico San Carlos, Madrid, Madrid, Spain (Cal Vazquez) Hospital Universitario de la Princesa, Community of Madrid, Madrid, Spain (Milla Collado) Hospital Central de la Defensa Gomez Ulla, Community of Madrid, Madrid, Spain (Rodriguez, Perna) Clinica Universidad de Navarra, Madrid, Madrid, Spain (Romero Roman) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Majadahonda, Spain (Ordonez) Hospital Clinico Universitario, Valencian Community, Valencia, Spain Publisher BMJ Publishing Group Abstract Introduction: Respiratory physiotherapy as a part of a perioperative physical training programme may reduce the risk of developing postoperative complications in patients diagnosed with non-small cell lung carcinoma (NSCLC) scheduled for surgery. However, there is heterogeneity in the design, implementation and evaluation of respiratory physiotherapy programmes.Fissios App contains a standardised respiratory physiotherapy programme. Analysing the usage data, the patient's personal history, the surgical procedure and the postoperative course, we will establish the relationship between compliance with a standardised respiratory physiotherapy programme and the development of postoperative complications in a group of patients diagnosed with NSCLC who underwent lung resection surgery. Methods and analysis: The Fissios and postoperative complications trial is a multicentre, prospective, randomised, parallel two-group, controlled, open-label, superiority study of the use of only face-to-face respiratory physiotherapy or the use of Fissios App as a complement to respiratory physiotherapy. Based on the percentage of postoperative respiratory complications and the anticipated reduction, a total of 560 patients will be required. Patients will be electronically randomised to the intervention or control group before the surgery with a proportion of 1:1 in blocks of six for each centre.All patients will attend face-to-face respiratory physiotherapy sessions at the place and times established in each centre. In addition, patients in the intervention group will use the Fissios App freely and without restrictions in terms of hour of the day, usage time or location. The primary clinical endpoint is postoperative complications during hospital admission and the estimated duration of the study is 12 months. Ethics and dissemination: This protocol was reviewed and approved by the Clinical Research and Clinical Trials Unit of Hospital Clinico San Carlos (Madrid, Spain) and complies with the ethics principles for medical research on humans stipulated in the Declaration of Helsinki of the World Medical Association. Trial registration number: NCT06732193. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <107> Accession Number 2050164973 Title Publication Trends in Congenital Heart Defect Repair: A Bibliometric Analysis of the 100 Most Cited Surgical Publications. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 4798274. Date of Publication: 2026. Author Alabadi A.I.; Alaraimi S.M.; Alduhami L.S.; AlQabbani H.M.; Alwan R.M.A.; Albishri A.F.; Basabrain S.O.; Almaqhawi Y.K.; Alwadaani H.A. Institution (Alabadi, Almaqhawi) College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia (Alaraimi) Sultan Qaboos University Hospital, University Medical City, Muscat, Oman (Alduhami) College of Medicine, Qassim University, Qassim, Saudi Arabia (AlQabbani) College of Medicine, University of Majmaah, Majmaah, Saudi Arabia (Alwan) College of Medicine, Royal College of Surgeons, Dublin, Ireland (Albishri) College of Medicine, University of Jeddah, Jeddah, Saudi Arabia (Basabrain) College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Alwadaani) General Surgery Department, King Faisal University, Al-Ahsa, Saudi Arabia Publisher John Wiley and Sons Inc Abstract Introduction: Congenital heart disease (CHD) ranks as one of the most prevalent congenital anomalies as detection rates have increased due to evolving surgical management over the past decades. Although there have been well-documented clinical and surgical outcomes, a lack of analysis interferes with the recognition of studies that have influenced surgical practices. The purpose of this study is to perform a detailed bibliometric analysis of the top 100 most-cited articles centered on CHD surgery. This analysis will help identify research trends, key authors, and encourage future research. Method(s): A comprehensive search using the Web of Science database identified publications aimed at CHD procedures. The screening process was conducted by four independent reviewers, who extracted numerous important details from the data and analyzed them. A fifth reviewer resolved any inconsistencies in the title and abstract screening. To analyze and summarize the bibliometric data, descriptive statistics were constructed. Result(s): Highly cited publications frequently reported improved outcomes in selected CHD lesions, including Ebstein's anomaly repair, total anomalous pulmonary venous connection, sinus venosus ASD, and isolated VSD. In contrast, publications addressing complex lesions such as interrupted aortic arch, Fontan circulation, pulmonary atresia, and complete atrioventricular septal defect more often reported higher morbidity and reintervention rates, although findings were heterogeneous across studies. These observations reflect the content of highly cited literature rather than a systematic outcome comparison and should be interpreted as patterns within the published record. Conclusion(s): This bibliometric analysis sets forth the foundation of CHD research by highlighting the need for more high-quality studies. It also points out how crucial it is to improve access to care in resource-constrained environments and the importance of authorship representation. Copyright © 2026 Abdulhamid I. Alabadi et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <108> Accession Number 2051368866 Title Comparison of Ultrasound-Guided Pecto-Intercostal Fascial Plane Block and Transversus Thoracic Muscle Plane Block for Post-Operative Analgesia in Cardiac Surgery: A Prospective Randomised Double-Blind Study. Source International Journal of Pharmacy Research and Technology. 16(1) (pp 5446-5453), 2026. Date of Publication: 01 Jan 2026. Author Shanthini S.; Stalin R.; Kamakshi S. Institution (Shanthini) Department of Anaesthesiology, Government Dindugal Medical College, Tamil Nadu, India (Stalin) Department of Anaesthesiology, Government Thiruvarur Medical College, Tamil Nadu, India (Kamakshi) Department of Anaesthesiology, Government Omandurar Medical College, Tamilnadu, Chennai, India Publisher Advanced Scientific Research Abstract Background: Post-operative pain after cardiac surgery requiring median sternotomy is common and, when inadequately controlled, contributes to hemodynamic instability, respiratory complications and delayed recovery. Ultrasound-guided interfascial plane blocks have emerged as safer alternatives to neuraxial techniques in anticoagulated cardiac patients. Aim(s): To compare the analgesic efficacy of ultrasound-guided pecto-intercostal fascial plane block (PIFB) and transversus thoracic muscle plane block (TTMPB) in patients undergoing open cardiac surgery. Material(s) and Method(s): A prospective randomised double-blind study was conducted on 86 patients (ASA III-IV, aged 30-50 years) undergoing elective cardiac surgery via median sternotomy. Patients were randomised into Group P (PIFB, n=43) and Group T (TTMPB, n=43); both received 20 mL of 0.25% bupivacaine bilaterally. Hemodynamic parameters (pulse rate, mean arterial pressure) were recorded peri-sternotomy, and post-operative pain (VAS), time to first rescue analgesia and 24-hour analgesic consumption were compared. Result(s): Intraoperative pulse rate and MAP during and after sternotomy were significantly lower in Group P than Group T (p<0.0001), indicating better intraoperative hemodynamic control with PIFB. Intraoperative fentanyl use was lower in Group P (351.05+/-41.25 vs 429.77+/-36.81 mcg, p<0.0001). However, Group T had a markedly longer time to first rescue analgesia (514.42+/-43.82 vs 110.93+/-34.00 min, p<0.0001), lower immediate post-operative median VAS (2 vs 7, p<0.0001) and lower 24-hour analgesic consumption (p<0.0001). Conclusion(s): PIFB provided superior intraoperative hemodynamic stability and pain control during sternotomy, whereas TTMPB provided superior post-operative analgesia with a longer duration and reduced rescue analgesic requirement. Copyright (c) 2026 Authors. This work is licensed under a Creative Commons Attribution 4.0 International License. https://creativecommons.org/licenses/by/4.0/ <109> Accession Number 2051330025 Title Analgesic efficacy of locoregional anesthesia techniques in cardiac surgery: a systematic review and network meta-analysis of randomized trials. Source Regional Anesthesia and Pain Medicine. (no pagination), 2026. Date of Publication: 2026. Author Dejaegere M.; Vandepitte J.; Van den Eynde J.; Coppens S.; Oosterlinck W.; Rex S.; Hoogma D.F. Institution (Dejaegere, Vandepitte, Coppens, Rex, Hoogma) Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium (Van den Eynde, Coppens, Oosterlinck, Rex, Hoogma) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (Oosterlinck) Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium Publisher BMJ Publishing Group Abstract Background: Postoperative pain following cardiac surgery remains a clinical challenge. Despite opioids remaining central to perioperative analgesia, their adverse-effect burden drives the search for effective locoregional analgesic (LRA) alternatives; yet guideline recommendations remain constrained by the lack of high-quality comparative data among LRA techniques. Method(s): This systematic review and network meta-analysis evaluated the analgesic efficacy of relevant LRA techniques in adult patients undergoing cardiac surgery. Primary outcomes were opioid consumption, pain scores, and time to first rescue analgesia within 24 hours postoperatively. Secondary outcomes included intensive care unit (ICU) and hospital length of stay (LOS), block-related complications, and side effects. PubMed, Embase, and CENTRAL were searched up to June 30, 2025. A Bayesian random-effects network meta-analysis was performed. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Result(s): 133 randomized trials (9816 patients) were included. Compared with control, three LRA techniques reduced 24-hour opioid consumption (MME, mean difference (95% credible interval)): intrathecal opioids (IT) -14.8 (-20.7; -9.2), erector spinae plane block (ESPB) -9.7 (-14.8; -4.9), and parasternal intercostal plane block (PIPB) -6.3 (10.5; -2.3). IT produced the largest and consistent pain score reductions (-1.2 cm (-3.3; -0.7) on the visual analog scale at 24 hours). No technique prolonged time to first rescue analgesia. ESPB -8.3 hours (-13.7; -2.8), PIPB -7.2 hours (-12.2; -2.3), and TEA -11.8 hours (-20.2; -3.0) reduced ICU LOS, while only TEA reduced hospital LOS by 1.2 days (-1.7; -0.6). No major block-related complications were reported. Conclusion(s): IT demonstrated the largest reductions in opioid consumption and pain scores in the first 24 hours. ESPB and PIPB represent promising alternatives when neuraxial techniques are contraindicated, though effect sizes were smaller, often below thresholds of clinical relevance. Substantial interstudy heterogeneity emphasizes the need for rigorous, high-quality trials to standardize LRA strategies in cardiac surgery and to better define their impact on recovery and safety endpoints. PROSPERO registration number: CRD42021261282. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <110> Accession Number 2050147101 Title The Association Between Chronic Obstructive Pulmonary Disease and Postoperative Delirium: A Systematic Review and Meta-Analysis. Source International Journal of COPD. 21 (no pagination), 2026. Article Number: 644864. Date of Publication: 2026. Author Wang Z.; Xu J.; Xi Y.; Luo Z.; Cheng J.; Xu Z.; Liang P. Institution (Wang, Xu, Liang) Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Sichuan, Chengdu, China (Xu) Department of Anesthesiology, West China Hospital, Sichuan University, Day Surgery Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Sichuan, Chengdu, China (Xi, Luo) West China Clinical Medical School, Sichuan University, Sichuan, Chengdu, China (Cheng) The First Clinical Medical College of Nanchang University, Jiangxi Medical College, Nanchang University, Jiangxi, Nanchang, China (Liang) Day Surgery Center, West China Hospital, Sichuan University, Sichuan, Chengdu, China Publisher Dove Medical Press Ltd Abstract Background: Postoperative delirium (POD) is a frequent and serious complication following surgery, particularly in high-risk patients such as those with chronic obstructive pulmonary disease (COPD). The relationship between COPD and the development of POD remains unclear, with existing studies providing inconsistent findings. This meta-analysis aims to evaluate the association between COPD and postoperative delirium in surgical patients. Method(s): A comprehensive literature search was conducted across multiple databases, including PubMed, MEDLINE, Web of Science, Embase, and the Cochrane Library, and other grey resources. Observational studies and randomized controlled trials assessing the incidence of POD in COPD patients were included. Data were extracted on study design, participant demographics, surgical context, and POD assessment. Both fixed-effect and random-effects models were evaluated, with model selection guided by statistical heterogeneity and study characteristics. Subgroup analyses were performed to explore heterogeneity. Result(s): A total of 26 studies involving 43,051 patients were included. Both unadjusted and adjusted analyses showed a significant association between COPD and the increased risk of POD. The pooled odds ratio (OR) for the association in adjusted analyses was 2.08 (95% CI: 1.60-2.71, P < 0.001; I2 = 67.2%). In the adjusted subgroup analysis, the association remained statistically significant in non-cardiac surgery but did not reach statistical significance in cardiac surgery; however, the between-subgroup difference was not statistically significant (P for interaction = 0.139). Geographic variation was identified as a potential effect modifier, with studies conducted in Asia showing a stronger association. Conclusion(s): The available evidence suggests an association between COPD and higher odds of POD in surgical patients, including in studies reporting multivariable-adjusted estimates. However, the predominantly observational evidence and between-study heterogeneity warrant cautious interpretation and do not establish causality. These findings highlight the potential importance of tailored perioperative management strategies for patients with COPD, although their effectiveness in reducing POD risk requires further investigation. Further well-designed prospective studies are necessary to confirm these findings and explore the underlying mechanisms. However, insufficient data on COPD severity precluded an assessment of whether this association varied across GOLD stages. Copyright © 2026 Wang et al. <111> Accession Number 2050143534 Title Effect-site concentrations of remifentanil to suppress coughing during emergence from general anesthesia in adults: a systematic review and meta-analysis. Source Canadian Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Kim N.; Park J.H.; Kim S.; Lee J.W.; Kim M.