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Total documents retrieved: 154 Results Generated From: Embase <1980 to 2026 Week 31> Embase Weekly Updates (updates since 2026-07-24) - (154 records) <1> Accession Number 2047626279 Title Enhanced Recovery After Cardiac Surgery: A Bibliometric Analysis With Emphasis on Perioperative and Anesthetic Practice. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Huang S.; Chao M.; Zhao X.-S.; Liu K.-X.; Gao S.-S.; Yao Y.-T. Institution (Huang, Zhao, Liu, Gao, Yao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Huang, Zhao, Liu, Gao, Yao) The Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Chao, Yao) Center of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Chao, Yao) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To systematically characterize the global research landscape and emerging trends of enhanced recovery after cardiac surgery (ERACS). Design(s): Bibliometric analysis. Data Source: Publications were retrieved from the Web of Science Core Collection database, a comprehensive repository of peer-reviewed international literature. Study Selection: A total of 725 publications related to ERACS published between 1979 and 2026 were included. Intervention(s): Not applicable. Measurements and Main Results: Annual publication output increased markedly after 2015, indicating growing interest in ERACS. The United States and Canada were the leading contributors in both productivity and academic influence. Co-occurrence and clustering analyses identified major research themes, including minimally invasive cardiac surgery, multimodal analgesia, perioperative management, and postoperative complications. Temporal keyword analysis demonstrated a transition from early extubation strategies toward comprehensive perioperative care pathways. Despite this expansion, high-quality randomized evidence remains limited. Conclusion(s): This bibliometric analysis provides a comprehensive overview of the evolving research landscape of ERACS. The field is rapidly expanding and shifting toward integrated perioperative care models. However, further high-quality studies are required to strengthen the evidence base and support clinical implementation. Copyright © 2026 Elsevier Inc. <2> Accession Number 2047104668 Title Approaches to transcatheter aortic valve replacement failure: is more focus on prevention required?. Source Expert Review of Cardiovascular Therapy. 24(7) (pp 593-607), 2026. Date of Publication: 2026. Author Androutsopoulou V.; Xanthopoulos A.; Zotos P.-A.; Athanasiou T.; Brecher V.; Magouliotis D.E. Institution (Androutsopoulou, Zotos) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Xanthopoulos) Department of Cardiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Brecher, Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Transcatheter aortic valve replacement (TAVR) has transformed the management of severe aortic stenosis across all surgical risk strata. As its use expands to younger, lower-risk patients, the durability of transcatheter heart valves and the clinical consequences of prosthetic failure have become critically important. Despite a growing literature on reintervention strategies, systematic prevention of TAVR failure remains comparatively underemphasized. Areas covered: We searched PubMed and the Cochrane Library (2000-2026, English language) for studies on TAVR failure and its prevention. This review examines the mechanisms of TAVR failure, including structural valve deterioration, paravalvular leak, prosthesis-patient mismatch, subclinical leaflet thrombosis, valve endocarditis, and device migration; appraises current management, including valve-in-valve TAVR, redo surgical aortic valve replacement, and medical therapy; and reviews prevention strategies spanning patient selection, procedural optimization, antithrombotic management, structural surveillance, coronary access preservation, and lifetime planning. Expert opinion: The evidence base has focused disproportionately on reintervention rather than prevention. Greater emphasis on structured lifetime management planning at index TAVR, individualized antithrombotic strategies, and evidence-based surveillance is needed. Several proposed measures, however, including routine anticoagulation for subclinical leaflet thrombosis and routine CT or artificial-intelligence-based surveillance, are not yet supported by outcome data and require prospective validation. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <3> Accession Number 2044599293 Title Digital Stethoscope-Derived Single-Lead Electrocardiogram and Artificial Intelligence to Detect Low Ejection Fraction: A Multicenter Observational Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(7) (pp 2015-2025), 2026. Date of Publication: 01 Jul 2026. Author Prakash Borde D.; Joshi S.; Chidambaram K.; Jasapara A.; Thimmarayappa A.; Bhargava D.V.; Santosh Kamat S.; Gandhe U.; Muniraj G.; Madanaik S.S.; Joshi P.; Apsingkar P.; Takalkar U.; Dharshini D.; Balakrishnan N.; Sridevi N.; Dhananjaya M.; Mutyala S.C.; Vaggar J.N.; Mishra S.; Dhulkhed V.; Shelke A.; Mali S.; Paul A.; Deshpande G.; Shetty V.; Shinde P.; Naidu V.; Mathias D.J.; Singh G.; Yadav R.; Kieu S.N.; Mathew G.; Jose J.; Chakravarthy M.; Padmanabhan D.; Koshy T. Institution (Prakash Borde, Joshi, Apsingkar) Department of Cardiac Anesthesia, Ozone Anesthesia Group, Care CIIGMA Hospital, Chhatrapati Sambhajinagar (Aurangabad), Maharashtra, India (Joshi, Dharshini) Department of Cardiac Anesthesia, Narayana Institute of Cardiac Sciences, Narayana Health, Karnataka, Bengaluru, India (Chidambaram, Sridevi) Department of Cardiac Anesthesia, Madras Medical Mission, Tamil Nadu, Chennai, India (Jasapara, Shetty, Shinde) Department of Cardiac Anaesthesia, Fortis Hospital Mulund, Maharashtra, Mumbai, India (Thimmarayappa, Dhananjaya) Department of Cardiac Anesthesiology, Sri Jayadeva Institute Of Cardiovascular Sciences And Research, Karnataka, Bengaluru, India (Bhargava) Department of Anaesthesiology, Armed Forces Medical College, Maharashtra, Pune, India (Santosh Kamat, Singh, Yadav) Department of Cardiac Anaesthesiology, Goa Medical College & Hospital, Goa, Bambolim, India (Gandhe, Mutyala, Vaggar, Mali) Department of Cardiac Anesthesiology, P.D. Hinduja National Hospital VMahim, Maharashtra, Mumbai, India (Muniraj, Paul, Deshpande) Department of Anesthesiology, Fortis Hospital, Bannerghatta Road, Karnataka, Bengaluru, India (Madanaik, Naidu, Mathias, Chakravarthy) Department of Cardiac Anaesthesia, Krishna Vishwa Vidyapeeth, Maharashtra, Karad, India (Takalkar, Mishra, Dhulkhed) Department of Surgery, Care CIIGMA Hospital, Chhatrapati Sambhajinagar (Aurangabad), Maharashtra, India (Balakrishnan) Department of Cardiac Anesthesia, Kauvery Heart City, Tamil Nadu, Tiruchirapalli, India (Shelke) Department of Cardiology, Krishna Vishwa Vidyapeeth Karad, Maharashtra, India (Kieu, Mathew) Eko Heath Inc. Emeryville, California, United States (Jose) Department of Cardiac Anesthesiology and Critical Care, Amrita Institute of Medical Sciences, Kerala, Kochi, India (Padmanabhan) Department of Electrophysiology, Narayana Institute of Cardiac Sciences, Narayana Health, Karnataka, Bengaluru, India (Koshy) Department of Cardiac Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, Trivandrum, India Publisher W.B. Saunders Abstract Objectives: Identifying patients likely to benefit from an echocardiogram before surgery is prudent in resource-limited settings. Recently, artificial intelligence has facilitated the diagnosis of low ejection fraction (EF) from electrocardiograms. This multicenter study aimed to evaluate the diagnostic accuracy of a single-lead electrocardiogram-based algorithm obtained by an electronic stethoscope (Eko CORE 500) for identifying individuals with reduced left ventricular ejection fraction (LVEF) (<=40%) during preoperative evaluation. Design(s): Multicenter, prospective, observational diagnostic accuracy study. Setting(s): Ten tertiary care-level hospitals across India. Participant(s): Nine hundred eighty-one preoperative patients. Intervention(s): None. Measurements and Main Results: Patients referred for a 2-dimensional echocardiogram as part of a preoperative workup were eligible. An Eko CORE 500 stethoscope was used to collect paired single-lead electrocardiograms and heart sounds at the pulmonic auscultation position. After data collection concluded, all recordings were analyzed using the Eko application. If a recording passed an automated electrocardiogram signal quality check, the algorithm categorized it as either LVEF <= 40% or LVEF > 40%. Performance was assessed against an echocardiogram-derived LVEF <= 40%. A total of 981 subjects undergoing various surgical procedures were included. After 114 recordings deemed to have poor electrocardiogram signal were excluded, the final cohort consisted of 867 subjects. One hundred thirty-eight patients had EF <= 40% as determined by echocardiography. The algorithm detected LVEF <= 40% with an area under the receiver operating characteristic curve (AUC-ROC) of 0.73 (95% confidence interval [CI], 0.67-0.78), sensitivity of 60.1% (95% CI, 51.8%-67.9%), and specificity of 81.3% (95% CI, 78.4%-84.0%). When patients were stratified by type of surgery, performance was superior in the noncardiac group (AUC-ROC of 0.75 [95% CI, 0.59-0.92] in noncardiac group v 0.70 [95% CI, 0.64-0.75] in cardiac group for LVEF <= 40%). Conclusion(s): The Eko digital stethoscope shows promise as a clinical decision-making tool for preoperative assessment. The ability to accurately detect reduced EF, especially in the setting of noncardiac surgery, suggests the algorithm's potential utility as a rule-out test to optimize resource allocation for preoperative screening. These findings suggest that its use could be considered in specific patient populations, particularly in resource-limited settings. Copyright © 2026 Elsevier Inc. <4> Accession Number 2047591703 Title Efficacy and Safety of Albumin in Critically Ill Adults: A Systematic Review. Source Emergency Medicine International. 2026(1) (no pagination), 2026. Article Number: 7434218. Date of Publication: 2026. Author Suarez T.G.P.; Valencia M.G.; Saiz L.C.; Leon J.P.T.; Hernandez A.A.; Lugea A.E.; Alegria L.L.; Erviti J. Institution (Suarez) Department of Health Sciences, Public University of Navarra, Navarra, Pamplona, Spain (Valencia, Saiz, Erviti) Innovation and Organization Unit, SNS-O, Navarra, Pamplona, Spain (Leon, Hernandez, Lugea) Intensive Medicine Service, University Hospital of Navarra, Navarra, Pamplona, Spain (Alegria) Pharmaceutical Benefit Management Service, Pharmacy and Benefits Subdirectorate, SNS-O, Navarra, Pamplona, Spain Publisher John Wiley and Sons Ltd Abstract Introduction: Albumin, the most abundant blood protein, is widely used as a plasma expander in critically ill patients. Objective(s): To evaluate the efficacy and safety of albumin compared to other alternatives in the prevention and treatment of complications in critically ill adults, considering different comparators and clinical situations. Method(s): A systematic review was conducted, including randomized controlled trials (RCTs) comparing albumin with crystalloids, other colloids, or standard care without albumin. Primary outcomes were total mortality, blood transfusion requirement, and serious adverse events. The search was performed in MEDLINE, Embase, and Cochrane Central. Meta-analysis was conducted using the Mantel-Haenszel method with a random-effects model, and heterogeneity was assessed with the I2 statistic. The risk of bias was evaluated using Cochrane RevMan 5.4, and the quality of evidence was assessed with the GRADE approach. Result(s): Thirty-five RCTs involving 13,975 critically ill adults were included. Mortality was 23.8% (1327/5586) with albumin and 24.2% (1361/5618). Compared with colloids, mortality was 21.9% (83/379) versus 24.4% (113/463). When compared with standard care without albumin, mortality was higher with albumin: 15.8% (60/380) versus 9.2% (39/424). SAEs occurred in 37.6% (298/793) of albumin-treated patients versus 33.5% (266/793) with crystalloids. Albumin required less transfused blood volume than colloids. Conclusion(s): Albumin showed no benefit over crystalloids, colloids, or standard care without albumin in reducing mortality. It resulted in less blood transfusions compared to colloids, but serious adverse events were higher than with crystalloids. Copyright © 2026 Talia Gabriela Porras Suarez et al. Emergency Medicine International published by John Wiley & Sons Ltd. <5> Accession Number 2046658726 Title Headless Pacemaker in Bradyarrhythmia After Transcatheter Aortic Valve Replacement: A Meta-Analysis. Source Cardiology in Review. Publish Ahead of Print (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Pajareya P.; Chuanchai W.; Laohasurayotin K.; Siranart N.; Phutinart S.; Tokavanich N.; Prasitlumkum N.; Chokesuwattanaskul R. Institution (Pajareya, Chuanchai, Laohasurayotin, Siranart, Phutinart, Chokesuwattanaskul) Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand (Tokavanich) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Prasitlumkum) Department of Cardiology, Electrophysiology Section, Pali Momi, Hawaii Pacific Health, Hawaii, HI, United States Publisher Lippincott Williams and Wilkins Abstract Leadless pacemaker (LPM) offers a favorable safety profile for bradyarrhythmia, especially in patients at high risk for infection from transvenous pacemaker (TPM). However, its use for bradyarrhythmia after transcatheter aortic valve replacement (TAVR) remains unexplored. We conducted a systematic search from the inception of PubMed to November 2025. Eligible studies included adults who received a pacemaker after TAVR. Primary endpoints were overall complications and device-related complications. Secondary endpoints included all-cause mortality, device-related mortality, hospitalization for heart failure, procedure time, fluoroscopy time, and length of stay after pacemaker implantation. We included a total of 11 studies involving 11, 750 patients who underwent TAVR (1243 with LPM and 10, 507 with TPM). None of the patients in the LPM group experienced device-related complications, with significantly lower rates compared to the TPM group [adjusted hazard ratio (aHR) 0.35, 95% confidence interval (CI): 0.13-0.97; I2 = 0%]. Similarly, no device-related mortality was observed in the LPM group. All-cause mortality and hospitalization for heart failure were comparable between the LPM and TPM groups (aHR 1.02, 95% CI, 0.05-20.68; I2 = 25% and aHR 0.87, 95% CI, 0.24-3.17; I2 = 0%, respectively). The feasibility of LPM was also similar to TPM in terms of procedural time (MD -28.66 minutes, 95% CI, -92.36 to 35.03; I2 = 11%), fluoroscopy time (MD -1.36 minutes, 95% CI, -6.30 to 3.59; I2 = 0%), and length of stay (MD -0.53 days, 95% CI, -1.33 to 0.27; I2 = 6%). In conclusion, LPM could serve as a first-line pacing strategy in bradyarrhythmia post-TAVR due to its safer profile with comparable efficacy and feasibility to TPM. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <6> Accession Number 2047580348 Title Outcomes of conservative management of CT-diagnosed hemothorax in chest trauma: A systematic review and meta-analysis. Source Injury. 57(10) (no pagination), 2026. Article Number: 113476. Date of Publication: 01 Oct 2026. Author Alomar Z.; El-Khatib A.; Khreibeh M.; Refai A.; Alomari M.; Alomar A.; El-Menyar A.; Rizoli S.; Al-Thani H.; Mahmood I. Institution (Alomar, El-Khatib, Khreibeh, Refai, Alomari, Alomar) Jordan University of Science and Technology, Jordan (El-Menyar, Rizoli, Al-Thani, Mahmood) Trauma Surgery, Hamad Medical Corporation, Qatar (Mahmood) Surgery Department, Qatar University, Doha, Qatar (El-Menyar) Clinical Medicine, Weill Cornell Medicine, Doha, Qatar Publisher Elsevier Ltd Abstract Background Hemothorax is one of the most common findings in traumatic chest injuries. Emerging evidence suggests that small-volume hemothoraces (less than 300 cc) diagnosed by CT scan can often be managed successfully with conservative (non-interventional) treatment. This choice is clinically important, as chest tube drainage may itself lead to complications. The aim was to evaluate the outcomes and complications of conservative management in patients with small-volume hemothorax. Methods This systematic review and meta-analysis followed PRISMA guidelines. We searched PubMed, Scopus, and the Cochrane Library for studies on CT-diagnosed traumatic hemothorax in stable patients managed conservatively. Articles meeting the inclusion criteria were reviewed. The main outcome measured was the failure rate of conservative management. Results Of 3089 articles screened, 10 studies met inclusion criteria, reporting on 3030 patients with CT-diagnosed hemothorax. Among these, 1679 patients (55.4%) were managed conservatively, achieving an 81% success rate. Most cases (94.4%) involved a hemothorax volume under 300 cc, and 409 patients had an associated occult pneumothorax. Delayed tube thoracostomy was needed in 19% (319/1679) of conservatively managed patients; only 1.8% required further surgical intervention. The primary indications for delayed tube thoracostomy were progression of hemothorax on follow-up chest x-ray (62.0%), worsening pneumothorax (16.4%), and development of respiratory distress (12.3%). All reported mortality was unrelated to thoracic injuries. Conclusion Patients with CT-diagnosed hemothorax < 300 cc (thickness <15 mm) can be managed conservatively, with 1 in 5 requiring later intervention. These results support observation in stable patients and highlight the need for careful monitoring and standardized protocols. However, these findings should be interpreted with caution, as prospective, high-quality clinical trials with standardized definitions, imaging criteria, and outcomes are needed before firm clinical recommendations can be made, to strengthen the current evidence base. Copyright © 2026 British Trauma Society. <7> Accession Number 2046199116 Title Outcomes after using cerebral embolic protection devices during transcatheter aortic valve replacement: an updated meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1782285. Date of Publication: 01 May 2026. Author Sayed M.S.; AlQurm A.K.; Rasheed W.M.; Abedal- Kareem K.Y.; Albsoul S.M.; AlQurm S.K.; Ramadneh S.M.; Haddad J.N.; Aqtash O.; Caldonazo T. Institution (Sayed) Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt (AlQurm, Abedal- Kareem, AlQurm, Ramadneh, Haddad) School of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Rasheed) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Albsoul) Faculty of Medicine, Yarmouk University, Irbid, Jordan (Aqtash) Department of Cardiology, Baylor Scott & White, the Heart Hospital, Plano, TX, United States (Caldonazo) Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany Publisher Frontiers Media SA Abstract Background - Cerebral embolic protection (CEP) devices have been developed to reduce periprocedural embolization through transcatheter aortic valve replacement (TAVR), yet their clinical benefit remains uncertain. This study aimed to systematically evaluate the efficacy and safety of CEP devices during TAVR using evidence restricted to randomized controlled trials (RCTs). Methods - We conducted a systematic review and meta-analysis following PRISMA guidelines. MEDLINE, Embase, Web of Science, Scopus, and Cochrane CENTRAL were searched through July 2025 for RCTs comparing CEP devices vs. no protection in patients undergoing TAVR. The primary outcome was the all-cause stroke. Random-effects model was applied for the primary analysis. Results - Nine RCTs comprising 11, 696 patients (6, 000 patients in CEP, 5, 696 patients in control) were analyzed. CEP use did not significantly reduce the overall risk of all-cause stroke (RR 0.92; 95% CI 0.73-1.14; p = 0.43). The results were consistent across different subgroups, either Sentinel (filter device) (RR 0.88; 95% CI 0.70-1.11; I2 = 0.00%) or TriGuard (deflection device) (RR 1.40; 95% CI 0.67-2.94; I2 = 0.00%) (Pinteraction = 0.50). Similarly, no significant differences between the two groups were observed for the risk of all-cause mortality, disabling stroke, non-disabling stroke, cardiovascular mortality, transient ischemic attack, major adverse cardiovascular and cerebrovascular events, major bleeding, major vascular complications, or acute kidney injury. Conclusions - Among patients undergoing TAVR, CEP devices could not reduce the risk of stroke compared with the control group. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251114450, CRD420251114450. Copyright © 2026 Sayed, AlQurm, Rasheed, Abedal- Kareem, Albsoul, AlQurm, Ramadneh, Haddad, Aqtash and Caldonazo. <8> Accession Number 2045835881 Title Hybrid Suture- and Plug-Based Closure Versus Dual Suture Devices in Transfemoral Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(7) (no pagination), 2026. Article Number: 105339. Date of Publication: 01 Jul 2026. Author Moeez A.; Shah S.W.; Huma S.; Salma Shabbar Banatwala U.E.; Ali A.; Khattak L.Z.; Bacha Z.; Khan A.; Shaid F.; Azeem T.; Razzaq S.; Khan M.W.Z.; Ikram J.; Ullah F.; Shaban M. Institution (Moeez) Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan (Shah, Huma, Ali, Bacha, Khan, Shaid, Azeem) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Salma Shabbar Banatwala) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Khattak, Ullah) Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan (Razzaq) Department of Medicine, Poonch Medical College, Rawalkot, Pakistan (Khan) Department of Internal Medicine, AdventHealth Orlando, Orlando, FL, United States (Ikram, Shaban) Cardiovascular Medicine, Department, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier B.V. Abstract Background Effective vascular closure is crucial in transfemoral transcatheter aortic valve replacement (TAVR) to minimize access-related complications. Although dual suture-based closure is widely used, a hybrid approach combining suture- and plug-based vascular closure devices (VCD) has gained increasing attention. This meta-analysis compared these 2 strategies in terms of vascular outcomes and procedural success. Methods A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched through January 2025 for studies comparing suture-plus-plug-based vs suture-based VCD in TAVR patients. Primary outcomes were major and minor vascular complications, bleeding events, VCD failure, and unplanned interventions. Risk ratios (RRs) with 95% CIs were calculated. Results Six studies involving 2308 patients were included. The suture-plus-plug-based approach significantly reduced major vascular complications (RR, 0.50; P = .001), minor vascular complications (RR, 0.58; P < .00001), and VCD failure (RR, 0.26; P < .00001) compared with suture-based closure alone. No significant differences were observed in major ( P = .30) or minor bleeding ( P = .47). Unplanned interventions were less frequent with the hybrid approach, but the difference was not statistically significant (RR, 0.68; P = .19). Conclusions The combination of suture- and plug-based closure devices in transfemoral TAVR provides superior vascular outcomes and lower device failure rates without increasing bleeding risk. These findings support the hybrid approach as a safe and effective strategy, although further randomized controlled trials are warranted to confirm long-term outcomes. Copyright © 2026 The Author(s). <9> Accession Number 2047356345 Title Machine Learning With Genetic and Clinical Data to Predict Ischemic Outcomes After PCI. Source Clinical and Translational Science. 19(7) (no pagination), 2026. Article Number: e70655. Date of Publication: 01 Jul 2026. Author Grant C.W.; Ingraham B.S.; Lennon R.J.; Raina A.; Tian S.; Kowlgi G.; Cavallari L.H.; Lee C.R.; Beitelshees A.; Angiolillo D.J.; Franchi F.; Duarte J.D.; Rossi J.S.; Stouffer G.A.; Klee E.; Gulati R.; Rihal C.; Farkouh M.; Athreya A.P.; Pereira N.L. Institution (Grant, Athreya) Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States (Ingraham, Raina, Kowlgi, Gulati, Rihal, Pereira) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Lennon, Tian, Klee) Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States (Cavallari, Duarte) Department of Pharmacotherapy & Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, United States (Lee) Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, United States (Beitelshees) Department of Medicine, University of Maryland, Baltimore, MD, United States (Angiolillo, Franchi) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Rossi, Stouffer) Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, NC, United States (Farkouh) Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA, United States Publisher John Wiley and Sons Inc Abstract Ischemic events after contemporary percutaneous coronary intervention (PCI) are uncommon but carry high morbidity/mortality. Identifying patients at highest risk is critical to guide dual antiplatelet therapy (DAPT) intensity while minimizing bleeding. Current machine learning (ML) model-developed risk scores do not incorporate pharmacogenetic data. To develop and externally validate ML models that integrate clinical, demographic, and CYP2C19 genetic information to predict 1-year ischemic outcomes post-PCI to refine clinical decision making. We analyzed 8317 patients from TAILOR-PCI trial (n = 4572) and the Precision PCI registry (n = 3745). The outcome was a composite of cardiovascular death, myocardial infarction, stroke, and stent thrombosis at 1 year. Boruta feature selection identified 11 predictors. Multiple ML algorithms were trained in TAILOR-PCI and validated in Precision PCI using cross-validation and synthetic minority oversampling (SMOTE). Model performance was assessed by area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. The best external performance was achieved with a support vector machine (SVM, polynomial kernel) (AUC 0.667; sensitivity 0.871; specificity 0.282), while XGBoost provided a more balanced profile (AUC 0.619; sensitivity 0.442; specificity 0.688). Variable importance for the SVM polynomial model demonstrated that all 11 included Boruta feature selected predictors had relatively high importance (> 75). ML models trained on large clinical trial and real-world registry datasets can help identify the small subset of patients at high ischemic risk after PCI. This distinction is of relevance because ischemic events are rare, and most patients may safely de-escalate DAPT to reduce bleeding risk while maintaining ischemic protection through a multimodal approach to risk stratification. Trial Registration: TAILOR-PCI URL: https://clinicaltrials.gov/ct2/show/NCT01742117. Copyright © 2026 The Author(s). Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics. <10> Accession Number 2047678920 Title Heart recipient outcomes following transplantation of donor hearts with impaired versus normal function: a study protocol for IMPROVED Heart, a prospective multicentre observational study. Source BMJ Open. 16(7) (no pagination), 2026. Article Number: e111146. Date of Publication: 01 Jul 2026. Author Doueh R.; Dellgren G.; Ternstrom L.; Hard Af Segerstad L.; Henden P.L.; Oras J. Institution (Doueh, Henden, Oras) Anesthesiology and Intensive Care Medicine, University of Gothenburg Institute of Clinical Sciences, Gothenburg, Sweden (Dellgren, Ternstrom) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Hard Af Segerstad) Department of Transplantation Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden Publisher BMJ Publishing Group Abstract Background: Cardiac transplantation remains the most effective treatment for patients with end-stage heart failure, but its use is limited by donor organ shortage. Expanding donor acceptance criteria may increase the availability of transplantable hearts. Left ventricular dysfunction due to neurogenic stunned myocardium is common among organ donors and is characterised by rapid functional and structural recovery. The IMPROVED Heart (IMPact of donor heart function on Recipient Outcomes: a prospectiVE observational study to increase the utilisation of Donor Hearts) study aims to increase the number of heart transplantations by systematically evaluating and using donor hearts with temporarily impaired function. Methods and analysis: IMPROVED Heart is a prospective, multicentre observational study. The primary objective is to determine whether recipients of donor hearts with regional wall motion abnormalities and/or mild to moderate global left ventricular dysfunction have outcomes comparable to recipients of hearts with normal function. Cardiac function in potential heart donors is assessed systematically using repeated echocardiography in addition to cardiac biomarkers and clinical data. Heart transplant recipients are managed according to routine clinical practice. Based on a non-inferiority power calculation, 445 transplanted hearts-including at least 89 with impaired function-are required. The study started enrolling in 2022. Ethics and dissemination: The study was approved by the Swedish Ethical Review Authority in March 2020 (Dnr 2019-06229). Study findings will be presented at scientific meetings and published in international peer-reviewed journals. Trial registration number: NCT04393181. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. <11> Accession Number 2038271832 Title Technological evolution of uniportal video-assisted thoracoscopic surgery in lung cancer: a comprehensive review. Source Current Thoracic Surgery. 11(1) (pp 82-88), 2026. Date of Publication: 2026. Author Elkhayat H.; Sezen C.B. Institution (Elkhayat) Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt (Sezen) University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Thoracic Surgery, Istanbul, Turkey Publisher Turkish Society of Thoracic Surgery Abstract In this review, we will examine how uniportal video-assisted thoracoscopic surgery (U-VATS) compares in the management of non-small cell lung cancer (NSCLC) in terms of effectiveness, safety, and advancements in technology, as supported by recent literature. The change from multiportal techniques to uniportal techniques has expanded the limits of minimal invasiveness in thoracic surgery. In all aspects evaluated in the literature included in this review, U-VATS is comparable to multiportal techniques in postoperative pain, drainage time, and oncologic outcomes. The learning curve criteria set by the ESTS consensus for the safe adoption of U-VATS provides a sound basis for promoting this technique. In essence, Uniportal VATS is an evolving technique that is equally minimally invasive and has great oncologic potential, given advancements in technology. Copyright © 2026, Turkish Society of Thoracic Surgery. All rights reserved. <12> Accession Number 2047562187 Title Safety and efficacy of magnetic-anchoring vs conventional video-assisted thoracoscopic surgery (VATS) lung resection: a randomized controlled trial. Source Surgical Endoscopy. (no pagination), 2026. Date of Publication: 2026. Author Yu C.; Wang T.; Chen N.; Li X.; Lv X.; Xu H.; Liang R.; Li C.; Liu A.; Cui X.; You J.; Lv Y.; Zhang Y. Institution (Yu, Wang, Chen, Li, Xu, Liang, Li, Liu, Cui, You, Zhang) Department of Thoracic Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Otorhinolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Zhang) Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China Publisher Springer Abstract Background: Video-assisted thoracic surgery (VATS) is the preferred approach for lung resection. Magnetic anchoring technology (MAT) utilizes magnetic forces for organ retraction and improves surgical field exposure. This trial aimed to evaluate the safety and efficacy of MAT-assisted VATS for lung resection. Method(s): This single-center randomized controlled trial (registered at the Chinese Clinical Trial Registry, ChiCTR2000029676) enrolled 40 patients scheduled for lung resection and randomly assigned them to MAT-assisted VATS (Group A, n = 20) or conventional VATS (Group B, n = 20). The primary outcomes included surgical field exposure efficacy, intraoperative collateral injuries, and operator-related adverse events. Secondary outcomes included surgeon satisfaction score, number of assistants, and perioperative recovery metrics with a 1-month postoperative follow-up. Result(s): Surgical field exposure efficacy (graded as Excellent, Satisfactory, Normal, and Poor) was as follows: Group A, 15, 4, 1, and 0 cases; and Group B, 17, 2, 1, and 0 cases (p = 0.115). Intraoperative collateral injuries (graded as None, Mild, Moderate, and Severe) were as follows: Group A, 13, 6, 1, and 0 cases; Group B, 9, 6, 3, and 2 cases (p = 0.304). No significant differences were observed in the operative time (p = 0.136), intraoperative blood loss (p = 0.380), postoperative drainage tube removal time (p = 0.180), time to extubation (p = 0.529), time to ambulation (p = 0.260), total hospitalization duration (p = 0.685), or postoperative hospitalization duration (p = 0.305). Surgeon satisfaction score was significantly higher in Group A (p = 0.003). Moreover, MAT use markedly reduced dependence on surgical assistants, with fewer cases requiring two assistants in Group A (p = 0.006). The magnetic anchoring devices demonstrated seamless operability, with no adverse events reported during postoperative follow-up. Conclusion(s): MAT-assisted VATS lung resection is as effective and safe as conventional VATS. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <13> Accession Number 2045138279 Title Anticoagulation Monitoring Strategies During Cardiopulmonary Bypass in Patients With Antiphospholipid Syndrome: A Systematic Review. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(7) (pp 2004-2014), 2026. Date of Publication: 01 Jul 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Publisher W.B. Saunders Abstract Objectives: Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder that complicates anticoagulation during cardiovascular surgery requiring cardiopulmonary bypass (CPB). This systematic review aimed to characterize the anticoagulation monitoring strategies reported during CPB in patients with APS and to identify recurring limitations and clinical patterns rather than to assess comparative efficacy between management approaches. Design(s): Systematic review of published clinical studies. Setting(s): Hospital-based cardiovascular surgery and perioperative care settings, including single- and multi-institutional reports. Participant(s): Patients with a confirmed diagnosis of APS who underwent cardiac or cardiovascular surgery using CPB with heparin anticoagulation. Intervention(s): Intraoperative anticoagulation strategies during CPB, including activated clotting time (ACT)-based monitoring and adjunctive strategies such as heparin concentration monitoring (Hepcon), anti-factor Xa assays, and viscoelastic testing. Measurements and Main Results: A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020-compliant search of PubMed, Scopus, and the Cochrane Library identified 66 studies, of which 17 met the inclusion criteria. ACT monitoring was reported in 25 patients, Hepcon-guided heparin concentration monitoring in 25, and heparin-ACT titration in 1; most studies used multimodal monitoring approaches. Among 62 patients, 15 perioperative complications were reported, predominantly from a single cohort study that contributed the majority of quantitative outcome data. The aggregated data illustrated the heterogeneous use of monitoring strategies and recurrent concerns regarding the reliability of ACT alone. Conclusion(s): Anticoagulation monitoring during CPB in patients with APS remains heterogeneous and insufficiently standardized. The available evidence does not permit conclusions regarding comparative efficacy among monitoring strategies. Instead, this review highlights recurrent limitations of ACT-based monitoring and the heterogeneous use of adjunctive modalities in reported cases, providing a conceptual framework to inform future prospective investigations. Copyright © 2026 The Author(s) <14> Accession Number 2047474679 Title CPAP Versus Conventional Oxygenation Postextubation in Children With Congenital Heart Disease. Source Respiratory Care. 71(5) (pp 460-465), 2026. Date of Publication: 01 May 2026. Author Shi A.; Li M.; Zhou J.; Peng M.; Bian L. Institution (Shi, Li) Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangsu Province, Nanjing City, China (Zhou, Peng, Bian) Department of Nursing, Children's Hospital of Nanjing Medical University, Jiangsu Province, Nanjing, China Publisher SAGE Publications Ltd Abstract Background: Congenital heart disease (CHD) is a leading contributor to pediatric morbidity and mortality worldwide. Postoperative respiratory complications, particularly reintubation, remain a critical concern following cardiac surgery in children. This study evaluates the effectiveness of early nasal CPAP in reducing reintubation rates and respiratory complications in children with CHD after extubation. Method(s): A single-center randomized controlled trial was conducted from July 2022 to July 2024. A total of 264 children (<=3 years) undergoing cardiac surgery for CHD were randomized to either an intervention group (n = 132), receiving nasal CPAP (4 cm H<inf>2</inf>O pressure, 5 L/min oxygen flow) immediately postextubation, or a control group (n = 132), receiving standard nasal cannula oxygen therapy. The primary outcome was reintubation within 48 h. Secondary outcomes included ventilation parameters (PaO<inf>2</inf>, P<inf>aCO</inf>, S<inf>pO</inf>) and respiratory complications (eg, bronchospasm, hypoxemia). Result(s): The reintubation rate within 48 h was significantly lower in the CPAP group compared with the control group (12% vs 28%, risk ratio 0.41, 95% CI 0.22-0.76, P < .05). The CPAP group demonstrated marked improvements in ventilation parameters (PaO<inf>2</inf>, P<inf>aCO</inf>, S<inf>pO</inf>) at 4, 8, and 12 h postextubation (P < .05 for all). Additionally, the incidence of respiratory complications was notably reduced in the intervention group (P < .05). Conclusion(s): Early application of nasal CPAP postextubation significantly reduces reintubation rates and enhances respiratory outcomes in children with CHD. This low-complexity CPAP shows promise for adoption in resource-limited settings, with potential cost advantages meriting further investigation. Copyright © Daedalus Enterprises <15> Accession Number 2046209326 Title Effects of deep parasternal intercostal plane block on opioid consumption and pain after cardiac surgery: a meta-analysis of randomized controlled trials with meta-regression and trial sequential analysis. Source Journal of Clinical Anesthesia. 113 (no pagination), 2026. Article Number: 112259. Date of Publication: 01 Jul 2026. Author Dost B.; Karapinar Y.E.; Turunc E.; Turan E.I.; Beldagli M.; De Cassai A. Institution (Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey (Karapinar) Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa Faculty of Medicine, Istanbul, Turkey (Turan) Department of Anesthesiology and Reanimation, Health Science University, Istanbul Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey (Beldagli) Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey (De Cassai) Department of Medicine (DIMED), University of Padua, Padua, Italy (De Cassai) Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy Publisher Elsevier Inc. Abstract Objective The deep parasternal intercostal plane (D-PIP) block has been used to relieve pain after cardiac surgery. However, the analgesic efficacy of the D-PIP block in adults undergoing cardiac surgery remains unclear. Methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing analgesic efficacy of the D-PIP block. PubMed, Embase, CENTRAL, Web of Science, Scopus, ClinicalTrials.gov , and gray literature were searched until February 2026. Trials comparing the D-PIP block with standard or placebo analgesia were pooled using a random-effects model. The primary outcome was 24-h opioid use, expressed as morphine milligram equivalents (MME). Risk of bias was assessed using RoB 2 and certainty using GRADE. Prespecified subgroup analyses, sensitivity analysis, meta-regression for the primary outcome, and trial sequential analysis were performed. Results Seventeen RCTs (n = 1165) were included. The D-PIP block was associated with a reduction in 24-h opioid consumption versus controls (MD -9.38 mg MME; 95% CI -14.72 to -4.03). Substantial heterogeneity was observed across studies (I2 = 98%). Pain scores at rest and movement were lower at all time points with substantial heterogeneity. Postoperative nausea and vomiting (PONV) incidence was significantly reduced in the D-PIP block group (OR 0.30; 95% CI 0.18-0.52), with no observed between-study heterogeneity (I2 = 0%). Extubation time and intensive care unit (ICU) length of stay (LOS) were shorter, while hospital LOS was unchanged. Comparator type explained most heterogeneity. Evidence certainty was low-very low overall and high for PONV. Conclusions There is very low-certainty evidence supporting a modest reduction in 24-h opioid consumption and early postoperative pain with D-PIP block. In contrast, high-certainty evidence supports a significant reduction in the incidence of PONV. Trial registration International Prospective Register of Systematic Reviews (PROSPERO: CRD420261298563) on February 1, 2026. Copyright © 2026 Elsevier Inc. <16> Accession Number 2047597300 Title Pseudo-publication bias in robotic surgery: structural mapping of narrative inertia. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 687. Date of Publication: 01 Dec 2026. Author Inga-Zapata E.; Silva H.; Perez C.; Ruiz-Ucar E.; Espinoza C.; Guarecuco J.; Lee J.T.; Oviedo R.J. Institution (Inga-Zapata, Silva, Espinoza) Surgical Research Lab, DRAA-Larkin Health System, Miami, FL, United States (Inga-Zapata, Silva, Espinoza) Unidad de Cirugia, Universidad de San Martin de Porres, Lima, Peru (Inga-Zapata, Silva, Espinoza) Peruvian Society of Robotic Surgery, Lima, Peru (Perez) Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, United States (Ruiz-Ucar, Oviedo) Bariatric, Metabolic & Endocrine Unit, General & Digestive Surgery Department, Fuenlabrada University Hospital, Madrid, Spain (Ruiz-Ucar, Oviedo) Rey Juan Carlos University, Madrid, Spain (Guarecuco, Lee, Oviedo) Department of General Surgery, Larkin Community Hospital, South Miami, United States (Guarecuco) Department of Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States (Lee) University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, United States (Oviedo) Sam Houston State University College of Osteopathic Medicine, Conroe, TX, United States Publisher Springer Nature Abstract The rapid worldwide adoption of robotic surgery often outpaces high-level comparative evidence. While evidence-based medicine relies on a hierarchical pyramid where causal inference resides at the apex, most of the scientific output is concentrated at the non-comparative base. It remains unknown whether the directional conclusions of these literature layers are symmetrically aligned. This study aimed to map the structural distribution of conclusions across the evidence hierarchy in visceral robotic surgery to evaluate potential narrative discordance. A stratified random sampling of intracavitary robotic surgery publications (thoracic, abdominal, and pelvic) was conducted from PubMed (1997-2026). Our sample size was calculated to achieve maximum representativeness (n = 800). Publications were equally partitioned into two pragmatic functional layers based on the presence of a control group: the Upper Hierarchy Zone (comparative layer, n = 400) and the Lower Hierarchy Zone (non-comparative layer, (n = 400). Directional orientations of author conclusions were operationally categorized as Favorable, Neutral, or Unfavorable. To ensure non-biased processing and scalability, semantic classification was executed via a Large Language Model (GPT-5.4), previously validated against a three-evaluator human pilot trial (absolute agreement 92%, Cohen's kappa > 0.81). Statistical analysis utilized Chi-square tests and Odds Ratio (OR) calculation with 95% Confidence Intervals (CI), with a secondary bipartite analysis (favorable vs. non-favorable). The global overview of the entire dataset (n = 800) demonstrated an illusion of literary equilibrium: 51.75% (n = 414) favorable, 45.50% (n = 364) neutral, and 2.75% (n = 22) unfavorable conclusions. However, stratification revealed a massive structural asymmetry (chi^2 = 312.9, p < 0.001). Within the upper hierarchy, conclusions were overwhelmingly non-favorable (79.50% vs. 20.50% favorable), dominated by neutral comparative outcomes (77.75%). Conversely, the lower hierarchy was heavily skewed toward favorable outcomes (83.00% favorable vs. 17.00% non-favorable). The lower zone also served as a sharper sensor of surgical failure, reporting a higher raw unfavorable rate (3.75%) than the apex (1.75%). Pragmatic bipartite analysis demonstrated that a publication at the base of the evidence pyramid has nearly 19 times higher odds of reporting a favorable conclusion compared to those at the comparative apex (OR 18.93, 95% CI: 13.84-26.87). A profound structural asymmetry exists within the robotic surgery literature. The disproportionate volume of highly favorable, lower-tier evidence numerically overwhelms comparative data, creating a phenomenon of "pseudo-publication bias." This structural distortion generates a powerful narrative inertia that drives global clinical adoption and shapes professional perception through cumulative enthusiasm rather than demonstrated methodological superiority. Copyright © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2026. <17> Accession Number 2047347461 Title Preoperative Ultrasound-Guided Stellate Ganglion Block for Prevention of Postoperative Sore Throat After Thoracic Surgery: Study Protocol for a Randomized Controlled Trial. Source Journal of Pain Research. 