-S. Institution (Kim, Park, Kim, Lee, Kim) Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea Publisher Springer Abstract Purpose: Remifentanil infusion titrated to effect-site concentration (Ce) is commonly used to suppress coughing during emergence from general anesthesia; nevertheless, the optimal Ce range remains unclear. We aimed to conduct a systematic review and meta-analysis to synthesize the existing evidence on the optimal Ce values of remifentanil for cough suppression during emergence. Source: We performed a comprehensive literature search using PubMed, Embase, Web of ScienceTM, the Cochrane Library, and Google Scholar on 27 February 2025. We included prospective studies that used the up-and-down method to estimate the effective concentrations of remifentanil in 50% of patients (EC<inf>50</inf>) and 95% of patients (EC<inf>95</inf>) for suppressing coughing during emergence from general anesthesia with tracheal intubation in adult patients. We excluded studies in children or patients undergoing cardiac surgery, as well as those that only compared predefined Ce targets of remifentanil to determine optimal dosing. We obtained pooled estimates using a random-effects model with inverse-variance method, and heterogeneity was quantified using the I2 statistic. We assessed risk of bias using the Cochrane Risk-of-Bias 2 tool for randomized trials and the Methodological Index for Non-Randomized Studies for nonrandomized comparative or single-arm studies. The primary outcome was EC<inf>50</inf> estimated using the up-and-down method, with secondary outcomes including model-based EC<inf>50</inf> and EC<inf>95</inf> estimates. Principal findings: We included 22 prospective studies comprising 857 adult participants, and none were assessed as being at a high risk of bias or of low methodologic quality. Based on 28 groups and 653 participants across 17 studies, the pooled mean EC<inf>50</inf> from the up-and-down method was 2.0 ng.mL-1 (95% confidence interval [CI], 1.8 to 2.3), with considerable heterogeneity (I2 = 74.5%). Based on 29 groups and 693 participants across 18 studies, the model-based EC<inf>50</inf> was 1.9 ng.mL-1 (95% CI, 1.6 to 2.1), with considerable heterogeneity (I2 = 96.1%). Based on 31 groups and 809 participants across 20 studies, the model-based EC<inf>95</inf> was 2.7 ng.mL-1 (95% CI, 2.5 to 3.0), with considerable heterogeneity (I2 = 99.5%). Subgroup analyses revealed higher mean EC<inf>50</inf> values in male individuals (2.6 ng.mL-1) and the highest mean EC<inf>50</inf> in patients undergoing video-assisted thoracic surgery (2.6 ng.mL-1). Using the Grading of Recommendations, Assessment, Development, and Evaluation framework, the certainty of evidence was rated as very low for all outcomes. Conclusion(s): The identified EC<inf>50</inf> and EC<inf>95</inf> values of remifentanil for suppressing coughing during emergence from general anesthesia in adults were 2.0 and 2.7 ng.mL-1, respectively. Patient sex and surgical type may influence the required Ce. Careful dose adjustment is recommended to avoid delayed awakening and hypoventilation, especially in cases requiring higher concentrations. Study registration: PROSPERO (CRD42024623581); first submitted 20 December 2024. Copyright © Canadian Anesthesiologists' Society 2026. <112> Accession Number 2051329344 Title Impact of continuous serratus plane analgesia on quality of recovery after video-assisted thoracic surgery: a prospective double-blind, randomized, placebo-controlled trial. Source Regional Anesthesia and Pain Medicine. (no pagination), 2026. Date of Publication: 2026. Author Biswas A.; Zidan H.; Kolodzey L.; Kumar K.; Nagappa M.; Fochesato L.-A.; Fortin D.; Inculet R.; Lin C.; Misurati M.; Nicolaou G.; Gomez Tamayo J.C.; Qiabi M.; Nayak R.; Van Doormaal C.J.; Malthaner R. Institution (Biswas, Zidan, Kolodzey, Kumar, Nagappa, Fochesato, Lin, Misurati, Nicolaou, Gomez Tamayo, Van Doormaal) Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, ON, Canada (Fortin, Inculet, Qiabi, Nayak, Malthaner) Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, ON, Canada Publisher BMJ Publishing Group Abstract Background: Video-assisted thoracoscopic surgery (VATS) offers numerous advantages over open surgery; nevertheless, it remains associated with significant postoperative pain. Multiple regional anesthesia techniques have been explored, and the serratus anterior plane block (SAPB) has emerged as a promising option; however, evidence on the use of continuous SAPB infusion for quality of recovery (QoR-40) remains limited. We hypothesized that continuous SAPB infusion, combined with multimodal analgesia, could improve QoR-40 after VATS. Method(s): In this prospective, double-blind, randomized controlled trial, adults undergoing elective VATS received an infusion of either 0.2% ropivacaine or saline via a SAPB catheter, in addition to standardized multimodal analgesia. The primary outcome was the QoR-40 score on postoperative day (POD) 1. Secondary outcomes included QoR-40 scores on POD 2-4, pain scores, opioid consumption in intravenous morphine milligram equivalents (IV MME), length of hospital stay (LOS), complications, and 30-day readmission. Result(s): A total of 173 patients were analyzed (SAPB: n=88; control: n=85). Median QoR-40 scores on POD 1 were higher in the SAPB group (176 (166-184) vs 172 (159-183); p=0.1036), and remained higher across POD 2 to 4, although not statistically significant. SAPB significantly reduced opioid consumption in recovery (8.0+/-7.4 vs 10.6+/-9.3 IV MME; p=0.0388) and on POD 1 (12.73+/-10.75 vs 16.45+/-12.17 IV MME; p=0.0349). LOS was also lower but not statistically significant by 0.8 days (2.69+/-1.76 vs 3.50+/-4.01; p=0.0872). Pain scores, complications, and 30-day readmissions were similar between groups. Conclusion(s): In this prospective, double-blind, randomized, placebo-controlled trial, continuous SAPB catheter infusion did not improve the primary outcome (QoR-40), and the observed differences in secondary outcomes should be interpreted as exploratory. Larger studies are needed to confirm effects on patient-reported recovery. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <113> Accession Number 2050158583 Title Residual Surgical Left Atrial Appendage Leaks: Thromboembolic Risk and Anatomy-Tailored Percutaneous Closure Strategies. Source PACE - Pacing and Clinical Electrophysiology. 49(11) (pp 1790-1798), 2026. Date of Publication: 01 Nov 2026. Author Kivrak A.; Dogan M.; Coteli C.; Keresteci A.H.; Ates A.H.; Canpolat U.; Yorgun H.; Sahiner M.L.; Kaya E.B.; Aytemir K. Institution (Kivrak, Coteli, Ates, Canpolat, Yorgun, Sahiner, Kaya, Aytemir) Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey (Dogan) Kozluk State Hospital, Batman, Turkey (Keresteci) Department of Cardiology, Sincan Training and Research Hospital, Ankara, Turkey (Yorgun) Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Limburg, Netherlands Publisher John Wiley and Sons Inc Abstract Background: Atrial fibrillation is a leading cause of cardioembolic stroke, and the left atrial appendage (LAA) is the principal source of thrombus formation in non-valvular disease. Surgical LAA exclusion is commonly performed during cardiac surgery, but incomplete closure resulting in a residual communication is not uncommon and may carry ongoing thromboembolic risk. Unlike peri-device leaks after transcatheter closure, residual surgical leaks are anatomically and mechanistically distinct, typically arising through a central, fibrotic ostium with a variable residual pouch, and no validated management pathway currently exists. Method(s): We conducted a structured literature search of PubMed/MEDLINE, Embase, the Cochrane Library, and Google Scholar for reported cases and surgical subgroups in which residual leaks after surgical LAA ligation or amputation were managed percutaneously. Because the evidence was predominantly observational and case-based, findings were synthesized narratively rather than as a formal meta-analysis. Result(s): Across 37 reported percutaneous procedures identified from case reports, small series, and registry surgical subgroups, closure strategies comprised vascular plugs and septal occluders, dedicated LAA occlusion devices, non-barbed disc-based occluders in anatomically high-risk cases, and endocardial radiofrequency ablation for uncrossable fibrotic leaks. Acute success was high, although outcome reporting was heterogeneous and long-term data were limited. Conclusion(s): Residual surgical LAA leaks are an underrecognized, anatomically distinct entity. We propose an anatomy-tailored management framework integrating leak traversability, adjacent vascular anatomy, ostial morphology, and residual pouch depth; given the limited evidence, this should be regarded as hypothesis-generating, and prospective multicenter data are needed. Copyright © 2026 Wiley Periodicals LLC. <114> Accession Number 2050148906 Title Efficacy of perioperative recombinant human brain natriuretic peptide for preventing acute kidney injury after cardiac surgery: Rationale, design, and study protocol for a multicenter, double-blind, randomized controlled trial (PROTECT-CS). Source American Heart Journal. 304 (no pagination), 2027. Article Number: 107615. Date of Publication: 01 Feb 2027. Author Han J.; Ma X.; Chen Q.; Zhou H.; Li F.; Li H.; Liu L.; Cai J.; Du J.; Zhang H.; Liu S. Institution (Han, Ma, Zhou, Li, Li, Liu, Cai, Du, Zhang, Liu) National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Chen) Department of Cardiovascular Surgery, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, China (Zhou, Li, Du, Zhang, Liu) Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Liu, Cai) Department of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Elsevier Inc. Abstract Background Acute kidney injury (AKI) is one of the most common and consequential complications after cardiac surgery. Despite improvements in perioperative care, no pharmacological intervention has been definitively shown to prevent AKI following cardiac surgery. Recombinant human brain natriuretic peptide (rhBNP) shares structural and biological activity with endogenous brain natriuretic peptide and has demonstrated favorable natriuretic, diuretic, and renal hemodynamic effects in prior studies. However, robust randomized evidence on whether perioperative rhBNP can prevent AKI is lacking. Design This is an investigator-initiated, multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-group trial comparing perioperative rhBNP with placebo in high-risk patients undergoing elective on-pump cardiac surgery. A total of 694 participants will be randomized 1:1 to receive a continuous intravenous infusion of rhBNP (0.01 microg/kg/min) or matched normal-saline placebo, initiated between anesthesia induction and the onset of cardiopulmonary bypass and continued for 48 +/- 2 hours. The primary efficacy endpoint is the incidence of AKI within 7 postoperative days defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints include AKI severity and duration, renal replacement therapy during the index hospitalization, major adverse kidney events at 30 and 90 days (MAKE-30, MAKE-90), 30-day all-cause mortality, intensive care unit and total length of stay. Conclusions To our knowledge, PROTECT-CS is the first adequately powered, multicenter, double-blind randomized trial designed to evaluate whether perioperative rhBNP prevents AKI after high-risk cardiac surgery. The study is intended to provide high-quality evidence to inform clinical practice and future guideline recommendations on pharmacological renal protection in cardiac surgery patients. Clinical trial registration https://www.clinicaltrials.gov (NCT07617675), Unique identifier : NCT07617675. Copyright © 2026 Elsevier Inc. <115> Accession Number 2050089562 Title Hemodynamic effects of ventilating or not, during cardiopulmonary bypass in a porcine model. Source Scandinavian Cardiovascular Journal. 61(1) (no pagination), 2027. Article Number: 2751272. Date of Publication: 2027. Author Kvalheim V.L.; Mongstad A.; Husby P.; Stangeland L.; Nginamau E.S.; Osman T.A.; Yamada S.; Grong K.; Svendsen O.S. Institution (Kvalheim, Mongstad) Department of Heart Disease, Section for Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway (Kvalheim, Stangeland, Grong) Department of Clinical Science, University of Bergen, Bergen, Norway (Husby, Svendsen) Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway (Husby, Svendsen) Department of Clinical Medicine, University of Bergen, Bergen, Norway (Nginamau) Department of Pathology, Haukeland University Hospital, Bergen, Norway (Osman, Yamada) Department of Clinical Dentistry, University of Bergen, Bergen, Norway Publisher Taylor and Francis Ltd. Abstract Background. Optimal ventilator setting during cardiopulmonary bypass (CPB) is unknown. Improved gas exchange and lung compliance have been suggested as favourable outcomes when lungs are ventilated. However, long-time effects have been hard to demonstrate. There has been less focus on the immediate circulatory effects of ventilator settings during cardioplegia and CPB, and potentially hemodynamic effects of different ventilator strategies are unknown. Methods. Sixteen anesthetized pigs on normothermic CPB with 80 min of aortic cross-clamp and cardioplegic arrest were randomized to a ventilated and a not ventilated group. After weaning, both cardiac-, hemodynamic-, and pulmonary functions were evaluated for up to 120 min. Results. Left ventricular variables and cardiac output did not differ between the two study groups, neither before nor after weaning. After weaning, mean pulmonary artery pressure was increased in ventilated compared to not ventilated animals. Neither pulmonary compliance nor oxygen uptake differed between groups in surviving animals. Conclusions. Disconnection of the ventilator during CPB and cardiac arrest did not affect lung compliance and oxygen uptake, neither positively nor negatively. In the ventilated group, a temporary increase in the pulmonary pressure after weaning was observed. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <116> Accession Number 2050055963 Title Colchicine and Perioperative Acute Kidney Injury: A Substudy of the COP-AF Randomized Clinical Trial. Source American Journal of Kidney Diseases. (no pagination), 2026. Date of Publication: 2026. Author Garg A.X.; Cuerden M.S.; Sontrop J.M.; Wang M.K.; Devereaux P.J.; Cata J.P.; Chan M.T.V.; Fleischmann E.; Grande A.M.; Landoni G.; Maziak D.E.; McLean S.R.; Parikh C.R.; Popova E.; Reimer C.; Trujillo Reyes J.C.; Roshanov P.; Sessler D.I.; Srinathan S.; Tallada A.G.; Conen D. Institution (Wang, Devereaux, Roshanov, Conen) Population Health Research Institute, Hamilton, Canada (Wang, Devereaux, Conen) Department of Medicine, McMaster University, Hamilton, Canada (Garg, Wang, Devereaux, Conen) Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada (Maziak) Division of Thoracic Surgery, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Canada (Reimer) Department of Anesthesiology, Queen's University, Kingston Health Sciences Centre, Kingston, Canada (Garg, Roshanov) Division of Nephrology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, United Kingdom (Garg, Sontrop, Roshanov) Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, United Kingdom (Garg, Cuerden, Sontrop) London Health Sciences Centre Research Institute, London, United Kingdom (Garg) London Health Sciences Centre, London, ON, Canada (McLean) Vancouver Acute Department of Anesthesiology and Perioperative Medicine, Vancouver General Hospital, Vancouver, BC, Canada (Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB, Canada (Cata) Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States (Sessler) Center for Outcomes Research and Department of Anesthesiology, UTHealth, Houston, TX, United States (Parikh) Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States (Grande) Hospital Universitario Ramon y Cajal, Madrid, Spain (Popova) Centro de Investigacion Biomedica en Red Enfermedades Cardiovaculares, Madrid, Spain (Trujillo Reyes) TRAIL Research Group, Institute de Recerca Sant Pau, Barcelona, Spain (Trujillo Reyes) Department of Thoracic Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Tallada) Department of Anesthesiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain (Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, San Raffaele, Milan, Italy (Landoni) School of Medicine, Vita-Salute University, San Raffaele, Milan, Italy (Chan) Chinese University of Hong Kong Shatin, Hong Kong Special Administrative Region, China (Fleischmann) Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria Publisher W.B. Saunders Abstract Rationale & Objective Perioperative inflammation may result in organ injury, including acute kidney injury (AKI). Colchicine, an anti-inflammatory drug, may help protect the organs from inflammation. This clinical trial substudy examined whether colchicine reduced the risk of perioperative AKI compared with placebo. Study Design Prespecified substudy of a placebo-controlled randomized clinical trial. Setting & Participants Patients aged 55 years or older undergoing major noncardiac thoracic surgery enrolled in the Colchicine for the Prevention of Perioperative Atrial Fibrillation (COP-AF) trial from 45 centers in 11 countries (2018-2023). Patients were excluded for a history of atrial fibrillation, for taking antiarrhythmic medication, or for a preoperative estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m2. Exposure Participants were randomized 1:1 to 0.5 mg oral colchicine or placebo, given twice daily for a total of 10 days. Patients, health care providers, data collectors, and outcome adjudicators were masked to the treatment assignment. Outcome Perioperative AKI, defined as an increase in serum creatinine concentration of either >=0.3 mg/dL within 48 hours of surgery or >=50% within 7 days of surgery. Alternative definitions of AKI were examined, as was effect modification by pre-existing chronic kidney disease (CKD). Results Among 3,209 patients enrolled in the main trial, 2,947 were included in this substudy (mean age, 68 years; mean eGFR, 83 mL/min/1.73 m2) and were randomly allocated to receive colchicine (n = 1,476) or placebo (n = 1,471). Perioperative AKI occurred in 67 participants (4.7%) in the colchicine group and in 63 participants (4.4%) in the placebo group (risk ratio [RR], 1.07 [95% CI, 0.76-1.50], P = 0.72; risk difference [RD], 0.3% [95% CI, -1.2% to 1.8%]). The RD of AKI in patients with CKD treated with colchicine versus placebo was -0.9%, and it was 0.5% in those without CKD (interaction P = 0.62). Limitations Limited statistical power to detect small clinically important effects on AKI treated with dialysis. Conclusions Among patients undergoing noncardiac thoracic surgery, the risk of perioperative AKI did not differ between patients allocated to receive colchicine versus placebo. Funding Grants from academic (Department of Medicine, Western University; Division of Cardiology, McMaster University), government (Canadian Institutes of Health Research; General Research Fund, Research Grants Council, Hong Kong Special Administrative Region, China), and not-for-profit (Accelerating Clinical Trials Consortium; Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario; Population Health Research Institute; Hamilton Health Sciences; Hanela Foundation) sources. Trial Registration Registered at ClinicalTrials.gov with study number NCT03310125. Plain-Language Summary Inflammation during and after surgery can lead to organ injury, including acute kidney injury (AKI). Colchicine, an anti-inflammatory drug, may help protect the organs from inflammation. This prespecified kidney substudy of the COP-AF trial (a placebo-controlled, randomized clinical trial of 3,209 patients aged 55 years and older having major noncardiac thoracic surgery), examined the effect of oral colchicine (0.5 mg tablet, taken twice daily starting within 4 hours before surgery for a total of 10 days) on the risk of perioperative AKI. The study found that the risk of perioperative AKI did not differ between patients assigned to receive colchicine versus placebo. The results were consistent for multiple definitions of AKI and in patients with pre-existing chronic kidney disease. Copyright © 2026. Published by Elsevier Inc. <117> Accession Number 2050124031 Title Residual physiological profiles in patients with CABG- or PCI-Favored coronary anatomy: A post hoc analysis of the PANDA III randomized clinical trial. Source Progress in Cardiovascular Diseases. (no pagination), 2026. Date of Publication: 2026. Author Hu K.; Xu H.; Li B.; Yuan S.; Wu S.; Guan C.; Song C.; Gao G.; Yang M.; An T.; Zhao Z.; Zhao Y.; Liu W.; Jia L.; Liu Q.; Wang C.; Wu C.; Song W.; Wang H.; Song L.; Feng L.; Zhu C.; Yin D.; Zhang R.; Dou K. Institution (Hu, Li, Wang, Yuan, Song, Zhang, Dou) Cardiometabolic Medicine Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Hu, Xu, Li, Wang, Yuan, Guan, Song, Gao, Yang, An, Zhao, Wang, Jia, Liu, Wang, Wu, Song, Wang, Song, Feng, Zhu, Yin, Zhang, Dou) Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Hu, Xu, Li, Wang, Yuan, Guan, Song, Gao, Yang, An, Zhao, Wang, Jia, Liu, Wang, Wu, Song, Wang, Song, Feng, Zhu, Yin, Zhang, Dou) Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Hu, Li, Wang, Yuan, Song, Zhang, Dou) State Key Laboratory of Cardiovascular Disease, Beijing, China (Wu) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Zhao) Medical Research and Biometrics Centre, National Centre for Cardiovascular Diseases, Beijing, China (Liu) State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Song) Catheterization Laboratories, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher W.B. Saunders Abstract Background and aims Patients with anatomically complex coronary artery disease may be considered more suitable for coronary artery bypass grafting (CABG) than percutaneous coronary intervention (PCI), but some undergo PCI because of clinical constraints and experience higher long-term cardiovascular risk. The physiological rationale underlying this excess post-PCI risk remains unclear. From the perspective of post-PCI revascularization completeness and physiological results, we sought to explain the drivers of excess long-term adverse risk among patients with Favor CABG anatomy undergoing PCI. Methods Coronary physiology based on quantitative flow ratio (QFR) was retrospectively evaluated in the randomized PANDA III trial in which all patients underwent PCI. Patients were stratified into 2 predefined groups by baseline SYNTAX score: Favor PCI or Favor CABG. Functional revascularization completeness was assessed using classic residual functional SYNTAX score (c-rFSS). Final physiological results were quantified by post-PCI QFR. Causal mediation analyses used 2-year major adverse cardiovascular events (MACE) excluding periprocedural MI as the outcome to estimate the proportion of the group-outcome association statistically accounted for by residual coronary physiological profiles. The primary endpoint was 2-year MACE, defined as the composite of all-cause death, all MI, or any ischemia-driven revascularization. Results A total of 1555 patients with complete post-PCI physiological assessment constituted the final study cohort, among whom 269 (17.3%) individuals were stratified to Favor CABG group by baseline SYNTAX score. The 2-year MACE rate was significantly higher in the Favor CABG than the Favor PCI group (18.6% vs 9.2%; adjusted HR: 1.78; 95% CI: 1.27-2.50). Functional incomplete revascularization (c-rFSS >0) was substantially more prevalent among patients in the Favor CABG group (53.2% vs. 15.1%, P < 0.001). Suboptimal post-PCI physiology defined by QFR <0.90 was more frequent in Favor CABG cohort (32.0% vs 11.8%, P < 0.001). In analyses using MACE excluding periprocedural MI, the estimated proportions mediated by functional incomplete revascularization and suboptimal post-PCI physiology were 49.4% and 47.8%, respectively, and their estimated joint proportion mediated was 79.8%. Integrating c-rFSS or post-PCI QFR into clinical-anatomic risk models significantly improved discrimination and reclassification capacity for 2-year MACE (all P < 0.05). Conclusions In this post hoc analysis of an all-comers PCI trial, approximately one-fifth of patients presented with anatomic complexity warranting CABG as the preferred revascularization strategy. Favor CABG anatomy was associated with higher 2-year MACE than Favor PCI anatomy. This association may be partly explained by the higher prevalence of residual functional incomplete revascularization and suboptimal post-PCI physiology. These findings between Favor CABG and Favor PCI anatomy do not represent a head-to-head comparison and should not be interpreted as a direct comparison of revascularization modalities. Trial registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02017275 . Copyright © 2026 Elsevier Inc. <118> Accession Number 2050123597 Title Cardiac Damage and Clinical Outcomes in Symptomatic Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement. Source JACC: Cardiovascular Interventions. 19(21) (pp 2837-2853), 2026. Date of Publication: 09 Nov 2026. Author Tobe A.; Gallazzi M.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.; Van den Branden B.J.L.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De Sousa Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.; Webster M.; Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Angeras O.; Kim W.-K.; Rothe J.; Abdel-Wahab M.; Kristic I.; Peral V.; Garg S.; Thakkar A.; Chandra U.; Smits P.C.; Andreini D.; Genereux P.; Morice M.-C.; Baumbach A.; Serruys P.W.; Onuma Y. Institution (Tobe, Serruys, Onuma) CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland (Gallazzi) Department of Medical and Surgical Sciences, Faculty of Medicine and Surgery, School of Cardiovascular Diseases, University of Milan, Milan, Italy (van Royen) Department of Cardiology, Radboud University Hospital, Nijmegen, Netherlands (Amat-Santos) Centro de Investigacion Biomedica en Red - Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Amat-Santos) Department of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain (Hudec) Department of Acute Cardiology, Middle-Slovak Institute of Cardiovascular Diseases, Banska Bystrica, Slovakia (Bunc) Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia (Van den Branden) Department of Cardiology, Amphia Hospital, Breda, Netherlands (Laanmets) Department of Invasive Cardiology, North Estonia Medical Centre, Tallinn, Estonia (Unic) Department of Cardiovascular and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia (Merkely) Heart and Vascular Center, Semmelweis University, Budapest, Hungary (Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands (Ninios) Department of Cardiology, European Interbalkan Medical Center, Thessaloniki, Greece (Protasiewicz) Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland (Protasiewicz) Department of Non-Procedural Clinical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland (Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands (Martin) Department of Interventional Cardiology, University Hospital of Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain (Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao Paulo, Brazil (De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal (van Belle) Department of Interventional Cardiology, Lille University, Lille, France (Linke) Department of Internal Medicine and Cardiology, University Clinic, Heart Center Dresden, University of Technology Dresden, Dresden, Germany (Ielasi) Department of Interventional Cardiology, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy (Montorfano) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (Webster) Department of Cardiology, Auckland City Hospital, Auckland, New Zealand (Toutouzas) Department of Cardiology, Hippokration Hospital, Athens, Greece (Teiger) Department of Interventional Cardiology, Henri Mondor University Hospital, Creteil, France (Bedogni) Clinical and Interventional Cardiology IRCCS Policlinico San Donato, Milan, Italy (Voskuil) Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands (Pan) Department of Cardiology, University Hospital Reina Sofia, University of Cordoba, Instituto Maimonides de Investigacion Biomedica de Cordoba, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares, Cordoba, Spain (Angeras) Department of Thoracic Surgery and Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Angeras) Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden (Kim) Department of Cardiology and Angiology, University of Giessen and Marburg, Giesen, Germany (Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany (Rothe) Department of Cardiology and Angiology, Campus Bad Krozingen, University Heart Center-University of Freiburg, Bad Krozingen, Germany (Rothe) Faculty of Medicine, University of Freiburg, Freiburg, Germany (Abdel-Wahab) Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Kristic) Department of Cardiology, University Hospital of Split, Split, Croatia (Peral) Department of Cardiology, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Palma, Spain (Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom (Garg) School of Medicine, University of Central Lancashire, Preston, United Kingdom (Thakkar, Chandra) Department of Clinical Research, Meril Life Sciences Pvt. Ltd, Vapi, India (Smits, Morice) Cardiovascular European Research Center (CERC), Massy, France (Andreini) Department of Clinical and Biomedical Sciences, University of Milan, Milan, Italy (Andreini) Department of Cardiology and Cardiovascular Imaging, Galeazzi-Sant'Ambrogio Hospital, Milan, Italy (Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, United States (Morice) ICPS, Hopital Prive Jacques Cartier, Massy, France (Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom (Baumbach) Cleveland Clinic, London, United Kingdom Publisher Elsevier Inc. Abstract Background The extent of cardiac damage in patients with aortic stenosis (AS) is associated with worse clinical outcomes. Objectives This study sought to investigate the clinical impact of cardiac damage using the updated criteria incorporating the echocardiographic probability of pulmonary hypertension. Methods This post hoc subanalysis of LANDMARK trial, which randomized 768 patients with severe AS to the Myval transcatheter heart valve (THV) series or to contemporary THVs (Sapien and Evolut series), used updated cardiac damage classification: stage 0, no cardiac damage; stage 1, left ventricular damage; stage 2, left atrial or mitral valve damage; stage 3, pulmonary artery or tricuspid valve damage; and stage 4, right ventricular damage. The impact of cumulative cardiac damage, defined as meeting all criteria for stages 1 to 4, was also assessed. The primary endpoint was 1-year all-cause mortality. Results Cardiac damage stages were assessed in 596 patients (stage 0, n = 36; stage 1, n = 88; stage 2, n = 284; stage 3, n = 84; stage 4, n = 104), with a mean age of 80.2 (5.7) years and a mean Society of Thoracic Surgeons score of 3.3% (2.4%). One-year mortality was 0%, 1.1%, 4.7%, 7.2%, and 20.4% in stages 0, 1, 2, 3, and 4, respectively (log-rank P < 0.001). The area under the curve for predicting 1-year mortality was 0.739. Patients with cumulative cardiac damage had the highest mortality (23.6%). In the multivariable analysis, stage 4 was independently associated with higher 1-year mortality. Conclusions The updated cardiac damage staging stratified 1-year mortality after transcatheter aortic valve replacement, highlighting the importance of comprehensive echocardiographic assessment in severe AS. (LANDMARK Trial: a Randomised Controlled Trial of Myval THV [LANDMARK]; NCT04275726 ) Copyright © 2026 The Authors. <119> Accession Number 2050135768 Title Oxidative stress and postoperative atrial fibrillation: A systematic review and meta-analysis. Source Current Problems in Cardiology. 52(2) (no pagination), 2027. Article Number: 103478. Date of Publication: 01 Feb 2027. Author Sun C.; Hasheminia A.; Thomas G.; Kim G.; Elsebaie A.; El Sherbini A.H.; Shah A.; Girard L.; El-Diasty M. Institution (Sun) School of Medicine, University of Ottawa, Ottawa, ON, Canada (Hasheminia, Girard) Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada (Thomas, Kim) College of Arts and Sciences, Case Western Reserve University, Cleveland, OH, United States (Elsebaie) Department of Medicine, Queen's University, Kingston, ON, Canada (El Sherbini) Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Shah) School of Medicine, Queen's University, Kingston, ON, Canada (El-Diasty) Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, United States (El-Diasty) Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada Publisher Elsevier Inc. Abstract Background Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery and is linked to higher mortality and hospitalizations. Oxidative injury may contribute to its development; therefore, this study systematically evaluated the relationship between oxidative stress biomarkers and POAF. Methods MEDLINE, Embase, and the Cochrane Library were searched from inception to August 2026 for studies reporting oxidative stress biomarkers and POAF in adults undergoing cardiac surgery. Similar studies were pooled using random-effects meta-analysis, associations between atrial and circulating measurements were compared using a three-level model with cluster-robust inference, and the remaining studies were summarized by effect direction. Results Altogether, 31 studies (4,983 patients) were included; most were at high risk of bias by Quality in Prognosis Studies (QUIPS) assessment. Pooled POAF incidence was 30.4% (95% CI 27.4 to 33.5). Pro-oxidant measures in atrial tissue were higher in patients who developed POAF (Hedges g 0.89, 95% CI 0.45 to 1.32), but those in the circulation did not differ significantly (g 0.13, 95% CI -0.04 to 0.30; between-compartment difference of 0.76, p = 0.005). Among individual markers, preoperative malondialdehyde differed only modestly between groups, while circulating pro-oxidant markers measured within 24 h of surgery were higher in patients who developed POAF (g 0.27, 95% CI 0.10 to 0.45). Atrial NADPH oxidase and monoamine oxidase activity and pericardial myeloperoxidase showed the most robust adjusted associations with POAF. Conclusions Oxidative-stress associations with POAF vary by sampling site and timing. Atrial tissue measures show stronger associations than preoperative blood biomarkers, while early postoperative pericardial and circulating markers may reflect reperfusion injury. Because the evidence is heterogeneous, standardized prospective studies are needed to validate these biomarkers and determine their clinical utility. Copyright © 2026 The Authors. <120> Accession Number 2051253630 Title Autologous Blood Pleurodesis for Postoperative Air Leakage Following Video-Assisted Thoracoscopic Surgery-A Randomized Controlled Trial. Source European Journal of Cardio-thoracic Surgery. 68(11-12) (no pagination), 2026. Article Number: ezag235. Date of Publication: 01 Nov 2026. Author Dittberner F.A.; Christensen T.D.; Licht P.B. Institution (Dittberner, Licht) Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark (Dittberner, Licht) Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Christensen) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Christensen) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: Postoperative air leakage following lung surgery prolongs chest drainage duration and length of hospitalization and the evidence regarding treatment with autologous blood pleurodesis (ABP) is scarce. We decided to investigate if ABP would influence postoperative air leakage when used on the first postoperative day following elective video-assisted thoracoscopic surgery (VATS). Method(s): In this multicentre randomized controlled trial, patients with an air leakage greater than 40 mL/min during cough and mobilization on their first postoperative day following elective VATS were randomized 1:1 to standard chest drain management with or without ABP (stratified by lobectomy or wedge resection). The chest drain was removed after standardized digital drainage criteria, and the primary endpoint was time to chest drain removal. Patients with persistent air leakage beyond postoperative day 7 were censored to allow for individualized management. Result(s): A total of 268 patients were randomized (134 in each group), after lobectomy (n = 238) or wedge (n = 30). Median chest drain duration was 3.4 days (95% CI, 3.0-4.9) in the ABP group vs 5.0 days (95% CI, 4.0-6.8) in the control group (P = .007). By postoperative day 7, chest drains had been removed in 74% vs 62% of patients, respectively. ABP significantly increased the rate of chest drain removal (HR 1.49; 95% CI, 1.11-2.01; P = .007). The treatment effect was consistent across both participating centres. Conclusion(s): Early autologous blood pleurodesis significantly shortens chest drain duration in patients with postoperative air leakage following VATS. This simple and low-cost intervention should be considered in Enhanced Recovery After Surgery protocols after thoracic surgery. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <121> Accession Number 2050962376 Title Perioperative Outcomes of Acute Normovolemic Hemodilution in Cardiac Surgery: Evidence From Randomized Controlled Trials. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Hassan J.; Azam H.; Kumar P.; Nasir W.; Ahmed I.; Chatta S.E.; Jadoon M.S.K.; Laiba F.; Zafar S.; Sufian M.; Bukhari S.M.H.; Khan K.A.; Bashir A.M.D.; Kumari K. Institution (Hassan) Department of Medicine, Abu Umara Medical and Dental College/ Green International University, Lahore, Pakistan (Azam) Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Kumar) Department of Medicine, Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Nasir) Department of Medicine, Faisalabad Medical University, Faisalabad, Pakistan (Ahmed, Jadoon) Department of Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan (Chatta) Department of Medicine, King Edward Medical University, Lahore, Pakistan (Laiba) Department of Internal Medicine, Capital Health Regional Medical Center, Trenton, NJ, United States (Zafar) Department of Medicine, Al-Aleem Medical College, Lahore, Pakistan (Sufian, Khan) Department of Medicine, Aga Khan University, Karachi, Pakistan (Bukhari) Department of Medicine, Gujranwala Medical College, Gujranwala, Pakistan (Bashir) Department of Clinical Pharmacology, Shalamar Medical & Dental College, Lahore, Pakistan (Kumari) Department of Medicine, Islamabad Medical and Dental College, Islamabad, Pakistan Publisher Lippincott Williams and Wilkins Abstract Acute normovolemic hemodilution (ANH) is a blood conservation strategy used in cardiac surgery, but its efficacy in reducing allogeneic blood transfusion remains debated. This systematic review and meta-analysis updates the existing evidence by incorporating recent randomized controlled trials (RCTs) to provide a contemporary assessment of ANH's impact on perioperative transfusion outcomes. We searched PubMed/MEDLINE, Scopus, and Cochrane Central up to August 2025 for RCTs comparing ANH to standard care in adult cardiac surgery. Primary outcomes were the number of allogeneic red blood cell units transfused, the rate of allogeneic blood transfusion, and estimated total blood loss. Data were pooled using random-effects models, and subgroup analyses were performed by type of surgery. Thirty-one RCTs involving 4426 patients (ANH = 2242, control = 2184) were included. ANH significantly reduced the rate of allogeneic blood transfusion (risk ratio 0.75, 95% confidence interval [CI] 0.66-0.87; P < 0.0001), the number of allogeneic red blood cell units transfused (standardized mean difference -0.42, 95% CI -0.64 to -0.20; P = 0.0001), and estimated total blood loss (standardized mean difference -0.42, 95% CI -0.63 to -0.21; P < 0.0001). Substantial heterogeneity was observed. Subgroup analysis demonstrated that benefits were most consistent in patients undergoing coronary artery bypass grafting. In patients undergoing cardiac surgery, particularly coronary artery bypass grafting, ANH reduces exposure to allogeneic blood transfusion and decreases perioperative blood loss. Despite significant heterogeneity across studies, these findings support the inclusion of ANH within multimodal blood management protocols. Further large, high-quality RCTs with standardized protocols are warranted to confirm its role in modern practice. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <122> Accession Number 652551591 Title The latest guidelines for the perioperative management of the thoracic noncardiac patient: a critical appraisal of the literature. Source Current opinion in anaesthesiology. (no pagination), 2026. Date of Publication: 29 Oct 2026. Author Piccioni F.; Rispoli M.; Senturk M. Institution (Piccioni) Anesthesia and Perioperative Medicine Unit, Department of Anesthesia, Perioperative Medicine and Critical Care, IRCCS Humanitas Research Hospital, Rozzano, Italy (Rispoli) Department of Anesthesia and Intensive Care, Monaldi Hospital, Naples, Italy (Senturk) Department of Anesthesiology and Reanimation, School of Medicine, Acibadem University, Istanbul, Turkey Abstract PURPOSE OF REVIEW: The management of patients before, during, and after surgical procedures on the thorax is influenced by a rapidly expanding set of guidelines that are only partially overlapping. The review is intended for clinicians who are interested in understanding how publication date influences their recommendations, and the points of agreement and divergence between sources. RECENT FINDINGS: Across the preoperative, intraoperative, and postoperative phases, the reviewed documents converge strongly on core process measures. These measures encompass multimodal opioid-sparing analgesia, a single chest drain, early ambulation, and the avoidance of reflex ICU admission. However, there is less consistency in the numerical thresholds, including exercise-testing cut-offs, transfusion triggers, and drain-removal volumes. The most recent documents demonstrate a shift toward more permissive values and an increasing emphasis on frailty, sarcopenia, and patient-reported outcomes. SUMMARY: The core enhanced recovery after surgery process measures have been demonstrated to be reliable. However, it is imperative for clinicians to ascertain the underlying guideline generation for any numerical threshold before its implementation. A significant number of intraoperative decisions are still made based on expert opinion rather than guideline-grade evidence, underscoring the necessity for future trials and consensus on patient-centered outcome measurement. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <123> Accession Number 652554519 Title A COMPARISON OF CARDIAC COMPUTERIZED TOMOGRAPHY AND EXERCISE STRESS ELECTROCARDIOGRAM TEST FOR INVESTIGATION OF STABLE CHEST PAIN: THE CLINICAL RESULTS OF THE CAPP RANDOMIZED PROSPECTIVE TRIAL. Source Ulster Medical Journal. Conference: Ulster Medical Society Junior Members Forum. Belfast United Kingdom. 85(2) (pp 130), 2016. Date of Publication: 01 May 2016. Author McKavanagh P.; Lusk L.; Ball P.A.; Trinick T.R.; Duly E.; Verghis R.M.; Agus A.M.; Walls G.W.; McCusker S.; Stevenson M.; James B.; Orr C.; Hamilton A.; Smyth A.; Harbinson M.T.; Donnelly P.M. Publisher Ulster Medical Society Abstract Aim: The Cardiac Computerised Tomography (CT) for the Assessment of Pain and Plaque (CAPP) study compared the economic and clinical outcomes of using cardiac CT compared to Exercise Stress Test (EST) in the patients with suspected stable chest pain. Method(s): CAPP randomised 500 patients without known coronary artery disease to either EST or cardiac CT. All patients were followed up for clinical outcomes and for angina symptoms with the Seattle Angina Questionnaires (SAQ). Result(s): Of the 500 patients 12 withdrew over the year, with 245 in the EST arm and 243 in CT arm receiving follow up. In the CT arm there were less chest pain Emergency Department attendances and unplanned admissions. Patients in the CT arm also had less secondary investigations and less time to diagnosis. The EST arm had 7 patients who underwent Coronary Artery Bypass Grafting (CABG) and 12 who had Percutaneous Coronary Intervention (PCI), compared to 8 CABG and 29 PCI in the CT arm. There was a significant improvement in domains of the SAQ scores at 1 year in the CT arm compared to EST (p =<0.05). Conclusion(s): Cardiac CT as an index investigation for stable chest pain improved symptoms and clinical outcomes. <124> Accession Number 652553905 Title Efficacy of Stellate Ganglion Block for Preventing Postoperative Atrial Fibrillation After Cardiac Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial. Source Journal of the American Heart Association. (pp e051373), 2026. Date of Publication: 30 Oct 2026. Author Zhang J.; Li N.; Ai Z.; Liang J.; Chen Y.; Lv H.; Sayer S.; Cao Y.; Li J.; Yu X.; Chen G. Institution (Zhang, Chen, Li, Ai, Liang, Chen, Lv, Cao, Yu, Chen) Department of Anesthesiology, Sir Run Run Shaw Hospital Zhejiang University, School of Medicine Hangzhou Zhejiang China, China (Sayer) Zhejiang University, School of Medicine Hangzhou Zhejiang China, China (Li) Department of Cardiac Surgery, Sir Run Run Shaw Hospital Zhejiang University, School of Medicine Hangzhou Zhejiang China, China (Yu) Sir Run Run Shaw Hospital Zhejiang University, School of Medicine Hangzhou Zhejiang China, Provincial Key Laboratory of Precise Diagnosis and Treatment of Abdominal Infection Abstract BACKGROUND: Stellate ganglion block (SGB) may reduce postoperative atrial fibrillation (POAF) by modulating the autonomic nervous system. This study evaluated the efficacy of preoperative SGB in preventing POAF following cardiac surgery. METHOD(S): In this single-center, randomized, double-blind, placebo-controlled trial, 140 patients undergoing valve surgery with cardiopulmonary bypass were assigned (1:1) to ultrasound-guided right SGB with 7 mL of 0.5% ropivacaine or 7 mL of normal saline. The primary outcome was the incidence of POAF from postoperative day 0 to day 7 or until discharge. RESULT(S): A total of 132 patients completed the study and were included in the modified intention-to-treat population (SGB group: n=65; saline group: n=67). POAF occurred in 43% of the SGB group and 40% of the saline group (odds ratio [OR], 0.99 [95% CI, 0.46-2.15], adjusted P=0.989). The SGB group demonstrated a lower incidence of intraoperative ventricular fibrillation/ventricular tachycardia requiring defibrillation after aortic cross-clamp release (6% versus 19%; OR, 0.21 [95% CI, 0.06-0.80]; adjusted P=0.022), lower postoperative high-sensitivity troponin I levels (median difference: -2562 ng/L [95% CI, -4301 to -45]; P=0.045), and a reduced risk of postoperative acute kidney injury (5% versus 18%; OR, 0.24 [95% CI, 0.06-0.98]; adjusted P=0.046). CONCLUSION(S): While preoperative SGB did not reduce the incidence of POAF, it was associated with potential benefits, including a lower requirement for intraoperative defibrillation attributable to ventricular arrhythmias, attenuated myocardial injury (as indicated by lower high-sensitivity troponin I levels), and a decreased risk of postoperative acute kidney injury. REGISTRATION: URL: https://www.chictr.org.cn; URL Identifier: ChiCTR2300068572. <125> Accession Number 652550763 Title Outcomes of Transcatheter Aortic Valve Replacement in the Middle East and North Africa: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. (pp e048377), 2026. Date of Publication: 30 Oct 2026. Author Bastan M.