19 (no pagination), 2026. Article Number: 612817. Date of Publication: 2026. Author Wang L.; Yan X.; Jiang J.; Wu A. Institution (Wang, Yan, Jiang, Wu) Anesthesia & Operation Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China Publisher Dove Medical Press Ltd Abstract Purpose: Postoperative sore throat (POST) is one of the most common complaints after thoracic surgery with double-lumen endobronchial tubes (DLTs), significantly impacting postoperative recovery and patient satisfaction, yet it is often overlooked. Stellate ganglion block (SGB), a minimally invasive technique, may alleviate airway inflammation and modulate sympathetic tone. It has significant potential in reducing the incidence of POST, but evidence in DLTs patients is lacking. This trial aims to test whether preoperative ultrasound-guided SGB can ameliorate the incidence and severity of POST after thoracic surgery. Study Design and Methods: In this prospective double-blind, randomized controlled trial, 132 patients undergoing thoracoscopic resection of pulmonary lobes/segments with DLTs will be randomized to receive either US-guided SGB with 0.25% ropivacaine 4mL (Group S) or 0.9% saline 4mL (Group C) at the C6 level, on the same side as the thoracic surgery before anesthesia induction. The primary outcome is POST incidence at 6 hours postoperatively. The secondary outcomes include the incidence and severity of POST at 1, 24 and 48 hours, postoperative pain score (NRS) at different time points, postoperative nausea and vomiting, hoarseness, Quality of Recovery-15 scores, RCSQ sleep score, PCIA dosage at 24 and 48 hours. Intraoperative hemodynamic fluctuations, regional cerebral oxygen saturation (rSO<inf>2</inf>), anesthetic and vasoactive drugs will be recorded. All statistical analyses will be performed using SPSS version 26.0. Two-sided P values <0.05 will be considered statistically significant. Discussion(s): This is the first prospective trial evaluating ultrasound-guided SGB for POST after thoracic surgery with DLTs, also assessing the effect of SGB on postoperative recovery quality. The findings will provide more clinical evidence for perioperative SGB application to enhance early postoperative recovery and patient satisfaction. Copyright © 2026 Wang et al. <18> Accession Number 2044198298 Title Early Versus Late Extubation After Pediatric Cardiac Surgery: A Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2571-2580), 2026. Date of Publication: 01 Aug 2026. Author Alkhatip A.A.A.M.M.; Mills K.E.; Akram A.; Farag E.; Hamza M.K.; Abdelkader M.; Bahr M.; ELEmady M.F.M.; Hosny H.; Sallam A.; Farag A.M.G.; Wagih M. Institution (Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom (Alkhatip, Farag, Abdelkader, Bahr) Department of Anesthesia, Pain Management and Surgical Intensive Care, Beni-Suef University Hospital and Faculty of Medicine, Beni Suef University, Beni Suef, Egypt (Mills) Department of Science and Technology, University of Canberra, Canberra, ACT, Australia (Akram) Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan (Hamza, ELEmady, Hosny, Wagih) Department of Anesthesia, Kasr Al Ainy Faculty of Medicine and Cairo University Hospitals, Cairo University, Cairo, Egypt (Hosny) Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Sallam) Department of Anaesthesia, St. Vincent's University Hospital, Dublin, Ireland (Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City, Makkah Mukarramah, Saudi Arabia Publisher W.B. Saunders Abstract Early extubation after pediatric cardiac surgery has been increasingly adopted as part of fast-track and enhanced recovery pathways, but its association with postoperative outcomes remains uncertain. The authors conducted a systematic review and meta-analysis of studies comparing early extubation (defined as extubation in the operating room or within 24 hours postoperatively) versus delayed extubation after pediatric cardiac surgery. Electronic databases were searched from inception through April 2024. Random-effects models were used to pool effect estimates for mortality, reintubation, and length-of-stay outcomes. Prespecified subgroup and sensitivity analyses were performed. Twenty-eight studies, including 37,995 children, were analyzed. Early extubation was associated with lower in-hospital mortality (odds ratio, 0.19; 95% confidence interval, 0.14-0.25); however, absolute mortality rates were low, and this association was vulnerable to confounding by indication and preferential selection of clinically stable patients for early extubation. Early extubation was also associated with lower reintubation rates and shorter intensive care unit and hospital lengths of stay. Associations were more consistent among older children than among neonates. In this predominantly observational evidence base, early extubation should be interpreted primarily as a marker of patient stability and institutional practice rather than a proven intervention that reduces mortality. Given the low to very low certainty of evidence, these findings are hypothesis-generating and may inform quality-improvement initiatives and future prospective studies, rather than definitive clinical guidance. Copyright © 2026 Elsevier Inc. <19> Accession Number 2047575330 Title Prognostic Value of Frailty in Aortic Surgery: A Systematic Review and Meta-Analysis Comparing Frailty Assessment Tools. Source Annals of Vascular Surgery. 132 (pp 200-213), 2026. Date of Publication: 01 Nov 2026. Author Coutinho M.L.; Delgado L.M.; Torres I.O.; Rocha-Neves J.; Zerati A.E.; D'Oria M.; Leao P.P. Institution (Coutinho, Torres, Zerati, Leao) Department of Vascular Surgery, Hospital das Clinicas FMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Delgado) Department of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Rocha-Neves) Faculty of Medicine of the University of Porto, Unity of Anatomy, Department of Biomedicine, Portugal (D'Oria) Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, Trieste, Italy Publisher Elsevier Inc. Abstract Background Frailty is increasingly recognized as an important determinant of outcomes after aortic vascular surgery, but assessment methods vary substantially and the optimal tool for risk stratification remains uncertain. This systematic review and meta-analysis evaluated the prognostic value of preoperative frailty and compared the predictive performance of different frailty instruments in aortic surgery. Methods PubMed, Embase, and Cochrane Library were searched from inception to April 27, 2026. Eligible studies included patients undergoing open, endovascular, or hybrid aortic procedures involving abdominal, thoracic, thoracoabdominal, arch, and proximal aortic diseases, including aneurysms and dissections, assessed frailty preoperatively, and reported postoperative outcomes. Results Thirty studies comprising 419,459 patients were included. Frailty was associated with higher early mortality (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.54-3.14) and late mortality (hazard ratio 2.18; 95% CI 1.64-2.90). Frail patients also had increased risks of major complications (OR 2.52; 95% CI 1.22-5.19), acute kidney injury (OR 1.64; 95% CI 1.34-2.02), and nonhome discharge (OR 5.50; 95% CI 3.05-9.92). Associations were consistent across surgical approaches and aortic segments. Judgment-based or phenotype-like tools yielded higher effect estimates than deficit-accumulation indices, although differences were not statistically significant; among index-based tools, Modified Frailty Index (mFI)-11 outperformed mFI-5. Conclusion Preoperative frailty strongly predicts mortality, morbidity, and loss of functional independence after open, endovascular, and hybrid aortic surgery across different aortic segments and pathologies, including aneurysmal and dissecting aortic disease. Routine frailty assessment may improve risk stratification and perioperative decision-making. Copyright © 2026 The Author(s). <20> Accession Number 2046450930 Title Impact of Gender on Outcomes Following Surgery for Infective Endocarditis: A Systematic Review and Meta-Analysis. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 7256304. Date of Publication: 2026. Author Kukreja N.S.; Singh R.; Fareed F.F.I.; Joshi S.; Awad W.I. Institution (Kukreja, Singh, Joshi) National Medical Research Association, London, United Kingdom (Kukreja) SHTAC, University of Southampton, Southampton Science Park, Southampton, United Kingdom (Fareed) University of Buckingham Medical School, Hunter Street, Buckingham, United Kingdom (Joshi) School of Medicine, Queen's University Belfast, Belfast, United Kingdom (Awad) Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom (Awad) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Awad) University of South Wales, Cardiff, United Kingdom Publisher John Wiley and Sons Inc Abstract Objective: Outcomes after surgical management of infective endocarditis (IE) for male and female patients is controversial, with some studies suggesting worse outcomes for female patients. The aim of this systematic review was to assess postoperative outcomes after surgery for IE in all studies reporting by patient gender. Method(s): A systematic review and meta-analysis was conducted in accordance with Preferred Reporting in Systematic Review and Meta-Analysis (PRISMA) guidelines. A comprehensive search of MEDLINE, Embase and Scopus databases was conducted from inception until 15th September 2025. Two authors independently conducted study screening and data extraction. Outcomes included mortality (< 30 day and > 1 year), postoperative (< 30 day) stroke, sepsis, acute kidney injury (AKI) and length of stay (LOS). Result(s): Database search yielded 3102 results, and 13 studies were included with 20,824 patients (14,479 male and 6345 female). Women had increased risk of 30-day mortality compared with men (odds ratio (OR): 1.36, 95% confidence interval (CI): 1.15-1.61 and p < 0.01), increased risk of > 1-year mortality (OR: 1.34, 95% CI: 1.04-1.73 and p = 0.02) and of developing postoperative (< 30 day) AKI (OR: 1.20, 95% CI: 1.03-1.41 and p = 0.02). No significant differences were found in postoperative stroke (OR: 1.12, 95% CI: 0.95-1.30 and p = 0.17), sepsis (OR: 1.03, 95% CI: 0.62-1.71 and p = 0.92) or LOS (standardised mean difference: -0.06 days, 95% CI: -0.71-0.59 and p = 0.78). Conclusion(s): Female patients had significantly worse short- and long-term mortality and increased risk of developing AKI than men; however, stroke, sepsis and LOS outcomes were comparable. Further research is needed to determine the reasons for worse mortality outcomes in females. Copyright © 2026 Niraj S. Kukreja et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <21> Accession Number 2047488534 Title Pediatric premature atrial contractions: Clinical characteristics, diagnosis, and management-A literature review. Source American Heart Journal Plus: Cardiology Research and Practice. 68 (no pagination), 2026. Article Number: 100811. Date of Publication: 01 Aug 2026. Author Yu R.; Qi J.; Wang X. Institution (Yu, Qi, Wang) Department of Neonatal Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, Jinan, China Publisher Elsevier Inc. Abstract Background: Premature Atrial Contractions (PACs) are among the most prevalent arrhythmias in the pediatric population, occurring from the fetal period through adolescence. While typically benign in children with structurally normal hearts, PACs carry significant clinical implications for patients with Congenital Heart Disease (CHD), genetic cardiomyopathies, and specific syndromic conditions. This review aims to clarify the clinical characteristics, diagnostic criteria, and management strategies for pediatric PACs. Method(s): A comprehensive review of the current literature was conducted regarding the epidemiology, etiology, diagnosis, and management of PACs in pediatric patients. This review synthesizes data from recent meta-analyses, observational studies, and clinical guidelines to establish age-stratified reference limits and risk stratification protocols. Result(s): In healthy school-aged children, the prevalence of PACs ranges from 0.11% to 0.515%, with significantly higher rates observed during the neonatal period. Recent meta-analysis data defines age-stratified reference limits for 24-h ambulatory electrocardiographic (Holter) monitoring: a maximum of 150 PACs per day for neonates and infants (0-12 months) and 50 PACs per day for older children. While fetal PACs generally resolve spontaneously, blocked PACs may rarely progress to sustained tachyarrhythmias. Diagnosis primarily relies on 12-lead electrocardiography (ECG) and Holter monitoring. Clinically, frequent or non-conducted PACs may cause "pseudo-bradycardia," occasionally requiring pharmacological intervention with agents such as propafenone. The incidence of PACs is notably increased in children with CHD or following interventional procedures. Conclusion(s): PACs are predominantly benign in children with structurally normal heartsyet comprehensive evaluation is mandated for patients with symptomatic frequent PACs concurrent structural heart disease or significant electrocardiographic abnormalities. Management should be guided by age-specific reference limits and the underlying cardiac substrate Copyright © 2026 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <22> Accession Number 2047467958 Title Colchicine for Prevention of Perioperative Atrial Fibrillation and Myocardial Injury After Major Thoracic Surgery: Surgical Subgroup Analyses From the COP-AF Trial. Source European Journal of Cardio-thoracic Surgery. 68(7) (no pagination), 2026. Article Number: ezag190. Date of Publication: 01 Jul 2026. Author Wang M.K.; Devereaux P.J.; Popova E.; Razeghi G.; Finley C.; Alvarez-Garcia J.; Borges F.K.; Cata J.P.; Chan M.T.V.; Fleischmann E.; Ghasemi F.; Guerra J.M.; Landoni G.; McIntyre W.F.; McLean S.R.; Ofori S.N.; Reimer C.; Sessler D.I.; Shargall Y.; Srinathan S.K.; Tandon V.; Conen D. Institution (Wang, Devereaux, Borges, Ofori, Conen) Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada (Wang, Devereaux, Borges, McIntyre, Ofori, Sessler, Conen) Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (Wang, Devereaux, Borges, Ghasemi, McIntyre, Ofori, Tandon, Conen) Department of Medicine, McMaster University, Hamilton, ON, Canada (Popova, Alvarez-Garcia, Guerra) Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares, Madrid, Spain (Razeghi) Department of Medicine, University of Ottawa, Ottawa, ON, Canada (Finley, Shargall) Department of Surgery, McMaster University, Hamilton, ON, Canada (Alvarez-Garcia) Department of Cardiology, Ramon y Cajal University Hospital, Madrid, Spain (Cata) Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States (Chan) Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong (Fleischmann) Department of Anesthesia, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria (Guerra) Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Guerra) Institut de Recerca Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain (Guerra) Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain (Landoni) Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy (Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (McIntyre) St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada (McIntyre) Hamilton Health Sciences, Hamilton, ON, Canada (McLean) Vancouver Acute Department of Anesthesiology, Vancouver General Hospital, Vancouver, BC, Canada (McLean) Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada (Reimer) Department of Anesthesiology, Queen's University, Kingston, ON, Canada (Sessler) Center for Outcomes Research and Department of Anesthesiology, University of Texas Health Science Center, Houston, TX, United States (Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB, Canada Publisher European Association for Cardio-Thoracic Surgery <23> Accession Number 2047461671 Title Effects of Combined Pectoserratus and Pecto-Intercostal Fascial Plane Blocks for Cardiac Surgery via Median Sternotomy: A Randomized Controlled Trial. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 4946. Date of Publication: 01 Jul 2026. Author Kim B.; Jeon Y.-G.; So J.H.; Hong S.; Park J.-H. Institution (Kim, Jeon, So, Park) Department of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei University, Wonju, South Korea (Hong) Department of Cardiovascular Surgery, Wonju College of Medicine, Yonsei University, Wonju, South Korea Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Ultrasound-guided fascial plane blocks have emerged as opioid-sparing analgesic strategies for cardiac surgery; however, evidence regarding combined block techniques remains limited. This randomized controlled trial evaluated the analgesic efficacy of combined pectoserratus plane block (PSPB) and pecto-intercostal fascial plane block (PIFB) in patients undergoing cardiac surgery via median sternotomy. Method(s): Sixty-two adult patients undergoing cardiac surgery via median sternotomy were randomized to either a block group receiving bilateral PSPB and PIFB after anesthetic induction or a control group receiving conventional analgesia alone. The primary outcome was postoperative visual analog scale (VAS) pain score at 6, 12, 24, and 48 h after surgery. Secondary outcomes included Korean version of Quality of Recovery-15 (QoR-15K) scores, total opioid consumption, rescue analgesic dose, time to first rescue analgesia, extubation time, intensive care unit (ICU) stay, hospital stay, and the incidence of postoperative nausea and vomiting. Result(s): Fifty-four patients were included in the final analysis. Postoperative VAS scores did not differ significantly between groups after Bonferroni correction for repeated measurements. No significant overall between-group effect was observed in repeated-measures ANOVA. ICU stay was statistically shorter in the block group, although the absolute difference was small and of uncertain clinical relevance. No significant differences were observed in the remaining secondary outcomes. Conclusion(s): Combined PSPB and PIFB did not reduce postoperative pain or improve recovery outcomes after cardiac surgery via median sternotomy. Early postoperative pain scores were numerically higher in the block group, although these differences were not statistically significant after correction for multiple comparisons. The incremental analgesic benefit of combined fascial plane blocks may therefore be limited in this clinical setting. Copyright © 2026 by the authors. <24> Accession Number 650937832 Title Prevalence and influencing factors of postoperative delirium in children undergoing low-risk surgeries: A meta-analysis. Source Journal of pediatric nursing. 89 (pp 38-49), 2026. Date of Publication: 01 Jul 2026. Author Liu S.-L.; Bai X.; Xu T.; Lin S.-Y.; Zhou X.-Y.; Xu H.-Y.; Jiang Y.-L. Institution (Liu, Bai, Xu, Lin, Zhou, Xu) College of Nursing, Chengdu University of Traditional Chinese Medicine, China (Jiang) Hospital of Chengdu University of Traditional Chinese Medicine, China Abstract BACKGROUND: Postoperative delirium (POD) is a serious complication in pediatric surgery that may induce prolonged hospital stays, while increasing risks of cognitive impairment and mortality. Its incidence after low-risk surgery remains incompletely characterized, despite extensive study in critically ill children, especially those following cardiac surgery. This meta-analysis systematically evaluated POD prevalence and its influencing factors in children undergoing low-risk surgeries to inform clinical prevention and management strategy development. METHOD(S): This meta-analysis was conducted by retrieving studies in PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CNKI, SinoMed, Wanfang, and VIP Database from their inception to 21 March 2025. Data processing was performed using RevMan 5.4 and Stata 15.0, with subgroup analyses, meta-regression, and sensitivity analyses. RESULT(S): This study screened 31 studies involving 13,718 pediatric patients. The overall pooled POD prevalence was 23.4% (95% CI: 0.185-0.286, P < 0.001). Furthermore, significant risk factors included age < 5 years (OR = 2.75, 95% CI: 1.85-4.08, P < 0.001), preoperative anxiety (OR = 1.16, 95% CI: 1.02-1.32, P = 0.03), postoperative pain (OR = 5.52, 95% CI: 3.15-9.67, P < 0.001), otolaryngologic surgery (OR = 2.61, 95% CI: 1.47-4.63, P < 0.001), and midazolam use (OR = 2.33, 95% CI: 1.48-3.67, P < 0.001). CONCLUSION(S): POD is particularly prevalent in children following low-risk pediatric surgery. IMPLICATIONS FOR PRACTICE: Priority should be given to early identification and suitable intervention targeting modifiable risk factors (preoperative anxiety, postoperative pain, and midazolam use), particularly in young children (<5 years) and those undergoing otolaryngologic surgeries. Copyright © 2026 Elsevier Inc. All rights reserved. <25> Accession Number 2047402817 Title Fractional flow reserve vs angiography in non-ST- elevation myocardial infarction: long-term results of the FAMOUS-NSTEMI trial. Source European Heart Journal. 47(12) (pp 1487-1490), 2026. Date of Publication: 21 Mar 2026. Author Berry C.; Stanley B.; Duklas P.; Layland J.; Oldroyd K.G.; Curzen N.; Sood A.; Balachandran K.; Das R.; Junejo S.; Eteiba H.; Lindsay M.; Shaukat A.; Watkins S.; Ford I.; Good R.I.S.; Henderson R.; McConnachie A. Institution (Berry, Oldroyd, Eteiba, Lindsay, Shaukat, Watkins, Good) West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (Berry, Oldroyd, Good) British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, United Kingdom (Stanley, Duklas, Ford, McConnachie) Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom (Layland) Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, Australia (Curzen) Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (Sood) Department of Cardiology, Hairmyres University Hospital, East Kilbride, United Kingdom (Balachandran) Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom (Das) Freeman Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom (Junejo) Department of Cardiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom (Henderson) Trent Cardiac Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom Publisher Oxford University Press <26> Accession Number 2047430649 Title Ultrasound-guided double-lumen tube size selection improves intubation success and postoperative airway outcomes in thoracic surgery: a randomized controlled study. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1865696. Date of Publication: 01 Jul 2026. Author Duran M.; Zengin S.U.; Ergun M.O. Institution (Duran, Zengin, Ergun) Department of Anesthesiology and Reanimation, Marmara University Pendik Training and Research Hospital, Kadikoy, Turkey Publisher Frontiers Media SA Abstract Background - Appropriate double-lumen tube (DLT) size selection is crucial for safe and effective one-lung ventilation in thoracic surgery. Conventional selection based on sex and height does not account for individual airway variability. This study evaluated whether ultrasound-guided DLT size selection improves intubation success and postoperative airway outcomes. Methods - In this prospective randomized controlled study, 70 patients undergoing thoracic surgery who required one-lung ventilation were assigned to either a conventional group (DLT size based on sex and height) or an ultrasound group (DLT size based on tracheal diameter measured by ultrasound at the suprasternal notch). The primary outcome was the incidence of postoperative sore throat at 24h. Secondary outcomes included postoperative cough, first-attempt intubation success, number of attempts, surgeon-rated lung collapse satisfaction, and intraoperative respiratory parameters. Results - Postoperative sore throat was significantly lower in the ultrasound group compared to the conventional group (8.6% vs. 37.1%, p=0.004). Postoperative cough was also reduced (8.6% vs. 40.0%, p=0.002). First-attempt intubation success was higher in the ultrasound group (97.1% vs. 62.9%, p=0.001). Additionally, peak airway pressure was lower, and dynamic compliance was higher in the ultrasound group (p=0.002 and p<0.001, respectively). Surgeon satisfaction was significantly improved (p=0.005). Conclusion - Ultrasound-guided DLT size selection improves intubation success, reduces postoperative airway complications, and enhances ventilatory parameters. This approach may provide a simple and effective method for optimizing airway management in thoracic surgery. Copyright © 2026 Duran, Zengin and Ergun. <27> Accession Number 2047447873 Title Exploring the Role of Foot Reflexology and Foot Massage in Managing Anxiety Disorders: A Scoping Review. Source International Journal of Drug Delivery Technology. 16(67 Supplement) (pp 1143-1155), 2026. Date of Publication: 2026. Author Dube B.; Shende S.; Uike S.G. Institution (Dube, Shende, Uike) Department of Kriya Sharira, All India Institute of Ayurveda, Gautampuri, Sarita Vihar, New Delhi, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Anxiety disorders are among the most common psychiatric conditions worldwide, affecting over 300 million individuals. Limitations of pharmacological and psychological treatments-such as side effects, cost, and accessibility-have driven interest in complementary therapies like foot massage and reflexology for anxiety management. Objective(s): This scoping review aimed to (1) map existing literature on foot massage as a complementary therapy for anxiety, and (2) highlight gaps to inform future research. Method(s): Following PRISMA-ScR guidelines, a systematic search was conducted in PubMed, Google Scholar, and EMBASE. Included studies were randomized controlled trials (RCTs) published between 2014 and 2025 involving adults aged 20-60 years with clinically diagnosed or situational anxiety and using validated assessment tools. Result(s): Out of 220 records, 12 RCTs met the inclusion criteria, covering diverse clinical settings. Eight studies reported significant reductions in anxiety after reflexology or foot massage, likely due to parasympathetic activation and stress modulation. However, three showed non-significant intergroup differences, potentially due to low baseline anxiety or acute severity. Some placebo groups also experienced relief, suggesting general tactile effects. Variability in oils, techniques, and duration highlighted the need for standardized protocols. Conclusion(s): Foot-based therapies, including reflexology, show promise as safe, low-cost adjuncts for anxiety relief. Further high-quality RCTs are warranted to confirm efficacy and optimize clinical integration. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <28> Accession Number 2047507855 Title Effect of transcutaneous auricular vagus nerve stimulation on postoperative pain in patients undergoing thoracoscopic partial lung resection: a randomized, double-blind, controlled clinical trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2703358. Date of Publication: 2026. Author Yuan M.; Lv S.-J.; Wu M.-R.; Lu Y.-C.; Zhang M.-H.; He J.-H. Institution (Yuan, Lv, Zhang, He) Department of Anesthesiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu, Nanjing, China (Wu, Lu, He) School of Anesthesiology, Xuzhou Medical University, Jiangsu, Xuzhou, China Publisher Taylor and Francis Ltd. Abstract Background: Postoperative pain after thoracic surgery remains common and challenging. Transcutaneous auricular vagus nerve stimulation (taVNS) is a noninvasive neuromodulation technique with potential analgesic effects. This study aimed to evaluate the efficacy and safety of taVNS for postoperative pain management in patients undergoing thoracoscopic partial lung resection. Method(s): Adults undergoing thoracoscopic partial lung resection were randomized to active or sham taVNS. The primary outcome was cough pain intensity at 48h post-surgery, assessed by Numeric Rating Scale (NRS). Secondary outcomes included cough pain at 24h and 72h, resting pain, moderate-to-severe pain incidence, opioid consumption, quality of recovery, postoperative pulmonary complications, chest tube duration, hospital stay, postoperative nausea/vomiting, and adverse events. Result(s): Among 119 analyzed patients (active n = 60, sham n = 59), active taVNS reduced cough pain scores at 24h, 48h, and 72h postoperatively, as well as resting pain (p < 0.05). It also lowered the incidence of moderate-to-severe cough pain at 24h and 48h, reduced cumulative postoperative opioid use at 24h and 72h, and decreased rescue analgesia on postoperative day 3 (p < 0.05). Active taVNS was associated with a lower incidence of postoperative pneumothorax (p < 0.05). No serious adverse events occurred. Conclusion(s): Perioperative taVNS was associated with a modest analgesic benefit and reduced postoperative opioid requirements after thoracoscopic partial lung resection. The observed reduction in postoperative pneumothorax requires cautious interpretation, and further multicenter trials are needed to determine its clinical utility. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <29> Accession Number 2047638505 Title Fractional Flow Reserve-Guided Versus Coronary Angiography Alone for Guiding Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Trials. Source American Journal of Cardiology. 273 (pp 150-153), 2026. Date of Publication: 15 Aug 2026. Author Abbas O.F.; Emara A.; Almarfadi A.; Haddad R.; Atta K.; Elbenawi H.; Zordok M.; Elgendy I.Y. Institution (Abbas, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Almarfadi) Department of Medicine, Ferhat Abbas University of Setif, Setif, Algeria (Haddad) Faculty of Medicine, October 6 University, Giza, Egypt (Atta) Institute of Medicine, National Research Mordovia State University, Saransk, Russian Federation (Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Zordok) Department of Cardiovascular Medicine, Baylor Scott & White, The Heart Hospital Plano, Plano, TX, United States (Elgendy) Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, United States Publisher Elsevier Inc. Abstract Coronary artery bypass grafting (CABG) has been traditionally guided by coronary angiography, although angiographic severity may not accurately reflect the physiological significance of coronary lesions. Fractional flow reserve (FFR) improves outcomes in percutaneous coronary intervention, but its role in guiding CABG remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing FFR-guided versus angiography-guided CABG. Electronic databases were systematically searched from inception to April 2026. Outcomes included all-cause death, myocardial infarction (MI), and stroke. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Three RCTs including 1,061 patients were analyzed, with 533 patients assigned to FFR-guided CABG. During a mean follow-up of 15 months, FFR-guided CABG was associated with a significantly lower risk of MI compared with angiography-guided CABG (RR 0.48, 95% CI 0.26 to 0.89; p = 0.01). There were no statistically significant differences in all-cause death (RR 0.74, 95% CI 0.52 to 1.07; p = 0.10) or stroke (RR 1.60, 95% CI 0.94 to 2.74; p = 0.08). Risk of bias was low across all included trials. In conclusion, FFR-guided CABG was associated with a reduced incidence of MI compared with angiography-guided CABG, without significant differences in all-cause death or stroke. Larger trials with longer follow-up are needed to further define the role of physiology-guided surgical revascularization. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <30> Accession Number 2047503866 Title Current status of various types of ICG contrast imaging in pediatric thoracic surgery. Source Surgery Today. (no pagination), 2026. Date of Publication: 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. <31> Accession Number 2034429712 Title Timing of multivessel revascularization in stable patients with STEMI: a systematic review and network meta-analysis. Source Revista Espanola de Cardiologia. 78(2) (pp 127-137), 2025. Date of Publication: 01 Feb 2025. Author Voll F.; Kuna C.; Scalamogna M.; Kessler T.; Kufner S.; Rheude T.; Sager H.B.; Xhepa E.; Wiebe J.; Joner M.; Byrne R.A.; Schunkert H.; Ndrepepa G.; Stahli B.E.; Kastrati A.; Cassese S. Institution (Voll, Kuna, Scalamogna, Kessler, Kufner, Rheude, Sager, Xhepa, Wiebe, Joner, Schunkert, Ndrepepa, Kastrati, Cassese) Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany (Scalamogna) Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoles, Italy (Kessler, Sager, Joner, Schunkert, Kastrati) Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK), Munich, Germany (Byrne) Cardiovascular Research Institute Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland (Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons of Ireland University of Medicine and Health Sciences, Dublin, United Kingdom (Stahli) Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland Publisher Ediciones Doyma, S.L. Abstract Introduction and objectives: Multivessel percutaneous coronary intervention (MV-PCI) is recommended in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD) without cardiogenic shock. The present network meta-analysis investigated the optimal timing of MV-PCI in this context. Method(s): We pooled the aggregated data from randomized trials investigating stable STEMI patients with multivessel CAD treated with a strategy of either MV-PCI or culprit vessel-only PCI. The primary outcome was all-cause death. The main secondary outcomes were cardiovascular death, myocardial infarction, and unplanned ischemia-driven revascularization. Result(s): Among 11 trials, a total of 10 507 patients were randomly assigned to MV-PCI (same sitting, n = 1683; staged during the index hospitalization, n = 3460; staged during a subsequent hospitalization within 45 days, n = 3275) or to culprit vessel-only PCI (n = 2089). The median follow-up was 18.6 months. In comparison with culprit vessel-only PCI, MV-PCI staged during the index hospitalization significantly reduced all-cause death (risk ratio, 0.73; 95%CI, 0.56-0.92; P = .008) and ranked as possibly the best treatment option for this outcome compared with all other strategies. In comparison with culprit vessel-only PCI, a MV-PCI reduced cardiovascular mortality without differences dependent on the timing of revascularization. MV-PCI within the index hospitalization, either in a single procedure or staged, significantly reduced myocardial infarction and unplanned ischemia-driven revascularization, with no significant difference between each other. Conclusion(s): In patients with STEMI and multivessel CAD without cardiogenic shock, multivessel PCI within the index hospitalization, either in a single procedure or staged, represents the safest and most efficacious approach. The different timings of multivessel PCI did not result in any significant differences in all-cause death. This study is registered at PROSPERO (CRD42023457794). Copyright © 2024 Sociedad Espanola de Cardiologia <32> [Use Link to view the full text] Accession Number 2045808612 Title Evaluation of clinical impact of ultra fast-track versus conventional extubation in patients undergoing nonemergency cardiac surgery: 'CARDU-FAST': A randomised clinical trial. Source European Journal of Anaesthesiology. Publish Ahead of Print (no pagination), 2026. Date of Publication: 28 Apr 2026. Author Cruces L.M.; Alcazar M.C.; Sial R.L.B.; Vizcayno M.L.; Martin R.S.; Camargo D.P.; Carnicer J.C.; Mercadal L.A.; Morenza A.A.; Lacruz F.R.; Fernandez P.C.; Molano M.A.G.; Torron J.M.M.; Chavez M.B.S.; Castellanos L.C.M. Institution (Cruces, Alcazar, Camargo, Carnicer, Lacruz, Fernandez, Molano, Torron, Chavez, Castellanos) Department of Cardiac Surgery, Spain (Sial, Vizcayno, Martin, Mercadal, Morenza) Department of Anaesthesiology, Hospital Clinico San Carlos, Madrid, Spain Publisher Lippincott Williams and Wilkins Abstract BACKGROUND - Immediate extubation in the operating theatre (Ultra Fast-Track, UFT), compared with early extubation in the intensive care unit (ICU) (Fast-Track, FT), has been proposed as a strategy to improve postoperative recovery after cardiac surgery. However, its effect on major clinical outcomes remains unclear. OBJECTIVE - To compare the risk of a composite outcome including perioperative all-cause mortality, respiratory complications, and acute kidney injury between UFT and FT in patients undergoing major nonemergency cardiac surgery. DESIGN - Single-centre, randomised clinical trial conducted between February 2023 and November 2024. SETTING - A tertiary cardiovascular centre with standardised perioperative and anaesthetic management. PARTICIPANTS - A total of 612 adult patients undergoing major cardiac surgery were randomised to UFT (n = 306) or FT (n = 306). INTERVENTION - Patients in the UFT group were extubated in the operating theatre, whereas patients in the FT group underwent early extubation in the ICU. MAIN OUTCOMES AND MEASURES - The primary endpoint was a composite outcome of all-cause mortality, respiratory complications (prolonged intubation >24 h, reintubation, pneumonia), and stage III acute kidney injury (AKIN III). RESULTS - The primary composite endpoint occurred in 6.5% of patients in the UFT group and 10.1% in the FT group, with no statistically significant difference (P = 0.105). Compared with FT, UFT was associated with shorter ICU and hospital length of stay, lower rates of prolonged intubation (2.0 versus 7.5%; P = 0.001), reduced need for noninvasive ventilation (5.6 versus 11.1%; P = 0.013), fewer reoperations for bleeding (2.6 versus 6.9%; P = 0.013) and a lower incidence of postoperative low cardiac output syndrome. CONCLUSIONS - Although UFT did not significantly reduce the primary composite outcome in the intention-to-treat (ITT) analysis, it was not associated with an increased risk of adverse events but was associated with improvements in several secondary outcomes. These findings suggest potential benefits of UFT in carefully selected cardiac surgery patients. TRIAL REGISTRATION - Evaluation of clinical impact of UFT versus conventional extubation in patients undergoing cardiac surgery. CARDU-FAST clinical trial. ClinicalTrials.gov Identifier: NCT05706857. Copyright © 2026 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited. <33> Accession Number 2047296501 Title Robotic coronary revascularization: a scoping review of the published evidence. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 31. Date of Publication: 01 Dec 2026. Author Arafat A.A.; Alshehri S.; Alhijab F.; Elkhouly A.; Alsaadi R.; Rafiq R.; Rafiq F.; Selan J.; Elmahrouk Y.; Alnasrallah S.; Alotaibi K.A.; AlAklabi M.M. Institution (Arafat, Alshehri, Alhijab, Alotaibi, AlAklabi) Cardiac Surgery Department, Prince Sultan Cardiac Center, Makkah Almukaramah Branch Road, Riyadh, Saudi Arabia (Arafat, Selan, Alnasrallah) Research and Innovation Institute, Ministry of Defense Health Services, Riyadh, Saudi Arabia (Elkhouly) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt (Alsaadi) Research Center, King Faisal Specialized Hospital and Research Center, Jeddah, Saudi Arabia (Rafiq) Army Medical College, Rawalpindi, Pakistan (Rafiq) Shifa College of Medicine, Islamabad, Pakistan (Elmahrouk) Faculty of Medicine, Tanta University, Tanta, Egypt Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Robotic coronary artery bypass grafting (CABG) has been performed for more than 25 years, but the published evidence base is dispersed across single-center experience, registry analyses, and a small number of trials. A consolidated map of what has been studied, where, and which outcomes have been reported is needed to support clinical decision-making and guide future research. This study aimed to systematically map the published original literature on robotic CABG, characterizing study designs, geography, sample sizes, procedures, and the outcomes reported. A scoping review was conducted and reported in accordance with PRISMA-ScR. PubMed/MEDLINE, Scopus, Embase, and Google Scholar were searched from 1998 to October 2025; 69 additional records were identified from secondary sources. Records were de-duplicated in Covidence; two reviewers independently screened titles, abstracts, and full texts. Editorials, commentaries, reviews, meta-analyses, abstracts, operative-technique articles, laser-revascularization studies, and full texts that could not be retrieved were excluded. Result(s): Of 3065 records identified, 2277 unique studies were screened, 595 underwent full-text review, and 369 met inclusion criteria. The evidence base was predominantly observational (cohort 64.8%; case report 17.1%; case series 15.7%); randomized trials accounted for only 1.9% (n = 7). Most studies were single-center (87.8%) and conducted in the United States (39.8%), Germany (8.7%), Canada, and Austria (each 7.9%). Sample sizes were highly skewed (median: 72, IQR: 12-234). TECAB was the most common procedure (43.4%), followed by robotic-assisted MIDCAB (39.0%) and hybrid coronary revascularization (13.0%). Some version of the da Vinci platform was used in 73.0% of studies; ZEUS accounted for 5.4%. Conduit use was dominated by the LIMA (84.8%); the RIMA was reported in 30.4%. In-hospital mortality was the most consistently reported outcome (69.6%); long-term graft patency (24.7%), economic outcomes (6.8%), and patient-reported outcomes (22.0%) were under-reported. Conclusion(s): The published evidence on robotic coronary revascularization is abundant but methodologically uneven: the field is dominated by single-center cohort experience, with very few randomized trials and limited reporting of long-term, economic, and patient-reported outcomes. Future research should prioritize multicenter prospective studies, standardized core-outcome reporting, and direct comparison with conventional and minimally invasive alternatives. Copyright © The Author(s) 2026. <34> Accession Number 2047461398 Title Prediction Models for Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Critical Appraisal. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 5255. Date of Publication: 01 Jul 2026. Author Tuesta B.L.; Alberca-Naira Y.; Leon-Rodriguez J.A.; Rodriguez-Pratto J.; Andrade-Saavedra J.D.; Calderon-Chilet F.J.; Sarmiento-Maldonado C.A.; Rivera-Lozada O.; Bonilla-Asalde C.; Barboza J.J. Institution (Tuesta) Departamento de Cardiologia, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru (Alberca-Naira) Escuela de Medicina, Universidad Nacional de Piura, Piura, Peru (Leon-Rodriguez) Universidad Cesar Vallejo, Trujillo, Peru (Rodriguez-Pratto) Facultad de Medicina, Universidad Del Norte, Barranquilla, Colombia (Andrade-Saavedra) Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru (Calderon-Chilet) Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru (Sarmiento-Maldonado) Escuela Superior de Medicina, Instituto Politecnico Nacional, Mexico City, Mexico (Rivera-Lozada, Bonilla-Asalde, Barboza) Escuela de Medicina, Universidad Senor de Sipan, Chiclayo, Peru Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery and is associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Numerous multivariable prediction models have been developed to estimate individual risk; however, their methodological robustness, validation status, and clinical transportability remain uncertain. This systematic review aimed to critically evaluate the methodological quality, validation strategies, and predictive performance of multivariable prediction models developed to estimate the risk of postoperative atrial fibrillation (POAF) after cardiac surgery. Method(s): In accordance with PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, Scopus, Web of Science, and Embase from inception to July 2025. Studies that developed or externally validated multivariable prediction models for POAF in adult patients undergoing cardiac surgery were eligible. Data extraction was performed using the CHARMS checklist, and methodological quality was assessed with PROBAST. Model performance was summarized descriptively, focusing on discrimination (C-statistic/AUC), calibration reporting, and validation strategies. Result(s): A total of 39 studies were included. Most models were based on logistic regression, whereas a minority employed Cox regression or machine learning techniques. Reported discrimination ranged from 0.60 to 0.98, demonstrating substantial heterogeneity in predictive performance. Calibration was inconsistently reported. Six studies performed external validation. According to PROBAST, 32 of 39 studies (82%) were rated at high risk of bias, predominantly within the analysis domain due to inadequate handling of overfitting, insufficient events-per-variable ratios, and limited validation procedures. Conclusion(s): Existing prediction models for POAF show variable discrimination but are frequently limited by high risk of bias, inadequate validation, and incomplete calibration assessment, thereby restricting their clinical applicability. Future research should prioritize rigorous external validation, transparent reporting in accordance with TRIPOD recommendations, and methodological strategies that enhance model generalizability and transportability across diverse surgical populations. Copyright © 2026 by the authors. <35> Accession Number 2047563540 Title Pharmacological Strategies for Postoperative Pain Control in Patients Undergoing Cardiac Surgery: A Mixed Methods Systematic Review of Clinical Efficacy, Opioid Consumption, Patient Experience, and Nursing Care. Source Journal of Pharmacy and Bioallied Sciences. 18(3) (pp 157-159), 2026. Date of Publication: 01 Jul 2026. Author Rajendran S.; Kuppusamy K.; Jayakumar S. Institution (Rajendran) Department of Medical Surgical Nursing, Vinayaka Mission's College of Nursing, Vinayaka Mission's Research Foundation (DU), Karaikal, Puducherry, Tamil Nadu, Salem, India (Kuppusamy) Department of Child Health Nursing, Vinayaka Mission's College of Nursing, Vinayaka Mission's Research Foundation (DU), Karaikal, Puducherry, Tamil Nadu, Salem, India (Jayakumar) Department of Mental Health (Psychiatric) Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Kerala, Kochi, India Publisher Wolters Kluwer Medknow Publications Abstract Postoperative pain following cardiac surgery remains a major challenge that can delay recovery, increase opioid use, and hinder rehabilitation. This systematic review evaluated mixed methods evidence on pharmacological pain management strategies and their integration with nursing care in adult patients undergoing cardiac surgery. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Google Scholar was conducted from database inception to December 2025 following PRISMA 2020 guidelines. Four mixed methods studies met the inclusion criteria. Pharmacological interventions included opioids, paracetamol, nonsteroidal anti-inflammatory drugs, gabapentinoids, ketamine, dexmedetomidine, and multimodal analgesic regimens. These approaches were associated with reduced postoperative pain, 15-38% lower opioid consumption, shorter intensive care unit stays, and improved rehabilitation. Qualitative findings emphasized patients' concerns regarding opioid dependence and sedation while highlighting the importance of nurse-led education and individualized pain assessment. Overall, multimodal opioid-sparing analgesic strategies integrated with patient-centered nursing care appear to enhance postoperative recovery after cardiac surgery, although further high-quality mixed methods research is required to strengthen the evidence. Copyright © 2026 Journal of Pharmacy and Bioallied Sciences. <36> Accession Number 2047607360 Title Colchicine in coronary heart disease: from inflammatory biology to secondary prevention. Source Clinical and Experimental Rheumatology. 44 (pp 1306-1311), 2026. Date of Publication: 14 Jul 2026. Author Imazio M. Institution (Imazio) Department of Medicine, University of Udine, and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Udine, Italy Publisher Clinical and Experimental Rheumatology S.A.S. Abstract Inflammation is now recognised as a central mechanism in atherosclerosis and its clinical complications, shifting coronary heart disease management beyond exclusive lipid lowering and antithrombotic therapy. In this setting, colchicine is a potential low-cost anti-inflammatory candidate for cardiovascular prevention. While the CANTOS trial provided proof of principle that targeting inflammation can reduce recurrent cardiovascular events independently of lipid lowering, randomised colchicine trials such as COLCOT and LoDoCo2 showed reductions in major adverse cardiovascular events in patients with recent myocardial infarction and chronic coronary disease, respectively. Later meta-analyses generally confirmed benefit for major adverse cardiovascular events, myocardial infarction, stroke, and coronary revascularisation, although without a consistent mortality reduction and with gastrointestinal intolerance as the most common adverse effect. This review summarises the biological rationale, clinical trial evidence, safety profile, practical use, limitations, and current place of colchicine in coronary heart disease highlighting that colchicine is a real available cheap option for secondary prevention at least in chronic coronary syndromes. © Copyright CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2026. <37> Accession Number 2047246410 Title Early mortality after mitral surgery for failed MitraClip/TEER: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 30. Date of Publication: 01 Dec 2026. Author Campailla A.; Lorusso R.; Agostinelli A.; Benassi F.; Oliva R.; Grassa G.; Nicolini F.; Carino D. Institution (Campailla, Agostinelli, Benassi, Oliva, Grassa, Nicolini, Carino) Cardiac Surgery Unit, Department of Medicine and Surgery, University of Parma, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Parma, Italy (Lorusso) Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Lorusso) Cardiovascular Research Institute Maastricht, Maastricht, Netherlands Publisher Springer Science and Business Media Deutschland GmbH Abstract Objectives: To estimate pooled early all-cause mortality after mitral surgery for failed transcatheter edge-to-edge repair (M-TEER) and, as an exploratory objective, to describe the feasibility of surgical repair while explicitly accounting for the limitations of the retrospective evidence base. Method(s): This systematic review and meta-analysis followed PRISMA 2020. MEDLINE, Embase, Scopus, and Web of Science were searched from inception to 8 January 2026, with reference-list screening. Eligible studies included adults undergoing mitral surgery after failed MitraClip/TEER and reporting extractable operative, in-hospital, or 30-day mortality. Reports with likely overlapping cohorts were adjudicated, and the most informative dataset was retained for the main analytic set. Pooled proportions were estimated using random-effects single-arm meta-analysis with logit transformation, with endpoint-homogeneous and small-study sensitivity analyses. Certainty of evidence was assessed using GRADE. The pooled estimates are derived entirely from retrospective case series/registries with high risk of bias and no adjustment for confounders; they should not be used for individual risk prediction without center-specific validation. Result(s): Fifteen full-text reports were identified; one was excluded for insufficient sample size. Fourteen studies entered the qualitative synthesis, and 8 unique surgical cohorts (N = 951) formed the main analytic set after overlap adjudication. The pooled mixed-definition early mortality was 11.7% (95% CI: 8.4-16.0%; I2 = 39.2%; 95% prediction interval: 5.5-23.1%). Endpoint-homogeneous analyses were directionally consistent but underpowered: operative-only mortality 9.5%, in-hospital-only mortality 11.9%, and 30-day-only mortality 15.3%. The pooled repair rate was 12.5% (95% CI: 6.1-24.1%), with considerable heterogeneity (I2 = 85.1%) and a prediction interval of 1.1-64.4%. Certainty of evidence was very low for both outcomes. Conclusion(s): Mitral surgery after failed M-TEER is associated with substantial early mortality in the published retrospective literature, but the pooled estimate is crude, unadjusted, and based on heterogeneous endpoint definitions. Valve replacement remains the predominant surgical strategy. Surgical repair is reported in a minority of patients and should be interpreted as an exploratory, center- and anatomy-dependent outcome rather than as a generalizable probability. These estimates should not be used for individual risk prediction without center-specific validation. Copyright © The Author(s) 2026. <38> Accession Number 2047152962 Title Effective orifice area after Myval and SAPIEN transcatheter valve implantation stratified by flow status: insights from the LANDMARK trial. Source IJC Heart and Vasculature. 65 (no pagination), 2026. Article Number: 101966. Date of Publication: 01 Aug 2026. Author Tobe A.; Onuma Y.; van Royen N.; Amat-Santos I.J.; Smits P.C.; Morice M.-C.; Baumbach A.; Serruys P.W. Institution (Tobe, Onuma, Serruys) CORRIB Research Centre for Advanced Imaging and Core Lab, University of Galway, Galway, Ireland (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 (Smits, Morice) Cardiovascular European Research Center (CERC), Massy, France (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 Ireland Ltd <39> Accession Number 651319086 Title The effect of the use of baby mobile accompanied by Brahms' lullaby on the physiological parameters and pain level of the baby during sternum dressing. Source Journal of pediatric nursing. 89 (pp 520-527), 2026. Date of Publication: 01 Jul 2026. Author Karakaya K.; Uysal G. Institution (Karakaya) Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey (Uysal) Sakarya University of Applied Sciences, Faculty of Health Sciences, Sakarya, Turkey Abstract BACKGROUND: Infants in intensive care units undergo numerous painful procedures, including medical dressings. Median sternotomy is commonly in pediatric cardiac surgery and infants experience sternum incisions in the postoperative period. To our knowledge, no studies have specifically examined pain levels during sternum dressing. PURPOSE: This randomized controlled trial was conducted to investigate the effect of a baby mobile accompanied by Brahms' Lullaby on physiological parameters and pain levels during sternum dressing in infants. METHOD(S): The study included 76 infants (aged 1-12 months) admitted to the Pediatric Cardiovascular Surgery Intensive Care Unit between July 2020 and February 2021. Data were collected using "Baby Monitoring Form" and " Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale". The clinical trial registration number was NCT04894487. RESULT(S): Heart rate, body temperature, and FLACC pain scores were significantly higher, while SpO2 levels were significantly lower in the control group compared to the intervention group (p < .05). CONCLUSION(S): This study demonstrated that using baby mobile with Brahms' Lullaby during sternum dressing effectively improved physiological parameters and reduced pain levels in infants. Its use may be recommended during painful procedures. IMPLICATIONS FOR PRACTICE: This research provides a novel, non-pharmacological approach for nurses in the clinics and demonstrated that such methods may be as effective as the pharmacological interventions. It reduced the contamination risk by keeping the babies calmer during sternum dressing, which is a painful procedure that should be done aseptically. Frequent use of this method may reduce the risk of developing tolerance to painkillers and narcotic analgesics. Copyright © 2026 Elsevier Inc. All rights reserved. <40> Accession Number 2047295671 Title Regenerative and molecular therapies for myocardial repair (Review). Source Medicine International. 6(4) (no pagination), 2026. Article Number: 42. Date of Publication: 01 Jul 2026. Author Puthooran D.M.; Tom A.; Anna; Sundaram H.; Anwar Y.; Poovendran K. Institution (Puthooran, Poovendran) Faculty of Medicine, Tbilisi State Medical University, Tbilisi, Georgia (Tom, Anna, Sundaram) Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia (Anwar) Faculty of Medicine, David Tvildiani Medical University, Tbilisi, Georgia (Puthooran) Faculty of Medicine, Tbilisi State Medical University, 33 Vazha Pshavela Ave., Tbilisi, Georgia Publisher Spandidos Publications Abstract Despite considerable progress being made in reperfusion, drugs and device-based therapies, myocar- dial infarction remains a primary cause of heart failure due to irreversible cardiomyocyte loss and maladaptive ventricular remodeling. Conventional surgical and interven- tional methods cannot regenerate functional myocardium, although they can restore perfusion. Limited endogenous cardiac renewal has driven the development of regenera- tive, molecular and bioengineering-based therapies aimed at myocardial repair after MI. The present narrative overview summarizes current approaches, including gene and RNA therapeutics, cell-based therapies, extracellular vesicles, engineered cardiac patches and pharmacological strategies. Copyright © 2026 Puthooran et al. <41> Accession Number 2045599801 Title The clinical use of cryoprecipitate and fibrinogen concentrate: A scoping review. Source Transfusion. 66(7) (pp 1424-1437), 2026. Date of Publication: 01 Jul 2026. Author Hess A.S.; White S.K.; Crowe E.P.; Raval J.S.; Andrews J.; Cohn C.S.; Covington M.L.; Cushing M.M.; Jacquot C.; Khan J.; Panigrahi A.K.; Saifee N.H.; Tobian A.A.R.; McFarland M.M.; Stanworth S.J.; Metcalf R.A. Institution (Hess) New Zealand Blood Service, Christchurch, New Zealand (White, Metcalf) Department of Pathology, University of Utah, Salt Lake City, UT, United States (Crowe, Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MD, United States (Raval) Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States (Andrews) Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States (Andrews) Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States (Cohn) Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States (Covington) Department of Pathology, Mass General Brigham, Harvard University, Boston, MA, United States (Cushing) Department of Pathology, Weill Cornell Medicine, Cornell University, New York, NY, United States (Jacquot) Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC, United States (Khan) Department of Pathology, University of Virginia, Charlottesville, VA, United States (Panigrahi) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States (Panigrahi) Department of Pathology, Stanford University, Stanford, CA, United States (Saifee) Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States (Saifee) Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, WA, United States (McFarland) University of Utah, Spencer S. Eccles Health Sciences Library, Salt Lake City, UT, United States (Stanworth) John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Stanworth) NHS Blood and Transplant, Oxford, United Kingdom (Metcalf) ARUP Laboratories, Salt Lake City, UT, United States Publisher John Wiley and Sons Inc Abstract Background: Acquired hypofibrinogenemia poses significant bleeding risks. Concentrated sources of fibrinogen, whether cryoprecipitate or fibrinogen concentrates, are widely used. This scoping review aimed to identify and map the available evidence on fibrinogen supplementation. Study Design and Methods: We used the JBI Manual and PRISMA-ScR guidelines. We included patients of all ages treated with fibrinogen supplementation. The concept was treatment with cryoprecipitate or fibrinogen concentrate (prophylactically or therapeutically); and context was any clinical setting worldwide. Eligible studies included randomized trials and observational studies with comparator arms. Comprehensive searches of three databases were performed on February 21, 2025. Primary studies meeting inclusion criteria were selected. UpSet data visualizations displayed studies with intersecting sets of characteristics. Result(s): From 8181 references screened, 134 met inclusion criteria, of which 61 were randomized trials and 16 propensity-matched observational cohort studies. The highest proportion of trials focused on cardiovascular surgery (28/61; 46%) then trauma (12/61; 20%) populations and mainly assessed use of fibrinogen therapeutically (34/61; 56%). More trials evaluated fibrinogen concentrate (53/61; 87%) compared to cryoprecipitate (8/61; 13%). Commonly reported outcomes included bleeding, transfusion needs, or mortality. Studies inconsistently reported dosing, timing, and definitions of hypofibrinogenemia. Studies evaluating certain key populations-including obstetrics and pediatrics-were limited. All but one propensity-matched study was in either cardiovascular surgery or trauma. Discussion(s): There is a growing body of literature informing use of fibrinogen supplementation, particularly in cardiovascular surgery and trauma populations. Meta-analyses appear feasible to inform evidence-based guideline development; however, variability in dosing, timing, and definitions highlights the need for more harmonized research. Copyright © 2026 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB. <42> Accession Number 2046467375 Title Clinical spectrum, cardiac phenotypes, and outcomes of FHL1-related cardiomyopathies: a systematic review. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 518. Date of Publication: 01 Dec 2026. Author Bobbio E.; Caiazza M.; Pisacane F.; Viscovo I.; Gentile A.; Monda E.; De Falco C.; Esposito D.; Borrelli F.; Losi M.; Bossone E.; Chen S.N.; Frisso G.; Calabro P.; Esposito G.; Lombardi R.; Limongelli G. Institution (Bobbio, Caiazza, Pisacane, Viscovo, Monda, Limongelli) Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, via Leonardo Bianchi 1, Naples, Italy (Pisacane) UOC Patologia Clinica, AORN dei Colli, via Leonardo Bianchi 1, Naples, Italy (Gentile, De Falco, Borrelli, Losi, Esposito, Lombardi) Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy (Gentile, Chen, Lombardi) Division of Cardiology, University of Colorado School of Medicine, 12505 E. 16th Avenue, Anschutz Inpatient Pavilion 2, Aurora, CO, United States (Esposito) Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden (Esposito) Department of Endocrinology at Sahlgrenska University Hospital, University of Gothenburg, Bla Straket 8, Gothenburg, Sweden (Bossone) Department of Public Health, University of Naples Federico II, Via Pansini 5, Naples, Italy (Bossone) Heart Centre of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia (Frisso) Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Pansini 5, Naples, Italy (Calabro, Limongelli) Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Caserta, Italy (Limongelli) Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom (Bobbio) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Bobbio) Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Publisher BioMed Central Ltd Abstract Background: Mutations in the Four-and-a-Half LIM Domains 1 (FHL1) gene are increasingly recognized as a rare cause of inherited cardiomyopathies, often associated with skeletal myopathy and adverse cardiac outcomes. The phenotypic spectrum and clinical implications of FHL1 variants remain poorly defined. Objective(s): To systematically review published cases of FHL1-related cardiomyopathy and characterize the clinical, genetic, and pathological features. Method(s): We conducted a systematic literature search in PubMed and EMBASE up to July 2025 using predefined criteria to identify studies reporting clinical cases of patients with FHL1 mutations and cardiac involvement. Data on genotype, phenotype, cardiac and neuromuscular features, and clinical outcomes were extracted and synthesized. Result(s): Twenty-two studies were included, comprising 114 patients with pathogenic or likely pathogenic FHL1 mutations. Most patients were male (69%), with a median age of onset of 18 (IQR 10-26) years. Cardiac involvement consisted in left ventricular hypertrophy (56%), followed by arrhythmias (51%), and conduction abnormalities (8%). The incidence of sudden cardiac death was 7%, and heart transplantation was reported in 5% of patients. Skeletal muscle involvement was present in 75%, ranging from mild contractures to more severe myopathic phenotypes with functional impairment. Creatine kinase levels were variably elevated. Truncating variants were reported in several severe cardiac presentations in young males, while isolated cardiac disease occurred with selected variants. Conclusion(s): FHL1-related cardiomyopathy is a rare but important diagnosis. Genetic testing should be considered in patients with cardiac hypertrophy and neuromuscular features. Further research is needed to define prognostic markers and guide management. Copyright © The Author(s) 2026. <43> Accession Number 2043741684 Title Incidence and Predictors of Pacemaker Implantation Post-Transcatheter Aortic Valve Replacement in Patients with Pre-existing Right Bundle-Branch Block. Source Canadian Journal of Cardiology. 42(7) (pp 1559-1574), 2026. Date of Publication: 01 Jul 2026. Author Prabhu R.; Rao K.; Ciofani J.L.; Litkouhi P.N.; Baer A.; Hansen P.; Bhindi R. Institution (Prabhu, Rao, Ciofani, Litkouhi, Hansen, Bhindi) Department of Cardiology, Royal North Shore Hospital, Sydney, Australia (Rao, Ciofani, Litkouhi, Hansen, Bhindi) School of Medicine, University of Sydney, Australia (Ciofani) Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom (Baer) Department of Cardiology, North Shore Private Hospital, Sydney, Australia Publisher Elsevier Inc. Abstract Background Pre-existing right bundle branch block (RBBB) is the leading predictor of permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). The applicability of conventional PPI predictors in this high-risk subgroup remains unclear. This review evaluates PPI incidence and associated predictors in TAVI patients with pre-existing RBBB. Methods A systematic review of PubMed, Scopus, Embase, and Web of Science identified studies reporting PPI incidence and predictors in RBBB patients undergoing TAVI. Studies not addressing RBBB-specific factors were excluded. Pooled PPI incidence was calculated, and a qualitative narrative synthesis of predictors was performed. Results Of 2269 identified references, 22 studies with 429,342 patients met the inclusion criteria. Within the RBBB cohort, the mean age was 81.6 +/- 7.4 years, with 64.2% being male, and 23.7% having atrial fibrillation. Balloon-expandable valves were used in 69.8% of cases, and the transfemoral approach in 88.6%. The pooled PPI incidence was 37% across 17 studies. Substantial interstudy heterogeneity necessitated further analysis among 13 studies reporting consistent 30-day follow-up, which yielded 39% incidence. PPI predictors in the RBBB cohort encompassed demographic, anatomic, electrophysiological, and procedural domains. Conclusions Patients with baseline RBBB have significantly higher post-TAVI PPI rates. Identifying RBBB specific predictors could facilitate individualized procedural planning and risk stratification. This review reinforces how both traditional (eg, implantation depth) and nontraditional (eg, female sex, myocardial fibrosis, calcium volume, and distribution) factors have an amplified role in predicting PPI risk, emphasizing the need for further research in this subgroup to improve risk stratification and reduce PPI incidence. Registration: PROSPERO CRD420251057657. Copyright © 2026 . <44> Accession Number 2044431896 Title The Effect of Text Messaging on the Postoperative Pain Experience in Pediatric Patients Undergoing Thoracic Surgery: Randomized Controlled Trial. Source Journal of Medical Internet Research. 28 (no pagination), 2026. Article Number: e81806. Date of Publication: 2026. Author Shi Y.; Wang Q.; Liu A.; Jiang L. Institution (Shi, Wang, Liu, Jiang) Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China Publisher JMIR Publications Inc. Abstract Background: Inadequately controlled postoperative pain continues to pose a significant clinical challenge in pediatric patients undergoing thoracic surgery. Objective(s): This randomized controlled study aimed to investigate the effectiveness of SMS-based educational support for postoperative pain management on patients' pain experience. Method(s): A total of 100 pediatric patients undergoing thoracic surgery were enrolled between December 2, 2023, and January 28, 2025. Patients in the intervention group (group 1) received structured postoperative pain management education via SMS text messages, whereas those in the control group (group 2) received standard oral education. Pain intensity and pain-related interference were assessed using the Brief Pain Inventory, and self-efficacy was measured using the Pain Self-Efficacy Scale. Result(s): The number of patients with moderate-to-severe average pain was significantly lower in group 1 than in group 2 (n=19, 18% vs n=19, 38%; P=.04), and group 1 had significantly higher patient self-efficacy scores (mean 29.3, SD 7.5 vs mean 25.2, SD 8.7; P=.01). Least pain scores were lower in group 1 compared with group 2 across all 3 consecutive postoperative days (PODs): POD1 (mean 2.8, SD 0.8 vs mean 3.3, SD 0.7; P<.001), POD2 (mean 2.2, SD 0.8 vs mean 2.7, SD 0.5; P<.001), and POD3 (mean 1.7, SD 0.7 vs mean2.2, SD 0.4; P<.001). Similarly, average pain intensity was lower in group 1 compared with group 2 across all 3 consecutive PODs: POD1 (mean 3.7, SD 0.9 vs mean 4.7, SD 0.6; P<.001); POD2 (mean 3.3, SD 0.8 vs mean 3.6, SD 0.5; P=.01); and POD3 (mean 2.5, SD 0.8 vs mean 3.1, SD 0.5; P<.001). General activity was significantly less affected in group 1 on POD 1 (mean 4.3, SD 1.0 vs mean 5.0, SD 1.5; P=.004) and POD 2 (mean 3.1, SD 0.7 vs mean 3.7, SD 1.3; P=.009). Conclusion(s): The use of an SMS-based educational intervention significantly improved the postoperative pain experience of pediatric patients undergoing thoracic surgery. Further research is needed to clarify its impact on clinical outcomes and to better understand the mechanisms underlying improved pain management. Copyright © Yun Shi, Qianqiu Wang, Aihua Liu, Li Jiang. <45> Accession Number 2043351710 Title Intravenous Bolus Fluid Therapy Versus No Fluid Therapy Prior to Pericardiocentesis in Dogs: A Randomized Controlled Trial in 30 Dogs. Source Journal of Veterinary Emergency and Critical Care. 36(3) (pp 298-307), 2026. Date of Publication: 01 May 2026. Author Jones N.; Humm K.; Tinson E.W. Institution (Jones, Humm, Tinson) Veterinary Clinical Science and Services, The Royal Veterinary College, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Objective: To determine the cardiovascular and respiratory effects of bolus IV isotonic crystalloid fluid therapy before pericardiocentesis in dogs with pericardial effusion. Design(s): Prospective, randomized, nonblinded clinical trial (January 2021 to November 2022). Setting(s): University teaching hospital. Animals: Thirty dogs diagnosed with pericardial effusion. Intervention(s): Dogs were randomized to receive a 10-mL/kg IV bolus of compound sodium lactate (IV fluid bolus [IVFB] group) or no fluid bolus (no-IVFB group) over 10 min before pericardiocentesis. Measurements and Main Results: Cardiovascular parameters, respiratory rate, peripheral blood lactate concentration, and point-of-care ultrasound (POCUS) findings were assessed. Shock index (SI) was calculated as heart rate divided by systolic blood pressure. Measurements were recorded at four time points (T): baseline (T0), 15 min later (T1, after fluid bolus for the IVFB group), immediately after pericardiocentesis (T2), and 4 h after pericardiocentesis (T3). Significant decreases in SI were observed in the no-IVFB group between T1 and T2 and between T1 and T3, and in the IVFB group between T1 and T3 (p = 0.034, p = 0.003, and p = 0.027, respectively). No differences in SI were found between the groups when compared at the same time point. Administration of an IVFB did not result in adverse respiratory effects, as no dogs required supplemental oxygen by T3, and there were no differences in respiratory rate. The no-IVFB group had a higher incidence of new B-lines compared with the IVFB group (60% vs. 20%), but the median B-line score was <=1 at all POCUS sites at T0 and T3. Twenty-four dogs survived to hospital discharge with no difference in survival between groups. Conclusion(s): Administering an IVFB of 10 mL/kg isotonic crystalloid before pericardiocentesis in dogs with pericardial effusion did not alter SI. This dose appears to be safe, with no adverse respiratory effects seen. However, the current study was underpowered to detect a significant difference, and further studies are needed. Copyright © 2026 Veterinary Emergency and Critical Care Society. <46> Accession Number 2044491099 Title Effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis: a randomized controlled trial utilizing high-frequency variability index. Source Journal of Clinical Monitoring and Computing. 40(4) (pp 845-855), 2026. Date of Publication: 01 Aug 2026. Author Kotani T.; Ida M.; Naito Y.; Tanaka N.; Kawaguchi M. Institution (Kotani, Ida, Naito, Tanaka, Kawaguchi) Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Nara, Kashihara, Japan Publisher Springer Science and Business Media B.V. Abstract In this study, we aimed to compare the effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis using heart rate variability (HRV) analysis. In this single-center randomized controlled trial, 28 patients scheduled for elective transcatheter aortic valve replacement were assigned to receive either remimazolam or propofol for anesthesia induction at a tertiary emergency medical facility. Parasympathetic activity was assessed using the high-frequency variability index (HFVI), derived from spectral analysis of HRV based on electrocardiographic R-R intervals. HFVI was recorded for 3 min before and after induction. Remimazolam or propofol was administered at 6 mg/kg/h or 2.0 microg/ml via target-controlled infusion, respectively. The primary outcome was the difference in mean HFVI values recorded between the 3-min period before and after induction. Hemodynamic parameters, including mean blood pressure, heart rate, cardiac output, stroke volume variation, pulse pressure variation, and dynamic arterial elastance, were also measured. Baseline HFVI values did not differ significantly between groups. After induction, HFVI decreased significantly more in the remimazolam group than in the propofol group (DELTAHFVI: 16 vs. 3, P = 0.010). Heart rate increased in the remimazolam group but decreased in the propofol group (P = 0.006). No significant intergroup differences were observed in other hemodynamic parameters. These findings suggest that remimazolam may be associated with distinct autonomic responses during anesthesia induction. Copyright © The Author(s) 2026. <47> Accession Number 2047417706 Title Self-expanding versus balloon-expandable transcatheter heart valves in patients with excessive aortic valve cusp calcification. Source American Heart Journal. 292 (no pagination), 2026. Article Number: 107279. Date of Publication: 01 Feb 2026. Author Tomii D.; Alaour B.; Heg D.; Okuno T.; Nakase M.; Samim D.; Praz F.; Lanz J.; Stortecky S.; Reineke D.; Windecker S.; Pilgrim T. Institution (Tomii, Alaour, Okuno, Nakase, Samim, Praz, Lanz, Stortecky, Windecker, Pilgrim) Department of Cardiology, Cardiovascular Center, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland (Heg) Department of Clinical Research, University of Bern, Switzerland (Reineke) Department of Cardiac Surgery, Cardiovascular Center, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Publisher Elsevier Inc. Abstract Background Excessive aortic cusp calcification increases the risk of periprocedural complications after transcatheter aortic valve replacement (TAVR). Differences in device performance in patients with excessive calcification may affect long-term clinical outcomes. Objectives To compare periprocedural and long-term outcomes between self-expanding (SEV) and balloon-expandable (BEV) prostheses in patients with excess cusp calcification undergoing TAVR. Methods Consecutive patients with severe aortic stenosis and aortic valve complex calcium volume >=235 mm3 (on contrast images with Hounsfield unit threshold of 850) who underwent TAVR with either CoreValve/Evolut SEV or SAPIEN BEV from August 2007 to June 2023 were included from a prospective-single center registry. A 1:1 propensity-matched analysis was performed to account for baseline differences between groups. Results Among 1,345 patients with excessive cusp calcification undergoing TAVR, 271 matched pairs were identified. Procedural success was achieved in >85% of patients with no difference between groups. Annular rupture occurred more frequently with BEV compared to SEV (2.2% vs 0%, P = .030). SEV had a lower transprosthetic gradient (8.0 mmHg vs 11.2 mmHg, P < .001) but higher rates of mild or greater paravalvular regurgitation (69.7% vs 58.1%, P = .008) and new permanent pacemaker implantation (22.6% vs 15.5%, P = .001). At 5 years, there was no statistically significant difference in mortality between groups (45.1% vs 50.2%, P = .173). Conclusions In patients with excessive leaflet calcification undergoing TAVR, BEV had a higher risk of annular rupture, but a lower risk of paravalvular regurgitation, and a lower risk of permanent pacemaker implantation compared to SEV. Mortality was comparable between SEV and BEV throughout 5 years of follow-up. Clinical Trial Registration https://www.clinicaltrials.gov . NCT01368250. Copyright © 2025 The Author(s). <48> Accession Number 2047601085 Title Superiority of Fibrinogen Concentrate Versus Cryoprecipitate for Treatment of Bleeding in Cardiac Surgery Patients: A Secondary Analysis of the FIBRES Randomized Clinical Trial Stratified by Surgical Risk. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Bartoszko J.; Karkouti K.; Callum J.L. Institution (Bartoszko, Karkouti) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Toronto, ON, Canada (Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada (Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher W.B. Saunders Abstract Objectives: To explore the superiority of fibrinogen concentrate (FC) versus cryoprecipitate for bleeding after cardiac surgery. Design(s): Secondary analysis of the FIBRES randomized trial. Setting(s): Eleven Canadian hospitals, February 2017-November 2018. Participant(s): Adult cardiac surgery patients experiencing significant postbypass bleeding and acquired hypofibrinogenemia (fibrinogen <2.0 g/L or FIBTEM A10 <10 mm). Intervention(s): FC (4 g) or cryoprecipitate (10 units) dosed within 24 hours after cardiopulmonary bypass as needed. Measurements and Main Results: In total, 735 patients (372 FC, 363 cryoprecipitate) were included in the primary analysis (median age 64 years, 30% women). The primary endpoint was cumulative blood components (red cells, platelets, plasma) administered within 24 hours postbypass. Superiority was assessed using deviance-scaled Poisson regression. FC was superior to cryoprecipitate in the a priori-defined, well-balanced subgroups of non-critically ill patients (n = 634, 86% of population; mean 13.6 versus 16.2 units, mean ratio 0.84 [95% CI 0.73, 0.96]; p = 0.01) and elective surgery patients (n = 466, 63% of population; 11.7 versus 14.4 units, 0.81 [0.69, 0.96]; p = 0.02). In elective surgery patients, adverse events (relative risk 0.85 [0.75, 0.97]; p = 0.02) and serious adverse events (0.71 [0.52, 0.99]; p = 0.04) were less frequent with FC. Conclusion(s): FC showed superior hemostatic efficacy to cryoprecipitate in the prespecified subgroups of elective cardiac surgery patients and patients who were not in a critical state before surgery, representing the large majority of patients with bleeding postbypass. FC may also offer safety advantages over cryoprecipitate. Copyright © 2026 The Author(s) <49> Accession Number 2047594957 Title Artificial Intelligence for Predicting Perioperative Outcomes in Cardiac Surgery: A Systematic Review. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Ha J.; Vohra H.A. Institution (Ha, Vohra) University of Bristol, United Kingdom Publisher SAGE Publications Ltd Abstract Objective: Cardiac surgery carries a significant risk of complications and mortality. Artificial intelligence (AI), particularly machine learning (ML), is increasingly being explored to enhance perioperative risk prediction and support clinical decision-making. This systematic review evaluates the clinical applications, predictive performance, and limitations of AI models in cardiac surgery. Method(s): PubMed and Embase were searched for studies published between January 2020 and July 2025. Of 939 records identified, 178 studies met the inclusion criteria following screening and full-text review. Included studies applied AI to predict clinical outcomes in patients undergoing cardiac surgery. Key outcomes assessed were model performance metrics and their clinical utility. Result(s): Among the 178 included studies, 114 (64%) were conducted in the United States or China. Most studies (n = 168, 94%) used retrospective designs and focused on adult populations. Random forest (n = 82, 46%), logistic regression (n = 82, 46%), and eXtreme Gradient Boosting (n = 70, 39%) were the most frequently used algorithms. AI applications primarily targeted the prediction of postoperative complications (n = 102, 57%) and mortality (n = 70, 39%), with common outcomes including acute kidney injury and stroke. ML models consistently outperformed traditional clinical risk scores (n = 39). SHapley Additive exPlanations was the most common interpretability method (n = 66, 37%). Only 26% of studies included external validation, and just 19% adhered to TRIPOD guidelines. Conclusion(s): AI models demonstrate superior predictive performance in cardiac surgery compared with traditional risk scores, but concerns regarding validation, transparency, and generalizability must be addressed to enable implementation. 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). <50> Accession Number 2047406388 Title The Effectiveness of Perioperative Intravenous Lidocaine for Postoperative Analgesia in Video-Assisted Thoracic Surgery: A Systematic Review and Meta-Analysis. Source Journal of Pain Research. 19 (no pagination), 2026. Article Number: 616585. Date of Publication: 2026. Author Liu J.; Zhong B.; Huang X.; Lei S.; Liu H.; Deng W.; Liu W.; Fan M. Institution (Liu, Zhong, Huang, Lei, Liu, Deng, Liu, Fan) Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, China (Fan) Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Background: Acute pain after video-assisted thoracic surgery (VATS) remains a significant challenge. While intravenous lidocaine is increasingly used for analgesia, its efficacy for VATS remains uncertain. This meta-analysis aimed to evaluate the impact of perioperative intravenous lidocaine on postoperative pain in patients undergoing VATS. Method(s): We systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Chinese databases (CNKI, WANFANG, SinoMed) from inception to December 31, 2025, for randomized controlled trials (RCTs) comparing intravenous lidocaine with placebo saline in adults undergoing VATS. Primary outcomes were static and dynamic pain scores. Secondary outcomes included opioid consumption, quality of recovery (QoR), postoperative nausea and vomiting (PONV), gastrointestinal recovery, postoperative pulmonary complications (PPCs), and length of hospital stay. Data were pooled using random-effects models. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Result(s): Sixteen RCTs involving 1045 patients were included. Compared with placebo, intravenous lidocaine significantly reduced static pain scores at 6-8 h (MD -0.61 cm, 95% CI [-0.99, -0.24]), 24 h (MD -0.48 cm, 95% CI [-0.79, -0.17]), and 48 h (MD -0.31 cm, 95% CI [-0.48, -0.14]), as well as dynamic pain scores at the corresponding time points. However, the magnitude of pain reduction did not reach the predefined threshold for clinical importance (>=1 cm), and prediction intervals crossed the line of no effect for all pain outcomes. Intravenous lidocaine was also associated with reduced postoperative opioid consumption and improved QoR, although neither effect reached established minimal clinically important difference (MCID) thresholds. Additionally, lidocaine reduced PONV and accelerated gastrointestinal recovery. No significant effects were observed on PPCs or lidocaine-related adverse events, and it slightly prolonged the length of hospital stay. The certainty of evidence ranged from very low to moderate. Conclusion(s): Although perioperative intravenous lidocaine infusion was associated with statistically significant improvements in postoperative pain and several recovery-related outcomes following VATS, the magnitude of benefit in pain, opioid consumption, and QoR did not consistently reach established thresholds for clinical importance. The certainty of evidence was generally low, and substantial heterogeneity was observed across studies. The overall clinical benefit of perioperative intravenous lidocaine remains uncertain and should be interpreted with caution. Copyright © 2026 Liu et al. <51> Accession Number 2046079871 Title Incidence and predictors of postoperative atrial fibrillation following coronary artery bypass graft surgery: a meta-analysis of 207 studies. Source Acta Cardiologica. 81(5) (pp 731-740), 2026. Date of Publication: 2026. Author Farzaneh A.; Zameni N.; Masoum A.; Karamian A. Institution (Farzaneh) School of Medicine, Department of Cardiology, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of (Zameni) Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic of (Masoum) Faculty of Medicine, Mashhad Islamic Azad University, Mashhad, Iran, Islamic Republic of (Karamian) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Taylor and Francis Ltd. Abstract Background: Postoperative atrial fibrillation (POAF) is one of the most common tachyarrhythmias after coronary artery bypass graft (CABG) surgery. This study aimed to determine the overall incidence and predictors of POAF after CABG surgery through a systematic review of existing research findings. Method(s): The protocol of this study was registered in PROSPERO (CRD420251023423) and written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result(s): 207 articles with a total sample size of 180,223 participants were included in our meta-analysis. The overall incidence of POAF following CABG surgery was 24% (95% CI 23%-26%). Increased age and male gender were associated with higher odds of developing POAF (ORs of 1.06 and 1.28, respectively, p < 0.01). Comorbidities, including congestive heart failure (CHF), hypertension, COPD, renal failure, and chronic kidney disease (CKD), were shown to be predictors of POAF. Those who do not use beta-blocker or have withdrawn from it were more likely to experience POAF (OR = 2.26, 95% CI 1.35-3.78, p < 0.01). Preoperative use of statins significantly reduced the odds of POAF (OR = 0.57, 95% CI 0.42-0.78, p < 0.01). On-pump surgery, grafting >= 3 vessels, longer length of stay in hospital, use of intra-aortic balloon pump (IABP), prolonged cross-clamp time, use of inotropic medications, and higher left atrial volume index (LAVI), and LA diameter were also predictors of POAF. Higher preoperative left ventricular ejection fraction (LVEF) was another factor that was associated with lower odds of developing POAF. Conclusion(s): Recognising the risk factors for POAF helps us to identify high-risk patients to provide better preventive measures and management strategies for POAF after CABG. Copyright © 2026 Belgian Society of Cardiology. <52> Accession Number 2046360710 Title Prevalence of healthcare-associated infections in developing and developed countries: a systematic review. Source BMC Infectious Diseases. 26(1) (no pagination), 2026. Article Number: 1135. Date of Publication: 01 Dec 2026. Author Nappi F.; Avtaar Singh S.S. Institution (Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord, Saint-Denis, France (Avtaar Singh) Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom Publisher BioMed Central Ltd Abstract Introduction: In the global context, healthcare-associated infections (HCAIs) are the most prevalent outcome of substandard patient care. There is a lack of data from developing regions, except for developing countries such as China and India, where reports from the World Health Organization (WHO) demonstrate a more substantial presence. This systematic review aims to investigate geographical disparities in HCAI occurrence in developing and developed countries. It also focuses on healthcare-associated infections, especially infectious endocarditis (IE) from implantable cardiac devices in high-income countries. Method(s): A literature review was conducted according to a pre-designed protocol. A search was performed in Embase, Ovid Medline, and PubMed for reports published between 2000 and 2024. No language restrictions were applied, and older, highly cited studies were retained. The search process retrieved 6,928 abstracts, of which 263 met eligibility criteria. The primary endpoint was to ascertain extant empirical research on the epidemiology of HCAIs in developing countries, with a focus on bacterial infections. The secondary endpoint investigated infections associated with transcatheter aortic valve replacement (TAVR) and cardiac implantable electronic devices (CIED) in developed countries. Result(s): The primary endpoint revealed a HCAI rate in adult ICUs that is at least three times the USA rate. Surgical site infections were the most prevalent type of infection, with rates significantly higher than in developed countries. Gram-negative bacilli caused the most hospital infections. Methicillin-resistant Staphylococcus aureus was detected in many cases. The secondary endpoint demonstrated that Staphylococcus aureus is responsible for approximately one-third of healthcare-associated IE cases. In the United States, the percentage increased from 24% to 32%. Healthcare-associated IE carries a higher in-hospital mortality rate than community-acquired IE (31.1% vs. 20.3%; p < 0.01). Comparisons between TAVR and surgical aortic valve replacement are few and mixed. Large national registries and pooled PARTNER-trial data show comparable IE rates for both procedures. CIEDs-IE have a lower three-year survival rate (53.8% vs. 33% for pacemakers, 47.7% vs. 31.6% for implantable cardioverter-defibrillators, and 50.8% vs. 36.5% for cardiac resynchronization therapy). Conclusion(s): Surveillance HCAIs is essential for tracking disease and evaluating interventions. Focusing on key procedural steps can improve adherence and intervention impact. IE after TAVR and CIED is rare but severe, with high in-hospital mortality. Copyright © The Author(s) 2026. <53> [Use Link to view the full text] Accession Number 2045940011 Title Pre-operative single-level ultrasound-guided superficial parasternal intercostal plane block and pulmonary recovery after cardiac surgery with sternotomy: a randomised controlled trial. Source European Journal of Anaesthesiology. 43(8) (pp 712-713), 2026. Date of Publication: 01 Aug 2026. Author Huette P.; Daumin C.; Fontaine R.; Lefebvre T.; Tarpin P.; Beyls C.; Gubler B.; Mahjoub Y.; Ollier A.; Abou-Arab O. Institution (Huette, Daumin, Fontaine, Lefebvre, Tarpin, Beyls, Mahjoub, Abou-Arab) The Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, France (Huette, Tarpin, Beyls, Mahjoub) UR UPJV 7518 SSPC Research Unit, Jules Verne University of Picardie, France (Gubler) Immunology Department & EA4666-HEMATIM, Amiens University Hospital, Amiens, France (Ollier) Department of Biostatistics, Amiens Picardy University Hospital, France (Abou-Arab) Laboratoire MP3CV, CURS, Universite Picardie Jules Verne, France Publisher Lippincott Williams and Wilkins <54> Accession Number 2038344267 Title Current trends in transcatheter aortic valve implantation modelling and simulation. Source Series on Biomechanics. 39(2) (pp 3-23), 2025. Date of Publication: 2025. Author Pil N.; Selivanov G.; Seleznev M.; Pandelani T.; Krestyaninov O.; Nemavhola F.; Kuchumov A.G. Institution (Pil, Selivanov, Seleznev, Kuchumov) Biofluids Laboratory, Perm National Research Polytechnic University, Perm, Russian Federation (Pandelani) Department of Mechanical, Bioresources and Biomedical Engineering, University of South Africa, Pretoria, South Africa (Krestyaninov) Research Department of Endovascular Surgery, Academician E.N. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation (Nemavhola) Department of Mechanical Engineering, Faculty of Engineering and the Built Environment, Durban University of Technology, Durban, South Africa (Kuchumov) Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, Perm, Russian Federation Publisher Bulgarska Akademiya na Naukite Abstract Transcatheter aortic implantation (TAVI) is an important minimally invasive procedure used to treat aortic stenosis, especially in high-risk patients. In recent years, there has been a significant increase in the number of TAVI procedures due to improved clinical outcomes and expanded indications for this technology in low-and intermediate-risk groups. Objective(s): This article provides an overview of current technologies and methods used to model and optimize transcatheter aortic valves. Material(s) and Method(s): The most prominent and authoritative scientific databases were utilized, including PubMed, Scopus, Web of Science, and Google Scholar papers published between 2010 and 2025.Search queries included combinations of keywords such as <<TAVI>>, <<transcatheter aortic valve implantation>>, <<aortic stenosis>>, <<computational modeling of TAVI>>, <<fluid-structure interaction>> and <<hemodynamics of TAVI>>. Result(s): We performed a systematic literature survey of peer-reviewed studies on numerical simulation of TAVI devices, focusing on Bernoulli-Euler beam approximations and Auricchio-Taylor model for shape memory stent, isotropic and anisotropic hyperelastic models of leaflet and skirt tissues-including Mooney-Rivlin, Ogden, and modified Holzapfel-Gasser-Ogden formulations and coupling strategies in fluid- structure interaction (FSI) frameworks. Key material parameters, modeling assumptions, and solver methodologies were extracted and compared. Discussion(s): This review provides a comprehensive analysis of the status and trends in TAVI, with an emphasis on the use of computer models and experimental studies to improve clinical outcomes. In addition, the future direction in personalized modeling using digital patient twins is discussed, allowing for accurate prediction of procedure outcomes and improved patient-specific valve selection. Copyright © 2025, Bulgarska Akademiya na Naukite. All rights reserved. <55> Accession Number 2046032670 Title Antiplatelet therapy for patients with stable coronary artery disease receiving oral anticoagulation: A meta-analysis of randomized controlled trials. Source Journal of Cardiology. 88(2) (pp 136-141), 2026. Date of Publication: 01 Aug 2026. Author Hiruma Y.; Watanabe A.; Aikawa T.; Iwagami M.; Hosseini K.; Slipczuk L.; Briasoulis A.; Takagi H.; Kuno T. Institution (Hiruma) United States Naval Hospital Okinawa, Okinawa, Japan (Watanabe) Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (Iwagami) Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (Iwagami) Department of Digital Health, Institute of Medicine, University of Tsukuba, Tsukuba, Japan (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Slipczuk) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, United States (Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA, United States (Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Kuno) Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background Evidence supporting the discontinuation of antiplatelet therapy in patients with stable coronary artery disease who require anticoagulation remains limited and continues to evolve. This study aimed to assess the efficacy and safety of antithrombotic therapy in this population. Methods We reviewed randomized controlled trials comparing the efficacy and safety of oral anticoagulant monotherapy versus oral anticoagulant plus single antiplatelet therapy in patients beyond six months after coronary revascularization requiring anticoagulation. The outcomes included major adverse cardiovascular events (MACE) and major bleeding. MACE was defined as a composite of all-cause death, myocardial infarction, stroke, systemic embolism, and revascularization. A pairwise meta-analysis using a random-effects model was conducted. Results A total of 5924 patients from 6 randomized controlled trials were included: 2970 received oral anticoagulant alone, and 2954 received oral anticoagulant plus single antiplatelet therapy. Anticoagulant monotherapy was associated with a comparable risk of MACE [hazard ratio (HR), 0.80; 95% confidence interval (CI), 0.62-1.04] and a significantly lower major bleeding risk (HR, 0.46; 95% CI, 0.32-0.66) than the combined therapy. Conclusion Oral anticoagulant alone may be a reasonable strategy to mitigate bleeding risk while preserving an ischemic risk comparable to combined anticoagulant and antiplatelet therapy. Copyright © 2026 Elsevier Ltd. <56> Accession Number 2047346341 Title Comparison of the Efficacy of Ciprofol and Propofol for Rapid Sequence Induction and Intubation in Elective Non-Cardiac Surgery: A Prospective, Randomized, Non-Inferiority Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 614980. Date of Publication: 2026. Author Lin Y.; Wang C.; Wu J.; Liu J.; Liu M.; Miao C.; Liang C. Institution (Lin, Wu, Wang, Wu, Liu, Liu, Miao, Liang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Background: Rapid sequence induction and intubation (RSII) requires an agent that provides excellent intubating conditions with minimal hemodynamic disturbance. Propofol is standard but often causes hypotension. We compared the novel agent ciprofol with propofol for RSII in adult patients scheduled for elective non-cardiac surgery. Method(s): In this prospective, randomized, double-blind, non-inferiority trial, 170 adult patients scheduled for elective non-cardiac surgery were allocated to receive intravenous ciprofol (0.4 mg/kg, n = 85) or propofol (2.0 mg/kg, n = 85) for induction, with remifentanil and rocuronium. The non-inferiority margin was set at -10% for the primary outcome. The primary outcome was the proportion of patients with excellent intubation conditions (Viby-Mogensen scale). Secondary outcomes included incidence of hypotension, induction success rate, time to loss of consciousness (LOC), bispectral index (BIS) values, and pain on injection. Result(s): Excellent intubation conditions were achieved in 96.5% (82/85) of the ciprofol group and 95.3% (81/85) of the propofol group (difference 1.2%, 95% CI: -4.4% to 6.7%). The lower limit of the 95% CI exceeded the prespecified non-inferiority margin of -10%. The per-protocol analysis confirmed non-inferiority (difference 1.2%, 95% CI -4.2% to 6.7%). The incidence of post-induction hypotension was significantly lower in the ciprofol group (15.3% vs 43.5%; RR 0.35, 95% CI 0.20 to 0.61; P < 0.001). No patient reported injection pain with ciprofol, compared to 68.2% with propofol (P < 0.001). Time to LOC and induction success rates were similar between groups. Conclusion(s): In adult patients undergoing elective non-cardiac surgery under a standardized RSI protocol, ciprofol 0.4 mg/kg provided intubating conditions non-inferior to propofol 2.0 mg/kg and was associated with less post-induction hypotension and injection pain. Further studies are needed in emergency, critically ill, and high-risk RSI populations. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2500095742). Copyright © 2026 Lin et al. <57> Accession Number 2047527849 Title Advanced organ protection strategies in aortic arch surgery: A narrative review. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 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). <58> Accession Number 2047369319 Title Quantitative PET coronary flow capacity and comprehensive management of chronic CAD: Lessons from the randomized CENTURY trial. Source Atherosclerosis. 419 (no pagination), 2026. Article Number: 120831. Date of Publication: 01 Aug 2026. Author Gould K.L.; Johson N.P. Institution (Gould, Johson) From the Weatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, McGovern Medical School, University of Texas, and Memorial Hermann Hospital, Houston, TX, United States Publisher Elsevier Ireland Ltd Abstract Background and aims Randomized trials in chronic coronary artery disease (CAD) tested single interventions of lifestyle, medical treatment, or revascularization. The randomized CENTURY trial tested a comprehensive strategy integrating intense lifestyle modification, medical treatment and revascularization reserved for severely reduced coronary flow capacity (CFC) by positron emission tomography (PET), for reducing death, myocardial infarction and revascularization compared with referring-cardiologist-directed standard community care. Methods Participants with high risk factors, suspected or known CAD were randomly assigned to comprehensive or standard care. Rest-stress PET quantified CFC for physiological CAD severity at baseline, 2 and 5 years. Comprehensive care group reviewed PET results with frequent clinic visits and open 24/7 phone/email support. Standard care lacked supportive contact with blinded PET results, unblinded for severely reduced CFC with high mortality risk for potential revascularization. Results Of 1028 randomized participants, 515 were assigned to comprehensive care and 513 to standard care for the 5-year protocol with additional follow-up over next 5 to 11 years. Comprehensive vs standard care significantly decreased summed risk factor score at 5-years (P < 0.0001), all-cause death (4.7% vs. 8.2%; P = 0.023), death or MI (7.0% vs. 11.1%; P = 0.024), late revascularization (9.6% vs 14.8%; P = 0.011) and major adverse cardiac events (20.5% vs 29.9%; P = 0.0006). Only 56 of 1028 (5.4%) CENTURY patients had revascularization within 90 days guided by CFC severity, thereby reassuring and motivating patients and physicians for safely pursuing preventive risk factor goals while reserving angiogram-revascularization for high-risk, severe CFC. Intensity of adherence to comprehensive risk factor control during 5-years associated with additional significantly reduced death, MI and revascularizations over next 5 to 11 years. Conclusions The randomised CENTURY trial demonstrates that comprehensive integrated lifestyle modification and optimal medical treatment with revascularization reserved for severely reduced CFC significantly reduced death, death or MI, and revascularization at 5 years and potentially over extended 5 to 11 years of non-predefined follow-up. ( ClinicalTrials.gov NCT00756379). Copyright © 2026 The Authors. <59> Accession Number 2047355468 Title Long-Term Outcomes and Predictors After Percutaneous Balloon Pulmonary Valvuloplasty for Pediatric Isolated Valvular Pulmonary Stenosis: A Systematic Review. Source Pediatric Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Pereira M.M.; Miranda J.O. Institution (Pereira, Miranda) Faculty of Medicine, University of Porto, Porto, Portugal (Miranda) Department of Pediatric Cardiology, Centro Materno-Infantil do Norte, ULS Santo Antonio, Porto, Portugal Publisher Springer Abstract Percutaneous Balloon Pulmonary Valvuloplasty (BPV) is the gold standard treatment for isolated pulmonary valve stenosis in the pediatric population. However, its long-term outcomes and associated risk factors remain incompletely characterized. This systematic review aimed to assess BPV long-term outcomes and predictors for restenosis/reintervention and pulmonary insufficiency (PI) following BPV in this population. PubMed, Scopus, Web of Science and Cochrane databases were searched to identify studies including pediatric populations with a minimum follow up of five years after BPV (ranging up to 20 years). Fifteen studies were included, comprising 1505 patients. BPV was associated with sustained relief of pulmonary valve stenosis and low procedure-related and late mortality (ranges 0-4.2% and 0-6%, respectively). Restenosis occurred in a minority of patients, (range 0-38%), and reintervention was uncommon (median rates: repeat BPV 5.0%, surgery 4.5%). Both were consistently associated with unfavorable hemodynamic characteristics including a higher initial transvalvular pulmonary gradient or a higher right ventricular overload and residual obstruction after the procedure, as well as unfavorable anatomical characteristics including a smaller pulmonary valve annulus size. PI was the most frequently late outcome identified (range 5.6%-60%), and was predominantly associated with younger age at intervention, lower body weight and greater severity of stenosis at baseline. Pulmonary valve replacement remained uncommon during follow-up (range 0-12.3%, median 1.4%). These results highlight the differential impact of anatomical, hemodynamic and procedural factors on long-term outcomes after BPV in pediatric patients. Due to substantial heterogeneity in outcome definitions and gradient assessment methods, results were synthesized narratively. Copyright © The Author(s) 2026. <60> Accession Number 2047435870 Title Suitability of sedative usage in patients undergoing cardiovascular surgery. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Martin N.J.; Brinkman H.M.; Ellis S.; Nabzdyk C.G.S.; Ortoleva J.P.; Wittwer E.D.; D'Andria Ursoleo J.; Wieruszewski P.M.; Monaco F. Institution (Martin, Brinkman, Wieruszewski) Department of Pharmacy, Mayo Clinic, Rochester, MN, United States (Ellis) Department of Anesthesiology, University of California San Diego, San Diego, CA, United States (Nabzdyk, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States (Ortoleva) Department of Anesthesiology, Boston Medical Center, Boston, MA, United States (D'Andria Ursoleo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Monaco) Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Publisher Taylor and Francis Ltd. Abstract Introduction: The provision of optimal anesthesia care is essential to the safe conduct of cardiac surgery. Nevertheless, evidence regarding ideal choices for anesthetic induction and maintenance remain conflicting. Individualized regimens balancing the patient's cardiac pathology and the expected hemodynamic perturbations from the anesthetics are likely optimal, underscoring the rationale for this review of contemporary anesthetic strategies in cardiac surgery. Areas covered: Descriptions of cardiac surgery trends and advancements that necessitate concomitant anesthesia, including the challenges with the provision of anesthesia in these patients were introduced. Induction and maintenance anesthesia considerations are discussed next, along with individual medication-specific commentary on volatile anesthetics, propofol, benzodiazepines, barbiturates, ketamine, etomidate, opioids, dexmedetomidine, and remimazolam. PubMed/MEDLINE, EMBASE, and Google Scholar were searched without date restriction through April 2026. Expert opinion: An optimal blanket anesthetic strategy for patients undergoing cardiac surgery remains elusive. Thoughtful combinations of multiple agents considering the patient's physiology, anticipated hemodynamic perturbations, and type and length of surgery are likely to continue to dominate practice. Novel agents, like remimazolam, may prove especially fruitful for patients given their unique properties, but more evidence is needed to prove impact on patient outcomes for this, and other agents in combination. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <61> 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. (no pagination), 2026. Date of Publication: 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. <62> Accession Number 2047367082 Title Patient overlap and the validity of SGLT2 inhibitor benefits after TAVI: a critique of recent meta-analytical findings. Source European Journal of Clinical Pharmacology. 82(8) (no pagination), 2026. Article Number: 201. Date of Publication: 01 Aug 2026. Author Mohamed A.A. Institution (Mohamed) Faculty of Medicine, Zagazig University, Zagazig, Egypt Publisher Springer Science and Business Media Deutschland GmbH <63> Accession Number 651684544 Title Prognostic Value of the Meta-Analysis Global Group in Chronic Heart Failure Risk Score in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair. Source Journal of the American Heart Association. 15(13) (pp e048383), 2026. Date of Publication: 07 Jul 2026. Author Nishimura Y.; Asami M.; Horiuchi Y.; Tanaka J.; Taniwaki M.; Komiyama K.; Yuzawa H.; Tanabe K.; Yamamoto M.; Kubo S.; Saji M.; Izumi Y.; Sugiura A.; Shimura T.; Enta Y.; Shirai S.; Izumo M.; Mizuno S.; Watanabe Y.; Amaki M.; Kodama K.; Otsuki H.; Naganuma T.; Bota H.; Ohno Y.; Yamawaki M.; Ueno H.; Nakazawa G.; Hachinohe D.; Otsuka T.; Hayashida K. Institution (Nishimura, Asami, Horiuchi, Tanaka, Taniwaki, Komiyama, Yuzawa, Tanabe) Division of Cardiology Mitsui Memorial Hospital Tokyo Japan, Japan (Yamamoto) Department of Cardiology Toyohashi Heart Center Toyohashi Japan, Japan (Kubo) Department of Cardiology Kurashiki Central Hospital Kurashiki Japan, Japan (Saji, Izumi) Department of Cardiology Sakakibara Heart Institute Tokyo Japan, Japan (Saji) Division of Cardiovascular Medicine, Department of Internal Medicine Toho University Faculty of Medicine Tokyo Japan, Japan (Sugiura) Department of Cardiology Nagoya Heart Center Nagoya Japan, Japan (Shimura) Department of Cardiology Gifu Heart Center Gifu Japan, Japan (Enta) Department of Cardiology Sendai Kosei Hospital Sendai Japan, Japan (Shirai) Division of Cardiology Kokura Memorial Hospital Kitakyushu Japan, Japan (Izumo) Division of Cardiology St. Marianna University School of Medicine Hospital Kawasaki Japan, Japan (Mizuno) Department of Cardiology Shonan Kamakura General Hospital Kamakura Kanagawa Japan, Japan (Watanabe) Department of Cardiology Teikyo University School of Medicine Tokyo Japan, Japan (Amaki) Department of Cardiology National Cerebral and Cardiovascular Center Suita Japan, Japan (Kodama) Division of Cardiology Saiseikai Kumamoto Hospital Cardiovascular Center Kumamoto Japan, Japan (Otsuki) Department of Cardiology Tokyo Women's Medical University Tokyo Japan, Japan (Naganuma) Department of Cardiology New Tokyo Hospital Chiba Japan, Japan (Bota) Department of Cardiology Sapporo Higashi Tokushukai Hospital Sapporo Japan, Japan (Ohno) Department of Cardiology Tokai University School of Medicine Isehara Japan, Japan (Yamawaki) Department of Cardiology Saiseikai Yokohama City Eastern Hospital Yokohama Kanagawa Japan, Japan (Ueno) Second Department of Internal Medicine Toyama University Hospital Toyama Japan, Japan (Nakazawa) Department of Cardiology Kindai University Faculty of Medicine Osaka Japan, Japan (Hachinohe) Cardiovascular Medicine, Sapporo Heart Center Sapporo Cardiovascular Clinic Sapporo Japan, Japan (Otsuka) Department of Hygiene and Public Health Nippon Medical School Tokyo Japan, Japan (Hayashida) Department of Cardiology Keio University School of Medicine Tokyo Japan, Japan Abstract BACKGROUND: The prognostic value of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) remains unclear. This study evaluated the MAGGIC score to predict outcomes after M-TEER in patients with functional (FMR) or degenerative mitral regurgitation (DMR) and compared its performance with conventional surgical and M-TEER-specific risk models. METHOD(S): We analyzed 3609 patients (FMR, 71%; DMR, 29%) who underwent M-TEER in the OCEAN (Optimized Catheter Valvular Intervention)-Mitral registry. Patients were stratified into MAGGIC score tertiles. The primary outcome was all-cause death at 1 and 3 years. Secondary outcomes included cardiovascular death. Predictive performance was compared with Society of Thoracic Surgeons score, European System for Cardiac Operative Risk Evaluation II, MitraScore, and COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) score. RESULT(S): The median age was 81 years, 55.3% were men, and median MAGGIC score was 30. In the FMR cohort, patients in tertile 3 had higher risks of all-cause death (1 year: adjusted hazard ratio [HRadj], 4.15 [95% CI, 2.34-7.36]; 3 years: HRadj, 1.83 [95% CI, 1.22-2.77]) and cardiovascular death (1 year: HRadj, 2.31 [95% CI, 1.56-3.43]; 3 years: HRadj, 1.61 [95% CI, 1.13-2.31]). In the DMR cohort, tertile 3 was associated with higher all-cause death (1 year: HRadj, 2.84 [95% CI, 1.18-6.86]; 3 years: HRadj, 2.25 [95% CI, 1.07-4.73]) and cardiovascular death at 3 years (HRadj, 3.49 [95% CI, 1.23-9.84]). The MAGGIC score demonstrated comparable or superior discrimination on the basis of the concordance index. CONCLUSION(S): The MAGGIC score independently predicted 1- and 3-year all-cause death after M-TEER in both FMR and DMR cohorts and cardiovascular death in the FMR cohort and at 3 years in the DMR cohort. It demonstrated comparable or superior predictive performance to conventional surgical and M-TEER-specific risk models. <64> Accession Number 651148046 Title Efficacy of 0.5M mannitol as an adjuvant to lidocaine and epinephrine for intra-oral nerve blocks - a split-mouth, randomized controlled trial. Source BMC oral health. 26(1) (no pagination), 2026. Date of Publication: 09 May 2026. Author Singh R.; Singh A.; Saha M.; Kudva A.; Gadicherla S.; Pentapati K.C.; Chitra A.; Poojary D.; Roy S. Institution (Singh, Singh, Saha, Kudva, Gadicherla, Chitra, Roy) Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India (Pentapati) Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India (Poojary) Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, India Abstract BACKGROUND: In dentistry operations, addition 0.5 M mannitol to lidocaine-epinephrine improves anesthesia efficacy. However, its effect on hemodynamic parameters and post-operative outcomes have not been evaluated. This study aimed to compare the efficacy, hemodynamic parameters, and post-operative outcomes of 2% lidocaine and 1:200,000 epinephrine, with or without 0.5 M mannitol, in intra-oral nerve blocks. MATERIALS AND METHODS: This prospective, randomized, controlled, triple-blind, split-mouth study included 25 patients who required intra-oral block for elective extraction of lower erupted teeth. The Test side (n = 25) received lidocaine-epinephrine-mannitol, while the Control side (n = 25) received lidocaine-epinephrine. The primary outcome measures were evaluated were onset and duration of anesthesia. The secondary outcome measures were pain (assessed with visual analogue scale [VAS] on day 0-3, and 7); hemodynamic parameters (including heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and oxygen saturation, assessed pre-, intra-, and post-operatively); and post-operative complications (swelling and trismus assessed on day 7). RESULT(S): The Test side had a significantly early onset of action (p = 0.006) and delayed return of sensation (p = 0.001). On day 0, VAS score was significantly lower in the Test side (p = 0.017), with no difference at other intervals (p > 0.05). Post-operatively, mouth opening was significantly greater on the test side (p = 0.023), with no difference in post-operative swelling (p = 0.317). The control side had a significantly higher intra- (p = 0.018) and post-operative (p = 0.006) heart rate, with comparable SBP, DBP, and oxygen saturation. CONCLUSION(S): Lidocaine-epinephrine-mannitol formulation showed improved anesthetic efficacy, reduced pain on the day of procedure, stable hemodynamic parameters, and increased post-operative mouth opening. TRIAL REGISTRATION: CTRI/2022/10/046921 [Registered on: 31/10/2022]. Copyright © 2026. The Author(s). <65> Accession Number 2047384537 Title Noninvasive Cardiac Output Monitoring Combined With Critical Care Ultrasound for Postoperative Volume Management in Cardiac Surgery Patients: A Randomized Controlled Trial. Source Journal of Surgical Research. 326 (pp 53-63), 2026. Date of Publication: 01 Oct 2026. Author Xu Y.; Zhang L.; Pan X.; Jiang Y.; Lv J. Institution (Xu, Zhang, Pan, Jiang, Lv) Department of Critical Care Medicine, Tongji University East Hospital, Shanghai, China, China Publisher Academic Press Inc. Abstract Introduction: Postoperative hemodynamic instability and low cardiac output syndrome are common complications following cardiac surgery. Conventional volume management guided by central venous pressure and mean arterial pressure has well-documented limitations. Noninvasive cardiac output monitoring (NICOM) and critical care ultrasound (CCUS) provide complementary, real-time hemodynamic and volumetric assessments. This randomized controlled trial evaluated whether NICOM+CCUS-guided fluid management improves clinical outcomes in cardiac surgery patients with postoperative hemodynamic instability. Material(s) and Method(s): In this single-center, parallel-group randomized controlled trial conducted at Tongji University East Hospital (January-December 2024), 86 adults (>=18 y) with postoperative hemodynamic instability cardiac index (CI) < 2.5 L/min/m2 plus >=1 of: lactate >2 mmol/L or norepinephrine >0.05 mug/kg/min after cardiac surgery were randomized 1:1 (control n = 43, observation n = 43) to conventional monitoring (central venous pressure/mean arterial pressure-guided) or NICOM+CCUS-guided management. Eighty-one patients (control n = 40, observation n = 41) completed analysis. Primary outcomes: extubation time category (<24 h, 24-48 h, >48 h), left ventricular ejection fraction (LVEF), and brain natriuretic peptide at intensive care unit (ICU) discharge. Secondary Outcomes: lactate normalization time (<2 mmol/L), 24-h urine output, net fluid balance, acute heart failure incidence, intra-aortic balloon pump use, mechanical ventilation duration, and ICU length of stay. Categorical variables were analyzed using chi2/Fisher's exact tests; continuous variables were analyzed using t-test/Mann-Whitney U-test after Shapiro-Wilk normality testing. Within-group changes were assessed using paired t-test/Wilcoxon test. Significance: P < 0.05 (two-sided). Result(s): Baseline characteristics were balanced (P > 0.05). The observation group had higher 24-h extubation rates 92.7% versus 60.0%; odds ratio 7.96 (95% CI 2.14-29.63), P < 0.001 and greater LVEF improvement median DELTA6.7% (95% CI 3.2-10.2), P < 0.001 versus control at discharge. The greater LVEF improvement in the observation group was accompanied by lower net fluid balance, earlier lactate normalization, and reduced diuretic use, suggesting that optimized volume status and improved oxygen delivery contributed to enhanced myocardial recovery. Brain natriuretic peptide reduction was more pronounced DELTA-104.0 +/- 68.2 versus -58.8 +/- 62.1 pg/mL; P = 0.031. Secondary outcomes favored the observation group: lactate normalization 16.2 +/- 8.5 versus 28.3 +/- 11.4 h; mean difference (MD) -12.1 h (95% CI -16.7 to -7.5), P < 0.001, urine output 4846.7 +/- 1653.4 versus 4086.5 +/- 1113.8 mL; MD 760.2 mL (95% CI 148.6-1371.8), P = 0.015, net fluid balance 101.4 +/- 32.3 versus 347.6 +/- 64.2 mL; MD -246.2 mL (95% CI -278.5 to -214.0), P < 0.001, acute heart failure 4.8% versus 17.5%; odds ratio 0.24 (95% CI 0.05-1.17), P = 0.045, mechanical ventilation 15.1 +/- 9.3 versus 27.3 +/- 11.5 h; MD -12.2 h (95% CI -16.9 to -7.5), P < 0.001, and ICU stay 31.1 +/- 13.3 versus 42.5 +/- 13.1 h; MD -11.4 h (95% CI -17.4 to -5.4), P < 0.001. Conclusion(s): NICOM+CCUS-guided fluid management significantly improved hemodynamic stability, cardiac recovery, and resource utilization compared to conventional monitoring. This noninvasive strategy reduced fluid overload and complications in high-risk cardiac surgery patients. Multicenter trials enrolling a broader range of cardiac surgical procedures with long-term follow-up are warranted. Copyright © 2026 Elsevier Inc. <66> Accession Number 2047437946 Title Efficacy of intraoperative hemoadsorption in patients undergoing cardiac surgery, a meta-analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Motawea K.R.; Abouainain L.; Amer A.E.; Mohamed M.S.; Kandil O.; Kheuka Y.A.; Almaraihah R.A.; Pelletier M.; El-Diasty M.; Elgudin Y.; Sabik J.; Abu-Omar Y. Institution (Motawea, El-Diasty, Elgudin, Sabik, Abu-Omar) Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Abouainain) Faculty of Medicine, University of Jordan, Amman, Jordan (Amer) Pulmonary and Critical Care Department, Tufts Medical Center, Boston, MA, United States (Mohamed) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Kandil) Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, United States (Kheuka) Department of Medicine, Azerbaijan Medical University, Baku, Azerbaijan (Almaraihah) Department of Cardiac Surgery, University College London Hospitals, London, United Kingdom (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher SAGE Publications Ltd Abstract Objectives: Comparing clinical outcomes after cardiopulmonary bypass with hemodsorption (HA) versus cardiopulmonary bypass without HA in patients undergoing cardiac surgery in terms of mortality and major complications. Method(s): PubMed, Scopus, and Web of Science databases were searched for relevant randomized control trials (RCTs) that compared postoperative clinical outcomes between patients receiving intraoperative HA with cardiopulmonary bypass versus patients receiving cardiopulmonary bypass without intraoperative HA in cardiac surgery. Result(s): Sixteen RCTs with 851 patients (433 in the HA group and 418 in the control group), were included in our meta-analysis. Our meta-analysis found no significant differences between the intraoperative HA group and the control group in patients undergoing cardiac surgery in terms of 30-days/in-hospital mortality, new-onset atrial fibrillation, stroke or cerebrovascular events, postoperative delirium, renal failure/acute kidney injury, need for renal replacement, postoperative liver dysfunction, thrombocytopenia, bleeding, volume of blood loss, pneumonia, sepsis, respiratory insufficiency, duration of postoperative ventilation, distributive/septic shock, pericardial tamponade, need for extracorporeal membrane oxygenation (ECMO) support, sequential organ failure assessment (SOFA) score at ICU admission, plasma-free hemoglobin levels, and fibrinogen levels. However, the pooled analysis showed a significant association between HA and decreased albumin at ICU admission (MD = - 0.28, 95% CI [0.55 to 0.01], p-value = 0.04), decreased length of ICU stay (MD = -0.66, 95% CI [-1.24 to 0.08], p-value = 0.03), and decreased length of hospital stay (MD = -0.99, 95% CI [-1.88 to -0.10], p-value = 0.03). Conclusion(s): Our findings suggest that there is not enough evidence to endorse the role of routine intraoperative HA during cardiopulmonary bypass in improving clinical outcomes after cardiac surgery. Factors such as patient risk profile, procedure complexity, and cost implications should be taken into account when considering this adjunct therapy. Copyright © The Author(s) 2026 <67> Accession Number 2047327657 Title Dual antiplatelet therapy with aspirin and ticagrelor vs aspirin alone in patients with acute coronary syndrome undergoing coronary artery bypass graft surgery: a systematic review and meta-analysis. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author AlSejari N.Y.; Gadelmawla A.F.; Alsubaiei A.A.; Alsultan A.M.; Alawadhi A.N.; Alwazzan A.; Alwazzan M.A.; Alkubaisi M.I.; AlSafy D.; Alattar R.N.; Alzeaby A.S.; Alwazzan H.A.; Alaskari E.; AlMadsari E.A.; Alharran A.M. Institution (AlSejari, Alsubaiei, Alsultan) Kuwait Institute for Medical Specializations, Kuwait City, Kuwait (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Alawadhi, Alwazzan, Alwazzan, AlSafy, Alattar, Alwazzan, Alaskari) University of Jordan, Amman, Jordan (Alkubaisi, Alzeaby, AlMadsari, Alharran) College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain Publisher Springer Abstract The role of dual antiplatelet therapy (DAPT) with ticagrelor plus aspirin after coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS) remains uncertain. We performed a systematic review and meta-analysis to compare ticagrelor plus aspirin versus aspirin alone in ACS patients undergoing CABG. We performed a comprehensive search of MEDLINE, Cochrane Library, Scopus, and Web of Science for studies that compared ticagrelor plus aspirin to aspirin alone in patients with ACS undergoing CABG. The main meta-analysis was restricted to randomized controlled trials, while observational evidence was incorporated only in exploratory analyses. Outcomes including myocardial infarction (MI), ischemic stroke, all-cause mortality, bleeding, repeat revascularization, graft occlusion, and major adverse cardiovascular events (MACE) were analyzed. Risk of bias was assessed using Rob-2 for RCTs and the Newcastle-Ottawa Scale (NOS) for cohort studies. GRADE was used to assess the certainty of the evidence. Seven articles representing five studies were included. There were no significant differences in myocardial infarction (MI) (OR: 0.95, 95% CI 0.53-1.72), ischemic stroke, all-cause mortality, while a significant increase in major bleeding was observed. No difference was also found in repeat revascularization, graft occlusion, or minor bleeding. Sensitivity analyses identified single studies as key sources of heterogeneity for several outcomes. In the combined analysis including randomized and observational evidence, ticagrelor plus aspirin showed a lower risk of study-defined MACE compared with aspirin alone (OR 0.6, 95% CI 0.43-0.83) although this estimate was based on only two studies and was largely driven by one observational cohort. Ticagrelor plus aspirin after CABG for ACS significantly increased major bleeding, while other ischemic, graft-related, and minor bleeding outcomes showed no consistent significant differences. Further high-quality randomized evidence is needed to clarify the net clinical benefit of this strategy. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <68> Accession Number 2047582008 Title Commissural and Coronary Alignment Strategies in Transcatheter Aortic Valve Replacement: Success Rate and Risks. Source European Cardiology Review. 21(1) (no pagination), 2026. Article Number: e32. Date of Publication: 2026. Author Fernandez-Cordon C.; Amat-Santos I. Institution (Fernandez-Cordon, Amat-Santos) Cardiology Department, University Clinical Hospital Valladolid, Valladolid, Spain (Amat-Santos) Centro de Investigacion Biomedica en Red, Enfermedades Cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid, Spain Publisher Radcliffe Medical Media Abstract Commissural alignment (CA) is becoming increasingly important in the lifetime management of younger patients with aortic stenosis undergoing transcatheter aortic valve implantation, potentially influencing coronary access, valve-in-valve feasibility and haemodynamics. Interest in the topic has led to a growing body of evidence, valve design improvements and optimised implantation techniques. In this review, we summarise the clinical impact of CA, its success rate and limitations, stressing the potential role of coronary alignment as opposed to CA. We also describe the techniques to achieve CA with the latest iterations of the most used transcatheter aortic valve implantation devices. Copyright © The Author(s) 2026. This work is open access and is licensed under CC BY-NC 4.0. Users may copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly. <69> Accession Number 2047606464 Title Letter to the Editor: Comparable outcomes of sevoflurane vs propofol anesthesia in gastrectomy for gastric cancer. Source World Journal of Gastrointestinal Oncology. 18(7) (pp 1-4), 2026. Article Number: 116791. Date of Publication: 2026. Author Zhan P.-W.; Wang T. Institution (Zhan, Wang) Laboratory of Protein Structure and Function, Institute of Medicine and Pharmacy, Qiqihar Medical University, Heilongjiang Province, Qiqihar, China (Zhan, Wang) School of Medical Technology, Qiqihar Medical University, Heilongjiang Province, Qiqihar, China Publisher Baishideng Publishing Group Inc Abstract A recent study published in World Journal of Gastrointestinal Oncology by Wang et al compared sevoflurane inhalation anesthesia and propofol-based total intravenous anesthesia for gastric cancer patients undergoing radical gastrectomy. The results demonstrated that both techniques achieved largely equivalent long-term survival and overall perioperative safety. However, specific short-term differences were noted: The propofol group exhibited higher average pain scores at 24 hours postoperatively, a greater incidence of postoperative nausea and vomiting, and more pronounced transient increases in blood pressure and heart rate during surgery. While these findings provide practical insights for individualized anesthesia selection, the study's retrospective design is a significant limitation, introducing potential confounding biases from non-randomized allocation and unmeasured factors. The higher postoperative nausea and vomiting incidence with propofol is particularly notable as it contradicts its established antiemetic properties, warranting further investigation. The authors consequently recommend future prospective, multicenter randomized trials to enhance the robustness and generalizability of the evidence. Copyright ©Author(s) 2026. <70> Accession Number 651772622 Title Uncovering the Evidence Frontier Beyond the Lipid-Lowering Effects of PCSK9 Inhibitors in Heart Transplantation. Source The American journal of the medical sciences. (no pagination), 2026. Date of Publication: 15 Jul 2026. Author Yazdanpanah F.; Ramirez G. Institution (Yazdanpanah) Department of General Preventive Medicine and Public Health, University of Texas Health Science Center at Tyler, TX, United States (Ramirez) Division of Population Health Leadership and Analytics, University of Texas Health Science Center at Tyler, TX, United States Abstract Cardiac allograft vasculopathy (CAV) is a major cause of long-term complications in heart transplant (HTx) recipients, with dyslipidemia playing a key role in its development. While statins are the standard therapy, their effectiveness can be limited by side effects, insufficient lipid-lowering response, or drug interactions. This scoping review examines the emerging role of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) as an alternative strategy, emphasizing their positive effects on lipid profiles, especially low-density lipoprotein cholesterol (LDL-c), in slowing CAV progression. Recent preclinical studies using a heterotopic murine heart transplant model have identified a novel finding: the PCSK9i "alirocumab" may protect against transplant rejection through mechanisms independent of lipid-lowering, possibly by modulating hepatic immune responses. These findings reveal a significant evidence frontier and highlight the need for clinical research to further explore the immunomodulatory properties of PCSK9i in the context of heart transplantation. Copyright © 2026. Published by Elsevier Inc. <71> Accession Number 2047600820 Title Patient-specific Factors Influencing Choice of Transcatheter Aortic Valve Prosthesis. Source Interventional Cardiology: Reviews, Research, Resources. 20 (pp 1-8), 2025. Article Number: e35. Date of Publication: 2025. Author Khokhar A.A.; Curio J.; Hammond-Haley M.; Adam M.; Ruparelia N. Institution (Khokhar) Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (Curio, Adam) Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany (Hammond-Haley, Ruparelia) Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom Publisher Radcliffe Medical Media Abstract Transcatheter aortic valve (TAV) implantation is an established treatment strategy for patients with severe aortic stenosis across the spectrum of surgical risk profiles. Numerous randomised controlled trials have consistently demonstrated the safety and efficacy of TAV implantation compared with surgical aortic valve replacement, prompting an expansion of indications towards lower surgical risk, often younger, patients. In parallel, the number and types of TAV prosthesis have also increased. Although all devices have generally demonstrated favourable procedural and longer-term clinical outcomes, variations in frame design, material properties and leaflet configurations render specific devices more favourable in certain settings. In this review, we describe key differences in TAV design and how this may affect the choice of TAV prosthesis in the challenging clinical scenarios of patients with small annuli, coronary disease, long life expectancy, risk of permanent pacing and aortic regurgitation, which are expected to be encountered more frequently as indications for TAV implantation expand. Copyright © The Author(s) 2025. <72> Accession Number 651756457 Title Effects of non-pharmacological interventions on post-operative delirium in cardiac surgery patients: a systematic review and network meta-analysis. Source European journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 13 Jul 2026. Author Zeng M.; Zhang Y.; Yu X.; Mo Q.; Liao Q.; Sun L.; Zheng W.; Lam M.; Luo W.; Zhang X. Institution (Zeng, Zhang, Yu, Mo) School of Nursing, Jinan University, No. 601, Huangpu Avenue West, Guangzhou, Guangdong, China (Liao, Luo, Zhang) Department of Cardiovascular Surgery, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China (Sun, Zheng) Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, No. 2999, Jinshan Road, Xiamen, Fujian, China (Lam) Psychiatric Service of the Centro Hospitalar Conde de Sao Januario, Estrada Coelho do Amaral, China Abstract AIMS: Although non-pharmacological interventions (NPIs) are important for preventing post-operative delirium, their comparative effectiveness in cardiac surgery patients remains unclear. This study aimed to compare different NPIs and identify the most effective strategy using a network meta-analysis (NMA). METHODS AND RESULTS: Randomized controlled trials (RCTs) were identified through systematic searches of PubMed, Web of Science, Embase, CINAHL, Cochrane Library, CNKI, Wanfang Data, and the VIP Database. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. NMA was conducted using Stata 18.0. Post-operative delirium incidence was summarized as odds ratios with 95% confidence intervals (CIs), and delirium duration as mean differences (MDs) with 95% CIs. A total of 26 RCTs (n = 2913) were included. Overall, NPIs were associated with a reduced incidence of post-operative delirium compared with routine care (OR = 0.42, 95% CI = 0.34-0.50, P < 0.05, I2= 51%). In the NMA, multicomponent therapy (OR = 0.30, 95% CI = 0.19-0.47) and health education (OR = 0.33, 95% CI = 0.12-0.88) significantly reduced delirium incidence. NPIs also shortened delirium duration (MD = -0.96, 95% CI = -1.06 to -0.86, P < 0.05, I2 = 0%), with multicomponent therapy showing the greatest reduction. CONCLUSION(S): NPIs reduce the incidence and duration of post-operative delirium in patients undergoing cardiac surgery, with multicomponent therapy combining several non-pharmacological strategies targeting different modifiable risk factors, such as delirium assessment, clinical adjustment, environmental control, and early mobilization, showing the most favourable effects. REVIEW REGISTRATION: PROSPERO: CRD420250655564. 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 <73> Accession Number 651757835 Title Adjunctive hyperbaric oxygen therapy for poststernotomy deep sternal wound infection, mediastinitis, and sternal osteomyelitis after cardiac surgery: a scoping review. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 14 Jul 2026. Author Bahramnezhad F.; Montaseri M.; Jackson A.C. Institution (Bahramnezhad) Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Montaseri) Critical Care Nursing Department, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Montaseri) Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Jackson) Australian Centre for Heart Health, Melbourne, Australia (Jackson) Faculty of Health, Deakin University, Geelong, Australia (Jackson) Centre on Behavioural Health, Hong Kong University, Pok Fu Lam, Hong Kong Abstract INTRODUCTION: Poststernotomy deep sternal wound infection (DSWI), mediastinitis, and sternal osteomyelitis are uncommon but serious complications of cardiac surgery. Hyperbaric oxygen therapy (HBOT) has been used as an adjunct in selected complex infections, but its incremental role within contemporary cardiac-surgery pathways is uncertain. METHOD(S): We conducted a scoping review according to JBI guidance and PRISMA-ScR reporting standards. MEDLINE, Embase, Cochrane CENTRAL, and CINAHL were searched from 1 January 1999 to 2 June 2026. We included adult and pediatric clinical sources and relevant experimental mediastinitis models. Two reviewers independently screened sources and charted data. Design-matched appraisal tools were used only to contextualize methodological limitations. Because populations, infection phenotypes, cointerventions, comparators, and endpoints differed substantially, findings were stratified and synthesized narratively; no meta-analysis was performed. RESULT(S): Eleven sources met the inclusion criteria: six adult cohorts/series, one pediatric cohort, two single-patient reports, and two MRSA rat models (179 adults in cohorts/series, 53 pediatric patients, two additional adult single-patient reports, and 103 animals). These sources represent distinct evidence strata and were not interpreted as one clinical entity. HBOT was always embedded within multimodal care, including surgery, antibiotics, NPWT, and/or reconstruction. Only two small adult studies provided direct nonrandomized HBOT-versus-non-HBOT comparisons. Li et al. compared sequential treatment eras and was analyzed separately. The evidence cannot isolate an incremental HBOT effect. CONCLUSION(S): Evidence for adjunctive HBOT remains sparse and highly heterogeneous. Current studies do not establish a causal or incremental benefit beyond surgery, source control, antibiotics, NPWT, and reconstruction. HBOT should not be routinely adopted or allowed to delay definitive surgical management. Its role, if any, is limited to carefully selected adjunctive use within multidisciplinary pathways and prospective evaluation. Copyright © 2026. The Author(s). <74> Accession Number 2047806028 Title A Comparison of Percutaneous Mitral Valve Repair and Surgical Mitral Valve Intervention: A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Nazir B.; Mukherjee P.; Balaji A.; Makam R.; Haqzad Y.; Javangula K. Institution (Balaji, Nazir, Mukherjee, Balaji) Department of Medical Education, University of Hull, Hull, United Kingdom (Makam) Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, United Kingdom (Haqzad, Javangula) Department of Cardiothoracic Surgery, Leeds General Infirmary, Leeds, United Kingdom Publisher Elsevier Ltd Abstract Background & Aim: Transcatheter edge-to-edge repair (TEER) has expanded options for high-risk patients with severe mitral regurgitation (MR), however its longer-term performance relative to surgical mitral valve repair (SMVR) remains uncertain. This systematic review and meta-analysis compares the clinical outcomes of TEER versus SMVR in adults with MR. Method(s): We performed a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-guided systematic review and random-effects meta-analysis of randomised and comparative observational studies including adults with primary or secondary MR treated with TEER (MitraClip therapy) or SMVR. Primary outcomes were mortality, reintervention and recurrent >=3+ MR; secondary outcomes included stroke, acute kidney injury (AKI) and permanent pacemaker implantation. Subgroup analyses explored modification by MR aetiology, study design and surgical strategy. Result(s): Twenty-one studies (70,641 patients; 24,820 TEER, 45,821 SMVR) met the inclusion criteria. TEER recipients were older, more comorbid and had higher baseline risk. In-hospital and 30-day mortality were similar between strategies. At 1 year, mortality was significantly higher after TEER (risk ratio [RR] 1.58, 95% confidence interval [CI] 1.10-2.28). Within 1 year, reintervention was almost three-fold more frequent after TEER (RR 2.98, 95% CI 2.14-4.14), and recurrent >=3+ MR was substantially higher both at approximately 1 year (RR 4.80, 95% CI 1.97-11.72) and 3 years (RR 6.51, 95% CI 2.60-16.29). TEER was associated with a lower 1-year stroke risk, while pooled AKI and pacemaker outcomes did not differ significantly. Conclusion(s): TEER is a short-term alternative for high-risk patients but demonstrates higher long-term recurrence and reintervention. SMVR remains superior for durability and survival. Further studies are needed to evaluate TEER in high-risk surgical cohorts. Copyright © 2026 The Author(s) <75> Accession Number 651746352 Title Clinical Effectiveness of Acute Normovolemic Hemodilution in Cardiac Surgery: A Systematic Review and Meta-analysis. Source Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 13 Jul 2026. Author Elfiki M.; Elfeky A.; Ali M.S.; Ibrahim A.; Zayed M.; Fahmy El-Nemr A.; Elshahat A.; Hendawy A.A.; Sobhy A.; Mohamed A.E.; Elnady M. Institution (Elfiki, Elfeky, Ali, Ibrahim, Zayed, Hendawy) From the Faculty of Medicine, Menoufia University, Egypt (Fahmy El-Nemr, Elshahat) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Sobhy, Elnady) Faculty of Medicine, Kafr Elsheikh University, Egypt (Mohamed) Faculty of Medicine, Tanta University, Egypt Abstract BACKGROUND: Acute normovolemic hemodilution (ANH) is endorsed by contemporary patient blood management guidelines as a cost-effective strategy for reducing allogeneic transfusion in cardiac surgery. However, evidence remains inconsistent due to protocol variability and limited statistical power in earlier trials. This systematic review and meta-analysis seek to evaluate the clinical effectiveness of ANH in adult patients undergoing cardiac surgery. METHOD(S): A comprehensive search of four databases was performed up to October 2025 to identify randomized controlled trials (RCTs) and matched cohort studies comparing ANH with standard intraoperative care. The primary outcome of interest was the incidence of allogeneic red blood cell (RBC) transfusion. Data were pooled using DerSimonian-Laird random-effects models, expressed as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). RESULT(S): Nineteen studies (15 RCTs, four cohorts) involving 9418 patients were included. ANH significantly reduced the incidence of allogeneic RBC transfusion compared with control (27.6% vs 31.5%; RR = 0.85, 95% CI [0.75-0.96], P = .01). The transfusion reduction was more evident in crystalloid-based protocols (RR = 0.72, 95% CI [0.54-0.96], P = .026) and on-pump surgeries (RR = 0.86, 95% CI [0.76-0.97], P = .01). Matched cohort analyses also confirmed the benefit (RR = 0.87, 95% CI [0.81-0.94], P = .001), whereas RCT-only analysis showed a nonsignificant difference (RR = 0.81, 95% CI [0.64-1.02], P = .07). No significant differences were found in hematocrit, hemoglobin, fresh frozen plasma transfusion, renal dysfunction, myocardial infarction, stroke, or mortality. CONCLUSION(S): ANH significantly reduces the need for allogeneic transfusions while maintaining a favorable safety profile for patients undergoing cardiac surgery. Copyright © 2026 International Anesthesia Research Society. <76> Accession Number 651758865 Title Current state of evidence for RATS lobectomy for NSCLC. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 14 Jul 2026. Author Galvaing G.; d'Ostrevy N.; Chadeyras J.-B.; Dupautet L.; Naamee A.; Filaire M. Institution (Galvaing, Chadeyras, Dupautet, Naamee, Filaire) Department of Thoracic and Endocrine Surgery, Jean Perrin Cancer Center, Clermont-Ferrand, 58 rue Montalembert, France (d'Ostrevy) Department of Cardiac Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France Abstract BACKGROUND: Robot-assisted thoracic surgery (RATS) has progressively been integrated into minimally invasive strategies for pulmonary lobectomy in patients with non-small cell lung cancer (NSCLC). Although video-assisted thoracic surgery (VATS) remains the most established minimally invasive approach, the clinical relevance and added value of robotic platforms continue to be debated. METHOD(S): This narrative review critically examines the existing literature on robot-assisted lobectomy for NSCLC. Emphasis is placed on comparative data evaluating oncological outcomes, lymph node assessment, perioperative results, technical considerations, learning curve, and economic implications in relation to VATS and open surgery. RESULT(S): Available evidence, predominantly derived from retrospective studies and large database analyses, indicates that RATS lobectomy is feasible and safe when performed in experienced centers. Long-term oncological outcomes, including overall and disease-free survival, appear broadly comparable across surgical approaches. While some studies suggest that robotic assistance may facilitate more extensive lymph node assessment, the clinical significance of these findings remains uncertain. Perioperative outcomes such as conversion rates, postoperative morbidity, and length of hospital stay are generally similar between RATS and VATS. Higher procedural costs associated with robotic platforms remain a consistent concern, with cost-effectiveness strongly influenced by institutional volume and resource allocation. CONCLUSION(S): Current evidence supports RATS lobectomy as a valid minimally invasive option for selected patients with NSCLC, offering outcomes comparable to those of established techniques. Despite clear technical advantages, definitive clinical superiority has not been demonstrated, highlighting the need for further prospective studies and standardized outcome reporting. Copyright © 2026. The Author(s). <77> Accession Number 2047862291 Title Sex-Related Differences in Outcomes and Thresholds for Intervention in Primary Mitral Regurgitation: A Systematic Review and Meta-Analysis. Source JACC: Cardiovascular Imaging. (no pagination), 2026. Date of Publication: 2026. Author Long E.; Hahn R.T.; Gulati M.; Demetrescu C.; Shah B.N.; Bhattacharya S.; Moorjani N.; Lucchese G.; Bilkhu R.; Bosco P.; Patterson T.; Redwood S.; Pibarot P.; Prendergast B.; Rajani R.; Androshchuk V. Institution (Long, Lucchese, Redwood, Rajani, Androshchuk) Faculty of Life Sciences and Medicine, King's College London, United Kingdom (Long, Demetrescu, Lucchese, Bilkhu, Bosco, Patterson, Redwood, Rajani, Androshchuk) Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Hahn) Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States (Gulati) Department of Cardiology, The Davis Women's Heart Center, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton General Hospital, Southampton, United Kingdom (Bhattacharya) Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (Bhattacharya, Prendergast) Cleveland Clinic London, London, United Kingdom (Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada Publisher Elsevier Inc. Abstract Background: Evidence on sex differences in outcomes after interventions for primary mitral regurgitation (PMR) remains conflicting. The authors performed a dedicated meta-analysis to examine whether guideline-recommended thresholds for intervention may contribute to these discrepancies. Method(s): Electronic databases were searched for studies reporting long-term outcomes of patients undergoing surgical or transcatheter interventions for PMR, stratified by sex. The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events. Reconstructed time-to-event individual patient data were used to derive frailty-adjusted Cox models and restricted mean survival time. To investigate whether sex-based differences in baseline characteristics had a modulating effect on differences in all-cause mortality, meta-regression was performed on individual patient data-derived HRs using a linear mixed-effects model. Result(s): Across 17 studies (N = 25,690), women comprised the minority (n = 9,632, 37.5%) and were significantly older (mean difference: 3.2 years, 95% CI: 2.2-4.3) with a greater proportion of heart failure symptoms (OR: 1.8; 95% CI: 1.6-2.1). At 15.7 years of follow-up, women had significantly greater risk of all-cause mortality compared with men (HR: 1.15; 95% CI: 1.07-1.24), corresponding to a survival deficit of 5.8 months (95% CI: 3.7-7.7). Similar results were observed in sensitivity analyses restricted to surgical intervention studies (HR: 1.18; 95% CI: 1.10-1.27). Female sex was also associated with significantly increased major adverse cardiovascular events (n = 2,775) (HR: 1.37; 95% CI: 1.11-1.70; DELTA restricted mean survival time: 8.5 months, 95% CI: 2.4-14.5). Age, >= moderate tricuspid regurgitation (TR), and concomitant tricuspid valve repair (TVr) emerged as significant moderators of sex differences in mortality after intervention for PMR (P < 0.001, P = 0.03, and P < 0.001, respectively). A greater proportion of >= moderate TR and TVr in women conferred increased mortality relative to men. Neither left ventricular nor left atrial parameters significantly moderated sex differences in all-cause mortality (all P > 0.05). Conclusion(s): At the time of PMR intervention, women are older, have more symptoms, and worse long-term outcomes compared with men. Older female age alongside higher prevalence of >= moderate TR and TVr explained a significant proportion of this heterogeneity in sex-related all-cause mortality, whereas differences in left ventricular and left atrial parameters had no significant influence. A careful appraisal of current guidelines to ensure equality of health care outcomes between sexes is warranted. Copyright © 2026 The Authors <78> Accession Number 2047661945 Title Sex Differences in the Effects of Perioperative Rehabilitation on Postoperative Pulmonary Complications After Cardiac Valve Surgery: A Prespecified Subgroup Analysis of the PORT Randomized Trial. Source International Journal of Women's Health. 18 (no pagination), 2026. Article Number: 576395. Date of Publication: 2026. Author Tan S.; Liu Z.; Cai X.; Bai B.; Jiang Z.; Zhang S.; Chen X.; Xu J.; Zhang G.; Guo L.; Ge Q.; Ma H. Institution (Tan, Liu, Cai, Bai, Jiang, Zhang, Chen, Zhang, Guo, Ma) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, Guangzhou, China (Tan, Liu, Cai, Zhang, Chen, Zhang, Guo, Ge, Ma) Department of Intensive Care Medicine, Peking University Third Hospital, Beijing, China (Xu) Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, Guangzhou, China (Xu) School of Medicine, South China University of Technology, Guangdong, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Purpose: To evaluate whether biological sex modifies the association between perioperative rehabilitation and short-term postoperative pulmonary outcomes in patients undergoing cardiac valve surgery. Patients and Methods: This prespecified subgroup analysis was based on the PORT randomized controlled trial, a single-center prospective study including 818 adults undergoing elective valve surgery. Patients were randomized to usual care or additional perioperative rehabilitation. Usual care followed standard institutional protocols without structured therapist-led rehabilitation. The intervention group received a supervised program including patient education, inspiratory muscle training, active cycle of breathing techniques, and early mobilization from admission to discharge. The primary endpoint was a composite of in-hospital mortality, postoperative pulmonary complications (PPCs), and prolonged hospitalization (>7 days). Key secondary endpoints were radiologically confirmed pneumonia and pneumothorax within 7 days and before discharge. Sex-stratified multivariable Cox models were used to estimate adjusted hazard ratios (HRs), adjusting for age, body mass index, left ventricular ejection fraction category, Global Initiative for Chronic Obstructive Lung Disease category, hypertension, and smoking history. Result(s): Perioperative rehabilitation was not associated with a significant reduction in the primary composite outcome in either sex. Among female patients, it was associated with lower risks of PPCs (adjusted HR 0.55, 95% CI 0.36-0.83; P = 0.005) and pneumonia (adjusted HR 0.48, 95% CI 0.33-0.70; P < 0.001), with a lower risk of pneumothorax also observed (adjusted HR 0.40, 95% CI 0.17-0.99; P = 0.047). No significant associations were observed in male patients. A significant sex-by-treatment interaction was identified for pneumonia (P for interaction = 0.041). Conclusion(s): Perioperative rehabilitation was associated with improved short-term pulmonary outcomes in female patients, particularly for pneumonia, whereas no significant benefit was observed in males. These findings suggest a potential sex-specific response, which requires confirmation in future multicenter studies. Copyright © 2026 Tan et al. <79> Accession Number 2047691194 Title Optimizing TAVI strategy: balancing predilatation benefits and direct implantation efficiency. Source Future Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Abdalwahab A.; Ibrahem A.; Farag M. Institution (Abdalwahab, Farag) Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (Abdalwahab) Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt (Ibrahem, Farag) School of Health, Medicine and Life Sciences, University of Hertfordshire, Hertfordshire, United Kingdom Publisher Taylor and Francis Ltd. Abstract Balloon aortic valvuloplasty (BAV) has historically been considered an integral step during transcatheter aortic valve implantation (TAVI), facilitating valve crossing and expansion, particularly in early-generation devices. However, advances in valve technology, delivery systems, and imaging have prompted a shift toward direct TAVI without routine predilatation. Contemporary evidence from randomized trials, large registries, and meta-analyses demonstrates that direct TAVI is feasible and safe in anatomically favorable cases, with comparable device success and early clinical outcomes to BAV-assisted implantation. Nonetheless, predilatation remains valuable in selected patients with complex anatomy, including severe leaflet calcification, high transvalvular gradients, bicuspid morphology, horizontal aorta, or challenging valve crossing. Predilatation may further improve procedural control, optimize valve expansion, and reduce residual paravalvular leakage, particularly with self-expandable valves and platforms with lower intrinsic opening force. Conversely, routine BAV may increase procedural complexity, radiation and contrast exposure, and embolic risk. Overall, current evidence supports a selective, anatomy-driven approach to predilatation, balancing procedural efficiency with optimal valve deployment and safety. This review critically examines the evolving role of BAV in contemporary TAVI practice. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <80> Accession Number 2047693966 Title Intracardiac Echocardiography-Guided Left Atrial Appendage Occlusion: A Comprehensive Narrative Review. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Gahona C.T.; Vempati R.; Ha Q.D.; Mohammed F.; Shah V.; Alla S.S.M.; Manickavelan H.V.; Bhatt P.; Sanusi M.; Umashankar D.; Jiwani S.; Ghannam M.; Reddy Y.M. Institution (Gahona, Mohammed) Cardiology Department, Trinity Health Oakland Hospital, Pontiac, MI, United States (Vempati, Ha, Alla, Manickavelan, Bhatt, Sanusi, Umashankar) Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI, United States (Shah) Internal Medicine, Smt. N.H.L. Municipal Medical College, Ahmedabad, India (Jiwani, Ghannam) Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, United States (Reddy) Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, United States Publisher John Wiley and Sons Inc Abstract Intracardiac echocardiography (ICE) is an alternative to transesophageal echocardiography for imaging guidance during left atrial appendage occlusion (LAAO) in patients with atrial fibrillation with intolerance to long-term oral anticoagulation. This narrative review synthesizes contemporary evidence on ICE-guided LAAO. Across observational studies, ICE provides real-time high-resolution imaging enabling accurate trans-septal puncture, device sizing, and deployment under conscious sedation. Procedural success, peri-device leak, and device-related thrombus rates appear comparable between ICE- and TEE-guided LAAO, while ICE may also shorten fluoroscopy time and avoid general anesthesia. Challenges with ICE include operator learning curve, need for additional venous access and intracardiac catheter manipulation, that may add to risks like pericardial effusions, vascular complications and higher costs. Emerging 3D/4D ICE and artificial-intelligence-integrated computed tomographic planning may improve efficiency and allow for combined ablation and LAAO procedures. Further randomized controlled trials and cost-effectiveness studies are needed to define the role of ICE-first approach. Copyright © 2026 Wiley Periodicals LLC. <81> Accession Number 2047722043 Title Long-term valve durability and clinical outcomes after transcatheter versus surgical aortic valve replacement in low-risk patients: a systematic review and meta-analysis of randomized trials. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author Ramamoorthy L.; Otmani F.; Gupta A.; George L.R.; Khanuja P.K.; Galadima H.S.; Lee D.S.; Skef S.; Al Khatib B.; B M.R.; Vapheas E.; Khawar M.; Khawar M.M.H. Institution (Ramamoorthy) University of Arizona College of Medicine Phoenix, Phoenix, AZ, United States (Otmani) First Community Health and Care, Surrey, Redhill, United Kingdom (Gupta) Department of Medicine, DMC Sinai Grace Hospital, Detroit, United States (George) Azeezia Institute of Medical Sciences and Research Institute, Kollam, India (Khanuja) Univeristy of North Carolina at Chapel Hill, Chapel Hill, NC, United States (Galadima) School of Medicine, New Vision University, Tbilisi, Georgia (Lee) Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain (Skef) Alfaisal University, Riyadh, Saudi Arabia (Al Khatib) Central Michigan University, Saginaw, United States (B) JSS Medical College, Mysore, India (Vapheas) St. Georges University School of Medicine, St. Georges, Grenada (Khawar) King Edward Medical University, Lahore, Pakistan (Khawar) Services Institute of Medical Sciences, Lahore, Pakistan Publisher Springer Abstract Transcatheter aortic valve replacement (TAVR) has extended its use to low-surgical-risk populations, yet long-term comparative data against surgical aortic valve replacement (SAVR) are still limited, particularly concerning durability and the need for reintervention. We conducted a search of PubMed/MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov through March 2026 for randomized trials comparing TAVR with SAVR in patients with low surgical risk and severe aortic stenosis, specifically those with at least three years of follow-up. Outcomes were pooled as risk ratios (RR) using Mantel-Haenszel random-effects models, and durability and mortality outcomes were analyzed as time-to-event hazard ratios (HR) to accommodate different follow-up durations. Prespecified subgroup analyses by valve platform were performed. Four trials involving 3,014 patients (follow-up ranging from 3 to 10 years) were included. Cardiovascular mortality (HR 1.11, 95% CI 0.86-1.42; P = 0.43) and all-cause stroke (HR 1.09, 95% CI 0.73-1.64; P = 0.67) did not differ significantly between TAVR and SAVR. Aortic valve reintervention was higher with TAVR in risk-ratio analysis (RR 1.58, 95% CI 1.16-2.16) but did not reach statistical significance in the prespecified time-to-event analysis (HR 1.29, 95% CI 0.81-2.05). The excess reintervention risk was confined to the self-expanding valve platform. Permanent pacemaker implantation was significantly more frequent after TAVR (RR 2.08, 95% CI 1.48-2.93; P < 0.0001), with a significant interaction by valve platform (self-expanding RR 2.57 vs balloon-expandable RR 1.40; P = 0.02 for interaction). Bioprosthetic valve failure showed a nonsignificant trend favoring TAVR (HR 0.80, 95% CI 0.54-1.17). The only available 10-year randomized data (NOTION trial) showed significantly less severe structural valve deterioration with TAVR than with SAVR. The results suggest that TAVR and SAVR are equivalent in terms of cardiovascular mortality and stroke outcomes. However, pacemaker implantation rates were higher with TAVR and were strongly dependent on the valve platform used. The observed excess in reinterventions was confined to self-expanding valves and did not show robust support in the time-to-event analysis. The unique 10-year data from the self-expanding platform indicate less severe structural valve deterioration compared to SAVR, suggesting that durability should not be generalized across different device families. These findings advocate for individualized, platform-aware decision-making in clinical practice. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <82> Accession Number 2047743893 Title Tailoring cardioplegia delivery circuits with modular heart-lung machines: A narrative review. Source JRSM Cardiovascular Disease. 15 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author El Dsouki Y.; Aydin S.; Alanazi H.A.M.; El Koraychi Z.; Thalapathy G.; Condello I. Institution (El Dsouki) Maastricht University Medical Centre MUMC, Maastricht, Netherlands (El Dsouki) Cardiovascular Research Centre Maastricht CARIM, Maastricht, Netherlands (Aydin) Department of Perfusion, Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkey (Alanazi) King Fahad Medical City, Riyadh, Saudi Arabia (El Koraychi) C.I.R - Cura In Rete SRL, Torino, Italy (Thalapathy) Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates (Condello) School of Medicine and Surgery, University of Insubria, Varese, Italy Publisher SAGE Publications Ltd Abstract Background: Cardioplegia remains a cornerstone of myocardial protection during cardiac surgery; however, the configuration of its delivery circuit, particularly priming volume and blood-synthetic surface area, can exert a measurable influence on patient outcomes. Oversized or non-tailored circuits inherently increase hemodilution, inflammatory activation, and coagulation disturbances, effects that are especially pronounced in neonates and small children, whose circulating blood volume is limited. Advances in modular heart-lung machine (HLM) technology have introduced the possibility of tailoring cardioplegia circuits to patient size and procedural requirements, aligning mechanical design with physiological principles. Material(s) and Method(s): A narrative review was conducted using PubMed, Scopus, and Google Scholar for studies published between January 1976 and July 2025. Search terms included "cardioplegia," "myocardial protection," "cardioplegia circuit," "priming volume," "modular heart-lung machine," "microplegia," "del Nido cardioplegia," and related keywords. The search identified 286 records; after duplicate removal and eligibility screening, 22 studies were included in the final qualitative synthesis. Evidence was analyzed according to four domains: priming volume and blood conservation, contact surface area and inflammation, modularity and circuit customization, and physiological implications of delivery strategy. Result(s): Cardioplegia delivery circuit design appears to be a clinically relevant but underrecognized component of myocardial protection. Modular HLM platforms provide a practical approach to reduce circuit complexity and adapt extracorporeal circulation to individual patient requirements. Further prospective multicenter studies are needed to define the impact of modular cardioplegia circuits on clinical outcomes. Conclusion(s): Modular HLM technology provides a flexible and physiologically grounded platform for tailoring cardioplegia delivery to individual patient profiles. Standardizing weight-banded modular configurations and implementing routine monitoring of priming volume-to-weight ratios could improve consistency in practice and serve as a foundation for prospective studies. The cumulative evidence suggests that extending modular principles to the cardioplegia circuit represents an underutilized but promising opportunity to enhance both pediatric and adult cardiac surgical outcomes. Copyright © The Author(s) 2026 <83> Accession Number 2047865156 Title Changes in Free and Total Remimazolam Concentrations During Cardiopulmonary Bypass: A Randomized Dose-Comparison Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Ohno S.; Yoshikawa Y.; Kurihara D.; Sato Y.; Kunigo T.; Takahashi K.; Sato T.; Hirahata T.; Maeda M.; Negishi K.; Ikeshima Y.; Ishida M.; Shimizu H.; Hayashi M.; Takasaki Y.; Chaki T.; Aoyama T.; Toda T.; Yamakage M. Institution (Ohno, Yoshikawa, Sato, Kunigo, Takahashi, Sato, Hirahata, Maeda, Negishi, Ikeshima, Chaki, Yamakage) Department of Anesthesiology, Sapporo Medical University School of Medicine, Hokkaido, Sapporo, Japan (Kurihara, Ishida, Shimizu, Hayashi, Takasaki, Aoyama, Toda) Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Sapporo, Japan Publisher W.B. Saunders Abstract Objectives: Remimazolam is increasingly used in cardiac surgery for hemodynamic stability; however, during cardiopulmonary bypass (CPB), hemodilution and hypoalbuminemia may increase its pharmacologically active free fraction, raising concern about unrecognized overexposure under constant infusion. Yet, the temporal profile of free remimazolam during CPB has not been fully elucidated. We investigated whether a pragmatic dose adjustment could maintain free remimazolam concentrations within a stable range. Design(s): Randomized, controlled, parallel-group trial. Setting(s): A university hospital. Participant(s): Thirty-six adults undergoing cardiac surgery with CPB. Intervention(s): Patients were assigned to a normal-dose group (1 mg/kg/h) or a low-dose group in which the infusion rate of remimazolam was reduced to 70% at CPB initiation (0.7 mg/kg/h). Measurements and Main Results: The primary outcome was free remimazolam concentration. Secondary outcomes included total remimazolam concentration, protein binding, and associations between bispectral index values and drug concentrations. Baseline-adjusted analysis of free remimazolam concentrations showed a significant time-by-group interaction (p<inf>interaction</inf> = 0.001), increasing over time in the normal-dose group but remaining stable in the low-dose group. The largest adjusted between-group difference was observed 30 minutes after CPB termination (mean difference [95% CI], 89 [58-120] ng/mL; p < 0.001). No linear association was observed between bispectral index values and free or total remimazolam concentrations. Conclusion(s): During CPB, free remimazolam concentrations increased over time under constant infusion without corresponding changes in bispectral index values, whereas reducing the infusion rate to 70% at CPB initiation maintained free remimazolam concentrations within a stable range. Copyright © 2026 Elsevier Inc. <84> Accession Number 2047743379 Title Transcatheter management of cardiogenic shock in severe aortic stenosis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1803093. Date of Publication: 29 Apr 2026. Author Di Muro F.M.; Sarto G.; Raona V.; Oliva A.; Chiarito M.; Silverio A.; Sciarretta S.; Attisano T.; Vecchione C.; Galasso G. Institution (Di Muro, Silverio, Attisano, Vecchione, Galasso) Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy (Di Muro, Silverio) Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Largo Citta di Ippocrate, Salerno, Italy (Sarto, Sciarretta) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Sarto) Department of Cardiology, ICOT Istituto Marco Pasquali, Latina, Italy (Raona, Oliva, Chiarito) Department of Biomedical Sciences, Humanitas University, Milan, Italy (Oliva) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Sciarretta, Vecchione) Department of Cardiology, IRCCS NeuroMed, Pozzilli, Italy Publisher Frontiers Media SA Abstract Management of cardiogenic shock (CS) in the setting of severe aortic stenosis (AS) remains clinically challenging, owing to the coexistence of fixed valvular obstruction, limited myocardial reserve, and rapidly evolving end-organ hypoperfusion. In this context, early identification of patients unlikely to recover with medical therapy alone and timely transition to definitive valve intervention are critical determinants of outcome. Despite growing clinical experience, decision-making in this setting remains heterogeneous and largely informed by observational evidence. Herein, in the present review, we synthesize contemporary evidence on transcatheter strategies for AS-related CS, with emphasis on clinical decision-making during the acute phase. A physiology-driven approach to early assessment and hemodynamic stabilization is outlined, integrating echocardiography, invasive monitoring, and tailored pharmacologic support to inform escalation pathways. Mechanical circulatory support (MCS) is discussed as a selective, time-limited strategy to achieve stabilization and facilitate procedural planning, while accounting for the unique physiological limitations imposed by fixed valvular obstruction. Available data on balloon aortic valvuloplasty and urgent or emergent transcatheter aortic valve implantation (TAVI) are examined with respect to procedural feasibility, early outcomes, and their positioning within bridging or definitive treatment pathways in CS. Collectively, this work proposes a pathway-oriented framework for AS-related CS that prioritizes early recognition, coordinated multidisciplinary decision-making, and timely progression to definitive valve intervention, tailored to patient risk profile and institutional expertise. Copyright © 2026 Di Muro, Sarto, Raona, Oliva, Chiarito, Silverio, Sciarretta, Attisano, Vecchione and Galasso. <85> Accession Number 2047718307 Title Right Heart Dysfunction and Postoperative Renal Injury: Venous Congestion, Renal Perfusion Pressure, and Perioperative Implications. Source Current Anesthesiology Reports. 16(1) (no pagination), 2026. Article Number: 10. Date of Publication: 01 Dec 2026. Author Siegman A.; Sidhu P.S.; Li D. Institution (Siegman, Sidhu, Li) Department of Anesthesiology and Pain Medicine, UC Davis Health, Patient Support Services Building 4150 V St, Sacramento, CA, United States Publisher Springer Abstract Purpose of Review: Postoperative acute kidney injury (AKI) remains a leading cause of morbidity after cardiac surgery. This review examines right ventricular (RV) dysfunction and systemic venous congestion as primary, underrecognized mediators of perioperative renal injury, operating through mechanisms largely independent of arterial hypoperfusion. Recent Findings: Human hemodynamic studies consistently demonstrate that central venous pressure is a stronger predictor of renal impairment than cardiac index across cardiovascular disease populations. Intraoperative venous congestion independently predicts postoperative AKI in cardiac surgery, and dynamic intraoperative deterioration of RV function is among the strongest predictors of cardiac surgery-associated AKI identified to date. Elevated renal venous pressure erodes the renal perfusion pressure gradient, producing congestive nephropathy - a potentially reversible renal dysfunction phenotype distinct from ischemic injury. Summary: RV dysfunction and venous congestion should be recognized as primary mediators of perioperative AKI. Postoperative oliguria with elevated venous pressure warrants decongestion rather than fluid administration. Preoperative RV assessment, intraoperative CVP surveillance, and bedside venous congestion phenotyping using tools such as Venous Excess Ultrasound represent practical and immediately applicable perioperative strategies. Copyright © The Author(s) 2026. <86> Accession Number 2047545947 Title Intermittent Bolus versus Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions:A Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Forrest P.B.; Guerra-Londono C.E.; Nowak K.; Meadows A.; Dexter F. Institution (Forrest, Guerra-Londono, Nowak, Meadows) Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Health, Detroit, MI, United States (Dexter) Department of Anesthesia, University of Iowa, Iowa City, IA, United States Publisher W.B. Saunders Abstract Objective: To compare the analgesic efficacy of programmed intermittent boluses (PIB) and continuous infusion via indwelling erector spinae plane (ESP) catheters following open heart surgery. It was hypothesized that the use of PIB would result in superior analgesia compared to continuous infusion of local anesthetics through ESP catheters after cardiac surgery. Design(s): An Institutional Review Board-approved parallel-group, prospective, randomized, double-blind trial. Setting(s): A large academic hospital in the midwestern United States. Participant(s): Adults undergoing open heart surgery via midline sternotomy and scheduled ESP analgesia with bilateral indwelling catheters. Intervention(s): Continuous infusion versus PIB of ropivacaine 0.2% via an electronic infusion pump. Measurements and Main Results: The primary outcome was postoperative opioid consumption in oral morphine milligram equivalents (OMME) through 72 hours. The secondary outcomes included postoperative pain intensity on a numerical rating scale, length of stay, quality of recovery (QoR-15), time to first bowel movement, and antiemetic use. A total of 240 participants were randomized at a 1:1 ratio to PIB or continuous infusion. The PIB group had an estimated 1.08-fold greater OMME than the continuous infusion group (95% confidence interval [CI], 0.90-1.31; p = 0.40). The mean difference was 4.1 OMME greater per day for the PIB group (95% CI, -5.6 to +13.8 mg; p = 0.41). There were no statistically significant differences in secondary outcomes between the 2 groups. Conclusion(s): In adults undergoing open heart surgery, ESP catheter-based analgesia via PIB did not significantly reduce early postoperative opioid consumption compared to a continuous infusion method. Copyright © 2026 The Authors <87> Accession Number 651738605 Title IMPACT OF ANTICOAGULANT THERAPY ON CEREBROVASCULAR EVENTS AND IN-HOSPITAL MORTALITY IN LEFT-SIDED INFECTIVE ENDOCARDITIS WITH NATIVE AND PROSTHETIC VALVES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Dewi K.A.C.; Sanjaya S.P. Institution (Dewi, Sanjaya) Udayana University, Indonesia Publisher Indonesian Heart Association Abstract Background: Anticoagulant therapy (ACT) in infective endocarditis (IE) has been a controversial issue, as it poses a significant risk of bleeding while also being crucial for preventing thromboembolic events due to mobile vegetations on heart valves. Existing guidelines suggest considering ACT case by case basis with pre-existing indications. This study aims to investigate cerebrovascular events (CVE) and in-hospital mortality in patients with left-sided IE, comparing those with ACT during their treatment course to those without. Method(s): A systematic literature search according to PRISMA guideline was conducted using four databases (PubMed, ScienceDirect, ProQuest, and Wiley's Library) for relevant studies. Primary outcome is reported CVE including cerebral hemorrhagic stroke, cerebral ischemic stroke, cerebral infection, and brain infarct. Secondary outcome is in-hospital mortality. All eligible studies were quality assessed using New-Castle Ottawa Scale (NOS). Meta-analysis was done using the Review Manager version 5.4. Result(s): We included five cohort studies involving a total of 1,204 patients with a mean age of 58.5 years in our analysis. All studies met high-quality assessment, with the majority utilizing in-hospital data. Native valve endocarditis (NVE) accounted for 86.5% of cases, predominantly affecting the mitral valves (56%). In our primary outcome, patients with left-sided IE who were treated with anticoagulants showed significantly lower rates of CVE compared to those without anticoagulants (OR: 0.51; 95% CI: 0.35-0.75; p = 0.0006, I2 = 49%, p-heterogeneity = 0.10). There was no significant difference in in-hospital mortality between patients with anticoagulants and those without (OR: 0.95; 95% CI: 0.58-1.56; p = 0.84, I2 = 15%, p-heterogeneity = 0.32). Conclusion(s): ACT was associated with lower frequency of CVE in left sided-IE patients involving native or prosthetic valves. Additionally, ACT was not associated with increased in-hospital mortality. These findings indicate that ACT could potentially benefit in lowering CVE in left-sided IE patients without impacting short-term mortality rates. Thus provide a reasonable approach for physicians in weighing benefits and risks of ACT in left-sided IE carefully. Further research is needed to confirm these findings and investigate long-term outcomes. <88> Accession Number 651738712 Title COMPARATIVE OUTCOMES OF MILRINONE VERSUS DOBUTAMINE IN CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW, META-ANALYSIS, AND META-REGRESSION OF RANDOMIZED CONTROLLED TRIALS AND OBSERVATIONAL STUDIES. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Ivan I.; Tanumihardja C.A.; Winata V.; Budiman F.; Juzar D.A. Institution (Ivan, Budiman) RSD Kalabahi, Alor, East Nusa Tenggara, Indonesia (Tanumihardja, Winata) RSD Kalabahi, Alor, East Nusa Tenggara, Indonesia (Juzar) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia Publisher Indonesian Heart Association Abstract Background: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) are severe complications from acute myocardial infarction (AMI), acute decompensated heart failure (ADHF), or cardiac surgery. Previous reviews have shown lower mortality with Milrinone compared to Dobutamine, but they did not consider clinical variations in their analyses. We aim to compare outcomes between Milrinone and Dobutamine in CS and LCOS. Method(s): We followed PRISMA 2020 guidelines and searched across 8 databases. We included observational and randomized trials published from inception to July 9, 2024, comparing Milrinone and Dobutamine in CS or LCOS. Outcomes include all-cause mortality and ICU length of stay (LOS). Meta-analyses and meta-regression were performed to evaluate the effects of age, sex, baseline mean arterial pressure (MAP), maximum doses of Milrinone and Dobutamine used, ejection fraction (EF), comorbidities (ischemic HF, coronary artery disease-CAD, renal failure, hypertension, diabetes, atrial fibrillation, stroke), precipitating factors (MI, ADHF, cardiac surgery), and follow-up duration. Study quality was assessed using the Newcastle-Ottawa Scale. Result(s): Our study included thirteen cohorts and two randomized trials, comprising 25,628 patients (28.18% received Milrinone). Average age ranged from 58 to 73 years. Follow-up duration varied based on hospital stay, and up to 1 year. There was a significant reduction in all-cause mortality among the Milrinone group (RR=0.78, 95%CI:0.66-0.92, p=0.004; I2=81%). There was no significant difference related to ICU LOS between groups (MD=0.33, 95%CI:-0.47-1.14, p=0.42; I2=79%). Older age, comorbidity such as CAD, and precipitating factor such as AMI were associated with smaller reduction in all-cause mortality in the Milrinone group (p=0.0484,p=0.0323,p=0.0271, respectively). Sex, baseline MAP, maximum doses of Milrinone and Dobutamine used, EF, comorbidities (ischemic HF, renal failure, hypertension, diabetes, atrial fibrillation, stroke), precipitating factors (ADHF, cardiac surgery), and follow-up duration did not influence mortality risk among patients receiving Milrinone (All p>0.05). Conclusion(s): Our study found a lower risk of all-cause mortality among CS and LCOS patients treated with Milrinone compared to Dobutamine. However, we observed a diminished treatment benefit specifically in patients with coexisting CAD or those who developed CS due to AMI. Therefore, we recommend that future studies focus on addressing this treatment disparity within this particular patient group. <89> Accession Number 651738981 Title PROGNOSTIC VALUE OF LATE GADOLINIUM ENHANCEMENT ON CARDIAC MAGNETIC RESONANCE IN PATIENTS WITH PERIPARTUM CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Nurhafizah A.; Huang W.; Kezia C.; Fathoni M.I. Institution (Nurhafizah, Huang, Kezia, Fathoni) Faculty of Medicine, University of Padjadjaran, Indonesia Publisher Indonesian Heart Association Abstract Background: Peripartum cardiomyopathy (PPCM) is a potentially life-threatening condition that occurs during the peripartum period. Late Gadolinium enhancement (LGE) by Cardiac Magnetic Resonance (CMR) can detect myocardial tissue damage specifically attributable to PPCM patients with worse prognosis associated with non-recovery. This review aims to explore the prognostic value of LGE by CMR in patients with PPCM. Method(s): A systematic review was conducted from PubMed, Science Direct, and Cochrane Library databases to include studies that evaluate the association of LGE parameters with clinical outcomes in PPCM patients. Composite endpoints of poor outcomes (persistently reduced LVEF, left ventricular assisted device implantation, heart transplantation, and all-cause mortality) were calculated as pooled hazard ratios using a generic inverse variance random effect model. Heterogeneity and publication bias were assessed with I2 and funnel plot respectively. Result(s): A total of 8 cohort studies, with a low to medium risk of bias, comprising 227 patients, were included. The mean age of patients was 32.4 years with the majority of patients were in NYHA class III. Diagnosis of PPCM was made during the postpartum period in 74.83% of patients. The prevalence of preeclampsia, gestational hypertension, and hypertension in the study population were 11.23%, 6.41%, and 18.71% respectively. The mean LVEF was 30.5% and the mean SBP was 108 mmHg. Compared to PPCM patients without LGE, PPCM patients with LGE were significantly associated with a 34% increased risk of poor outcomes (HR 1.34, CI 1.04-1.73, I2 = 52%, p = 0.02). The risk of persistently reduced LVEF in patients with LGE was not significantly different (HR 1.11, CI 0.85-1.45, I2 = 14%, p = 0.45) but LGE presence was significantly associated with composite outcome other than persistently reduced LVEF (HR 2.05, CI 1.04-4.02, I2 = 56%, p = 0.04). Exclusion of study with preeclamptic population >50% resulted in a non-significant association with poor outcomes (p = 0.05). No publication bias was found based on funnel plot assessment. Conclusion(s): In patients with peripartum cardiomyopathy, LGE presence in CMR imaging is significantly associated with poor outcome. Hence, long-term monitoring would be necessary to evaluate these patients (Figure Presented). <90> Accession Number 651738914 Title FACTORS ASSOCIATED WITH FFR/IFR DISCORDANCE IN CORONARY ARTERY DISEASE PATIENTS: A META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Dirjayanto V.J.; Amirah S.; Yumnanisha D.A.; Sarayar A.M.; Adiarto S. Institution (Dirjayanto, Amirah, Yumnanisha) Faculty of Medicine, Universitas Indonesia, Indonesia (Sarayar) Kramat Jati Regional Hospital, Indonesia (Adiarto) Harapan Kita National Cardiovascular Referral Center, Jakarta, Indonesia Publisher Indonesian Heart Association Abstract Background: Identification of functionally significant stenosis by invasive physiological assessments such as FFR and iFR have been proven to benefit coronary revascularization. However, FFR/iFR discordance occurs in 20% of cases, making decisions for revascularization dubious. Identifying factors associated with FFR/iFR discordance and understanding the mechanism is important in guiding treatment decision. Objective(s): To identify factors associated with FFR/iFR discordance. Method(s): Following the PRISMA statement, we searched 7 databases for studies reporting predictors of FFR/iFR discordance. We pooled proportions using random-effects meta-analysis in R software (version 4.1.3) and mean differences using inverse variance, random-effects model in Review Manager (version 5.4). Quality assessment was performed using the Newcastle-Ottawa Scale. Result(s): Our search yielded 16 studies with 5,742 patients. There were large pooled proportions of discordant patients who had dyslipidemia (FFR-/iFR+:0.74[95%CI:0.66-0.82];I2=68%, FFR+/iFR-:0.75[95%CI:0.65- 0.85];I2=84%) and lesion in left anterior descending (LAD) artery (FFR-/iFR+:0.81[95%CI:0.74-0.89];I2=45%, FFR+/iFR-:0.71[95%CI:0.59-0.83];I2=75%); small proportions were found for females (FFR-/iFR+:0.30[95%CI:0.20-0.40];I2=88%, FFR+/iFR-:0.17[95%CI:0.12-0.21];I2=40%), smokers (FFR-/iFR+:0.28[95%CI:0.10-0.47];I2=97%, FFR+/iFR-:0.25 [95%CI: 0.14-0.36];I2=83%), chronic kidney disease (CKD) (FFR/iFR+:0.13[95% CI:0.02-0.25];I2=75%, FFR+/iFR-:0.09[95%CI:0.00-0.20];I2=80%), previous infarction (FFR+/iFR-:0.12[95%CI:0.06-0.18];I2=38%, FFR-/iFR+:0.15[95%CI:0.07-0.24];I2=63%), and family history of coronary artery disease (CAD) (FFR-/iFR+:0.19[95%CI:0.12-0.27];I2=0%, FFR+/iFR-:0.20[95%CI:0.12-0.28];I2=24%). Older age was associated with FFR-/iFR+ discordance (MD:2.05[95%CI:0.28-3.81];P=0.02;I2=52%). Meanwhile, for FFR+/iFR- discordance, lesion length was significantly longer (MD:2.02[95%CI:0.45-3.59];P=0.010;I2=44%). Conclusion(s): Large proportions of discordant patients had dyslipidemia and lesions in LAD. Meanwhile, the percentages of females, smokers, those who had CKD, previous infarction, and family history of CAD were small. FFR-/iFR+ discordance was associated with older age; FFR+/iFR- discordance was associated with younger age and increased lesion length. <91> Accession Number 651749593 Title Anticoagulant regimen for non-valvular atrial fibrillation in the elderly and frail population. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 14 Jul 2026. Author Scalia L.; Gatto L.; Agnello F.; Calderone D.; Celeski M.; Rubbio A.P.; Prati F.; Testa L.; Capodanno D.; Barbanti M. Institution (Scalia) Department of Cardiology, Umberto I Hospital, Enna, Italy (Gatto, Prati) Cardiovascular Department, San Giovanni Addolorata Hospital, Rome, Italy; Department of Cardiovascular Sciences, UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy (Agnello, Barbanti) Department of Cardiology, Umberto I Hospital, Enna, Italy; Faculty of Medicine and Surgery, University of Enna "Kore", Enna, Italy (Calderone) Invasive Cardiology, Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy (Celeski) Department of Cardiology, Fabrizio Spaziani Hospital, Frosinone, Italy (Rubbio, Testa) Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy (Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco" University of Catania, Catania, Italy Abstract Anticoagulant therapy is the cornerstone of stroke prevention in atrial fibrillation (AF), yet its management in elderly and frail patients remains particularly challenging. This review aims to summarize current evidence, guideline recommendations, and future perspectives regarding the optimal anticoagulant strategy in this vulnerable population. Main findings A narrative review of pivotal randomized clinical trials and major real-world registries was conducted, focusing on outcomes of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients aged >=75 years or meeting frailty criteria. Across studies, DOACs consistently demonstrated similar or superior efficacy compared with VKAs for the prevention of stroke and systemic embolism, with a substantially lower risk of intracranial hemorrhage. Apixaban and edoxaban, particularly at adjusted doses, showed the most favorable balance between thromboembolic protection and bleeding risk. Conversely, switching stable elderly patients from long-term VKAs to DOACs, as in the FRAIL-AF trial, was associated with an early excess of clinically relevant non-major bleeding. Frailty, multimorbidity, renal impairment, and polypharmacy remain critical modifiers of both efficacy and safety, underlining the need for individualized dosing and regular renal function monitoring. Recent European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) and the American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guidelines recommend DOACs as the preferred treatment for non-valvular AF, emphasizing comprehensive risk assessment and shared decision-making. Emerging agents, such as factor XI inhibitors, offer a promising approach to minimizing bleeding risk in the elderly, though confirmation of their efficacy against ischemic events remains to be fully established. Conclusions In elderly and frail patients with AF, DOACs represent the first-line anticoagulant therapy when appropriately dosed and monitored. A personalized, multidisciplinary approach incorporating frailty assessment, renal evaluation, and patient preference is essential to optimize outcomes. Future trials specifically enrolling very old and severely frail patients are urgently needed to close existing evidence gaps. Copyright © 2026. Published by Elsevier Inc. <92> Accession Number 651738851 Title DRUG COATED BALLOON AS TREATMENT OF CHOICE FOR DE NOVO CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Baravia P.A.; Subali A.D.; Qhabibi F.R.; Mayangsari V.; Tjahjono C.T. Institution (Baravia) Idaman General Hospital, Indonesia (Subali) Dr. Saiful Anwar General Hospital, Indonesia (Qhabibi) Dharma Yadnya General Hospital, Indonesia (Mayangsari, Tjahjono) Department of Cardiovascular Prevention and Rehabilitation, Dr Saiful Anwar General Hospital, Indonesia Publisher Indonesian Heart Association Abstract Background: Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is a common approach for coronary artery disease management. Nevertheless, the presence of permanent metal stents increases restenosis risk. Drug-coated balloons (DCBs) offer an alternative, delivering antiproliferative drugs directly to the vessel wall without leaving metal behind, aligning with the "leave nothing behind" strategy. At present, DCB is only taken into account when the risk of developing restenosis is high. DCBs have shown efficacy in treating in-stent restenosis and are endorsed by current myocardial revascularization guidelines. Whether the long-term safety and efficacy of DCBs will surpass that of the latest generation of drug-eluting stents in patients with de novo coronary lesions remains uncertain. This study aims to answer the uncertainity by comparing DCB performance on de novo lesions versus in-stent restenosis. Method(s): We performed a meta-analysis of randomized controlled trials by performing systematic search of studies comparing DCB clinical outcome in de novo and in-stent restenosis lesion using PubMed, Europe PMC, and ScienceDirect, reported until June 14, 2024. Result(s): Five studies met the inclusion criteria with a total of 7,302 patients. Pooled dichotomous data were analyzed using Odds Ratio (OR) and 95% confidence intervals (CI) via the Inverse Variance method. Over a 6-12 months period, DCB application on de novo lesions demonstrated significantly better clinical outcomes based on cardiac death (OR = 0.45; P = 0.67; 95% CI: 0.32 - 0.62), myocardial infarction (OR = 0.25; P = 0.45; 95% CI: 0.17 - 0.37), target lesion revascularization (TLR) (OR = 0.22; P = 0.09; 95% CI: 0.17 - 0.28) that conclude lower Major Adverse Cardiac Events (MACE) (OR = 0.27, 95% CI = 0.23 - 0.33). Conclusion(s): DCBs should not solely be considered an alternative for managing stent restenosis; they are also a viable treatment option for de novo coronary lesions. <93> Accession Number 2047555859 Title Efficacy of a small-volume blood culture diversion device across three wards: a 6-month retrospective review. Source Microbiology Spectrum. 14(7) (pp 1-11), 2026. Date of Publication: 09 Jun 2026. Author Dolin H.H.; Krupp A.M.; John A.R.; Cherian S.S.; Lewin G.R.; Saade E.A.; Ransom E.M. Institution (Dolin, Cherian, Ransom) Department of Pathology, University Hospitals Cleveland Health, Cleveland, OH, United States (Krupp, John, Saade) Department of Internal Medicine, University Hospitals Cleveland Health, Cleveland, OH, United States (Cherian, Lewin, Ransom) Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, United States (Lewin) Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, United States (Lewin) Case Western Reserve University, Cleveland VA Medical Center for Antimicrobial Resistance and Epidemiology, Cleveland, OH, United States Publisher American Society for Microbiology Abstract Blood culture contamination (BCC) is a challenging issue that can negatively impact patients and healthcare costs. The Clinical and Laboratory Standards Institute (CLSI) historically encouraged a BCC rate of <3%, although recent evidence suggests <1% is achievable. One approach to reducing BCC is initial specimen blood diversion devices (ISDDs). ISDDs prevent the initial blood, which may contain contaminating microorganisms, from inoculating the blood bottles. The ISDD literature remains limited, particularly for evaluating performance across different wards. Here, the Kurin Lock ISDD was evaluated in an emergency department (ED), cardiothoracic intensive care unit (CTICU), and medical intensive care unit (MICU). A comparison of 6 months pre- and post-implementation revealed a 35.3% BCC reduction overall (P = 0.016), with variation across wards: ED 41.0% (P = 0.043), CTICU 38.7% (P = 0.20), and MICU 20.3% (P = 0.61). Device compliance rates varied by ward: ED (62.5%), CTICU (32.2%), and MICU (35.4%). When post-implementation cultures were segregated by ISDD usage, the MICU BCC rate was 0.39% versus 3.02% without ISDD usage (P = 0.025). The ED and MICU also had multiple months below 1%. The CTICU did not have a month below 1% nor a significant BCC rate difference post-implementation with or without ISDD usage (2.52% and 3.19%, P > 0.99). Furthermore, an estimated $170,378 of contamination costs were avoided using a cost per contamination of $6,553 from a prior meta-analysis. Given our low ISDD compliance, contamination rates and financial savings can still be improved. Taken together, ISDDs are a promising approach to lower BCC rates and costs, although impact may vary by ward. Copyright © 2026 Dolin et al. <94> Accession Number 651744046 Title PERCUTANEOUS CORONARY INTERVENTION OR MINIMALLY INVASIVE CORONARY BYPASS FOR ISOLATED LEFT ANTERIOR DESCENDING ARTERY DISEASE. Source European Heart Journal, Supplement. Conference: 57th Congress of the Italian Association of Hospital Cardiologists, ANMCO 2026. Rimini Italy. 28(Supplement 6) (pp vi66), 2026. Date of Publication: 01 May 2026. Author Tuttolomondo D.; Francesco N.; Hernandez-Vaquero D.; Singh G.; Formica F. Institution (Tuttolomondo, Francesco, Hernandez-Vaquero, Singh, Formica) Azienda Ospedaliero Universitaria Di Parma; Hospital Universitario Central De Asturias; Mazankowski Alberta Heart Institute, University of Alberta; Presidio Ospedaliero Vito Fazzi Publisher Oxford University Press Abstract The optimal revascularization strategy for isolated left anterior descending (LAD) artery disease, minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI), remains a subject of debate. This updated meta-analysis aimed to compare the long-term outcomes of MIDCAB versus PCI for patients with isolated LAD artery disease. Three databases were systematically searched to identify randomized controlled trials (RCTs) and adjusted studies. Primary outcomes included long-term survival and repeat target vessel revascularization (TVR). The secondary endpoint was long-term major adverse cardiovascular events (MACEs). Hazards ratios (HR) and Confidence Intervals (CI) were calculated for long-term outcomes and a random effects model was used. Sensitivity analyses included subgroups analysis of stent-type. Nine articles, comprising 4 RCTs, totaling 2,168 patients (MIDCAB = 1,086 and PCI = 1,080) were included. The weighted mean follow-up was 4.35 +/- 4.9 years. Long-term survival was comparable between MIDCAB and PCI (HR = 0.76; 95% CI, 0.58 to 1.00; p = 0.05). MIDCAB was associated with a significantly lower rate of repeat TVR (HR = 0.35; 95% CI, 0.25 to 0.49; p <0.0001) and a reduced risk of MACEs (HR = 0.59; 95% CI, 0.43 to 0.81; p <0.0001), although the difference was not evident in subgroup analysis comparing MIDCAB and PCI with drug-eluting stent (HR = 0.66; 95% CI, 0.46 to 1.06; p = 0.09). In conclusion, this meta-analysis of RCTs and adjusted studies shows that in patients with isolated LAD lesion, MIDCAB and PCI exhibit comparable long-term survival. <95> Accession Number 651738972 Title PRESERVED FRACTIONAL FLOW RESERVE GUIDED PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED-CONTROL TRIALS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Rasyid I.; Qorina F.; Rostiati D.; Fathini F. Institution (Rasyid, Rostiati, Fathini) Hermina Arcamanik Hospitals, Indonesia (Qorina) Faculty of medicine, Universitas Indonesia, Indonesia Publisher Indonesian Heart Association Abstract Background: Despite the growing evidence, controversies persist among different studies regarding the efficacy and cost-effective impact of preserved fractional flow reserve (FFR) compared to conventional coronary angiography for guiding percutaneous coronary intervention in coronary artery disease patients. Method(s): This study was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Systematic literature searches were performed through PubMed, Scopus, Science Direct, and EBSCOHost from inception to July 6, 2024. Studies fulfilling pre-determined inclusion and exclusion criteria were qualitatively appraised using Joanna-Briggs Institute (JBI) Critical Appraisal Tools for Randomized-controlled Trials and quantitatively analysed using Review Manager version 5.4. Pooled estimates of outcomes are presented as Risk Ratio (RR) with 95% confidence interval. Result(s): The qualitative analysis includes seven published studies with a total of 308.755 patients. The FAME trial and other studies suggest that FFR-guided PCI can reduce patient costs by $675 and $5,931 respectively. Quantitative analysis was performed on six published RCTs. Patients who underwent FFR-guided PCI had significantly associated with a lower risk of cardiovascular death events (RR, 0.66; 95% CI, 0.52 - 0.83; p = 0.0004), major adverse cardiovascular events (RR, 0.75; 95% CI, 0.66 - 086; p = <0.0001), and repeat revascularisation events (RR, 0.76; 95% CI, 0.63 - 0.91; p = 0.003) compared to patients who underwent angiography coronary revascularisation. The length of hospital stay in days between the FFR-guided PCI and angiography group was not statistically significant (Mean Difference: -0.04; 95% CI: -0.19 - -0.11; p: 0.59). Further randomised controlled trials with larger sample sizes and cost-benefit analysis are recommended. Conclusion(s): Among patients with CAD, FFR-guided PCI reduces medical costs compared to non-FFR-guided procedures. Furthermore, FFR-guided PCI is associated with significantly lower risks of cardiovascular death, major adverse cardiovascular events, and repeat revascularization. <96> Accession Number 2038395023 Title TARGETED DRUG DELIVERY SYSTEMS IN SURGICAL ONCOLOGY AND CARDIOVASCULAR DISORDERS: EMERGING THERAPEUTIC STRATEGIES. Source Genetics and Molecular Research. 25(10s) (no pagination), 2026. Date of Publication: 07 Jul 2026. Author Marupudi L.; Al-Taai I.J.; Lim F.P.C. Institution (Marupudi) Department of Pharmacy Practice, Sri Venkateshwara College of Pharmacy; affiliated to Osmania University", India (Al-Taai) Department of Pharmacy, Ashur University, Iraq (Lim) American Management University, Charisma University, Turks and Caicos Islands, UT, United States Publisher Fundacao de Pesquisas Cientificas de Ribeirao Preto Abstract Conventional drug delivery systems often suffer from poor specificity, systemic toxicity, and limited therapeutic efficacy. The emergence of targeted drug delivery systems (TDDS), particularly those based on nanotechnology, has provided new opportunities to enhance treatment precision in complex diseases such as cancer and cardiovascular disorders. This review aims to comprehensively analyze the design, mechanisms, and applications of targeted drug delivery systems in surgical oncology and cardiovascular diseases, while highlighting recent advancements, clinical translation, and future directions. A narrative review of recent literature was conducted, focusing on nanotechnology-based delivery platforms, targeting strategies, and emerging therapeutic approaches relevant to oncology and cardiovascular medicine. Advanced drug delivery platforms, including polymeric nanoparticles, liposomes, dendrimers, hydrogels, and nucleic acid-based systems, demonstrated improved drug stability, bioavailability, and site-specific targeting. In oncology, targeted strategies such as ligand-receptor interactions, antibody-mediated delivery, and stimuli-responsive systems enhanced tumor specificity and reduced toxicity. In cardiovascular disorders, nanomedicine enabled targeted treatment of atherosclerosis, myocardial infarction, and inflammation. Emerging technologies, including AI-integrated design, theranostic nanoparticles, and personalized medicine approaches, further improved therapeutic precision. Targeted drug delivery systems represent a promising paradigm shift in modern therapeutics. Despite challenges related to toxicity, scalability, and regulatory approval, continued advancements and interdisciplinary integration are expected to drive their clinical translation and improve patient-specific treatment outcomes. Copyright © 2026, Fundacao de Pesquisas Cientificas de Ribeirao Preto. All rights reserved. <97> Accession Number 651738969 Title NEUTROPHIL-TO-LYMPHOCYTE RATIO AS A NOVEL BIOMARKERS IN PREDICTING IN-STENT RESTENOSIS FOLLOWING CORONARY AND NON-CORONARY STENT IMPLANTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Siahaan P.P.; Widiarti W.; Saputra P.B.T.; Christianto R.Y.; Gloria A.; Putranto J.N.E. Institution (Siahaan, Widiarti, Christianto) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Saputra) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Cardiovascular Research and Innovation Center, Universitas Airlangga, Indonesia (Gloria) Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia (Putranto) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Universitas Airlangga, Indonesia Publisher Indonesian Heart Association Abstract Background: The recurrence of stenosis due to atherosclerosis in stenting patients, known as in-stent restenosis (ISR), still harbors a massive disease burden. The inflammatory role of neutrophil and lymphocyte in atherosclerotic disease may show a great potential as a predictor. This meta-analysis were conducted to assess the capacity of NLR as predictor of ISR. Method(s): Comprehensive literature searching was conducted in PubMed, Scopus, Science Direct, Proquest, Cochrane on 10th June 2024. Observational studies evaluating NLR in stented patients were included. Random effect meta-analysis and linear regression model were used to investigate odds ratios (OR) as predictor and linear dose-response relationship of ISR. Sensitivity and specificity of NLR to predict this outcome were pooled and a summary receiver operating characteristics (sROC) curve was generated. Result(s): There were 3889 patients from 15 studies pooled. This study found that high NLR was associated with increased risk of ISR in coronary stenting [aOR = 1.61 (95%CI 1.14-2.25)] and non-coronary stenting [aOR=1.69 (95%CI 1.52-1.87)]. One unit increase of NLR is equal to 30% and 44% increased risk of ISR in subsequently coronary and non-coronary patients. Ten pooled studies showing NLR as a robust predictor of ISR with sensitivity and specificity of 70.5% (95%CI 60.1%-79.2%) and 74.1% (95%CI 56.7%-86.2%) for coronary stenting and 77.7% (95%CI 69.8%-84.0%) and 66.4% (95%CI 49.6%-79.8%) non-coronary stenting, with AUC of 0.77 (0.70-0.82) in the coronary and 0.79 (0.70-0.85) in the non-coronary sub-groups. Given the time since stent placement, the NLR is generally more effective at predicting early ISR [AUC of 0.78 (0.53-0.94) for coronary and 0.83 (0.71-0.87) for non-coronary stenting] than late ISR [AUC of 0.73 (0.64-0.80) for coronary and 0.68 (0.49-0.85) for non-coronary stenting] Conclusion(s): NLR has a great potential to predict ISR in coronary and non-coronary stent, and during the early ISR rather then late ISR in both different stenting placement. <98> Accession Number 651744483 Title ROLE OF GLP1 AGONIST AFTER TAVI: INSIGHTS FROM MOTIVE REGISTRY. Source European Heart Journal, Supplement. Conference: 57th Congress of the Italian Association of Hospital Cardiologists, ANMCO 2026. Rimini Italy. 28(Supplement 6) (pp vi26), 2026. Date of Publication: 01 May 2026. Author Ferrua Trucco M.; Giacobbe F.; Balducci M.; Nebiolo M.; Bruno F.; De Filippo O.; D'Ascenzo F.; Conrotto F.; Cimino G.; Carando L.; De Ferrari G. Institution (Ferrua Trucco, Giacobbe, Balducci, Nebiolo, Bruno, De Filippo, D'Ascenzo, Conrotto, Cimino, Carando, De Ferrari) Aou Citta Della Salute E Della Scienza Di Torino, Ospedale Molinette, Italy Publisher Oxford University Press Abstract Introduction: GLP-1a are a novel class of cardiometabolic drugs that have been shown to reduce the risk of MACE and cardiovascular mortality in patients with type 2 diabetes, overweight, or obesity. Improved outcomes have also been reported in patients undergoing TAVI treated with the SGLT2 inhibitor dapagliflozin in the recent DAPA-TAVI trial. Whether GLP-1a could provide similar benefits in patients with valvular heart disease, such as aortic stenosis, remains unknown. Method(s): We retrospectively analysed TAVI patients enrolled in the monocentric MOTIVE registry at Molinette Hospital, Turin, between 2015 and 2025. Patients were stratified according to whether they were prescribed GLP-1a at discharge. Outcomes were compared between groups using both propensity score matching (PSM) and inverse probability weighting (IPW). Cox regression was applied to assess the following endpoints: the composite of all-cause death and hospitalization for heart failure (HHF), all-cause death, cardiovascular death, HHF, and stroke. Result(s): A total of 803 TAVI patients were included, of whom 45 (5.6%) received GLP-1a at discharge. The mean age was 81.1 +/- 6.2 years, with a slight female predominance (403, 50.2%). Mean left ventricular ejection fraction was 56.5 +/- 11.3%, and mean transvalvular gradient was 42.1 +/- 12.3 mmHg. A self-expandable valve was implanted in 509 patients (63.4%), most commonly the Evolut R/PRO/PRO+ (362, 45.0%). Baseline, echocardiographic, and procedural characteristics were balanced between groups, except for diabetes, which was markedly more prevalent in the GLP-1a group (43/45, 95.5%). After a median follow-up of 363.5 days (IQR 224-592), in the IPW-adjusted cohort, GLP-1a prescription at discharge was associated with a lower risk of the composite endpoint of all-cause death or HHF (HR 0.34, 95% CI 0.17-0.68, p = 0.01), primarily driven by a reduction in HHF (HR 0.30, 95% CI 0.15-0.56, p = 0.008). No significant differences were observed in cardiovascular death or stroke during long-term follow-up. Conclusion(s): In this cohort, GLP-1a prescription at discharge was associated with a marked reduction in the composite of all-cause death and HHF, mainly due to fewer heart failure hospitalizations. Given the observational and monocentric nature of this study, these findings should be considered hypothesis-generating. Larger multicenter registries and randomized controlled trials are warranted to confirm these preliminary results. <99> Accession Number 651744083 Title N-ACETYLCYSTEINE IN ADULT CARDIAC SURGERY: AN UMBRELLA REVIEW OF RANDOMIZED EVIDENCE ON POAF AND AKI. Source European Heart Journal, Supplement. Conference: 57th Congress of the Italian Association of Hospital Cardiologists, ANMCO 2026. Rimini Italy. 28(Supplement 6) (pp vi65), 2026. Date of Publication: 01 May 2026. Author Meco M.; Agosteo E. Institution (Meco, Agosteo) Clinica San Carlo, Milano, Italy Publisher Oxford University Press Abstract Background: Postoperative atrial fibrillation (POAF) and acute kidney injury (AKI) remain frequent complications after adult cardiac surgery. N-acetylcysteine (NAC) has antioxidant and anti-inflammatory properties, but clinical results have been heterogeneous. Method(s): We conducted an umbrella review of meta-analyses of randomized controlled trials (RCTs) evaluating perioperative NAC in adult cardiac surgery. Outcomes were POAF and AKI (primary) and short-term mortality (secondary). We summarized the most comprehensive evidence across overlapping meta-analyses and quantified overlap using corrected covered area (CCA). Result(s): Ten meta-analyses of RCTs were included. Across the evidence base, NAC was consistently associated with lower POAF risk (pooled estimates typically around RR ~0.6) (Figure 1), with the signal appearing stronger in protocols using prolonged intravenous administration (48-72 h). In contrast, effects on AKI were neutral overall (pooled estimates around RR ~0.9), with any potential benefit mainly confined to intravenous-only subgroups in larger (Figure 2) datasets. No clear mortality reduction was observed, and event numbers were limited. Conclusion(s): In adult cardiac surgery, NAC shows the most consistent evidence for reducing POAF, whereas benefits for AKI and mortality remain uncertain. Future trials should standardize POAF surveillance and AKI definitions, prespecify NAC dose/duration, and focus on high-risk phenotypes in whom an intravenous, prolonged regimen may be most biologically plausible. (Figure presented). <100> Accession Number 651746250 Title Evolocumab in patients with atherosclerotic cardiovascular disease: a systematic review and meta-analysis of efficacy and safety. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 13 Jul 2026. Author Li S.; Zhang C.; Liu Y. Institution (Li) Physical Examination Center, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei, China (Zhang, Liu) Physical Examination Center, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei, China Abstract BACKGROUND: Evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, potently reduces low-density lipoprotein cholesterol. However, its effects on hard clinical endpoints and safety in patients with atherosclerotic cardiovascular disease (ASCVD) require updated synthesis, particularly incorporating data from recent long-term extension studies and diverse subpopulations. OBJECTIVE(S): To systematically evaluate the efficacy and safety of evolocumab in patients with ASCVD. METHOD(S): PubMed, Embase, Cochrane Library, OVID, China National Knowledge Infrastructure (WANFANG MED ONLINE and CNKI), and ClinicalTrials.gov were systematically searched from January 2014 to March 2026. Randomized controlled trials (RCTs) comparing evolocumab with placebo in patients with ASCVD were included. The primary endpoint was major adverse cardiovascular events (MACE). A random-effects model was used for meta-analysis, with subgroup analyses, meta-regression, sensitivity analyses, and publication bias assessment. RESULT(S): Eight RCTs comprising 40,658 patients were included. Regarding lipid parameters, evolocumab significantly reduced levels of low-density lipoprotein cholesterol (LDL-C; standardized mean difference [SMD]: -2.546, 95% confidence interval [CI]: -3.024 to -2.067, P < 0.001), total cholesterol (TC; SMD: -1.543, 95% CI: -1.947 to -1.139, P < 0.001), apolipoprotein B (Apo B; SMD: -1.598, 95% CI: -2.169 to -1.027, P < 0.001), and lipoprotein(a) (Lp(a); SMD: -0.713, 95% CI: -0.938 to -0.489, P < 0.001) compared with placebo, but showed no significant effect on high-density lipoprotein cholesterol (HDL-C; SMD: 0.233, 95% CI: -0.058 to 0.524, P = 0.117) or triglycerides (TG; SMD: -0.315, 95% CI: -0.765 to 0.136, P = 0.171). For clinical endpoints, evolocumab significantly reduced the odds of MACE compared with placebo (OR: 0.416, 95% CI: 0.248-0.698, P < 0.001; I2 = 86.7%); however, the 95% prediction interval crossed unity (0.13-1.36), indicating uncertainty about the true effect in future studies. Myocardial infarction (OR: 0.711, 95% CI: 0.661-0.765, P < 0.001), stroke (OR: 0.774, 95% CI: 0.693-0.864, P < 0.001), and coronary revascularization (OR: 0.777, 95% CI: 0.734-0.821, P < 0.001) all showed significant odds reductions. Evolocumab significantly reduced odds of cardiovascular death (OR: 0.771, 95% CI: 0.657-0.904, P = 0.002) and all-cause mortality (OR: 0.852, 95% CI: 0.762-0.953, P = 0.004). Safety analysis indicated that injection site reactions were more common with evolocumab (OR: 1.33, 95% CI: 1.12-1.59, P < 0.01), with no significant differences in serious adverse events, neurocognitive events, muscle-related events, or liver function abnormalities. CONCLUSION(S): In the context of optimized background therapy, evolocumab significantly reduces the odds of MACE, myocardial infarction, and stroke, and improves multiple atherogenic lipid parameters in patients with ASCVD. Notably, significant reductions in both cardiovascular and all-cause mortality were also observed in this updated analysis. Its overall safety profile is favorable. Copyright © 2026. The Author(s). <101> Accession Number 651738999 Title THE IMPACT OF PRE-SURGERY NUTRITIONAL STATUS ON CONGENITAL CARDIAC SURGERY OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL STUDIES. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Satria F.N.; Harmen C.A. Institution (Satria, Harmen) Fakultas Kedokteran, Universitas Indonesia, Indonesia Publisher Indonesian Heart Association Abstract Background: Corrective surgery is shown to have a positive impact on weight gain of patients with congenital heart disease. However, suboptimal preoperative nutritional state may affect the outcomes of the corrective surgery. Therefore, a study to review the effect of nutritional status on congenital heart surgery outcomes is needed. Method(s): Following PRISMA, three databases including PubMed, Cochrane, and Scopus were searched for clinical studies assessing clinical outcomes of paediatric patients who have undergone congenital cardiac procedures from inception up to June 2024. Critical appraisal was performed using Newcastle-Ottawa Scale for cohort studies. For statistical analyses, heterogeneity was assessed using the I2 statistic. Inverse variance and random effects model was utilised for quantitative synthesis in RevMan (Version 5.4.1). Subsequent subgroup and sensitivity analyses were performed where appropriate. Result(s): The analysis included six studies with a combined total of 2,119 patients. Mortality odds were higher in the malnourished group (pooledOR:1.57[95%CI:0.59-4.22],p=0.37;I2=70%], though not statistically significant. Malnourished patients tended to have longer ICU stays (pooledOR:1.69[95%CI:0.74-2.64],p<0.05;I2=88%). A significantly extended hospital stay was observed in malnourished patients (pooledOR:2.41[95%CI:1.02-3.79],p=0.02;I2=65%). Additionally, the duration of mechanical ventilation was longer for malnourished paediatric patients compared to those with normal nutritional status (pooledOR:0.93[95%CI:0.46-1.40],p<0.05;I2=79%). Conclusion(s): Malnutrition in patients is associated with a trend towards higher mortality, longer ICU and hospital stays, and extended mechanical ventilation duration, underscoring the significant impact of nutritional status on patient outcome.(Figure presented) <102> Accession Number 651738967 Title EFFICACY OF ASPIRIN MONOTHERAPY COMPARED TO DUAL THERAPY WITH CLOPIDOGREL FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION: A SYSTEMATIC REVIEW. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Lim S.T.; Huang E.; Kurniawan A. Institution (Lim, Huang) Faculty of Medicine, Pelita Harapan University, Indonesia (Kurniawan) Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Indonesia Publisher Indonesian Heart Association Abstract Background: Transcatheter aortic valve implantation (TAVI) is a minimally invasive approach to treat aortic stenosis and is especially done for those with a high risk for open surgery. Optimal antiplatelet therapy post-TAVI to prevent thromboembolic events remains a subject of debate. This systematic review aims to evaluate the efficacy of aspirin monotherapy compared to aspirin plus clopidogrel in patients after TAVI focusing on clinical outcomes such as major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events. Method(s): 2 individuals systematically search the PubMed, ScienceDirect, NEJM and Europe PMC database up to 24 June 2024 using the keywords "aspirin", "clopidogrel" and "transcatheter aortic-valve implantation". Eligible studies were selected based on the inclusion criteria including randomized controlled trials, clinical trials and cohort studies comparing aspirin monotherapy with aspirin plus clopidogrel. The outcome assessed will be the occurrence of major adverse events and bleeding events after the therapy. The risk of bias for randomized trials would be measured using the Revised Cochrane Risk of Bias Tool (ROB 2) and the ROBINS-I tool would be used to assess non-randomised trials. Systematic review, meta-analysis and trials on animals were excluded. Result(s): 5 studies met the inclusion criteria after screening of title and abstract. After assessment of full-text, 4 randomized studies were included with 1086 patients, of which 2 were of low risk of bias and 2 had some concerns of bias based on RoB 2. All included studies found that the incidence of MACCE following TAVI including myocardial infarction, major stroke and life-threatening bleeding was reduced with aspirin only, thus dual antiplatelet therapy was not necessary. Conclusion(s): In conclusion, aspirin monotherapy is sufficient to reduce bleeding events and the occurrence of major adverse events after receiving TAVI. However, further studies with a larger sample size are required to substantiate these findings. <103> Accession Number 651752354 Title Effect of Luseogliflozin on Myocardial Flow Reserve in Patients with Type 2 Diabetes Mellitus (LUCENT-J Study). Source Diabetes. Conference: 86th Scientific Sessions of the American Diabetes Association, ADA 2026. New Orleans United States. 75(Supplement 1) (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Tamanaha T.; Son C.; Koezuka R.; Tochiya M.; Omura-Ohata Y.; Kohmo K.; Noguchi M.; Makino H. Institution (Tamanaha, Son, Koezuka, Tochiya, Omura-Ohata, Kohmo, Noguchi, Makino) Suita, Japan, Kobe, Japan Publisher American Diabetes Association Inc. Abstract Introduction and Objective: Sodium-glucose cotransporter2 (SGLT2) inhibitors reduce hospital admission rates for heart failure (HF) in patients with type 2 diabetes (T2DM). However, the mechanisms of cardioprotection of SGLT2 inhibitors are not fully understood. Despite advances in the treatment of coronary artery disease (CAD), the prevalence of HF continues to increase among patients with T2DM. Preclinical studies suggest that SGLT2 inhibitors may improve vascular endothelial function through multiple molecular pathways, thereby contributing to the amelioration of impaired myocardial microcirculation commonly observed in diabetes. This study investigated the effects of SGLT2 inhibitors on cardiac microcirculation in patients with T2DM. 13N-ammonia positron emission tomography (PET) studies can be used to assess coronary microvascular dysfunction non-invasively. This study aimed to elucidate the effects of SGLT2 inhibitors on cardiac microcirculation as measured by myocardial flow reserve (MFR) using 13N-ammonia PET. Method(s): This study was a prospective, single-center, randomized, parallel-group open-label, active-controlled study including 40 patients. Registration was set with a target HbA1c <8% to minimize the impact on glycemic control, and patients with CAD requiring coronary revascularization or suspected CAD requiring coronary angiography were excluded. The primary outcome was the detection of changes in MFR at week 24. Result(s): 33 participants met the per-protocol criteria, 17 in the luseogliflozin group and 16 in the control group. Participants were men (55%), with mean (SD) Age of 72.9y (+/-9.6), HbA1c of 6.9% (+/-0.9). There was no significant change in MFR in the luseogliflozin group (2.26 +/- 0.38 vs 2.35 +/- 0.55 p = 0.464 compared with the placebo group 2.25 +/- 0.44 vs 2.28 +/- 0.51 p = 0.869; Pint= 0.699). Luseogliflozin significantly improved LVEF (72.7 +/- 4.9 vs 75.7 +/- 4.6 p = 0.033 compared with the placebo group 75.0 +/- 5.9 vs 74.6 +/- 6.5 p = 0.573; Pint= 0.041). Conclusion(s): This study showed that MFR didn't increase by luseogliflozin. <104> Accession Number 651744109 Title INCIDENCE OF STROKE AFTER SEVERE AORTIC STENOSIS TREATMENT: A NETWORK META-ANALYSIS COMPARING SEVERAL STRATEGIES OF INTERVENTION. Source European Heart Journal, Supplement. Conference: 57th Congress of the Italian Association of Hospital Cardiologists, ANMCO 2026. Rimini Italy. 28(Supplement 6) (pp vi211), 2026. Date of Publication: 01 May 2026. Author Dalu A.; Giacobbe F.; Nebiolo M.; Morena A.; D'Ascenzo F.; Bruno F.; De Filippo O.; Conrotto F.; Montefusco A.; Omede P.; De Ferrari G. Institution (Dalu, Giacobbe, Nebiolo, Morena, D'Ascenzo, Bruno, De Filippo, Conrotto, Montefusco, Omede, De Ferrari) Aou Citta'Della Salute E Della Scienza; Universita'Degli Studi Torino Publisher Oxford University Press Abstract Background: Transcatheter aortic valve implantation (TAVI) with third generation devices has become the standard of care for many patients with severe aortic stenosis. Stroke is a non-negligible complication after TAVI that may affect post-procedural and long-term outcomes, leading to disability. However, comparative data on neurological outcomes across different transcatheter heart valve (THV) models are limited. Method(s): A Network Meta Analysis was performed including all randomized controlled trials comparing third-generation THV, surgical aortic valve replacement (SAVR) and clinical surveillance, with available data on neurological outcomes. The primary endpoint was stroke; major adverse cardiovascular and cerebrovascular events (MACCE) were the secondary ones. Result(s): A total of seven randomized trials encompassing 5,232 patients were analysed. The mean age of the study population was 80.2 years, with a slight prevalence (54%) of females. Hypertension (84.8%), dyslipidemia (63.1%), and coronary artery disease (47%) were the most prevalent comorbidities. Procedural success was achieved in 96.6% of cases, with transfemoral access used in 95%. The majority of patients received the Edwards Sapien bioprosthetic valve (40.2%), followed by Evolut R/PRO (20.7%), Acurate NEO (14.7%), and Portico (7.1%). A small subset of patients (8.7%) underwent SAVR, while 446 patients (8.6%) received clinical surveillance alone. No significant differences in the risk of stroke or MACCE were observed across the different THV types (stroke incidence rate ratio [IRR] 0.56, 95% CI 0.21-1.52; MACCE IRR 0.59, 95% CI 0.30-1.17). In contrast, clinical surveillance was associated with significantly worse outcomes for both endpoints, while SAVR was linked to an increased risk of MACCE and showed a non-significant trend toward higher stroke rates. At SUCRA analysis, PORTICO valve resulted the device with the highest probability of preventing strokes. A Sensitivity analysis restricted to THV comparisons confirmed the absence of between-device differences. Conclusion(s): In this comprehensive network meta-analysis encompassing different strategies of severe aortic stenosis management no device demonstrated superiority in reducing the risk of stroke or MACCE. Among THV models, PORTICO was the highest ranking in terms of stroke prevention. Conversely, both conservative management and SAVR were associated with less favorable outcomes compared to TAVI. <105> Accession Number 2047558965 Title Prognostic Value of the Meta-Analysis Global Group in Chronic Heart Failure Risk Score in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair. Source Journal of the American Heart Association. 15(13) (no pagination), 2026. Article Number: e048383. Date of Publication: 2026. Author Nishimura Y.; Asami M.; Horiuchi Y.; Tanaka J.; Taniwaki M.; Komiyama K.; Yuzawa H.; Tanabe K.; Yamamoto M.; Kubo S.; Saji M.; Izumi Y.; Sugiura A.; Shimura T.; Enta Y.; Shirai S.; Izumo M.; Mizuno S.; Watanabe Y.; Amaki M.; Kodama K.; Otsuki H.; Naganuma T.; Bota H.; Ohno Y.; Yamawaki M.; Ueno H.; Nakazawa G.; Hachinohe D.; Otsuka T.; Hayashida K. Institution (Nishimura, Asami, Horiuchi, Tanaka, Taniwaki, Komiyama, Yuzawa, Tanabe) Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan (Yamamoto) Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan (Kubo) Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan (Saji, Izumi) Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan (Saji) Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan (Sugiura) Department of Cardiology, Nagoya Heart Center, Nagoya, Japan (Shimura) Department of Cardiology, Gifu Heart Center, Gifu, Japan (Enta) Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan (Shirai) Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (Izumo) Division of Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki, Japan (Mizuno) Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Kamakura, Japan (Watanabe) Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan (Amaki) Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan (Kodama) Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan (Otsuki) Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan (Naganuma) Department of Cardiology, New Tokyo Hospital, Chiba, Japan (Bota) Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan (Ohno) Department of Cardiology, Tokai University School of Medicine, Isehara, Japan (Yamawaki) Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Yokohama, Japan (Ueno) Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan (Nakazawa) Department of Cardiology, Kindai University Faculty of Medicine, Osaka, Japan (Hachinohe) Cardiovascular Medicine, Sapporo Heart Center, Sapporo Cardiovascular Clinic, Sapporo, Japan (Otsuka) Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan (Hayashida) Department of Cardiology, Keio University School of Medicine, Tokyo, Japan Publisher American Heart Association Inc. Abstract BACKGROUND: The prognostic value of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) remains unclear. This study evaluated the MAGGIC score to predict outcomes after M-TEER in patients with functional (FMR) or degenerative mitral regurgitation (DMR) and compared its performance with conventional surgical and M-TEER-specific risk models. METHOD(S): We analyzed 3609 patients (FMR, 71%; DMR, 29%) who underwent M-TEER in the OCEAN (Optimized Catheter Valvular Intervention)-Mitral registry. Patients were stratified into MAGGIC score tertiles. The primary outcome was all-cause death at 1 and 3years. Secondary outcomes included cardiovascular death. Predictive performance was compared with Society of Thoracic Surgeons score, European System for Cardiac Operative Risk Evaluation II, MitraScore, and COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) score. RESULT(S): The median age was 81years, 55.3% were men, and median MAGGIC score was 30. In the FMR cohort, patients in tertile 3 had higher risks of all-cause death (1 year: adjusted hazard ratio [HR<inf>adj</inf>], 4.15 [95% CI, 2.34-7.36]; 3years: HR<inf>adj</inf>, 1.83 [95% CI, 1.22-2.77]) and cardiovascular death (1 year: HR<inf>adj</inf>, 2.31 [95% CI, 1.56-3.43]; 3years: HR<inf>adj</inf>, 1.61 [95% CI, 1.13-2.31]). In the DMR cohort, tertile 3 was associated with higher all-cause death (1 year: HR<inf>adj</inf>, 2.84 [95% CI, 1.18-6.86]; 3years: HR<inf>adj</inf>, 2.25 [95% CI, 1.07-4.73]) and cardiovascular death at 3years (HR<inf>adj</inf>, 3.49 [95% CI, 1.23-9.84]). The MAGGIC score demonstrated comparable or superior discrimination on the basis of the concordance index. CONCLUSION(S): The MAGGIC score independently predicted 1- and 3-year all-cause death after M-TEER in both FMR and DMR cohorts and cardiovascular death in the FMR cohort and at 3years in the DMR cohort. It demonstrated comparable or superior predictive performance to conventional surgical and M-TEER-specific risk models. Copyright © 2026 The Author(s). <106> Accession Number 651738551 Title EFFICACY AND SAFETY OF TRANSCATHETER EDGE-TO-EDGE REPAIR FOR MITRAL REGURGITATION: A SYSTEMATIC REVIEW. Source Indonesian Journal of Cardiology. Conference: 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2024. Jakarta Indonesia. 45(Supplement C) (no pagination), 2024. Date of Publication: 2024. Author Santoso K.J.A.; Prawira J.M.; Sabran M.Z.; Damay V.A.; Kurniawan A. Institution (Santoso, Prawira, Sabran) Faculty of Medicine, Pelita Harapan University, Indonesia (Damay) Department of Cardiovascular, Siloam Hospital Lippo Village, Pelita Harapan University, Indonesia (Kurniawan) Department of Internal Medicine, Siloam Hospital Lippo Village, Pelita Harapan University, Indonesia Publisher Indonesian Heart Association Abstract Background: Mitral regurgitation (MR) is a prevalent valvular heart disease associated with significant increase of morbidity and mortality. Transcatheter edge-to-edge repair (TEER) has emerged as a minimally invasive alternative to surgical repair for high-risk patients. This systematic review aims to evaluate the clinical efficacy and safety of TEER in patients with MR. Method(s): A comprehensive literature search of PubMed, ScienceDirect, and NEJM was conducted up to June 7, 2024, by two independent investigators. Studies reporting clinical outcomes of TEER for MR, including randomized controlled trials (RCTs) and cohort studies, were included. Data were extracted and analyzed, and the Risk of Bias 2.0 (ROB 2.0) tool was used to assess the risk of bias. Result(s): This review included four RCTs and one cohort study, encompassing a total of 1,937 patients. Of the 19 studies assessed, 14 were excluded due to data overlap. The included studies demonstrated significant improvements in MR patients undergoing TEER, including reduced rates of heart failure hospitalizations and decreased mortality. One study reported non-significant improvements, attributed to differing baseline characteristics. All studies confirmed that TEER is a safe procedure, with a low risk of bias assessed via the ROB 2.0 tool. Conclusion(s): TEER appears to be an effective and safe procedure for treating MR. However, further research is warranted to corroborate these findings and optimize patient outcomes. <107> Accession Number 2047780603 Title Coronary artery bypass grafting in women: a review of literature. Source Vessel Plus. 9 (no pagination), 2025. Article Number: 25. Date of Publication: 2025. Author Wester M.-L.; Soliman-Hamad M.A.; Von Meijenfeldt D.; Maas A.H.E.M.; ter Woorst J.F.J. Institution (Wester, Soliman-Hamad, Von Meijenfeldt, ter Woorst) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands (Maas) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands Publisher OAE Publishing Inc. Abstract The role of sex in coronary artery disease (CAD), including its treatment and prognosis, is complex and has been studied for several decades. It is well known that men and women differ physiologically and that the pathophysiology of CAD varies between sexes. Additionally, there are sex differences in outcomes after coronary artery bypass grafting (CABG), with women experiencing worse outcomes than men. A PubMed search was conducted using terms related to differences between men and women with CAD requiring CABG. We will discuss the status of CABG in women with respect to preoperative profile, surgical strategy, short- and long-term outcomes, and quality of life. The leading causes of these differences remain debated. Generally, women are older and have a greater clustering of risk factors at the time of CABG. In particular, short-term outcomes appear worse for women, while studies on long-term outcomes are contradictory. Women also report a worse quality of life after CABG and experience higher rates of depression. Copyright © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. <108> Accession Number 2047778575 Title Long-term efficacy and safety of left atrial appendage closure vs. oral anticoagulation in atrial fibrillation: a meta-analysis of randomized controlled trials. Source Europace. 