-M.; Siami S.; Jodeiri F.; Kazemian S.; Ebrahimzade M.; Seighali N.; Maleki S.; Anaraki N.; Abdelhamid M.; Abdel-Rahman S.-E.-D.; Hosseini K. Institution (Bastan, Siami, Jodeiri, Kazemian, Seighali, Maleki, Anaraki) Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran, Iran, Islamic Republic of (Siami, Jodeiri) School of Medicine Islamic Azad University, Tehran Medical Branch Tehran Iran, Iran, Islamic Republic of (Ebrahimzade) School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran, Iran, Islamic Republic of (Seighali) Student Research Committee, School of Medicine Alborz University of Medical Sciences Karaj Iran, Iran, Islamic Republic of (Abdelhamid) Faculty of Medicine, Department of Cardiovascular Medicine Cairo University Giza Egypt, Kasr Al Ainy (Abdel-Rahman) Department of Cardiology Leeds Teaching Hospitals Leeds UK (Hosseini) Department of Cardiology Copenhagen University Hospital-Herlev and Gentofte Copenhagen Denmark, 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, Denmark Abstract BACKGROUND: Data on transcatheter aortic valve replacement (TAVR) outcomes in the Middle East and North Africa region are limited. We synthesized available evidence on post-TAVR clinical outcomes in the Middle East and North Africa region. METHOD(S): We systematically searched PubMed, Embase, and Scopus from inception through May 2025 for studies reporting TAVR outcomes in this region. Outcomes included device success, all-cause death, cardiovascular death, myocardial infarction, stroke, new-onset atrial fibrillation, moderate to severe paravalvular leak, and permanent pacemaker implantation. Overall incidence rates were pooled via Poisson analysis and reported per 100 person-years with 95% CIs. RESULT(S): Forty-eight studies encompassing 7331 patients (mean age, 76.9+/-8.5 years; 52.4% women) were included. Pooled device success rate was 96.4% (95% CI, 95.8%-97.0%). At latest follow-up, pooled incidence rates per 100 person-years were 13.7 for all-cause death (95% CI, 12.9-14.6), 4.8 for cardiovascular death (95% CI, 4.1-5.7), 1.0 for myocardial infarction (95% CI, 0.7-1.4), 1.6 for stroke (95% CI, 1.3-1.9), 2.7 for moderate to severe paravalvular leak (95% CI, 2.2-3.4), 6.5 for new-onset atrial fibrillation (95% CI, 5.5-7.7), and 10.0 for permanent pacemaker implantation (95% CI, 9.2-10.9). Post hoc exploratory meta-regression identified significant study-level modifying effects, with higher mean age and greater use of first-generation versus second-generation valves associated with higher overall all-cause mortality incidence following TAVR. Certainty of evidence was low or very low across all outcomes. CONCLUSION(S): TAVR in the Middle East and North Africa region was associated with high device success rate and relatively low cardiovascular death. Permanent pacemaker implantation was the most prevalent post-TAVR complication. Further studies are warranted to optimize TAVR practice in this region. <126> Accession Number 2050141117 Title An Updated Meta-Analysis of Randomized Controlled Trials Comparing the Analgesic Efficacy of Intercostal Nerve Block Versus Erector Spinae Plane Block in Thoracic Surgery. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 7833175. Date of Publication: 2026. Author Faheem M.S.B.; Munir S.U.; Maryam K.U.E.; Abbasi S.U.A.M.; Samadi S. Institution (Faheem) Department of Medicine and Surgery, Karachi Institute of Medical Sciences, Sindh, Karachi, Pakistan (Munir) Department of Medicine, Karachi Medical and Dental College, Sindh, Karachi, Pakistan (Maryam) Department of Medicine, Foundation University Medical College, Islamabad, Pakistan (Abbasi) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Samadi) Department of Medicine, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan Publisher John Wiley and Sons Ltd Abstract Background: ESPB, an ultrasound-guided fascial plane block, gained considerable attention as a regional anaesthetic because of its longer duration of action, favourable safety profile, and multidermatomal analgesic effect. ICNB, however, is associated with a relatively short duration of action, often requiring repeated dosing and adjunctive systemic analgesics. Method(s): The methodology of this meta-analysis adhered to the PRISMA 2020 guidelines and included randomized controlled trials comparing ESPB with ICNB in thoracoscopic surgery. A systematic PubMed, Cochrane, and ClinicalTrials.gov search was performed that reviewed the publications available till March 16, 2025. Studies were screened, data were extracted, and two reviewers independently evaluated the risk of bias using the Cochrane ROB 2 tool. Dynamic pain at 48 h was the primary outcome; the secondary outcome was analgesic use. Standardized mean differences (SMDs) or mean differences (MDs), as appropriate, with 95% confidence intervals were computed. Version 5.4 of Review Manager (RevMan) was used to process the statistical analysis, with a random-effects model where necessary. Result(s): We identified 444 records, out of which 6 randomized controlled trials were part of this meta-analysis, totalling 353 cases: 176 being part of the ESPB group, while the remaining 177 constituted the ICNB group. For the principal outcome of dynamic pain score at 48 h postoperatively, combined analysis from five studies (n = 295) revealed a statistically significant lowered pain score with ESPB in contrast to ICNB (SMD = -0.34, 95% CI: -0.57 to -0.10, p = 0.004; I2 = 0%). For postoperative analgesic use, all six studies (n = 353) data showed insignificant group difference (MD = 0.14, 95% CI: -1.04 to 1.32, p = 0.81; I2 = 57%). Conclusion(s): This study suggests that ESPB contributed to a reduction in pain scores at 48 h after thoracoscopic surgery compared with ICNB, yet both methods exhibited equivalent postoperative analgesic consumption. These findings show that ESPB can be a preferable option for prolonged postoperative analgesia; however, additional well-designed studies are needed to corroborate the evidence base. Copyright © 2026 Muhammad Shaheer Bin Faheem et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <127> Accession Number 652566088 Title Transcatheter Aortic Valve Replacement in Pure Aortic Regurgitation: The Randomized SEASON-AR Clinical Trial. Source Circulation. (no pagination), 2026. Date of Publication: 31 Oct 2026. Author Gao X.-F.; Wang Y.; Jiang H.; Li B.; Shao Y.-B.; Luo J.; Ren F.-X.; Ouyang F.; Chen Z.-K.; Yuan H.-T.; Wang C.; Han B.; Xiao P.-X.; Yuan Y.-Q.; Yang Z.-W.; Miao L.; Ma X.; Yang J.; You D.-F.; Chen S.-L.; Zhang J.-J. Institution (Gao, Chen, Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (X.-F.G., China (Wang) Department of Cardiology, Xiamen Cardiovascular Hospital, China (Y.W.), China (Jiang) Department of Cardiology, Renmin Hospital of Wuhan University, China (H.J.), China (Li) Department of Cardiology, Zibo Central Hospital, China (B.L.), China (Shao) Department of Cardiology, Qingdao Municipal Hospital, China (Y.-B.S.), China (Luo) Department of Cardiology, Ganzhou People's Hospital, China (J.L.), China (Ren) Department of Cardiology, Yantai Yuhuangding Hospital, China (F.-X.R.), China (Ouyang) Department of Cardiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, China (F.O.), China (Ouyang) Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, China (F.O.), China (Chen) Department of Cardiology, Ningbo Medical Centre of Lihuili Hospital, China (Z.-K.C.), China (Yuan) Department of Cardiology, Shandong Provincial Hospital, China (H.-T.Y.), China (Wang) Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, China (C.W.), China (Han) Department of Cardiology, Xuzhou Central Hospital, China (B.H.), China (Xiao) Department of Cardiology, First Affiliated Hospital of Wannan Medical University (Yijishan Hospital of Wannan Medical University), China (P.-X.X.), China (Yuan) Department of Cardiology, Henan Chest Hospital, China (Y.-Q.Y.), China (Yuan) Department of Cardiology, Fuwai Central China Cardiovascular Hospital, China (Y.-Q.Y.), China (Yang) Department of Cardiology, Tianjin Medical University General Hospital, China (Z.-W.Y.), China (Miao) Department of Cardiology, Liuzhou People's Hospital, China (L.M.), China (Ma) Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, China (X.M.), China (Yang) Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, China (J.Y.), China (You) Department of Biostatistics, School of Public Health, Nanjing Medical University, China (D.-F.Y.), China Abstract BACKGROUND: For patients with severe pure aortic regurgitation (AR) at high surgical risk, guideline-directed medical therapy (GDMT) is often the only available option. Transfemoral transcatheter aortic valve replacement (TAVR) is an established treatment for aortic stenosis and has also been evaluated in patients with pure AR. However, no adequately powered randomized trial has compared TAVR with GDMT alone in this population. METHOD(S): We conducted a prospective, investigator-initiated, multicenter, randomized, open-label trial in China. Patients with severe pure AR for whom surgery was considered difficult or unacceptable by the local heart team or who persistently declined surgery were randomly assigned at a 1:1 ratio to receive transfemoral TAVR with the VitaFlow system plus GDMT or GDMT alone. The primary end point was a composite of all-cause death, disabling stroke, or heart failure rehospitalization at 1 year. RESULT(S): We assigned 210 patients with severe pure AR to the TAVR group (n=109) or GDMT group (n=101) at 18 centers. At 1-year follow-up, the Kaplan-Meier estimate of the primary end point was significantly lower in the TAVR group than in the GDMT group (8.3% vs 24.8%; hazard ration [HR], 0.31 [95% CI, 0.14-0.66]; P=0.001), driven primarily by a reduction in heart failure rehospitalization (3.7% vs 21.3%; HR, 0.16 [95% CI, 0.06-0.47]; P < 0.001). TAVR was associated with higher rates of major or life-threatening bleeding and new permanent pacemaker implantation, most of which occurred within 30 days after the procedure. CONCLUSION(S): Among patients with severe pure AR, TAVR plus GDMT significantly reduced the rate of all-cause death, disabling stroke, or heart failure rehospitalization at 1 year compared with GDMT alone despite higher 30-day rates of major or life-threatening bleeding and new permanent pacemaker implantation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04864145. <128> Accession Number 2050133833 Title Prognostic value of cardiovascular magnetic resonance in acute myocarditis: a systematic literature review and meta-analysis of late gadolinium enhancement and narrative literature review of parametric mapping. Source BMC Medical Imaging. 26(1) (no pagination), 2026. Article Number: 568. Date of Publication: 01 Dec 2026. Author Gaizauskiene K.; Skorniakov V.; Silinskiene D.; Valeviciene N.; Glaveckaite S. Institution (Gaizauskiene, Valeviciene) Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Santariskiu st. 2, Vilnius, Lithuania (Skorniakov) Faculty of Mathematics and Informatics, Institute of Applied Mathematics, Vilnius University, Naugarduko str. 24, Vilnius, Lithuania (Silinskiene) Vilnius University Hospital Santaros Klinikos, Santariskiu st. 2, Vilnius, Lithuania (Glaveckaite) Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu st. 2, Vilnius, Lithuania Publisher BioMed Central Ltd Abstract Background and aims: Limited data exist on the prognostic value of parametric mapping and late gadolinium enhancement (LGE) in patients with acute myocarditis (AM). This meta-analysis aimed to investigate the prognostic value of LGE as assessed by using cardiovascular magnetic resonance (CMR) in patients with AM, including more recent evidence. Additionally, the prognostic value of CMR parametric mapping was narratively reviewed. Material(s) and Method(s): The systematic search was conducted in the PubMed and Scopus databases from inception to January 17, 2026 (PubMed) and January 20th 2026 (Scopus). 1296 records were found through the search. Finally, sixteen studies were included in this systematic review. Thirteen studies were included in the meta-analysis on association between LGE and clinical outcomes in AM. The composite endpoint was defined as MACE and/or one of the following endpoints: all-cause death, heart failure decompensation requiring hospitalization, heart transplantation, and recurrent AM. MACE was defined as a composite of cardiovascular death (including sudden death), sustained ventricular tachycardia, ventricular fibrillation, complete atrioventricular heart block requiring a pacemaker, and cardiogenic shock. Five studies were reviewed for the prognostic value of parametric mapping parameters. After initial calculations, it appeared that studies using broader composite endpoints than only MACE introduced substantial heterogeneity. Therefore, we have additionally conducted analysis incorporating only eight studies with MACE as the endpoint. Result(s): The presence of LGE was associated with higher odds of the composite endpoint. The unadjusted pooled OR demonstrated a significant relationship between the presence of LGE and higher chances of the composite endpoint (OR<inf>LGE(+) vs. LGE(-)</inf>[95% CI] = 3.02 [1.40, 6.51], p < 0.001) with high heterogeneity (I2 = 81.98%, p < 0.0001) On the qualitative level, results obtained in the MACE studies subgroup remained the same (OR<inf>LGE(+) vs. LGE(-)</inf>[95% CI] = 2.88 [2.01, 4.13], p < 0.0001). No clear evidence of publication bias was detected; however, power to detect small-study effects is limited and results should be interpreted cautiously. The prognostic value of parametric mapping parameters did not undergo meta-analysis and was reviewed narratively due to the shortage of the respective data. The data on the prognostic value of native T1, T2, and extracellular volume (ECV) are controversial and limited. Conclusion(s): Based on the findings, the presence of LGE appears to be associated with an adverse prognosis in patients with AM. However, these findings should be interpreted with caution because of substantial heterogeneity among studies and the unadjusted effect estimations. Evidence regarding the prognostic value of CMR-derived parametric mapping remains limited. Large, prospective, well-designed studies are needed to determine the incremental prognostic value of parametric mapping beyond LGE for risk stratification and outcome prediction in patients with AM. Copyright © The Author(s) 2026. <129> Accession Number 2050147763 Title Impact of preprocedural frailty on long-term mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 1016. Date of Publication: 01 Dec 2026. Author Zhan Y.; Mao Y.; Tang X.; Li R.; Li M.; Hua D. Institution (Zhan, Mao, Tang, Li, Li, Hua) Department of Nursing, The Second Affiliated Hospital of Zhejiang, University School of Medicine, Hangzhou, China Publisher BioMed Central Ltd Abstract Background: This study aimed to investigate the association between preprocedural frailty and long-term all-cause mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Method(s): A systematic search of PubMed, Web of Science, Embase, CINAHL, Scopus, and the Cochrane Library was conducted from database inception to 15 February 2026. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was performed to pool adjusted hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs). Result(s): Thirteen cohort studies involving 429,827 patients were included in the systematic review. Of these, 8 studies (4,726 patients) reporting comparable adjusted effect estimates were included in the quantitative meta-analysis. Preprocedural frailty was associated with a higher risk of long-term all-cause mortality after TAVR (HR = 1.85, 95% CI 1.51-2.25; I2 = 39.4%). The association was generally consistent across subgroup analyses stratified by follow-up duration and frailty assessment methodology. Five studies that were not amenable to quantitative pooling because of non-comparable effect formats or data structures showed a concordant direction of effect, with some studies demonstrating a graded relationship between increasing frailty burden and mortality risk. Conclusion(s): Preprocedural frailty is significantly associated with increased long-term all-cause mortality in older adults undergoing TAVR. These findings support the incorporation of frailty assessment into routine preprocedural geriatric risk stratification and multidisciplinary decision-making. Copyright © The Author(s) 2026. <130> Accession Number 2051328594 Title Therapeutic challenges in prosthetic valve Granulicatella adiacens endocarditis: a case report and focused review of alternative antimicrobial strategies. Source Diagnostic Microbiology and Infectious Disease. 117(2) (no pagination), 2027. Article Number: 117720. Date of Publication: 01 Feb 2027. Author Reidy N.; Lapthorne S.; Kenny S.; Healy T.; McLoughlin S.; Connolly S.; Doherty A.; Hickey C.; Mullane N.; Hannan M.; Doddakula K.; Sadlier C.; Walsh J. Institution (Reidy, Lapthorne, Kenny, Healy, McLoughlin, Doherty, Hickey, Mullane, Walsh) Department of Clinical Microbiology, Cork University Hospital, Ireland (Connolly, Sadlier) Department of Infectious Diseases, Cork University Hospital, Ireland (Hannan) Department of Clinical Microbiology, Mater Misericordiae University Hospital, Ireland (Doddakula) Department of Cardiothoracic Surgery, Cork University Hospital, Ireland Publisher Elsevier Inc. Abstract Purpose: To describe a case of prosthetic valve (PV) Granulicatella adiacens infective endocarditis (IE) requiring deviation from guideline-supported therapy, and review published experience with alternative treatment strategies. Method(s): A case report and focused literature review of Granulicatella IE and other invasive Granulicatella infections treated with non-standard antimicrobial regimens. Result(s): Ceftriaxone-resistant PVIE was complicated by DRESS syndrome and linezolid-associated thrombocytopaenia. Treatment with ertapenem and levofloxacin was completed following surgery. Literature review identified limited published experience with alternative regimens, most commonly carbapenems, fluoroquinolones and linezolid. Outcomes were heterogeneous across reports. Conclusion(s): Evidence supporting alternative treatment strategies for Granulicatella infections remains limited, highlighting the need for further research. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <131> Accession Number 2051329784 Title Impact of advanced cardiac damage in severe aortic stenosis on short-term and mid-term mortality and rehospitalisation after transcatheter aortic valve implantation: a systematic review and meta-analysis. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Baay M.; Hosseini Z.; Zadgari E.; Moayerifar M.; Taghavi S.; Sammak Salekdeh M.; Amouzadeh Lichahi M.; Jafari M.; Agajani A.; Firouzi A.; Abdi S.; Khalilipur E.; Alemzadeh Ansari M.J.; Elahifar A.; Safavi Rad A.; Gholipour M.; Ghasemzadeh G. Institution (Baay, Hosseini, Firouzi, Abdi, Alemzadeh Ansari, Elahifar, Safavi Rad, Gholipour) Cardiovascular Intervention Research Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of (Zadgari) Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Moayerifar, Gholipour, Ghasemzadeh) Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Moayerifar) Department of Cardiovascular Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Taghavi, Khalilipur) Rajaie Cardiovascular Medical and Research Center, Tehran, Iran, Islamic Republic of (Sammak Salekdeh, Amouzadeh Lichahi, Jafari, Agajani) Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Anzali International Campus, Rasht, Iran, Islamic Republic of Publisher BMJ Publishing Group Abstract Background: Severe aortic stenosis (AS) is commonly associated with advanced cardiac damage, including right ventricular dysfunction (RVD), pulmonary hypertension (PH) and tricuspid regurgitation (TR), which may worsen prognosis after transcatheter aortic valve implantation (TAVI). This systematic review and meta-analysis aimed to assess the effect of these conditions on short-term and mid-term mortality and rehospitalisation following TAVI. Method(s): We conducted a systematic search of PubMed, Scopus and Web of Science for studies published up to June 2025. Eligible studies included adults with AS undergoing TAVI and reported outcomes at 1 month, 6 months or 12 months stratified by the presence of RVD, PH or TR. Studies had to report either HRs, risk ratios (RRs) or sufficient raw event data for mortality or rehospitalisation. Data were synthesised using a random-effects meta-analysis. Subgroup analyses were conducted by cardiac damage severity according to the Genereux staging system and stratified by valve type and diagnostic modality. Risk of bias in included studies was assessed using the Joanna Briggs Institute's checklist for cohort studies. Meta-regression was performed to explore sources of between-study heterogeneity. Result(s): A total of 34 studies including 26 076 patients met inclusion criteria. Twelve-month HRs for all-cause mortality increased with advancing cardiac damage: borderline stage HR 1.61 (1.22-2.12), stage 3 HR 2.06 (1.63-2.60) and stage 4 HR 2.77 (2.11-3.64). RRs followed a similar trend. Cardiovascular mortality was highest in stage 4 (HR 3.13 (1.20-8.17); RR 2.63 (1.54-4.47)). Rehospitalisation data were limited but suggested elevated risk in stage 3 (RR 1.33 (1.12-1.58)). Meta-regression indicated that age, sex and comorbidities contributed to between-study heterogeneity, particularly in stage 3 analyses. Conclusion(s): Extravalvular cardiac damage, especially RVD (stage 4), is strongly associated with increased short-term and mid-term mortality and rehospitalisation after TAVI. Even borderline-stage patients face elevated risk, underscoring the continuous nature of AS-related cardiac injury. Incorporating cardiac damage staging into preprocedural assessment can enhance risk stratification and guide management to improve patient outcomes. PROSPERO registration number: CRD420250638838. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <132> Accession Number 2051306956 Title Multivessel Versus Single-Vessel Coronary Endarterectomy as an Adjunct to Coronary Artery Bypass Grafting: A Meta-Analysis of Short-Term Outcomes and Implications for Target-Vessel Selection. Source Interdisciplinary Cardiovascular and Thoracic Surgery. 41(11) (no pagination), 2026. Article Number: ivag238. Date of Publication: 01 Nov 2026. Author Hon J.J.; Arjomandi Rad A.; Tahir A.; Salagean E.; Moscarelli M.; Magouliotis D.E.; Casula R.; Athanasiou T. Institution (Hon, Moscarelli, Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Arjomandi Rad, Salagean) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Tahir) Department of Trauma and Orthopaedics, University Hospitals of North Midlands, United Kingdom (Moscarelli) Department of Cardiovascular Surgery, Maria Eleonora Hospital, GVM Care & Research, Palermo, Italy (Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA, United States (Casula, Athanasiou) Department of Cardiothoracic Surgery, Hammersmith Hospital Imperial College Healthcare NHS Trust, London, United Kingdom Publisher Oxford University Press Abstract Objectives: Coronary endarterectomy (CE) extends complete revascularization to patients with diffuse coronary disease unsuitable for conventional bypass but adds perioperative risk to coronary artery bypass grafting (CABG). Whether the number of vessels endarterectomized influences early outcomes has not been formally synthesized. We compared short-term outcomes of single-vessel and multivessel CE-CABG. Method(s): MEDLINE, Embase, and CENTRAL were searched for studies of CE-CABG reporting outcomes stratified by single-vessel vs multivessel CE within the same cohort. The primary outcome was 30-day or in-hospital mortality. Risk ratios (RR) were pooled using DerSimonian-Laird random-effects models. Sensitivity analyses included leave-one-out analysis, Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, and univariate meta-regression on study-level covariates. Risk of bias was assessed with ROBINS-I. Result(s): Nine studies (1988-2022; 7302 patients; 4731 single-vessel CE, 2571 multivessel CE) met inclusion criteria. Multivessel CE was associated with higher mortality (RR, 2.59; 95% CI, 1.78-3.77), higher perioperative myocardial infarction (RR, 2.09; 95% CI, 1.67-2.62), and higher stroke (RR, 1.62; 95% CI, 1.01-2.61). Intra-aortic balloon pump use did not differ. Findings were stable on leave-one-out, HKSJ adjustment, and exclusion of pre-2000 studies. No single covariate accounted for the multivessel effect on meta-regression. Conclusion(s): Multivessel CE substantially increases early mortality and infarction relative to single-vessel CE. The signal is consistent across analyses but the evidence is largely retrospective and unadjusted. These data support a selective approach to CE in which the prognostic value of each target vessel is weighed against the cumulative operative cost, rather than routine extension of endarterectomy to multiple territories. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <133> Accession Number 2051230003 Title Peripheral Nerve Blocks for Postoperative Pain Management in Cardiothoracic Surgery: A Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Southwell B.J.; Parikh R.R.; Brandt S.; Choconta-Piraquive L.A.; Forte M.L.; Pagadala S.; Persson D.J.; Kolbow M.M.; Lott G.L.; Claussen A.M.; Yam H.; Duval S.; Belani K.; Tignanelli C.J.; Banik R.; Butler M.E. Institution (Southwell, Belani, Banik) Department of Anesthesiology, University of Minnesota, Minneapolis, MN, United States (Southwell, Brandt, Tignanelli, Butler) Center for Learning Health System Sciences, University of Minnesota, Minneapolis, MN, United States (Parikh, Brandt, Choconta-Piraquive, Forte, Pagadala, Persson, Claussen, Yam, Butler) School of Public Health, University of Minnesota, Minneapolis, MN, United States (Persson, Kolbow, Lott) University of Minnesota Medical School, Minneapolis, MN, United States (Duval) Department of Medicine, University of Minnesota, Minneapolis, MN, United States (Tignanelli) Department of Surgery, University of Minnesota, Minneapolis, MN, United States Publisher W.B. Saunders Abstract Objective: To evaluate the effectiveness, comparative effectiveness, and safety of peripheral nerve blocks for postoperative pain management after cardiothoracic surgery. Design(s): Systematic review and meta-analysis of randomized controlled trials, with strength of evidence rated using the Agency for Healthcare Research and Quality methodology (PROSPERO CRD42024549561). Setting(s): Perioperative care settings in studies published between 2013 and 2024. Participant(s): Adults undergoing open or minimally invasive cardiothoracic surgery. Intervention(s): Peripheral nerve blocks, including chest wall blocks and erector spinae plane blocks, compared with sham, no block, local infiltration, or neuraxial techniques. Measurements and Main Results: A total of 104 randomized controlled trials were included. Chest wall blocks reduced 24-hour pain scores and opioid consumption compared with sham or no block in both open cardiac and minimally invasive thoracic surgery. Erector spinae plane blocks demonstrated similar effects, with no clinically meaningful differences compared with chest wall blocks. Peripheral nerve blocks provided analgesia comparable to neuraxial techniques across several outcomes. Reported adverse events were rare and inconsistently defined. Conclusion(s): Peripheral nerve blocks provide some reductions in postoperative pain and opioid use after cardiothoracic surgery and appear to have a favorable safety profile. Chest wall blocks and erector spinae plane blocks were found not to differ in effectiveness, and both offer analgesia comparable to neuraxial techniques. Copyright © 2026 The Authors <134> Accession Number 2050066333 Title Clamp-on versus open distal anastomosis in acute type a aortic dissection: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 45. Date of Publication: 01 Dec 2026. Author de Aquino R.G.F.; Lobo Filho H.G.; Gurgel B.L.T.F.; Kilic A. Institution (de Aquino, Lobo Filho) Department of Cardiac Surgery, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Av. Frei Cirilo, CE, Messejana, Fortaleza, Brazil (Lobo Filho) Department of Surgery, Federal University of Ceara, Fortaleza, Brazil (Gurgel) Walter Cantidio University Hospital, Federal University of Ceara, Fortaleza, Brazil (Kilic) Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: The clamp-on technique for acute type A aortic dissection (ATAAD) repair has gained traction as an alternative to open distal anastomosis (ODA), but procedure-specific evidence comparing these strategies remains limited. This study aimed to compare surgical safety, postoperative morbidity, and organ protection between the clamp-on technique and conventional ODA. Method(s): PubMed, Embase, and Cochrane Library were systematically searched through May 2026 for studies comparing clamp-on versus ODA in adults with ATAAD. Random-effects models with Mantel-Haenszel weighting were used to estimate pooled risk ratios (RRs) for binary endpoints. Confidence intervals were adjusted using the Hartung-Knapp-Sidik-Jonkman (HKSJ) method, and 95% prediction intervals were calculated. Result(s): Nine observational studies (2,032 patients) were included, of which eight contributed crude event data to the quantitative synthesis, whereas the propensity-matched IRAD analysis (Pupovac et al.) was addressed narratively because its event counts derive from multiply imputed matched cohorts of varying size (94-101 pairs). No significant differences were observed between groups in hospital mortality (RR 1.26; 95% CI 0.83 to 1.92) or postoperative stroke (RR 0.98; 95% CI 0.41 to 2.35). Risks did not differ significantly for distal reoperation (RR 1.41; 95% CI 0.34 to 5.80) or new-onset dialysis (RR 0.78; 95% CI 0.42 to 1.45). The clamp-on strategy was associated with a non-significant trend toward lower acute kidney injury (RR 0.76; 95% CI 0.52 to 1.11; three studies) and sepsis (RR 0.64; 95% CI 0.33 to 1.26; three studies). Conclusion(s): In patients undergoing surgical repair for acute type A aortic dissection, clamp-on repair and open distal anastomosis showed no detectable difference in hospital mortality or stroke, although confidence intervals remain compatible with clinically important benefit or harm in either direction. The association of clamp-on with lower acute kidney injury and sepsis did not remain statistically significant with Hartung-Knapp-Sidik-Jonkman-adjusted confidence intervals and should be regarded as hypothesis-generating. Given the very low certainty of evidence and inherent selection biases, these findings support a patient-tailored approach over a standardized strategy and underscore the need for prospective multicenter registries. Copyright © The Author(s) 2026. <135> Accession Number 2050060893 Title Data-driven reweighting of the Charlson and Elixhauser comorbidity indices using German claims data: development for in-hospital mortality only, external validation across clinical and health-economic outcomes. Source Health Economics Review. 16(1) (no pagination), 2026. Article Number: 130. Date of Publication: 01 Dec 2026. Author Kaier K.; Hazard D.; Heidenreich A.; Maier A.; Westermann D.; von zur Muhlen C.; Oettinger V. Institution (Kaier, Hazard) Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, Freiburg, Germany (Kaier, Heidenreich, Maier, von zur Muhlen, Oettinger) Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, University of Freiburg, Freiburg, Germany (Hazard, Heidenreich, Maier, Westermann, von zur Muhlen, Oettinger) Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center, Medical Center University of Freiburg, University of Freiburg, Freiburg, Germany Publisher BioMed Central Ltd Abstract Background: Comorbidity scores such as the Charlson and Elixhauser indices are widely used for risk adjustment in health-economic and clinical outcomes research. Yet the existing weighting schemes, originally designed for mortality prediction, may no longer reflect today's patient populations or perform equally well across diverse outcomes. This study aimed to reweight both indices using a data-driven approach and to evaluate their predictive validity for multiple clinical and health-economic outcomes. Method(s): Using administrative data from a large tertiary care teaching hospital in Germany (N = 198,819 hospitalizations), we applied adaptive lasso regression to recalibrate the Charlson (Deyo weights) and Elixhauser (van Walraven weights) comorbidity indices. Reweighting was performed for in-hospital mortality as the development endpoint. Penalized coefficients were converted into integer-based weights. Model performance was assessed for three dichotomous endpoints (in-hospital mortality, severe bleeding, prolonged mechanical ventilation) and two continuous outcomes (length of hospital stay, total reimbursement). External validation was performed in three independent cohorts: Elective endometrial cancer (N = 85,204), interventional left atrial appendage closure (N = 28,039), and emergency ST-elevation myocardial infarction (STEMI; N = 248,062). AUC, R2, and RMSE were used as complementary measures of discrimination and predictive accuracy. Pooled relative improvements of AUC, R2, and RMSE across the three validation cohorts was calculated using random effects meta-analyses. Result(s): Reweighting consistently improved predictive performance across endpoints and cohorts, with modest absolute gains for in-hospital mortality and more pronounced gains for severe bleeding and continuous outcomes. When analysing in-hospital mortality in the three validation cohorts, the reweighted Charlson improved AUC from 0.679 to 0.714 in left atrial appendage closure, 0.588 to 0.594 in STEMI, and 0.798 to 0.810 in endometrial cancer (pooled relative increase: 2.05% [95% CI 0.56-3.53]); the reweighted Elixhauser showed larger gains, particularly in STEMI (0.708 to 0.766) and left atrial appendage closure (0.780 to 0.818; pooled relative increase: 4.86% [0.07-9.65]). The Elixhauser reweighting demonstrated consistently larger gains for severe bleeding (pooled AUC increase: 6.57% [4.23-8.92]). For continuous outcomes, the reweighted Elixhauser index yielded the largest gains in explained variance, with a pooled relative R2 increase of 39.66% [33.72-45.60] for total reimbursement. Corresponding reductions in RMSE were modest and often not statistically significant. Conclusion(s): Adaptive lasso reweighting consistently enhances the predictive validity of the Charlson and Elixhauser indices across both clinical and health-economic endpoints. Our multi-endpoint evaluation shows consistent performance gains across the three examined German validation cohorts, offering a practical basis for risk adjustment in health-economic studies using German claims data. Because development and validation were based exclusively on German data and a single coding system (ICD-10-GM), international validation across other coding systems and healthcare systems is required before broader applicability can be assumed. Copyright © The Author(s) 2026. <136> Accession Number 2038825019 Title Machine Learning-Based Prediction of Long-Term Survival and Failure to Rescue after Coronary Artery Bypass Grafting: A Systematic Review. Source Cor et Vasa. 68(5) (pp 590-599), 2026. Date of Publication: 2026. Author Dwintasari M.; Limanto D.H.; Rachmi C.N.; Pribadi O.R.S.; Sembiring Y.E. Institution (Dwintasari, Limanto, Sembiring) Departement of Thoracic, Cardiac, and Vascular Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia (Dwintasari, Limanto, Rachmi, Pribadi, Sembiring) Departement of Thoracic, Cardiac, and Vascular Surgery, Dr. Soetomo General Teaching Hospital, Surabaya, Indonesia Publisher Czech Society of Cardiology Z.S Abstract Introduction: Coronary artery bypass grafting (CABG) remains the gold standard for surgical revascularization in complex coronary artery disease. Although short-term mortality has improved substantially, long-term survival and failure to rescue (FTR) after major complications remain clinically relevant. Traditional regression-based risk models may insufficiently capture complex nonlinear interactions among perioperative variables. This review synthesizes contemporary evidence regarding determinants of survival and the role of machine learning (ML) in outcome prediction after CABG. Method(s): A PRISMA-guided systematic search of PubMed and ScienceDirect was conducted for studies published between January 2015 and January 2024. Eligible studies included adult patients undergoing isolated coronary artery bypass grafting (CABG) that reported survival outcomes or failure-to-rescue (FTR) using statistical or machine learning-based predictive models. Relevant model performance metrics and key predictive variables were extracted and qualitatively synthesized. Result(s): From 3,701 identified records, 26 studies met the inclusion criteria and were included in the qualitative synthesis. One-year survival after CABG ranged from 87-94%, while 5-year survival ranged from 67-88% and 10-year survival from 52-75%. The overall incidence of failure to rescue (FTR) was approximately 2-3%, with markedly higher mortality observed following major complications such as renal failure (~25%) and stroke (~13%). Consistent predictors of adverse outcomes included advanced age, reduced left ventricular ejection fraction, diabetes mellitus, renal dysfunction, and cerebrovascular disease. Machine learning models-particularly ensemble algorithms combined with SHAP interpretability techniques-demonstrated improved predictive accuracy and discriminatory performance compared with traditional regression-based approaches. Conclusion(s): Long-term survival after CABG remains heterogeneous and influenced by multifactorial clinical determinants. Machine learning-based risk stratification provides improved predictive accuracy and interpretable individualized assessment. Integration of validated artificial intelligence tools into CABG workflows may enhance perioperative decision-making and reduce failure-to-rescue rates. Copyright © 2026, Czech Society of Cardiology Z.S. All rights reserved. <137> Accession Number 652543830 Title Vascular Surgery is Overrepresented by Multiple Medical Societies Compared to its Peers. Source Journal of vascular surgery. (no pagination), 2026. Date of Publication: 28 Oct 2026. Author Tulimieri M.; Eagleton M.J.; Yassa E.; Ascher E.; Kashyap V.S. Institution (Tulimieri, Yassa, Kashyap) Frederik Meijer Heart and Vascular Institute, Corewell Health, Grand Rapids, MI, United States (Eagleton) Massachusetts General Hospital, Boston, MA, United States (Ascher) Vascular Institute of New York, Brooklyn, NY, United States Abstract Medical societies play an important role in representing physicians and their interests. Our objective was to compare the number, size, and fiscal strength of vascular societies compared to other cardiovascular specialties. All information was found via a systematic Internet search and with publicly available data (i.e. www.aamc.org). Medical societies representing vascular surgery (VS), cardiology (CARD), cardiothoracic surgery (CTS), and interventional radiology (IR) in the United States were compared. Board-certified physicians (www.abms.org) and publicly available financial information were tabulated (www.ProPublica.org). Board-certified vascular surgeons (n=4464) can choose to join 30 VS societies (4 national, 10 regional, 12 city/state, 4 other). In comparison, 12 societies (2 national) represent CTS (n=5869) and 16 (1 national) represent IR (n=4032) physicians. Cardiologists (n=22843) are represented by 14 (5 national) societies and an additional 27 chapters of a parent national society. The available number of vascular surgeons per national society is markedly lower than comparative specialties. Vascular societies generated $23M in revenue compared to $52M for CTS, $6M for IR, and $1.03B for CARD. CARD societies have 93% of total revenue for these four specialties and 52 times the revenues compared to VS societies. Compared to similar specialties, VS has few surgeons, yet a high number of medical societies. This segmentation may dilute the educational, governmental, societal, and patient advocacy impact of VS compared to its peers. Copyright © 2026. Published by Elsevier Inc. <138> Accession Number 652543001 Title PROlonged posterior PERicardial chest tube treatment to reduce rates of postoperative atrial fibrillation following cardiac surgery (PROPER trial): Rationale and design of a prospective, multinational, randomized clinical trial. Source American heart journal. (pp 107635), 2026. Date of Publication: 28 Oct 2026. Author Johannesson E.; Thelaus L.; Larsson M.; Teurneau-Hermansson K.; Ede J.; Forsberg A.; Gudbjartsson T.; Jeppsson A.; Moller C.H.; Wahba A.; Grinnemo K.-H.; Hansson E.C.; Holmdahl A.J.; Krogstad L.E.M.; Riber L.; Sjogren J.; Nozohoor S.; Mortsell D.; Zindovic I. Institution (Johannesson, Thelaus, Larsson, Teurneau-Hermansson, Ede, Sjogren, Nozohoor, Zindovic) Department of Cardiothoracic Surgery, Clinical sciences, Lund University, Skane University Hospital, Lund, Sweden (Forsberg) Department of Cardiothoracic Surgery, Clinical sciences, Lund University, Skane University Hospital, Lund, Sweden; Department of Health Sciences, Lund University, Lund, Sweden (Gudbjartsson) Department of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Iceland (Jeppsson, Hansson) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Moller) Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark (Wahba, Krogstad) Department of Cardiology and Cardiothoracic Surgery, St. Olavs Hospital HF, Trondheim, Norway; Department of Circulation and Medical Imaging, University of Science and Technology, NTNU, Trondheim, Norway (Grinnemo) Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (Holmdahl) Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden; Department of Cardiothoracic Surgery, Umea University Hospital, Umea, Sweden (Riber) Department of Cardio, Thoracic and Vascular Surgery, Odense University Hospital, Denmark and Institute of Clinical Medicine, University of Southern Denmark, Denmark (Mortsell) Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden Abstract Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery and is associated with increased morbidity and prolonged hospitalization. Accumulation of pericardial blood after surgery triggers a localized inflammatory response that has been identified as a contributing factor in POAF development. The PROPER trial (ClinicalTrials.gov Identifier: NCT06800781) is a prospective, multinational, randomized, controlled clinical trial designed to determine whether evacuation of pericardial blood through prolonged drainage using a posterior pericardial chest tube reduces the incidence of POAF following elective cardiac surgery. In addition to routine surveillance, patients will be monitored using a wearable electrocardiographic patch monitor. Patients undergoing non-emergent, first-time coronary bypass grafting, aortic valve replacement, aortic surgery without circulatory arrest, or a combination of these procedures, are randomized 1:1 to either receive intraoperative placement of a posterior pericardial chest tube or standard care. A total of 624 patients will be enrolled across eight Nordic cardiac surgery centers. The primary endpoint is atrial fibrillation (AF) recorded within seven days after surgery. Secondary endpoints include AF recurrence, hospitalization due to bleeding or ischemic stroke, and all-cause mortality. Patients will be followed for five years. If effective, posterior pericardial drainage represents a readily available, low-risk strategy with the potential for rapid and broad adoption in clinical practice. Copyright © 2026. Published by Elsevier Inc. <139> Accession Number 652543052 Title Rationale for Early Discontinuation of Aspirin After Transcatheter Aortic Valve Implantation: Design of the SOLOTAVI Randomized Trial. Source American heart journal. (pp 107634), 2026. Date of Publication: 28 Oct 2026. Author Beygui F.; Caussin C.; Marliere S.; Bonnet G.; Durand E.; Lhermusier T.; Morelle J.-F.; Delepine S.; Souteyrand G.; Ghostine S.; Van Belle E.; Barthelemy O.; Akodad M.; Cayla G.; Chamandi C.; Chemouni F.; Parienti J.