28(7) (no pagination), 2026. Article Number: euag159. Date of Publication: 01 Jul 2026. Author Karakasis P.; Tzeis S.; Samaras A.; Vlachos K.; Pamporis K.; Theofilis P.; Tzikas A.; Antoniadis A.P.; Jais P.; Fragakis N. Institution (Karakasis, Samaras, Tzikas, Antoniadis, Fragakis) Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Tzeis) Department of Cardiology, Mitera Hospital, 6, Erythrou Stavrou Str., Marousi, Athens, Greece (Vlachos, Jais) Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Universite and Universite de Bordeaux, INSERM U1045, Pessac, France (Vlachos, Jais) Cardiac Arrhythmia Department, INSERM U1045, CHU de Bordeaux, Pessac, France (Vlachos) Electrophysiology Department, Hygeia Hospital, Athens, Greece (Pamporis, Theofilis) First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece Publisher Oxford University Press Abstract Aims: Left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF), but its long-term comparative efficacy remains uncertain. This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) comparing LAAC with OAC in AF. Methods and Results: MEDLINE, Embase, Scopus, and the Cochrane Database of Systematic Reviews were searched through 8 April 2026. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models. Certainty of evidence (CoE) was assessed using GRADE. Six RCTs involving 7004 participants were included (3681 assigned to LAAC and 3323 to OAC). Compared with OAC, LAAC resulted in a significantly higher risk of ischaemic stroke or systemic embolism (134 vs. 80 events; RR 1.41, 95% CI 1.07-1.86; moderate CoE). No significant differences were observed for any stroke or systemic embolism (RR 1.10, 95% CI 0.87-1.39; moderate CoE), all-cause mortality (RR 0.92, 95% CI 0.77-1.10; high CoE), cardiovascular mortality (RR 0.90, 95% CI 0.67-1.21; moderate CoE), non-cardiovascular mortality (RR 0.92, 95% CI 0.75-1.12; moderate CoE), major bleeding (RR 0.91, 95% CI 0.77-1.08; high CoE), or haemorrhagic stroke (RR 0.58, 95% CI 0.28-1.17; moderate CoE). LAAC reduced the risk of nonprocedural clinically relevant bleeding compared with OAC (RR 0.50, 95% CI 0.43-0.59; high CoE). Conclusion(s): In patients with AF, LAAC results in a higher risk of ischaemic stroke or systemic embolism than an OAC-based strategy. Compared with OAC, LAAC has no effect on major bleeding or mortality and does not reduce haemorrhagic stroke. 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. <109> Accession Number 2047704694 Title Intraoperative hemoadsorption and cardiac surgery-associated acute kidney injury: an updated systematic review and meta-analysis with trial sequential analysis. Source Critical Care. 30(1) (no pagination), 2026. Article Number: 385. Date of Publication: 01 Dec 2026. Author Liu M.; Lin D.; Zhou R. Institution (Liu, Lin, Zhou) Department of Anesthesiology, West China Hospital, Sichuan University, Sichuan, Chengdu, China Publisher BioMed Central Ltd Abstract Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) following cardiopulmonary bypass (CPB) remains a high-risk complication with limited effective management. Hemoadsorption is increasingly used as an adjunctive therapy due to its potent cytokines clearance in experimental settings, yet its clinical efficacy is debated. This study aimed to evaluate the effect of hemoadsorption versus standard care on CSA-AKI and other major outcomes in adult cardiac surgery patients. Method(s): An updated systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. PubMed, Medline, Embase, Web of Science, and the Cochrane Library were systematically searched from inception to 8 February 2025. Eligible RCTs enrolled adult patients undergoing cardiac surgery and compared intraoperative hemoadsorption with standard care, with reported outcomes including CSA-AKI and other major endpoints. Pooled estimates were synthesized using inverse-variance random-effects models, with heterogeneity quantified by I2 statistics. Subgroup, sensitivity and trial sequential analyses (TSA) were further performed. Result(s): Fifteen RCTs were included, of which nine reported CSA-AKI (947 patients). Hemoadsorption was not associated with a statistically significant reduction in CSA-AKI (RR 0.80, 95% CI 0.63-1.03, P = 0.08, I2 = 40%, GRADE: very low). The finding was sensitive to model choice and the inclusion of two studies (Diab 2022 and Abou-Arab 2025). Subgroup analyses revealed no significant interaction by device type. TSA indicated that the required information size was not reached. No significant differences were observed for CSA-AKI Stage 1 (RR 0.72, 95% CI 0.49-1.05, P = 0.09, I2 = 16%), Stage 2 (RR 0.66, 95% CI 0.30-1.43, P = 0.29, I2 = 11%), Stage 3 (RR 0.43, 95% CI 0.17-1.05, P = 0.06, I2 = 0%), or renal replacement therapy (RR 0.52, 95% CI 0.22-1.25, P = 0.15, I2 = 0%). Mortality and other clinical endpoints were comparable between groups. Among exploratory outcomes, only an overall reduction in IL-8 was noted (MD -18.23, 95% CI -31.90 to -4.56, P = 0.009, I2 = 40%). Conclusion(s): Intraoperative hemoadsorption did not significantly reduce CSA-AKI or improve clinical outcomes in adult cardiac surgery. Although trends favored severe AKI, very low certainty evidence and insufficient information preclude definitive conclusions, warranting further large-scale RCTs. Registration: PROSPERO identifier CRD420250651941. Copyright © The Author(s) 2026. <110> Accession Number 2047810154 Title A Systematic Review on the Impact of Postoperative Rehabilitation Programs in Thoracic Surgery Patients. Source Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Wang N.; Luan K. Institution (Wang) Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Luan) Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China Publisher W.B. Saunders Abstract Post-operative challenges, including reduced respiratory function and slower overall recovery, are often associated with thoracic surgeries. Rehabilitation strategies have been important over the years for their potential to support patient recovery and improve post-surgical outcomes. Studies published up to March 2025 across the databases, including Google Scholar, PubMed, and ProQuest, were retrieved and analyzed for this systematic review.Out of the initially selected 29 studies systematically reviewed, 8 fulfilled the final inclusion criteria and were included in the analysis. Postoperative rehabilitation strategies such as physiotherapy-based programs, nurse-led initiatives, and technology-assisted interventions have been included in the systematic review and found to influence the recovery following thoracic surgery. Interventions like these improve pulmonary function, better pain management, enhanced functional capacity, reduced complication rates, and shorter recovery periods.The findings suggest that rehabilitative approaches may contribute to better postoperative outcomes. However, further clinical research is still needed to develop more standardized rehabilitation protocols. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <111> Accession Number 2047726204 Title Use of argatroban as a heparin alternative in cardiac surgery-a rapid review of case reports and series. Source Journal of Thrombosis and Haemostasis. (no pagination), 2026. Date of Publication: 2026. Author Bouvette S.; Butt A.L.; Clifton S.C.; Stewart K.E.; Boylan P.M.; Mazzeffi M.A.; Tanaka K.A. Institution (Bouvette, Butt, Tanaka) Department of Anesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Clifton) Reference & Instructional Services, Robert M. Bird Health Sciences Library, University of Oklahoma Health, Oklahoma City, OK, United States (Stewart) Department of Surgery, University of Oklahoma Health, Oklahoma City, OK, United States (Boylan) College of Pharmacy, University of Oklahoma Health, Oklahoma City, OK, United States (Mazzeffi) Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States Publisher Elsevier B.V. Abstract Background Argatroban has been used as an alternative anticoagulant for cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia (HIT) or heparin allergy. Its mechanism of action differs from heparin, and concerns regarding dosing, monitoring, and circuit thrombosis risk remain insufficiently characterized. Objectives This study systematically reviewed published cases of argatroban anticoagulation during CPB for dosing patterns, activated clotting time (ACT) responses, thrombotic and bleeding events, and transfusions. Methods A rapid review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Rapid Reviews guidance. Searches of MEDLINE, Embase, and other index databases identified clinical reports involving argatroban use during CPB. Two investigators independently screened studies, extracted data, and assessed risk of bias. Results Twenty-nine publications describing 30 patients (24 adult and 6 pediatric cases) met inclusion criteria. The median initial argatroban bolus was 0.1 mg/kg, but it was doubled to achieve ACTs of >=400 seconds. Median infusion rate (25th-75th percentile) was 6.8 (4.6-9.7) mug/kg/min. ACT responses were nonlinear, with fluctuations of >100 seconds occurring in 70% of cases. Despite ACTs of >=400 seconds, circuit thrombosis occurred in 40% of cases, most commonly in the reservoir or oxygenator. Recovery to ACT of <200 seconds required a median of 7 hours after discontinuing drug infusion. Perioperative transfusion occurred in 80% of cases. Conclusion Published experience demonstrates major limitations of argatroban as a heparin substitute for CPB, including unpredictable ACT responses and frequently documented circuit thromboses. The reported complication rates should be interpreted as an upper bound given the descriptive nature of case-level evidence and the likelihood of publication bias. Copyright © 2026 International Society on Thrombosis and Haemostasis. <112> Accession Number 2047689278 Title Cost-Effectiveness of TAVI vs Minimally Invasive SAVR for Low-Risk Aortic Stenosis in Japan. Source JACC: Asia. 6(8) (pp 1386-1398), 2026. Date of Publication: 01 Aug 2026. Author Kawakami H.; Nakayama T.; Miyabe R.; Nakao Y.; Miyoshi T.; Nishimura K.; Inoue K.; Ikeda S.; Nakamura Y.; Yamaguchi O. Institution (Kawakami, Miyabe, Nakao, Miyoshi, Nishimura, Inoue, Ikeda, Yamaguchi) Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Ehime, Toon, Japan (Nakayama, Nakamura) Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo, Japan Publisher Elsevier Inc. Abstract Background Transcatheter aortic valve implantation (TAVI) and minimally invasive surgical aortic valve replacement (MICS-AVR) are both less invasive options for treating severe aortic stenosis (AS). However, most cost-effectiveness analyses have compared TAVI with conventional full-sternotomy surgery, and the economic value of TAVI relative to MICS-AVR under current surgical practice remains uncertain. Objectives This study sought to assess the long-term cost-effectiveness of TAVI compared with MICS-AVR for patients with isolated severe AS from the Japanese health care payer's perspective. Methods A decision analytical model was developed to evaluate long-term clinical and economic outcomes of TAVI and MICS-AVR. Model inputs were derived from randomized trials, meta-analyses, and Japanese national cost data. Incremental cost-effectiveness ratios (ICERs) were calculated in Japanese yen per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses tested model robustness, and a scenario analysis reflected outcomes from high-volume Japanese surgical centers. The willingness-to-pay threshold was set at 5 million per QALY. Results In the base case, TAVI resulted in higher total costs (8.45 million vs 7.68 million) and slightly greater QALYs (6.55 vs 6.42), yielding an incremental cost-effectiveness ratio of 5,885,068 per QALY gained-marginally above the willingness-to-pay threshold, indicating that TAVI was not clearly cost-effective. In the high-volume surgical center scenario, MICS-AVR dominated TAVI, being both less costly and more effective. Conclusions TAVI and MICS-AVR showed broadly comparable cost-effectiveness in low-risk patients with isolated severe AS. The relative economic value of TAVI depended strongly on institutional performance and surgical expertise. Copyright © 2026 The Authors. <113> Accession Number 2047681388 Title A critical appraisal of "A novel survival prediction model after isolated surgical aortic valve replacement in the transcatheter aortic valve replacement era". Source General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Akhtar I.; Javaid M.H. Institution (Akhtar) Ayub Medical College, Abbottabad, Pakistan (Javaid) Shifa College of Medicine, Islamabad, Pakistan Publisher Springer Abstract Maeda et al. recently proposed a model to predict long-term survival after isolated surgical aortic valve replacement (SAVR) in the transcatheter aortic valve replacement (TAVR) era. While the model shows encouraging discrimination and calibration, several methodological and clinical limitations may restrict its broader applicability. The authors selected the final six-variable model primarily on the basis of maximal five-year C-statistic, without formal sample size justification or contemporary shrinkage-based criteria. Validation was restricted to internal resampling within the same registry, limiting evidence for transportability. Important prognostic domains, notably frailty and key anatomical and comorbidity variables, were not incorporated, and performance was not directly compared with established risk scores. Reporting only partially aligns with modern prediction model guidelines and omits decision curve analysis, leaving clinical utility uncertain. Overall, the model represents a valuable step but requires methodological refinement and external validation before guiding lifetime management between SAVR and TAVR. EBM Rating: Level V evidence. The article represents expert opinion derived from the author's clinical experience and interpretation of existing literature, without original experimental, randomized, controlled, cohort, or comparative analytic data. Copyright © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026. <114> Accession Number 2047660298 Title Observational analyses in cardiovascular device evaluation, methods, applications, and challenges: A comprehensive review. Source Current Problems in Cardiology. 51(10) (no pagination), 2026. Article Number: 103398. Date of Publication: 01 Oct 2026. Author Sandeep B.; Cheng H.; Liu X.; Huang X.; Yan Y.; Jiang F.; Xiong D.; Wu Q.; Gao K.; Xiao Z. Institution (Sandeep, Cheng, Liu, Yan, Xiong, Wu, Gao, Xiao) Department of Cardio-Thoracic Surgery, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital, Sichuan, Chengdu, China (Huang) Department of Anesthesiology, The Third People's Hospital of Chengdu, Sichuan, Chengdu, China (Jiang) Department of Nursing, Pengzhou Peoples's Hospital, 255 South Third Ring Road, Sichuan, Pengzhou City, China Publisher Elsevier Inc. Abstract The evaluation of cardiovascular devices represents a critical component of modern cardiology and cardiovascular surgery. While randomized controlled trials (RCTs) remain the gold standard for establishing efficacy and safety, observational analyses have emerged as indispensable tools for assessing cardiovascular devices in real-world settings. This comprehensive review examines the frameworks, methodologies, and applications of observational analyses in cardiovascular device evaluation. We discuss the target trial framework, causal inference methods, propensity score techniques, instrumental variable analysis, and the integration of real-world evidence into regulatory decision-making. Furthermore, we explore the role of large-scale administrative databases, electronic health records, and national registries in generating robust evidence for device effectiveness and safety. The review addresses methodological challenges including confounding by indication, immortal time bias, device learning curves, and the dynamic nature of device technology. We present case studies from major cardiovascular device categories including transcatheter aortic valve replacement, left atrial appendage closure devices, coronary stents, ventricular assist devices, and wearable cardiovascular monitors. The article concludes with recommendations for improving the quality and interpretability of observational device studies and discusses future directions in the field. Copyright © 2026 Elsevier Inc. <115> Accession Number 2047861690 Title Left Atrial Appendage Closure vs Anticoagulation for Stroke Prevention in Atrial Fibrillation: Meta-Analysis of Randomized Trials. Source JACC: Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Turagam M.K.; Halperin J.L.; Granger C.B.; Bhatt D.L.; Velagapudi P.; Dukkipati S.R.; Gurol M.E.; Sartori S.; Nair D.G.; Neuzil P.; Doshi S.K.; Leon M.B.; Fuster V.; Reddy V.Y. Institution (Turagam, Dukkipati, Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY, United States (Halperin, Bhatt, Sartori, Fuster) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Granger) Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States (Velagapudi) Division of Cardiology, Barnes-Jewish Christian Cardiology, St. Louis, MO, United States (Gurol) Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Nair) St. Bernards Medical Center & Arrhythmia Research Group, Jonesboro, AR, United States (Neuzil) Charles University and Faculty Hospitals Motol and Homolka, Prague, Czechia (Doshi) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States (Leon) Department of Cardiology, Columbia University Irving Medical Center, New York, NY, United States (Leon) Cardiovascular Research Foundation, New York, NY, United States Publisher Elsevier Inc. Abstract Background: Oral anticoagulation (OAC) and left atrial appendage closure (LAAC) are stroke prevention strategies for patients with atrial fibrillation. Objective(s): To compare stroke and bleeding outcomes from a meta-analysis of randomized controlled trials comparing LAAC to OAC. Method(s): The primary outcome was stroke or systemic embolism (stroke/SE). Secondary outcomes included ischemic stroke, hemorrhagic stroke, major bleeding (MB), clinically significant bleeding (MB + clinically relevant nonmajor bleeding), non-procedure related clinically-significant bleeding, and cardiovascular or all-cause mortality. Result(s): Seven randomized controlled trials met inclusion criteria (n = 7,353 patients; CHA<inf>2</inf>DS<inf>2</inf>-VASc score: 3.9; mean follow-up: 37.6 months), including 294 stroke/SE events. LAAC was similar to OAC for preventing stroke/SE (risk ratio [RR]: 1.10, 95% CI: 0.82-1.48). Clinically significant bleeding (RR: 0.60, 95% CI: 0.36-0.98) and non-procedure-related clinically significant bleeding (RR: 0.50, 95% CI: 0.39-0.64) were less frequent after LAAC. No statistically significant differences were observed for ischemic stroke, hemorrhagic stroke, MB, cardiovascular mortality, or all-cause mortality. The annualized incidence rate difference of stroke with LAAC did not increase with higher CHA<inf>2</inf>DS<inf>2</inf>-VASc scores and did not exceed 0.37%/year in any nonwarfarin-OAC comparative trial. In postablation patients, LAAC showed similar stroke/SE rates (RR: 0.92, 95% CI: 0.53-1.60; P-interaction = 0.76) and less nonprocedural clinically significant bleeding (RR: 0.51, 95% CI: 0.42-0.62; P-interaction = 0.56). Conclusion(s): LAAC prevents stroke/SE at rates not significantly different from OAC while reducing clinically significant bleeding, with possibly a more favorable benefit in postablation patients. In the full cohort, the numerically higher ischemic stroke rate was not statistically significant, and small in absolute terms. These findings support LAAC based on individualized, patient-centered decision-making, balancing stroke and bleeding risks. Copyright © 2026 The Authors <116> Accession Number 2047778574 Title Left atrial appendage closure in patients with atrial fibrillation: grey zones involving trials, meta-analysis, and decision-making. Source Europace. 28(7) (no pagination), 2026. Article Number: euag182. Date of Publication: 01 Jul 2026. Author Romiti G.F.; Corica B.; Boriani G. Institution (Romiti) Department of Wellbeing, Health, and Environmental Sustainability, Sapienza University of Rome, Rieti, Italy (Corica, Boriani) Cardiology Division, Department of Biomedical Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena University Hospital, Via G. Campi 287, Modena, Italy Publisher Oxford University Press <117> Accession Number 2047687886 Title Measuring patient disability in the peri-operative period using the WHODAS 2.0 questionnaire: a systematic review. Source Anaesthesia. (no pagination), 2026. Date of Publication: 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. <118> Accession Number 2047778587 Title Comparative evaluation of left atrial appendage occlusion and oral anticoagulation: a Bayesian meta-analysis of randomized controlled trials. Source Europace. 28(7) (no pagination), 2026. Article Number: euag163. Date of Publication: 01 Jul 2026. Author Athmakuri K.S.; Nandyal S.R.; Pamreddy H.R.; Vinjamuri S.; Lingamsetty S.S.P.; Mahajan A.V.; Hussain M.; Chaliki H.P.; Srivathsan K. Institution (Athmakuri, Mahajan, Hussain, Chaliki, Srivathsan) Department of Cardiovascular Medicine, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, United States (Nandyal) Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, United States (Pamreddy) Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, United States (Vinjamuri) Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH, United States (Lingamsetty) Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Publisher Oxford University Press Abstract Aims: Randomized trials comparing percutaneous left atrial appendage occlusion (LAAO) with oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation have yielded conflicting results across device generations and anticoagulant eras. This Bayesian meta-analysis of randomized trials aimed to compare LAAO vs. OAC for stroke or systemic embolism (SSE) and non-procedural clinically relevant bleeding (CRB). Methods and Results: We conducted a systematic search across five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane CENTRAL) to identify randomized trials of LAAO vs. OAC. Primary outcomes of stroke or systemic embolism, non-procedural CRB and clinical benefit composite were estimated using a Bayesian hierarchical random effects model and findings confirmed across robust sensitivity and subgroup analyses. Posterior probabilities for superiority, non-inferiority and equivalence were estimated using clinically meaningful margins. Six randomized trials including 7004 participants in the intention-to-treat groups, were analysed. LAAO was not associated with lower SSE vs. OAC (pooled RR, 1.11; 95% CrI, 0.80-1.49), with a 74.6% posterior probability of favouring OAC. The posterior probability of crossing non-inferiority was P(HR < 1.4) of 89%. In contrast, LAAO reduced non-procedural CRB (pooled RR, 0.59; 95% CrI, 0.45-0.78). The net clinical benefit composite, pooling contemporary trials, demonstrated a pooled RR of 0.90 (95% CrI 0.51-1.50), with P(RR < 1) of 76%, with substantial heterogeneity for this outcome. Conclusion(s): This Bayesian meta-analysis found no clear evidence supporting clinically meaningful non-inferiority of LAAO over OAC for stroke prevention. Despite reduced non-procedural bleeding, LAAO did not demonstrate a similar reduction in major bleeding. 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. <119> Accession Number 2047410806 Title The expanding role of palliative care in critical illness: A narrative review. Source Turkish Journal of Intensive Care. 24(2) (pp 95-106), 2026. Date of Publication: 2026. Author Quinlan M.; Carhuapoma J.R.; Mehta A.K. Institution (Quinlan, Carhuapoma) Division of Neurosciences Critical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Quinlan, Carhuapoma, Mehta) Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Carhuapoma) Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Mehta) Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Mehta) Department of Palliative Care, Johns Hopkins University School of Medicine, Baltimore, MD, United States Publisher Galenos Publishing House Abstract Objective: To synthesize current evidence on the integration of palliative care into the care of critically ill patients, with a focus on models of delivery, symptom management, communication frameworks, ethical dimensions, and emerging trends in the field. Material(s) and Method(s): This narrative review was conducted through a structured literature search of PubMed, MEDLINE, and Cochrane databases using terms including 'palliative care,' 'intensive care unit,' 'critical illness,' 'goals of care,' and 'symptom management,' restricted to English-language articles published between 2000 and 2024. Articles were selected based on relevance to the review's core domains and methodological quality, prioritizing randomized controlled trials, systematic reviews, and consensus guidelines where available. Result(s): Early and structured integration of palliative care in the ICU is associated with improved symptom control, reduced rates of postintensive care syndrome in patients and families, decreased non-beneficial interventions, shorter ICU stays at end of life, and lower healthcare costs without increasing mortality. Structured communication interventions and validated trigger-based referral criteria demonstrate consistent benefit. Evidence is strongest in medical ICU and oncology populations; emerging data support application across neurocritical care, cardiac, and surgical ICUs. Conclusion(s): As ICU populations continue to age and life-sustaining treatments grow more complex, integrating palliative care principles alongside intensive therapies is essential to providing high-quality, goal-concordant, and compassionate critical care globally. Copyright © 2026 The Author(s). <120> Accession Number 2047595024 Title Effect of preoperative prehabilitation in adults undergoing cardiac surgery on physical status and perioperative complications: a systematic review and meta-analysis. Source Minerva Anestesiologica. 92(5) (pp 458-468), 2026. Date of Publication: 01 May 2026. Author Gil-Casado C.; Fernandez-Vazquez U.; Luna-Rojas P.; Diaz-Vidal P.; Diz-Ferreira E.; Diz J.C. Institution (Gil-Casado, Fernandez-Vazquez, Luna-Rojas, Diaz-Vidal) School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (Diz-Ferreira) Well-Move Research Group, School of Medicine, University of Vigo, Vigo, Spain (Diz) Department of Anesthesia and Postoperative Critical Care, Alvaro Cunqueiro Hospital, Vigo, Spain (Diz) Department of Functional Biology and Health Sciences, Well-Move Research Group, University of Vigo, Vigo, Spain Publisher Edizioni Minerva Medica Abstract BACKGROUND: Many patients scheduled for cardiac surgery have low cardiorespiratory fitness, which is associated with increased perioperative morbidity and mortality. There is limited evidence to suggest that prehabilitation can reduce perioperative complications. The objective was to evaluate the impact of prehabilitation comprising physical exercise on the cardiorespiratory fitness of cardiac patients, and on quality of life, hospital stay, postoperative complications and mortality. METHOD(S): A systematic review and meta-analysis, following the PRISMA statement, encompassing randomized controlled trials on prehabilitation for adult patients undergoing cardiac surgery. The protocol was pre-registered on Open Science Framework. RESULT(S): We included eight studies comprising 894 patients. The prehabilitation group exhibited a greater improvement in preoperative six-minute walk test than the control group (MD 36.65 m; 95% CI 1.72, 71.58; P=0.04). The number of patients demonstrating a clinically relevant improvement was not significantly different between the groups (OR 1.86; 95% CI 0.82, 4.21). The prehabilitation group exhibited a shorter hospital stay (MD -1.01 days; 95% CI -2, -0.02; P=0.04). No differences were observed in other outcomes. Overall, the certainty of the evidence was low. CONCLUSION(S): Our findings suggest an association between prehabilitation and preoperative enhancement in cardiorespiratory fitness. However, the effect size is modest and may have marginal clinical significance. It remains unclear whether prehabilitation can improve clinical outcomes beyond the reduction of hospital length of stay. Further research is required to provide evidence of the efficacy of these programs. Copyright © 2026 Edizioni Minerva Medica. All rights reserved. <121> Accession Number 651720382 Title The Radial artery in Melbourne: Introduction, evolution, lessons learnt and the radial artery patency and clinical outcomes trial. Source European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. (no pagination), 2026. Date of Publication: 10 Jul 2026. Author Tatoulis J.; Hare D.L. Institution (Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia (Hare) Department of Cardiology, Austin Hospital, Department of Medicine, University of Melbourne, Melbourne, Australia <122> Accession Number 651721969 Title Determinants and Implementation of Hybrid Cardiac Rehabilitation in Adolescents and Young Adults With Congenital Heart Disease: Insight From the QUALIREHAB Study. Source Journal of the American Heart Association. (pp e049698), 2026. Date of Publication: 10 Jul 2026. Author Andrianoely M.; Desir A.; Huguet H.; Picot M.-C.; Audie M.; Lagorce S.; Venna A.; Rheault M.; Batterton M.-K.; Weissland T.; Marguin G.; Auer A.; Guillaumont S.; Amedro P. Institution (Andrianoely, Amedro) IHU Liryc, INSERM 1045 University of Bordeaux Bordeaux France (Andrianoely) Just Coaching Paris France (Desir, Venna, Rheault, Batterton, Amedro) Heart & Lung Center, Heart Research Institute Children's National Hospital Washington DC USA (Huguet, Picot) Epidemiology and Clinical Research Department, Clinical Investigation Center, INSERM 1411 Montpellier University Hospital Montpellier France (Audie, Lagorce, Amedro) Pediatric and Congenital Cardiology Department, M3C National Reference Center Bordeaux University Hospital Bordeaux France (Audie) Rehabilitation Center Le Hillot Pessac France (Venna, Amedro) George Washington University School of Medicine & Health Sciences Washington District of Columbia USA (Weissland) IMS Bordeaux University of Bordeaux Talence France (Marguin) Patient advocacy "Petit Coeur de Beurre" Paris France (Auer, Guillaumont) Pediatric Cardiac Rehabilitation Center Saint-Pierre Institute Palavas-Les-Flots France (Guillaumont) Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Center Montpellier University Hospital Montpellier France Abstract BACKGROUND: The QUALIREHAB (Cardiac Rehabilitation in Youth With Congenital Heart Disease) trial demonstrated the efficacy of a hybrid cardiac rehabilitation model in adolescents and young adults with congenital heart disease. This post hoc mixed-methods study aimed to identify baseline predictors of clinical improvement and to characterize key components supporting implementation and scalability. METHOD(S): Seventy participants aged 13 to 25 years from the intervention arm were analyzed. Clinical improvement was defined as a clinically meaningful increase in cardiopulmonary fitness (increase in peak oxygen uptake >=3.5 mL/kg per min) or health-related quality of life (Pediatric Quality of Life Inventory increase >=4.3 points). Multivariable logistic regression models identified predictors of clinical improvement. Semistructured interviews with patients and health care professionals explored experiences, barriers, and implementation mechanisms. RESULT(S): The absence of prior cardiac surgery or interventional catheterization was independently associated with short-term improvement in peak oxygen uptake. At 1 year, male sex and lower baseline ventilatory anaerobic threshold were associated with greater peak oxygen uptake improvement. Lower baseline ventilatory anaerobic threshold was also the only predictor of clinically meaningful health-related quality of life improvement. Qualitative findings highlighted the accessibility and acceptability of the hybrid model but underscored the need for higher-intensity and more varied exercise modalities, integrated digital tools, continuous psychological support, family involvement, and structured postrehabilitation follow-up to sustain long-term benefits. CONCLUSION(S): Among treated participants, male sex, absence of prior cardiac surgery, and marked baseline deconditioning were associated with greater clinical improvement, supporting a shift from standardized toward tailored cardiac rehabilitation in congenital heart disease. By addressing key logistical and psychosocial barriers, this scalable framework offers a pragmatic model for routine care implementation and may be transferable to other pediatric chronic conditions. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03690518. <123> Accession Number 651736314 Title Reduced Dose-Direct Oral Anticoagulant Vs Dual Antiplatelet Therapy After Left Atrial Appendage Closure in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and Meta Analysis. Source The Annals of pharmacotherapy. (pp 10600280261460464), 2026. Date of Publication: 13 Jul 2026. Author Jha A.; Paudel N.; Malik M.A.; Azam S.; Butt A.G.; Bista A.; Memon S.; Muhammad Naeem R.; Chang Baloch M.S.; Ahmed S.; Awais M.; Saddique M.N. Institution (Jha, Malik, Awais, Saddique) King Edward Medical University, Lahore, Pakistan (Paudel) Nishtar Medical University, Multan, Pakistan (Azam) Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Lahore, Pakistan (Butt) Foundation University Medical College, Islamabad, Pakistan (Bista) Institute of Medicine, Kathmandu, Nepal (Memon, Chang Baloch) Liaquat University of Medical and Health Sciences, Pakistan (Muhammad Naeem) Dr. Faisal Masood Teaching Hospital, Sargodha, Pakistan (Ahmed) International School of Medicine, Bishkek, Kyrgyztan Abstract BACKGROUND: Reduced-dose direct oral anticoagulants (DOACs) are increasingly used after left atrial appendage closure (LAAC) in nonvalvular atrial fibrillation (NVAF), but their benefit over dual antiplatelet therapy (DAPT) remains uncertain. OBJECTIVE(S): To evaluate the efficacy, safety, and net clinical benefit of reduced-dose DOAC versus DAPT following percutaneous LAAC in adults with NVAF. METHOD(S): A systematic review and meta-analysis of randomized controlled trials and observational cohorts comparing reduced-dose DOAC (apixaban 2.5 mg twice daily or rivaroxaban 10-15 mg once daily) with DAPT after successful LAAC in adults (>=18 years) with NVAF was conducted by searching PubMed, Embase, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov from inception through February 2026. Dichotomous outcomes were pooled as risk ratios (RRs) with 95% confidence intervals (CIs) using random-effects models; heterogeneity was assessed with I2 and chi2 statistics. Analyses were performed with RevMan 5.4. RESULT(S): Seven studies (3 randomized controlled trials, 4 cohorts) including 2126 patients (reduced-dose DOAC = 1088; DAPT = 1038) were analyzed. Reduced-dose DOAC significantly reduced composite thromboembolic events (RR = 0.20, 95% CI = 0.10-0.39; I2 = 0%), ischemic stroke (RR = 0.33, 95% CI = 0.13-0.80; I2 = 0%), and device-related thrombosis (RR = 0.33, 95% CI = 0.18-0.60; I2 = 0%) compared with DAPT. The net clinical benefit composite (thromboembolism plus major bleeding) favored reduced-dose DOAC (RR = 0.36, 95% CI = 0.19-0.70; I2 = 63%), with apixaban-predominant subgroups showing strongest effects (RR = 0.14, 95% CI = 0.05-0.36). Major bleeding was lower (RR = 0.54, 95% CI = 0.35-0.83; I2 = 0%), any bleeding reduced (RR = 0.52, 95% CI = 0.30-0.88; I2 = 64%), and minor bleeding trended lower (RR = 0.66, 95% CI = 0.42-1.02; I2 = 34%), whereas cardiovascular (RR = 0.66, 95% CI = 0.23-1.92) and all-cause mortality (RR = 0.74, 95% CI = 0.42-1.30) did not differ significantly between groups. CONCLUSION AND RELEVANCE: Reduced-dose DOAC therapy after LAAC lowered thromboembolic events, device-related thrombosis, and major bleeding versus DAPT, without affecting mortality. These findings support consideration of reduced-dose DOACs, especially apixaban-based regimens, in appropriately selected patients. <124> Accession Number 651717739 Title Intermittent Bolus versus Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions:A Randomized Controlled Trial. Source Journal of cardiothoracic and vascular anesthesia. (no pagination), 2026. Date of Publication: 07 Jun 2026. Author Forrest P.B.; Guerra-Londono C.E.; Nowak K.; Meadows A.; Dexter F. Institution (Forrest) Department of Anesthesiology, Pain Management, Perioperative Medicine, Henry Ford Health, Detroit, MI, United States (Guerra-Londono, Nowak, Meadows) Department of Anesthesiology, Pain Management, Perioperative Medicine, Henry Ford Health, Detroit, MI, United States (Dexter) Department of Anesthesia, University of Iowa, Iowa City, IA, United States Abstract OBJECTIVE: To compare the analgesic efficacy of programmed intermittent boluses (PIB) and continuous infusion via indwelling erector spinae plane (ESP) catheters following open heart surgery. It was hypothesized that the use of PIB would result in superior analgesia compared to continuous infusion of local anesthetics through ESP catheters after cardiac surgery. DESIGN: An Institutional Review Board-approved parallel-group, prospective, randomized, double-blind trial. SETTING: A large academic hospital in the midwestern United States. PARTICIPANTS: Adults undergoing open heart surgery via midline sternotomy and scheduled ESP analgesia with bilateral indwelling catheters. INTERVENTIONS: Continuous infusion versus PIB of ropivacaine 0.2% via an electronic infusion pump. MEASUREMENTS AND MAIN RESULTS: The primary outcome was postoperative opioid consumption in oral morphine milligram equivalents (OMME) through 72 hours. The secondary outcomes included postoperative pain intensity on a numerical rating scale, length of stay, quality of recovery (QoR-15), time to first bowel movement, and antiemetic use. A total of 240 participants were randomized at a 1:1 ratio to PIB or continuous infusion. The PIB group had an estimated 1.08-fold greater OMME than the continuous infusion group (95% confidence interval [CI], 0.90-1.31; p = 0.40). The mean difference was 4.1 OMME greater per day for the PIB group (95% CI, -5.6 to +13.8 mg; p = 0.41). There were no statistically significant differences in secondary outcomes between the 2 groups. CONCLUSION(S): In adults undergoing open heart surgery, ESP catheter-based analgesia via PIB did not significantly reduce early postoperative opioid consumption compared to a continuous infusion method. Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved. <125> Accession Number 2047711401 Title Telenutrition Versus Face-to-Face Nutrition Care After Myocardial Infarction: Results of a Three-Month Randomized Controlled Trial. Source Current Developments in Nutrition. Conference: Current Developments in Nutrition. Washington United States. 10(Supplement 1) (no pagination), 2026. Article Number: 107980. Date of Publication: 01 Jul 2026. Author Dishon D.; Klempfner R.; Gil T.I.; Weiner D.; Henkin Y.; Kaufman-Shriqui V. Institution (Dishon, Kaufman-Shriqui) Ariel University, Israel (Klempfner) Leviev Cardiovascular Institute, Chaim Sheba Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Israel (Gil) Ariel University and Chaim Sheba Medical Center, Israel (Weiner) Chaim Sheba Medical Center, Department of Nutrition, Tel-Hashomer, Israel (Henkin) Soroka University Medical Centre, Israel Publisher Elsevier B.V. Abstract Objectives: To compare the effectiveness of tele-nutrition (TN) versus face-to-face (FTF) nutrition counseling in improving adherence to the Mediterranean diet (Med-Diet) among patients undergoing cardiac rehabilitation after myocardial infarction or coronary revascularization. Method(s): Single-center randomized trial among cardiac rehabilitation patients <=6 months after MI, CABG, or catheterization. Participants (>=25 years) were randomized 1:1 to web-based nutrition counseling (via Zoom) or in-person counseling. Both groups received identical Mediterranean diet guidance at baseline, 6 weeks, and 3 months. I-MEDAS adherence, lifestyle questionnaires, anthropometry, and grip strength were assessed at baseline, 6 weeks, and 3 months. Analyses followed intention-to-treat using mixed-effects models. Result(s): The cohort (n=126) was predominantly male (84%) with a mean age of 61.2+/-9.2 years. Adherence at 3 months: 82.5% TN vs 89.8% FTF; at 6 months: 73.6% vs 86.4%. The I-MEDAS score showed an approximately normal distribution across time points, supporting parametric analyses. Baseline Mediterranean diet adherence did not differ between intervention and control groups (p=0.25). The overall mean I-MEDAS score was 8.18+/-1.93. Using the cardiovascular-adapted scoring, the mean was 10.03+/-2.23, also with no between-group differences (p=0.162). Mixed-effects GLM showed a significant time effect on I-MEDAS (F(2,169.1)=51.86, p< 0.001), with scores increasing by ~1.8 points during the intervention. No group effect (p=0.308) or groupxtime interaction (p=0.357) was observed, indicating similar improvement in both tele-nutrition and face-to-face groups. Conclusion(s): Both TN and FTF counseling significantly improved adherence to the Mediterranean diet during the 3-month intervention, with no difference between groups. Given evidence that higher Med-Diet adherence reduces cardiovascular events and mortality, TN may represent a feasible and effective alternative for delivering dietary care in cardiac rehabilitation. Funding Sources: This study was supported by the Research Authority of Ariel University. Copyright © 2026 <126> Accession Number 651721723 Title The Battle of the Shunts: A Systematic Review and Meta-Analysis of Cryopreserved and Antibiotic-Preserved Saphenous Vein Homografts Versus Polytetrafluoroethylene Grafts for Systemic-to-Pulmonary Artery Shunts in Pediatric Patients. Source Cardiology in review. (no pagination), 2026. Date of Publication: 10 Jul 2026. Author Wahba A.; El-Helbawy A.; Hanna F.; Kandil A.H.; Said S.M. Institution (Wahba) From the Department of Cardiothoracic Surgery, Faculty of Medicine, Port Said University, Port Said, Egypt (Wahba, Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Westchester Medical Center and Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, United States (El-Helbawy) Faculty of Medicine, Helwan University, Cairo, Egypt (Hanna) Faculty of Medicine, Cairo University, Cairo, Egypt (Kandil) Faculty of Medicine, Benha University, Egypt (Said) Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt Abstract Polytetrafluoroethylene (PTFE) grafts are the most widely used conduits for systemic-to-pulmonary artery shunts in pediatric patients with congenital heart disease requiring supplemental pulmonary blood flow, yet they carry well-documented risks of thrombosis, neointimal hyperplasia, and seroma formation. Saphenous vein homografts (SVH), available as cryopreserved or antibiotic-preserved preparations, have emerged as a biological alternative, but no prior meta-analysis has compared these conduit types. We systematically searched PubMed, Scopus, Web of Science, and Google Scholar from inception through 2026, identifying 16 studies (3 comparative, 13 single-arm, and 684 patients). Double-arm meta-analysis employed fixed-effect risk ratios (RR) with generalized linear mixed model sensitivity analysis; single-arm proportional meta-analysis used Freeman-Tukey double arcsine transformation. In the double-arm analysis (235 patients), SVH was associated with significantly lower early shunt thrombosis compared to PTFE [RR 0.29; 95% confidence interval (CI): 0.08-0.96; P = 0.04; I2 = 0.0%), confirmed by sensitivity analysis (odds ratio 0.25; P = 0.03). No significant differences were observed in overall mortality (RR 1.00; 95% CI: 0.44-2.24), infection (RR 0.68; 95% CI: 0.05-9.13), or catheter-based reintervention (RR 0.86; 95% CI: 0.52-1.42). Single-arm analyses showed similar early mortality (SVH 9% vs PTFE 11%) and stenosis rates (both 8%). GRADE certainty was very low to low for all outcomes. SVH is associated with significantly reduced early shunt thrombosis without increased mortality or reintervention; however, the low certainty of evidence underscores the need for adequately powered multicenter randomized trials with standardized perioperative protocols. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <127> Accession Number 651718268 Title Deep learning-based treatment decision support framework for multi-vessel coronary artery disease using integrated coronary angiography and clinical data. Source BMC medical informatics and decision making. (no pagination), 2026. Date of Publication: 08 Jul 2026. Author Kim B.; Kim J.; Kim Y.-H.; Jun T.J.; Ahn J.