-J.; Bouleti C.; Eltchaninoff H. Institution (Beygui) Cardiology Department, Centre Hospitalier Universitaire de Caen, Caen, France (Caussin, Chemouni) Cardiology Department, Paris, France (Marliere) Cardiology Department, Centre Hospitalier Universitaire de Grenoble, France (Bonnet) Cardiology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France (Durand, Eltchaninoff) Cardiology Department, Centre Hospitalier Universitaire de Rouen & INSERM U1096 & Institut Alain Cribier, Rouen, France (Lhermusier) Cardiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France (Morelle) Cardiology Department, Caen, France (Delepine) Cardiology Department, Centre Hospitalier Universitaire de Angers, Angers, France (Souteyrand) Cardiology Department, Centre Hospitalier Universitaire de Clermont Ferrand, Clermont Ferrand, France (Ghostine) Cardiology Department, Center Chirurgical Marie Lannelongue, France (Van Belle) Cardiology Department, Centre Hospitalier Universitaire de Lille, Lille, France (Barthelemy) Cardiology Department, Centre Hospitalier Universitaire Pitie-Salpetriere, AP-HP, Paris, France (Akodad) Institut Cardiovasculaire Paris Sud, Massy, France (Cayla) Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France (Chamandi) Cardiology Department, Hopital Europeen Georges Pompidou, AP-HP, Paris, France (Parienti) Department of Clinical Research, Centre Hospitalier Universitaire de Caen, Caen, France (Bouleti) University of Poitiers, Clinical Investigation Center Inserm 1402 & Cardiology Department, Centre Hospitalier Universitaire de Poitiers, Poitiers & FACT network, France Abstract BACKGROUND: Trans-aortic valve implantation (TAVI) has become the first line treatment of aortic stenosis, a condition predominantly affecting elderly patients. In absence of a specific indication for antithrombotic therapy, lifetime aspirin is recommended after TAVI while it may be discontinued 3 months after bioprosthetic surgical valve replacement. Primary prevention, using aspirin compared to placebo among elderly patients is associated with an increased risk of major bleeding and no reduction rates of thrombotic events. Hence, there is a gap of knowledge on whether aspirin should be continued >3 months after TAVI. STUDY DESIGN: SOLOTAVI is a multicenter, open label, blinded endpoint assessment, 1:1 randomized, non-inferiority trial comparing aspirin discontinuation 3 months after TAVI (experimental) to long-term therapy (control). Adult patients with successful transfemoral TAVI for symptomatic aortic stenosis and no indication or contraindication for long-term antithrombotic therapy will be enrolled. Randomization is stratified on center and valve type. The primary endpoint is the 12-month composite of all cause death, myocardial infarction, stroke, and non-procedure-related major or disabling bleeding. A hierarchical analysis is performed for the primary and 3 principal secondary endpoints. The sample size is computed for demonstrating the non-inferiority of the experimental strategy compared with the control strategy, with a conservative non-inferiority margin of 6.5%. A total of 1400 patients will be enrolled. CONCLUSION(S): The SOLOTAVI trial will assess the non-inferiority of a 3-month duration of aspirin compared to the long-term therapy after successful transfemoral TAVI in terms of thrombotic and bleeding events. NCT06518317 clinicaltrials.org. Copyright © 2026. Published by Elsevier Inc. <140> Accession Number 652541456 Title Redefining Noninvasive Post-Transplant Surveillance: A Bayesian Decision Framework for Donor-Derived Cell-Free DNA in Heart Transplantation. Source JACC. Heart failure. (pp 103483), 2026. Date of Publication: 27 Oct 2026. Author John J.D.; Henna F.; Waseem F.; Hassan M.A.; Bacha Z.; Mukhlis M.; Mohammed B.K.; Cheema S.; Shah K. Institution (John) Tau Square Academy, Hyderabad, Telangana, India; Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India. Electronic address: dr.jabezdavid@gmail.com (Henna) Dubai Medical College for Girls, Dubai, United Arab Emirates (Waseem) University College of Medicine and Dentistry, Lahore, Punjab, Pakistan (Hassan) Gomal Medical College, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan (Bacha) Khyber Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Khyber Pakhtunkhwa, Pakistan (Mohammed) Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Cheema) King Edward Medical University, Lahore, Punjab, Pakistan (Shah) SMS Medical College and Hospital, Jaipur, Rajasthan, India <141> Accession Number 2051118127 Title External validation and calibration of risk models in isolated coronary artery bypass grafting: a systematic review. Source Patologiya Krovoobrashcheniya i Kardiokhirurgiya. 30(2) (pp 55-66), 2026. Date of Publication: 2026. Author Arutyunyan L.A.; Shalaev S.V.; Tsiryatieva S.B.; Kremneva L.V.; Ostanina V.V.; Gaibova R.T.; Martynenko M.V. Institution (Arutyunyan, Shalaev, Tsiryatieva, Kremneva, Ostanina, Gaibova, Martynenko) Tyumen Regional Clinical Hospital No. 1, Tyumen, Russian Federation Publisher Meshalkin National Medical Research Center Abstract Introduction: In-hospital mortality after isolated coronary artery bypass grafting is now low, yet it differs markedly between centers and countries. Preoperative risk estimates guide patient routing, informed consent, and quality benchmarking. Because surgical technique, perioperative care, and patient profiles have shifted since 2018, risk models built on earlier cohorts lose calibration and call for re-examination in current practice. Objective(s): To assess contemporary external validity and calibration of EuroSCORE II and the Society of Thoracic Surgeons risk model (STS) for short-term mortality in adults undergoing isolated coronary artery bypass grafting. Method(s): We performed a systematic search of PubMed/MEDLINE, Scopus, and Web of Science restricted to 2018-2025 and English-language publications. Eligible records were original external validations in isolated coronary artery bypass grafting or studies with a clearly reported subgroup; endpoints were in-hospital mortality or 30-day survival. We extracted discrimination (area under the ROC curve) and calibration metrics (observed-to-expected mortality ratio, Hosmer - Lemeshow p-value, calibration slope and intercept when available). Study selection and data extraction were performed independently by two reviewers; unreported metrics were recorded as "not reported". Risk of bias was assessed using Prediction Model Risk of Bias Assessment Tool (PROBAST). Result(s): Nine studies from Europe, Asia, and Latin America were included (sample sizes 438-14,118). Discrimination ranged from modest to high: for EuroSCORE II AUC 0.55-0.90 (0.82-0.90 in the largest cohorts); for the STS model AUC 0.65-0.88. Calibration was heterogeneous: overestimation in low-risk and younger patients (e.g., overall observed-to-expected ratio 0.58; 0.26 in patients <60 years) contrasted with underestimation in older adults, in procedures with cardiopulmonary bypass, and in several non-European populations. In some reports, simple centre-specific recalibration improved agreement between predicted and observed outcomes. Conclusion(s): In contemporary isolated coronary artery bypass grafting, EuroSCORE II and the STS model remain useful for risk ranking but centre-level calibration checks and - when indicated - straightforward recalibration are recommended. Regular auditing of observed-to-expected mortality and stratified verification in key subgroups is also recommended. Copyright © 2026 Arutyunyan et al. <142> Accession Number 652543634 Title Direct Oral Anticoagulants Versus Vitamin K Antagonists for Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in review. (no pagination), 2026. Date of Publication: 29 Oct 2026. Author Al-Harrasi A.; Almutairi A.; Alghazali R.A.; Alrefaei N.; Rusheidi R.S.A.; Zuhair S.A.; Alfailakawi A.K.E.A.E.A.; Zamzamy D.A.; Mousa H.A.; Elkasaby M.H.; Frishman W.H.; Aronow W.S. Institution (Al-Harrasi) From the Department of Medicine, Arabian Gulf University, Manama, Bahrain (Almutairi, Alghazali, Rusheidi) Department of Medicine, Royal College of Surgeons in Ireland, Bahrain (Alrefaei) Department of Medicine, University of Sharjah, Sharjah, United Arab Emirates (Zuhair) Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia (Alfailakawi) Department of Medicine, Alexandria University, Alexandria, Egypt (Zamzamy) Department of Medicine, Hera General Hospital, Makkah, Saudi Arabia (Mousa) Department of Internal Medicine, Kingdom Medical Center, Makkah, Saudi Arabia (Elkasaby) Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Frishman, Aronow) Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Abstract Atrial fibrillation after cardiac surgery is common and is associated with stroke, prolonged hospitalization, and mortality; yet, the optimal oral anticoagulant in this setting remains uncertain. We performed a systematic review and meta-analysis comparing direct oral anticoagulants (DOACs) with vitamin K antagonists (VKAs) in adults requiring oral anticoagulation for atrial fibrillation after cardiac surgery. PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception through August 2026 for randomized controlled trials. The primary outcome was any bleeding; secondary outcomes were stroke or transient ischemic attack, systemic embolism, major bleeding, intracranial hemorrhage, reoperation, and length of hospital stay. Odds ratios (ORs) and mean differences (MDs) were pooled with random-effects models, risk of bias was assessed with the Cochrane Risk of Bias 2 tool, and certainty of evidence was rated with GRADE. Five randomized trials including 302 patients (153 DOACs and 149 warfarin) were included; rivaroxaban was tested in 3 trials, and apixaban and dabigatran in 1 trial each. Any bleeding did not differ significantly between DOACs and VKAs (9.2% vs 8.1%; OR, 1.24; 95% confidence interval [CI], 0.39-3.99). Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <143> Accession Number 2049956334 Title Efficacy of Ultrasound-Guided Pectointercostal Fascial Block Versus Control and Alternative Regional Techniques in Cardiac Surgery: A Systematic Review and Meta-Analysis with Dose-Response Analysis. Source Medicina (Lithuania). 62(10) (no pagination), 2026. Article Number: 1890. Date of Publication: 01 Oct 2026. Author Elnahas M.; Zidan M.; Abusamra Y.; Hassan M.; Saravi B.; Hochrein S.; Lang P. Institution (Elnahas, Hochrein, Lang) Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, Sozialstiftung Bamberg, Bamberg, Germany (Zidan) Department of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom (Abusamra) Department of Anaesthesia, Manchester University NHS Foundation Trust, Manchester, United Kingdom (Hassan) Department of Thoracic and Cardiovascular Surgery, Julius-Maximilians-University Hospital, Wuerzburg, Germany (Saravi) Department of Oral, Maxillofacial and Facial Plastic Surgery, Medical Faculty and University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Ultrasound-guided pectointercostal fascial block (USG-PIFB) is increasingly used for post-sternotomy analgesia, but its efficacy remains uncertain. Prior meta-analyses pooled ultrasound-guided blocks with surgeon-performed infiltration, introducing heterogeneity. We aimed to determine the analgesic efficacy of USG-PIFB in adult cardiac surgery by restricting inclusion to ultrasound-guided techniques. Material(s) and Method(s): Six databases were searched through December 2025, with an update search of open sources and trial registries in September 2026, for randomized controlled trials comparing USG-PIFB with control (Comparison 1) or with an alternative regional technique (Comparison 2) in adults undergoing sternotomy. The primary outcome was 24-h opioid consumption in intravenous morphine milligram equivalents. Random-effects meta-analysis (REML, Knapp-Hartung), subgroup, sensitivity and meta-regression analyses, an exploratory trial sequential analysis and GRADE assessment were performed. Result(s): Twenty-nine trials (2664 participants) were included: 24 in Comparison 1 and eight in Comparison 2. In 13 trials (902 participants), USG-PIFB reduced 24-h opioid consumption (mean difference -6.60 mg; 95% CI, -10.92 to -2.27; I2 = 97.7%), but the 95% prediction interval (-22.24 to 9.04 mg) included no effect and small-study effects could not be excluded. Pain scores were lower by 0.8 to 1.4 points at rest (extubation, 12 and 24 h) and during movement (12 h). Extubation was earlier and intensive care stay shorter, with extreme heterogeneity. No dose-response relationship was detected, and the difference from deep parasternal techniques was near zero. No local anesthetic systemic toxicity or block-attributable pneumothorax was reported; one block-site hematoma occurred in a USG-PIFB recipient. Certainty of evidence was low for rescue analgesic use and block-related complications and very low for all other outcomes. Conclusion(s): USG-PIFB may modestly reduce 24-h opioid consumption, but the magnitude and reproducibility of this effect across clinical settings remain uncertain. It is best regarded as one component of multimodal analgesia, and adequately powered multicentre trials are needed. Copyright © 2026 by the authors. <144> Accession Number 2050082605 Title Preoperative empagliflozin and ventricular remodeling after coronary artery bypass grafting in type 2 diabetes: a prespecified analysis of the POST-CABGDM randomized trial. Source Diabetology and Metabolic Syndrome. 18(1) (no pagination), 2026. Article Number: 227. Date of Publication: 01 Dec 2026. Author Popp V.O.; Pitta F.G.; de Brito G.D.; Popp J.O.; Carvalho L.N.S.; Sampaio L.P.C.; Rached F.H.; Mioto B.M.; Bolta P.M.P.; Asdrubal Vilca Mejia O.; Dallan L.A.O.; Filho R.K.; Abizaid A.A.C.; Serrano C.V.; Lima E.G. Institution (Popp, Pitta, Carvalho, Sampaio, Rached, Mioto, Bolta, Asdrubal Vilca Mejia, Dallan, Filho, Abizaid, Serrano, Lima) Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Sao Paulo, Brazil (Popp, de Brito) Complexo Hospital Sao Marcelino Champagnat, PR, Curitiba, Curitiba, Brazil (Popp, Popp) Hospital Universitario Cajuru, PR, Curitiba, Brazil (Popp) Pontificia Universidade Catolica do Parana (PUCPR), PR, Curitiba, Brazil (Lima) Hospital Nove de Julho, Sao Paulo, Brazil Publisher BioMed Central Ltd Abstract Background: Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are associated with adverse ventricular remodeling. Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) may further contribute to myocardial injury through inflammatory and ischemia-reperfusion mechanisms. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardioprotective effects, including reduction in left ventricular mass, but their impact in the perioperative setting of cardiac surgery remains unclear. Method(s): This study is a prespecified secondary analysis of the open-label randomized POST-CABGDM trial (NCT04523064). Patients with T2DM and multivessel CAD undergoing CABG with CPB were randomized to receive empagliflozin 25 mg once daily or standard antidiabetic therapy. SGLT2i were discontinued 3 days before surgery and were not protocol-mandated postoperatively. Transthoracic echocardiography was performed preoperatively and at 1-6 months postoperatively. The primary endpoint was the change in left ventricular mass index (DELTALVMI). Secondary endpoints included changes in left ventricular ejection fraction (DELTALVEF) and ventricular dimensions. Result(s): A total of 118 patients were included (53 in the intervention group and 65 in the control group). Baseline characteristics were well balanced. No significant difference was observed in DELTALVMI between groups (- 1.39 +/- 18.7 vs. -4.55 +/- 16.8 g/m2; p = 0.337), and this finding remained unchanged after adjustment for baseline LVMI. Similarly, no differences were found in DELTALVEF or ventricular dimensions. Surgical characteristics and postoperative complications were comparable. In a separate exploratory, non-randomized multivariable analysis, continued use of SGLT2i during follow-up was associated with a higher likelihood of LVMI reduction (OR 4.69; 95% CI 1.20-18.40; p = 0.03). Conclusion(s): Preoperative empagliflozin use was not associated with significant short-term changes in LVMI, LVEF, or ventricular dimensions after CABG with CPB. Exploratory, non-randomized analyses suggested an association between continued SGLT2i use during follow-up and LVMI reduction, but these findings should be considered hypothesis-generating and require confirmation in prospective studies designed to evaluate sustained perioperative and postoperative therapy. Trial registration: ClinicalTrials.gov NCT04523064. Copyright © The Author(s) 2026.

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