-M. Institution (Kim) Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil, Seoul, South Korea (Kim) Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil, Seoul, South Korea (Kim) Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil, Seoul, South Korea (Jun) Department of Medical Informatics and Statistics, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil, Seoul, South Korea (Ahn) Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil, Seoul, South Korea Abstract BACKGROUND: Treatment selection between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for multi-vessel coronary artery disease remains challenging, requiring careful consideration of both anatomical and clinical factors. METHOD(S): We developed a deep learning framework that automatically analyzes coronary angiography videos and integrates clinical data to support revascularization decisions. The framework consists of three key modules: (1) a video filtering module for quality screening, (2) a representative frame selection module based on curriculum learning, and (3) a treatment classification module combining imaging features with clinical characteristics. The framework was evaluated using 5,647 patients' data from a single center, with cross-validation. RESULT(S): Our framework demonstrated superior performance with a mean AUC of 0.8275 +/- 0.0167 in 5-fold cross-validation, significantly outperforming traditional machine learning approaches (baseline AUC: 0.66 +/- 0.007, [Formula: see text]). Ablation studies showed sequential improvements: representative frame selection improved performance over baseline by 3.69% (AUC: 0.6657 to 0.7026), video quality filtering provided additional 0.56% improvement (AUC: 0.7026 to 0.7082), and clinical information integration achieved final enhancement of 1.35% (AUC: 0.7082 to 0.7217). For frame selection specifically, curriculum learning outperformed supervised learning by 6.3% (AUC: 0.9067 to 0.9637). CONCLUSION(S): This study provides a promising approach for objective, data-driven decision support in complex coronary revascularization cases. The framework's multi-modal integration strategy and automated analysis capabilities demonstrate potential for improving the consistency and efficiency of treatment selection while maintaining high standards of clinical care. CLINICAL TRIAL NUMBER: Not applicable. Copyright © 2026. The Author(s). <128> Accession Number 651733183 Title Sex-Related Differences in Outcomes and Thresholds for Intervention in Primary Mitral Regurgitation: A Systematic Review and Meta-Analysis. Source JACC. Cardiovascular imaging. (no pagination), 2026. Date of Publication: 08 Jul 2026. Author Long E.; Hahn R.T.; Gulati M.; Demetrescu C.; Shah B.N.; Bhattacharya S.; Moorjani N.; Lucchese G.; Bilkhu R.; Bosco P.; Patterson T.; Redwood S.; Pibarot P.; Prendergast B.; Rajani R.; Androshchuk V. Institution (Long, Lucchese, Redwood, Rajani, Androshchuk) Faculty of Life Sciences and Medicine, King's College London, United Kingdom; Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Hahn) Department of Medicine, Columbia University Irving Medical Center, NY, United States (Gulati) Department of Cardiology, Davis Women's Heart Center, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Demetrescu, Bilkhu, Bosco, Patterson) Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton General Hospital, Southampton, United Kingdom (Bhattacharya) Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom; Cleveland Clinic London, London, United Kingdom (Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada (Prendergast) LondonUnited Kingdom Abstract BACKGROUND: Evidence on sex differences in outcomes after interventions for primary mitral regurgitation (PMR) remains conflicting. The authors performed a dedicated meta-analysis to examine whether guideline-recommended thresholds for intervention may contribute to these discrepancies. METHOD(S): Electronic databases were searched for studies reporting long-term outcomes of patients undergoing surgical or transcatheter interventions for PMR, stratified by sex. The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events. Reconstructed time-to-event individual patient data were used to derive frailty-adjusted Cox models and restricted mean survival time. To investigate whether sex-based differences in baseline characteristics had a modulating effect on differences in all-cause mortality, meta-regression was performed on individual patient data-derived HRs using a linear mixed-effects model. RESULT(S): Across 17 studies (N = 25,690), women comprised the minority (n = 9,632, 37.5%) and were significantly older (mean difference: 3.2 years, 95% CI: 2.2-4.3) with a greater proportion of heart failure symptoms (OR: 1.8; 95% CI: 1.6-2.1). At 15.7 years of follow-up, women had significantly greater risk of all-cause mortality compared with men (HR: 1.15; 95% CI: 1.07-1.24), corresponding to a survival deficit of 5.8 months (95% CI: 3.7-7.7). Similar results were observed in sensitivity analyses restricted to surgical intervention studies (HR: 1.18; 95% CI: 1.10-1.27). Female sex was also associated with significantly increased major adverse cardiovascular events (n = 2,775) (HR: 1.37; 95% CI: 1.11-1.70; DELTA restricted mean survival time: 8.5 months, 95% CI: 2.4-14.5). Age, >= moderate tricuspid regurgitation (TR), and concomitant tricuspid valve repair (TVr) emerged as significant moderators of sex differences in mortality after intervention for PMR (P < 0.001, P = 0.03, and P < 0.001, respectively). A greater proportion of >= moderate TR and TVr in women conferred increased mortality relative to men. Neither left ventricular nor left atrial parameters significantly moderated sex differences in all-cause mortality (all P > 0.05). CONCLUSION(S): At the time of PMR intervention, women are older, have more symptoms, and worse long-term outcomes compared with men. Older female age alongside higher prevalence of >= moderate TR and TVr explained a significant proportion of this heterogeneity in sex-related all-cause mortality, whereas differences in left ventricular and left atrial parameters had no significant influence. A careful appraisal of current guidelines to ensure equality of health care outcomes between sexes is warranted. Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved. <129> Accession Number 651736725 Title Abbreviated Dual Antiplatelet Therapy in Patients With High Bleeding Risk Undergoing PCI of Bifurcation Lesions: A Prespecified Substudy of the MASTER DAPT Trial. Source Circulation. Cardiovascular interventions. (pp e016222), 2026. Date of Publication: 13 Jul 2026. Author Chevalier B.; Cao D.; Smits P.C.; Brunel P.; Frigoli E.; Heg D.; Higuchi Y.; Kauer F.; Landi A.; Lopes R.D.; Mainar V.; Mamas M.A.; Mateev H.; McDonald J.; McFadden E.P.; Mulassary A.; Munir S.; Polad J.; Reimers B.; Sardella G.; Ungi I.; von Birgerlen C.; Weidinger F.; Paradies V.; Valgimigli M. Institution (Chevalier) Institut Cardiovasculaire Paris-Sud, Hopital Prive Jacques Cartier, Massy, France (Cao) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, United States (Cao) Department of Cardiology, Humanitas Gavazzeni, Bergamo, Italy (Smits, Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands (Brunel) Cardiology Department, Dijon, France (Frigoli, Landi, Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, A.L, Switzerland (Heg) Department of Clinical Research, University of Bern, Switzerland (Higuchi) Cardiovascular Division, Osaka Keisatsu Hospital, Japan (Y.H.), Japan (Kauer) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, South Africa (Landi, Valgimigli) Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland (Lopes) Duke University Medical Center, Durham, United Kingdom (Mainar) Hospital General Alicante, Spain (Mamas) Keele Cardiovascular Research Group, School of Medicine, Keele University, United Kingdom (M.A.M.), United Kingdom (Mateev) Department of Interventional Cardiology, National Heart Hospital, Sofia, Bulgaria (McDonald) Department of Cardiology, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom (J.M.) (McFadden) Interventional Cardiology, Cork University Hospital, Ireland (Mulassary) Madras Medical Mission Hospital, Chennai, India (Munir) Royal Wolverhampton NHS Trust, United Kingdom (S.M.), Wolverhampton, United Kingdom (Polad) Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, Netherlands (Reimers) Cardio Center, Humanitas Research Hospital IRCCS, Italy (Sardella) Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy (Ungi) Division of Invasive Cardiology, Department of Internal Medicine, Center of Cardiology, University of Szeged, Hungary (I.U.), Hungary (von Birgerlen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (von Birgerlen) Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, Netherlands (Weidinger) 2nd Medical Department with Cardiology and Intensive Care Medicine, Klinik Landstrasse, Vienna, Austria (Valgimigli) University of Bern, Switzerland Abstract BACKGROUND: Coronary stenting of bifurcation lesions has been associated with an increased risk of thrombotic events. However, the optimal duration of dual antiplatelet therapy (DAPT) after treatment of bifurcations, particularly among patients with high bleeding risk, is unknown. We aimed to evaluate the safety and efficacy of abbreviated DAPT in patients with high bleeding risk undergoing percutaneous coronary intervention (PCI) of bifurcation lesions. METHOD(S): The MASTER DAPT trial (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Standard DAPT Regimen) randomized patients with high bleeding risk who were free from ischemic or bleeding events after 1 month of PCI to discontinue DAPT (abbreviated regimen) or continue DAPT for a minimum of 2 additional months (standard regimen). Coprimary outcomes were net adverse clinical outcomes events, major adverse cardiac and cerebral events, and BARC (Bleeding Academic Research Consortium) type 2, 3, or 5 bleeding at 335 days after randomization. This prespecified substudy evaluates the outcomes of abbreviated versus standard DAPT according to treatment of bifurcation lesions. RESULT(S): Of the 4579 patients randomized, 976 (21.2%) underwent bifurcation PCI. Net adverse clinical event and major adverse cardiac and cerebral events did not differ between abbreviated and standard DAPT in both patients with (hazard ratio [HR], 0.98 [95% CI, 0.73-1.17] and HR, 0.92 [95% CI, 0.63-1.54], respectively) and without bifurcation PCI (HR, 1.14 [95% CI, 0.67-1.93] and HR, 0.96 [95% CI, 0.74-1.25]; P interaction=0.803 and 0.563, respectively). Abbreviated DAPT consistently reduced BARC 2, 3, or 5 bleeding in patients with (HR, 0.83 [95% CI, 0.53-1.30]) or without (HR, 0.65 [95% CI, 0.51-0.82]) bifurcation (P interaction=0.321). CONCLUSION(S): Among patients with high bleeding risk with or without bifurcation PCI, abbreviated DAPT was associated with lower bleeding risk without an excess of ischemic or net adverse events compared with standard DAPT. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03023020. <130> Accession Number 2047784468 Title Acute normovolaemic haemodilution after cardiac surgery: failed diffusion or clinical re-invention? Comment on Br J Anaesth 2026; 136: 836a"46. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Tanaka K.; Alhamami R.; Butt A.L.; Stewart K.E. Institution (Tanaka, Butt, Stewart) Department of Anaesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Alhamami) College of Medicine, University of Oklahoma Health, Oklahoma City, OK, United States (Stewart) Department of Surgery, University of Oklahoma Health, Oklahoma City, OK, United States Publisher Elsevier Ltd <131> Accession Number 2047705256 Title Optimizing hemostasis to prevent bleeding and reduce transfusion requirements in neonatal and infant cardiac surgery with cardiopulmonary bypass: a systematic review and network meta-analysis. Source Frontiers in Pediatrics. 14 (no pagination), 2026. Article Number: 1823450. Date of Publication: 10 Jun 2026. Author Lu X.; Zhang J.; Pan J. Institution (Lu) Department of Critical Care Medicine, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China (Zhang, Pan) Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China Publisher Frontiers Media SA Abstract Background - Effective hemostatic management remained a critical challenge in neonatal and infant cardiac surgery with cardiopulmonary bypass (CPB), and a systematic review and network meta-analysis (NMA) had not been conducted to evaluate optimal strategy selection for this vulnerable population. Methods - We systematically searched PubMed, Web of Science, Cochrane Library, and Embase from inception to December 3, 2025. We use bivariate analysis and NMA with random effects. We use the surface beneath the cumulative ranking curve (SUCRA) to display the order of interventions. Results - Of the 8, 280 records screened, 27 studies involving 4, 556 patients were included. Aprotinin (APR) was identified as the optimal hemostatic strategy for reducing 24-hour blood loss (SUCRA=99.15%), platelet (PLT) (SUCRA=82.19%) and fresh frozen plasma (FFP) (SUCRA=84.82%) transfusion requirements, re-sternotomy for hemostasis (SUCRA=72.85%), and risks of thrombosis (SUCRA=79.13%) and renal dysfunction (SUCRA=72.61%). epsilon-aminocaproic acid (EACA) was found to be the most effective strategy for reducing red blood cell (RBC) transfusion needs (SUCRA=69.04%). Tranexamic acid (TXA) emerged as the optimal intervention for reducing mortality (SUCRA=84.77%). Conclusion - Antifibrinolytic agents may demonstrated significant hemostatic efficacy and a generally acceptable safety profile in neonatal and infant cardiac surgery with CPB. Among these agents, while APR showed the highest efficacy, its use is constrained by regulatory restrictions and evidence limitations; therefore, it should be used with caution. TXA remains a practical first-line alternative. In the available network, blood component therapies did not emerge as consistently superior strategies compared with other hemostatic interventions. For 24-hour blood loss, APR was associated with lower blood loss than FFP, FC, and PCC. However, because the relevant comparisons were largely against active comparators rather than placebo or no hemostatic intervention, the efficacy of blood component therapies relative to no blood component therapy remains uncertain. Future large-scale RCTs are needed to further validate these findings. Copyright © 2026 Lu, Zhang and Pan. <132> Accession Number 2047692044 Title Is Faster Always Better? Ultra-Fast-Track Versus Fast-Track Extubation in Adult Cardiac Surgery: A Comprehensive Meta-analysis With Meta-regression. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Santos K.; Patel N.; Umibe T.; Abo T.; Sakai W.; Oya K.; Kim Kim J.Y.B.; Plonek T. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Umibe, Abo, Sakai, Oya) National Center for Global Health and Medicine, Tokyo, Japan (Kim Kim) Faculty of Medical Sciences, Universidad Nacional de Asuncion, Asuncion, Paraguay (Plonek) Department of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, Netherlands Publisher W.B. Saunders Abstract Objectives: To compare the clinical outcomes of ultra-fast-track extubation (UFTE), defined as extubation in the operating room or within 1 hour postoperatively, versus fast-track extubation (FTE), defined as extubation within 6 hours in the intensive care unit [ICU]), in adult patients undergoing cardiac surgery. Design(s): Systematic review and meta-analysis. Setting(s): Studies identified from MEDLINE, Scopus, and the Cochrane Library. Participant(s): Adult patients undergoing cardiac surgery. Intervention(s): Comparison of UFTE versus FTE. Measurements and Main Results: Twenty studies including nearly 800,000 patients were analyzed. UFTE was associated with lower 30-day mortality (odds ratio [OR], 0.54), shorter ICU length of stay (LOS) (mean difference [MD], -12.27 hours), shorter hospital LOS (MD, -1.19 days), reduced stroke rate (OR, 0.85) and reduced readmission rate (OR, 0.64). Rates of reintubation, reoperation for bleeding, acute kidney injury, pneumonia, and atrial fibrillation were similar. In the minimally invasive cardiac surgery subgroup, UFTE was associated with lower reintubation risk (OR, 0.26), whereas in the coronary artery bypass grafting subgroup, only hospital LOS was reduced. In propensity-matched cohorts, mortality and reintubation were comparable, although ICU and hospital stays remained shorter with UFTE. Meta-regression identified male sex and baseline left ventricular ejection fraction as significant moderators of the mortality effect. Conclusion(s): UFTE appears safe in selected patients and is associated with improved efficiency and recovery, particularly reduced ICU and hospital LOS. However, the observed mortality benefit is not sustained after adjustment, suggesting an important role of patient selection and perioperative optimization. Prospective randomized trials are required to confirm these findings. Copyright © 2026 Elsevier Inc. <133> Accession Number 2047633683 Title Aortocoronary Versus Composite Grafting Strategies in Coronary Artery Bypass Surgery: a Network Meta-analysis. Source Canadian Journal of Cardiology. (no pagination), 2026. Date of Publication: 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, NSW, 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. Copyright © 2026 The Authors. <134> Accession Number 2047748383 Title Treatment of Bicuspid Aortic Valve Stenosis Using Transcatheter Heart Valves. Source Interventional Cardiology Clinics. (no pagination), 2026. Date of Publication: 2026. Author Kolkailah A.A.; Engel Gonzalez P. Institution (Kolkailah) Division of Cardiology, Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, United States (Engel Gonzalez) Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, MI, United States Publisher Elsevier Inc. Abstract The paucity of data from randomized clinical trials regarding the use of transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve anatomy due to exclusion from pivotal studies continues to present a challenge as we expand TAVR to patients with BAV. This article discusses the important anatomic and clinical considerations in the selection and management of BAV patients with TAVR and reviews the emerging evidence, which increasingly suggests this procedure is safe, device success is excellent, and procedural outcomes are much improved. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <135> Accession Number 2047612662 Title Effect of Transcranial Alternating Current Stimulation on Prevention of Postoperative Pain After Video-Assisted Thoracic Surgery: A Randomized Controlled Trial. Source Pain Research and Management. 2026(1) (no pagination), 2026. Article Number: 6121920. Date of Publication: 2026. Author Chen S.; Li Z.-H.; Du N.; Lei L.; Yang J.-J. Institution (Yang, Chen, Li, Du, Lei, Yang) Department of Anesthesiology, Pain, and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou, China (Yang, Chen, Li, Du, Lei, Yang) Henan Province International Joint Laboratory of Pain, Cognition and Emotion, Zhengzhou, China Publisher John Wiley and Sons Ltd Abstract Introduction: Transcranial alternating current stimulation (tACS), which can noninvasively entrain oscillatory brain activity, has attracted scientific attention as a possible technique to control pain. However, there is a scarcity of studies investigating the preventive effect of tACS on postoperative pain. Method(s): This double-blind, randomized, sham-controlled trial enrolled 72 patients undergoing elective video-assisted thoracoscopic surgery (VATS). Patients were randomly allocated (1:1) to receive a single 20-min session of alpha-tACS on the primary somatosensory cortex (S1) or sham stimulation postoperatively. The primary outcomes were postoperative numerical rating scale pain scores and opioid consumption at 24 h postoperatively. Secondary outcomes included cumulative opioid consumption within 48 h and Quality of Recovery-15 (QoR-15) score. Adverse events were also assessed. Result(s): The tACS group exhibited significantly lower resting pain scores versus the sham group (beta = -0.49, 95% confidence interval [CI], -0.78 to -0.20, p = 0.001) and lower movement pain scores versus the sham group (beta = -0.45, 95% CI, -0.84 to -0.06, p = 0.025), though cumulative opioid consumption showed no difference at 24 h (median difference [MD] = 1.0 mg; 95% CI, -2.3 to 2.5; p = 0.76) and 48 h (MD = 3.3 mg; 95% CI, -0.6 to 9.1; p = 0.10) postoperatively. Additionally, the area under the curve for resting pain over 2-24 h (AUC<inf>2-24 h</inf>) and 2-48 h (AUC<inf>2-48 h</inf>), as well as the AUC<inf>2-48 h</inf> of movement pain scores, were significantly lower in the tACS group. Moreover, QoR-15 scores and adverse events were also comparable. Conclusion(s): For patients undergoing VATS, a single alpha-tACS treatment targeting the bilateral S1 regions yielded a statistically significant yet modest reduction in postoperative pain. However, no significant decrease in postoperative opioid consumption was observed, and further research is warranted. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2300078723. Copyright © 2026 Jin-Jin Yang et al. Pain Research and Management published by John Wiley & Sons Ltd. <136> Accession Number 651713735 Title EA-230 attenuates the duration of clinically relevant postoperative complications in on-pump cardiac surgery patients: a post hoc analysis of a phase 2b study. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Van Doren S.; Kox M.; Wensvoort G.; Pickkers P. Institution (Van Doren, Kox, Pickkers) Radboudumc, Intensive Care, Nijmegen, Netherlands (Wensvoort) Exponential Biotherapies, Inc. EBI, The Hague, Netherlands Publisher BioMed Central Ltd Abstract Introduction: In the phase 2b EASI study [1], administration of the PAMP/DAMP signaling attenuator EA-230 during on-pump cardiac surgery improved hemodynamic stability and attenuated organ dysfunction. Additionally, EA-230 significantly reduced hospital and ICU length of stay (LoS). We investigated whether or not these findings could be explained by a shorter duration of clinically relevant Post-Operative Complications (POCs). Method(s): By double-blinded post hoc analysis of the EASI study, adverse events were adjudicated according to the European Perioperative Clinical Outcome (EPCO) definitions [2] to assess POCs. Following EPCO definitions, POCs are determined as clinically relevant when they require specific clinical treatment. POC incidence, severity and duration were compared to LoS and between EA-230 and placebo groups. Result(s): Of 179 patients, 110 developed >= 1 POC; predominantly arrhythmias, delirium, and infections. Although reduced incidence and severity-scores of POCs were found in the active versus placebo group, these did not reach statistical significance. EA-230 compared to placebo significantly attenuated the duration of clinically relevant POCs (median [IQR] 17.2 [9.4-32.0] vs 44.3 [10.1-171.0] hrs; p= 0.003). Patients with >=1 POC had a significantly longer hospital LoS compared to those without POCs (median [IQR] 24 [20.0-146.0] vs 220 [189-282] hrs; p = 2e-16). In linear regression of log-transformed hospital LoS in patients with defined POC duration (R2 0.336), longer POC duration was associated with longer hospital LoS (beta [95% CI] 1.05 [1.03-1.07] per 24 hr increase; p<0.001), whereas treatment with EA-230 was associated with reduced LoS (beta [95% CI] 0.73 [0.60-0.88]; p = 0.002). Accordingly, in a Cox proportional hazard model including cumulative POC duration as a time dependent covariate for the population with no POCs and POCs of defined duration, longer POC duration was associated with a lower hazard of discharge (HR [95% CI] 0.87 [0.79-0.96] per 24 hr increase; p = 0.005), while treatment with EA-230 was linked to an increased hazard of discharge (HR [95% CI] 1.46 [1.03-2.09]; p = 0.036). Conclusion(s): Intraoperative treatment with EA-230 significantly attenuates the duration of clinically relevant POCs. This plausibly accounts for the previously reported shorter hospital LoS. <137> Accession Number 651713658 Title Fibrinogen concentrate versus cryoprecipitate for bleeding in cardiac surgery patients stratified by surgical urgency in the phase 3 FIBRES study. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Callum J.; Karkouti K.; Solomon C.; Werner S.; Gareis M.; Knaub S. Institution (Callum) Queens University, Kingston Health Sciences Centre, Kingston, Canada (Karkouti) University of Toronto, University Health Network, Toronto, Canada (Solomon, Knaub) Octapharma AG, Lachen, Switzerland (Werner) Octapharma USA, Paramus, NJ, United States (Gareis) Octapharma Pharmazeutika Produktionsges.m.b.H, Vienna, Austria Publisher BioMed Central Ltd Abstract Introduction: This post-hoc analysis explored efficacy of fibrinogen concentrate (FC) vs cryoprecipitate (cryo) for treatment of coagulopathic bleeding related to acquired fibrinogen deficiency in cardiac surgery patients from the Phase 3 FIBRES study, stratified by surgical urgency. FIBRES previously demonstrated non-inferiority of FC vs cryo in the population overall [1]. Method(s): FIBRES (NCT03037424) enrolled adult cardiac surgery patients on cardiopulmonary bypass (CPB) requiring fibrinogen replacement for clinically significant bleeding. Patients were randomized (1:1) to receive 4 g FC or 10 U cryo for each order within 24 h post-CPB. Patients were stratified by elective/non-elective surgery status. The primary endpoint was allogeneic blood products (ABP) administered up to 24 h after CPB end. Some patients experienced catastrophic bleeding with high, variable transfusion requirements, likely reflecting severe coagulopathies and requiring surgical re-exploration. To eliminate the disproportional impact of these outliers, an exploratory analysis excluded those receiving>=35 U ABPs within 24 h post-CPB (>90th percentile). Result(s): The primary analysis included 735 patients (N=372 FC, N=363 cryo). The majority (N=466; 63%) underwent elective surgery, with 269 (37%) undergoing non-elective surgery. In patients receiving<35 U ABPs (N=658, representing 90% of the primary analysis population), and in all patients undergoing elective surgery, FC was non-inferior and superior to cryo (Figure). Non-inferiority, but not superiority, was also demonstrated in patients undergoing non-elective surgery when excluding those receiving>=35 U ABPs (Figure). Conclusion(s): FC was superior to cryo after excluding the 10% most extreme or variable surgical cases and in patients undergoing elective surgery. These results support using FC as the preferred treatment for bleeding in cardiac surgery patients with acquired hypofibrinogenemia.(Figure presented) <138> Accession Number 651713681 Title Thoracic fascial plane blocks in cardiac anesthesia-systematic review and meta-analysis. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Tunde S.F.; Csomos A.; Molnar Z.; Csoke-Kabai K.; Laczko D.; Turan C.; Hegyi P. Institution (Csomos, Csoke-Kabai, Laczko, Turan, Hegyi) Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (Molnar) Semmelweis University, Department of Anaesthesiology and Intensive Therapy, Budapest, Hungary Publisher BioMed Central Ltd Abstract Introduction: The increasing number of cardiac surgeries requires new anesthetic approaches to ensure enhanced patient recovery. Thoracic fascial plane blocks (TPBs) are safe and effective additions to conventional analgesia; the evidence for their role in cardiac analgesia is lacking. This systematic review and meta-analysis aim to find the possible role of additional TPBs in cardiac analgesia. Method(s): We conducted our systematic search in three databases (PubMed, Embase, Cochrane) on November 4, 2024 (PROSPERO ID CRD42024601988). We included 70 randomized controlled studies investigating adults undergoing cardiac surgery and receiving TPB in addition to conventional analgesia, in a total of 4632 patients (2318 intervention, 2314 control group). Other study types, studies comparing two types or combining TPBs, and pediatric patients were excluded. Data were pooled using a random-effects model, and the pooled mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated. Result(s): TPBs administered before the surgical incision significantly reduced intraoperative fentanyl requirements by 271.38 microg (CI 95% (-370.99) - (-171.76); p< 0.001) [Figure]. Data showed lower VAS scores in the TPB group at the 12th postoperative hour, especially during coughing (-1.34; CI 95% (-2.01)-(-0.67); p= 0.001). TPBs were associated with faster extubation (-1.56 h; CI 95% (-2.28) - (-0.94); p< 0.001) and shorter ICU stay (-0,38 days; CI 95% (-0.54) - (-0.23); p< 0.001). Conclusion(s): Our results suggest that additional TBPs are safe and effective in enhancing recovery in cardiac surgery. However, analgesia of minimally invasive approaches needs to be further investigated.(Figure presented) <139> Accession Number 2047668214 Title Diagnosis of postoperative atrial fibrillation using smartwatch monitoring after cardiac surgery: protocol for the FAWATCH single-centre, open-label, randomised controlled trial. Source BMJ Open. 16(7) (no pagination), 2026. Article Number: e118691. Date of Publication: 01 Jul 2026. Author Beyls C.; Hermida A.; Mollet N.; Vermander M.; Noe F.; Bara H.; Josse E.; Khamari M.; Diouf M.; Abou-Arab O.; Mahjoub Y. Institution (Beyls, Mollet, Abou-Arab, Mahjoub) Anesthesiology and Critical Care Medicine, CHU Amiens-Picardie, Amiens, France (Beyls, Mollet, Mahjoub) UR UPJV 7518 SSPC, Amiens University, Amiens, France (Hermida, Vermander, Noe, Bara) CHU Amiens-Picardie, Amiens, France (Josse, Khamari) Project Management Unit, Clinical Research and Innovation Directorate, CHU Amiens-Picardie, Amiens, France (Diouf) Biostatistics Unit, Clinical Research and Innovation Directorate, CHU Amiens-Picardie, Amiens, France (Abou-Arab) MP3CV, EA7517, CURS, Amiens University, Amiens, France Publisher BMJ Publishing Group Abstract Introduction: Postoperative atrial fibrillation (POAF) remains the most frequent arrhythmic complication after cardiac surgery, with most episodes occurring after discharge from the intensive care unit (ICU) when continuous rhythm monitoring is no longer routinely available. Early detection of POAF is clinically relevant and influences long-term cardiovascular outcomes. Wearable devices combining photoplethysmography technology with single-lead ECG capability offer a potential solution for continuous rhythm monitoring in conventional surgical wards. However, their effectiveness and feasibility in the immediate postoperative in-hospital setting remain insufficiently evaluated. The FAWATCH trial aims to determine whether smartwatch-based rhythm monitoring improves POAF detection within the first 5 days after ICU discharge compared with standard. Methods and analysis: FAWATCH is a single-centre, open-label, randomised controlled trial conducted in the cardiac surgery department of Amiens-Picardie University Hospital. Adult patients undergoing cardiac surgery with cardiopulmonary bypass and transferred to the conventional surgical ward within 96 hours are eligible for inclusion. Patients are randomised in a 1:1 ratio using a centralised, computer-generated block randomisation sequence implemented through secure electronic software. Randomisation is stratified by age (>65 years), diabetes status and type of surgery (valvular, coronary or combined procedures). Participants are allocated to either standard care or smartwatch-based monitoring using a conformity European-marked single-lead ECG device (ScanWatch, Withings Move ECG, Withings, France). In the intervention group, patients wear the smartwatch continuously for 5 days and perform on-demand single-lead ECG recordings when alerted or symptomatic, with confirmation by standard 12-lead ECG. In the control group, POAF is diagnosed exclusively by a 12-lead ECG performed on clinical suspicion, as per routine practice. The primary outcome is the incidence of POAF within 5 days following ICU discharge. Secondary outcomes are the proportion of asymptomatic POAF, the association between left atrial reservoir strain and POAF occurrence, the feasibility of smartwatch monitoring, recurrence of POAF and major adverse cardiovascular events at 30 days, 3 months and 6 months. Recruitment began in January 2023, and the trial is currently ongoing, with 258 patients enrolled to date. Ethics and dissemination: Ethical approval has been obtained from the Institutional Review Board of Amiens-Picardie University Hospital (IRB-ID: 2022-A00497-36). All participants provide written informed consent in accordance with French regulations for interventional clinical research. The study's results will be disseminated through peer-reviewed publications and presentations at national and international conferences. Trial registration number: NCT05573633. 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/. <140> Accession Number 651713723 Title Continuation versus discontinuation of renin-angiotensin-aldosterone system inhibitors in patients undergoing major non-cardiac surgery-systematic review and meta-analysis. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Weber Z.W.; Turan C.; Tunde S.F.; Zubek L.; Molnar Z.; Zima E. Institution (Weber, Turan, Zubek, Molnar, Zima) Semmelweis University, Department of Anaesthesiology and Intensive Therapy, Budapest, Hungary (Tunde) Hospital of the Hungarian Defence Forces, Department of Anaesthesiology and Intensive Care, Budapest, Hungary Publisher BioMed Central Ltd Abstract Introduction: Many patients undergoing major non-cardiac surgery are chronically treated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) for hypertension or chronic heart failure. Perioperative management of these drugs remains controversial, as both continuation and discontinuation may lead to adverse outcomes. This study aimed to assess which strategy-continuation or discontinuation-is safer. Method(s): A systematic literature search was performed in CENTRAL, PubMed, and Embase on November 10, 2024, according to a registered PROSPERO (ID: CRD42024607744) protocol. Eligible studies included randomized controlled trials (RCTs) and observational studies of adult patients chronically treated with ACEIs or ARBs and undergoing major non-cardiac surgery. Studies comparing continuation versus discontinuation and reporting at least one predefined outcome were included. The risk of bias was assessed using the ROB2 tool for RCTs and ROBINS-I for observational studies. Result(s): Sixteen studies with a total of 74,032 patients met the inclusion criteria, including seven observational studies, seven RCTs, and two posthoc analyses. Data from six RCTs showed a significantly higher incidence of intraoperative episodes of hypotension (OR: 1.33, 95% CI: 1.20-1.47, p<0.0001) in the continuation group (Figure). Other outcomes, such as myocardial injury after non-cardiac surgery (MINS) (OR:1.09, 95%CI: 0.95-1.24, p=0.276) and mortality (OR: 0.91, 95% CI: 0.8-1.03, p=0.104), were not statistically significant but tended to be higher in the continuation group. Conclusion(s): Continuation of ACEIs or ARBs before major non-cardiac surgery is associated with a higher risk of intraoperative hypotension. Further studies are needed to determine optimal discontinuation timing and identify subgroups that may benefit from continuation.(Figure presented) <141> Accession Number 651713557 Title Urinary albumin-to-creatinine ratio for prediction of acute kidney injury: a systematic review and meta-analysis. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Kitisin N.; Neto A.S.; Raykateeraroj N.; Ismail J. Institution (Kitisin, Raykateeraroj) Faculty of Medicine, Siriraj Hospital, Mahidol University, Department of Anesthesiology, Bangkok, Thailand (Neto, Ismail) Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia Publisher BioMed Central Ltd Abstract Introduction: The urine albumin-to-creatinine ratio (UACR) is a well-established marker of chronic kidney disease, but its utility for predicting acute kidney injury (AKI) in hospitalized adults remains uncertain. We evaluated UACR performance for predicting AKI incidence and progression. Method(s): We performed a PRISMA-compliant systematic review and meta-analysis [1] (PROSPERO CRD420250648041) of studies in adults (>= 18 years) assessing UACR for AKI incidence or progression. Ovid MEDLINE, Embase and CENTRAL were searched to February 2025. Random-effects models pooled odds ratios (ORs), sensitivity, specificity and constructed a summary receiver operating characteristic (sROC) curve. Result(s): Sixteen studies were included (13 AKI incidence; 3 AKI progression), enrolling 10,438 and 1,596 patients, respectively, across settings including cardiac surgery, sepsis, COVID-19, acute myocardial infarction and cirrhosis. Elevated UACR was associated with increased risk of AKI development (8 studies; pooled OR 1.45, 95% CI 1.10-1.90). Pooled sensitivity and specificity for AKI prediction were 0.71 (95% CI 0.59-0.80) and 0.67 (95% CI 0.56-0.76), with sROC area under the curve 0.74 (95% CI 0.64-0.84), indicating moderate diagnostic accuracy (Figure). In cardiac surgery patients, elevated UACR consistently predicted AKI (3 studies; pooled OR 1.56, 95% CI 1.14-2.15). For AKI progression, elevated UACR strongly predicted worsening stage (3 studies; pooled OR 3.76, 95% CI 2.59-5.45). Conclusion(s): Elevated UACR is significantly associated with both development and progression of AKI in hospitalized adults and shows moderate diagnostic accuracy, particularly in cardiac surgery. Given its low cost, non-invasiveness and wide availability, UACR is a promising candidate for early AKI risk stratification; standardized thresholds and further validation are needed before routine implementation.(Figure Presented) <142> Accession Number 2047597683 Title Global research trends in robotic applications in cardiovascular medicine: a bibliometric analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 664. Date of Publication: 01 Dec 2026. Author Oguz O.; Erdol M.A.; Yayla C.; Ertem A.G. Institution (Oguz) Department of Cardiology, Sakarya Yenikent State Hospital, Sakarya, Turkey (Erdol, Yayla, Ertem) Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Turkey Publisher Springer Nature Abstract This study aimed to analyze global research trends in robotic applications in cardiovascular medicine. Robotic technologies have been increasingly integrated into cardiovascular medicine, providing enhanced precision, improved visualization, and reduced operator-related risks. Despite growing interest in this field, comprehensive evaluations of global research trends remain limited. In this bibliometric study, publications indexed in the Web of Science Core Collection between 2019 and 2025 were systematically analyzed, and 261 original articles meeting predefined criteria were included. Bibliometric analyses were carried out using VOSviewer and Biblioshiny to evaluate publication trends, citation dynamics, leading sources, and collaboration patterns. Scientific output showed a steady upward trajectory over time, with a more pronounced increase after 2021 and reaching its peak in 2025. The highest average citation rate was observed in 2024. Journal of Robotic Surgery and Journal of Cardiac Surgery were identified as the most productive journals. The United States was the leading contributor in terms of both publication volume and citation impact and also played a central role in international collaborations. Keyword analysis showed that research activity was primarily focused on robotic surgery, minimally invasive surgery, coronary artery bypass grafting, and percutaneous coronary intervention. Overall, robotic applications in cardiovascular medicine represent a rapidly expanding research area characterized by increasing scientific output and growing international collaboration. The concentration of publications in specific journals and the prominence of leading countries suggest a developing and increasingly structured research landscape. Copyright © The Author(s) 2026. <143> Accession Number 651713664 Title Four-factor prothrombin complex concentrate is superior to frozen plasma in bleeding adult cardiac surgery patients with coagulopathy-results from a phase 3 study. Source Critical Care. Conference: 45th International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. 30(1 Supplement 1) (no pagination), 2026. Article Number: 327. Date of Publication: 01 Jul 2026. Author Karkouti K.; Callum J.; Solomon C.; Knaub S.; Werner S.; Tanaka K.; Levy J.H. Institution (Karkouti) University of Toronto, University Health Work, Anesthesia and Pain Management, Toronto, Canada (Callum) Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada (Solomon, Knaub) Octapharma AG, Lachen, Switzerland (Werner) Octapharma USA, Paramus, NJ, United States (Tanaka) University of Oklahoma, Health Sciences Center, Oklahoma City, OK, United States (Levy) Duke University, School of Medicine, Durham, NC, United States Publisher BioMed Central Ltd Abstract Introduction: This trial compared the efficacy and safety of four-factor prothrombin complex (PCC; Octaplex/BALFAXAR, Octapharma) with frozen plasma (FP) in cardiac surgery. Cardiac surgery with cardiopulmonary bypass (CPB) is often complicated by coagulopathic bleeding, leading to morbidity and mortality. Although guidelines recommend using either PCC or FP for bleeding management, the mainstay therapy in North America is FP. Method(s): LEX-211 (FARES-II; NCT05523297) included patients aged>=18 years undergoing cardiac surgery with CPB. After protamine administration, patients with coagulopathic bleeding and INR>=1.5 were randomized 1:1 to receive PCC (1500 IU if<=60 kg; 2000 IU if>60 kg) or FP (3 U if<=60 kg; 4 U if>60 kg). Clinical teams were blinded to group allocation until treatment start. The primary endpoint was hemostatic response (effective if no additional hemostatic interventions were administered from 60 min to 24 h after treatment start). Safety endpoints included 30-day treatment-emergent thromboembolic events (TEEs) and death. Result(s): Of 538 enrolled patients at 12 sites in Canada and the US, 420 were randomized, treated, consented, and included in the analysis (PCC=213; FP=207). Baseline characteristics were comparable between groups. Effective hemostasis was achieved in 77.9% (n=166) of PCC vs 60.4% (n=125) of FP patients (diff. 17.6%; 95% CI 8.7, 26.4; p<0.001 for superiority). Overall, the mean (95% CI) number of allogeneic blood product units transfused within 24 h post-CPB, excluding intervention FP, was 6.6 (5.7, 7.7) in PCC and 9.3 (8.0, 10.8) in FP patients (ratio 0.71; 95% CI 0.57, 0.88; p=0.002). Treatment-emergent TEEs and mortality occurred in 8.5% (n=18) and 3.3% (n=7) of PCC patients and 7.2% (n=15) and 3.9% (n=8) of FP patients, respectively. Conclusion(s): In cardiac surgery patients, PCC was more efficacious than FP in controlling coagulopathic bleeding without increasing thromboembolic risk. These results support the use of PCC over FP for bleeding management in cardiac surgery. <144> Accession Number 651708414 Title Inspiratory muscle training as part of multimodal prehabilitation improves maximal inspiratory pressure in elderly surgical patients: an exploratory secondary analysis of a randomised controlled trial. Source BMC geriatrics. (no pagination), 2026. Date of Publication: 07 Jul 2026. Author Dueblin S.W.-S.; Wuethrich P.Y.; Engel D.; Eser P.; Beilstein C.M.; Wilhelm M.; Vetsch T. Institution (Dueblin) Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Wuethrich, Engel, Beilstein, Vetsch) Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Eser, Wilhelm, Vetsch) Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Abstract BACKGROUND: Older adults awaiting major surgery often present with reduced physical fitness and respiratory muscle weakness, which are associated with increased postoperative complications. Prehabilitation may improve functional capacity, but evidence for its effect on inspiratory muscle strength in high-risk older adults remains limited. The main objective was to assess the change in maximal inspiratory pressure (MIP) in the preoperative period in high-risk patients receiving home-based tele-supervised prehabilitation compared to standard care. METHOD(S): This exploratory analysis included a subset of secondary outcome data from a prospective, two-arm, parallel-group randomised controlled trial conducted at a single university hospital in Switzerland. Patients aged >= 65 years awaiting elective cardiac or major non-cardiac surgery with a proven fitness deficit measured by cardiopulmonary exercise testing (CPET) were included. Participants randomized in the intervention arm received a multimodal, home-based tele-supervised prehabilitation programme over 2-4 weeks addressing deficits in physical fitness, nutrition, and anaemia, while controls received standard preoperative care. RESULT(S): Eighty eight participants were analysed (intervention n = 48; control n = 40). Patients in the intervention group showed improvement in MIP after the training period, whereas the control group demonstrated a decline (median change + 10.5 [0.00; 16.2] vs. - 3.00 [-8.00; 1.50] cmH2O; p < 0.001). After adjustment for baseline MIP, the estimated between-group difference was 13.39 cmH2O (95%CI 8.12-18.75; p < 0.001). CONCLUSION(S): Home-based tele-supervised IMT, delivered as part of a multimodal prehabilitation programme, improved maximal inspiratory pressure over the preoperative period in elderly high-risk surgical patients. The observed MIP decline in the control group suggests that the preoperative waiting period itself may carry a risk of functional deterioration in this population. Whether MIP improvements translate into reduced postoperative morbidity will be addressed by the primary outcome of the ongoing PREHABIL trial. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT04461301 (First Submitted: 02.07.2020, First Posted: 08.07.2020). Copyright © 2026. The Author(s). <145> Accession Number 651709683 Title Prevention of Surgical Site Contamination With Cutibacterium acnes During Cardiac Surgery: A Randomized Clinical Trial. Source JAMA network open. 9(7) (pp e2621857), 2026. Date of Publication: 01 Jul 2026. Author Moter I.; Schubert S.; Goncalves A.; Saha S.; Sarbandi K.; Kikhney J.; Moter A.; Eszlari E.; Hagl C.; Eichinger W. Institution (Moter, Saha, Hagl) Department of Cardiac Surgery, Ludwig Maximilians University (LMU) Hospital Munich, Munich, Germany (Moter, Schubert) Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Faculty of Medicine, LMU Munich, Munich, Germany (Moter, Goncalves, Eszlari, Eichinger) Department of Cardiac Surgery, Academic Teaching Hospital of the Technical University Munich, Munich, Germany (Sarbandi) Institute of Microbiology, Infectious Diseases and Immunology, Charite-Universitatsmedizin Berlin, Berlin, Germany (Kikhney, Moter) Institute of Medical Microbiology and Virology, University of Leipzig Medical Center, Leipzig, Germany (Hagl) German Center for Cardiovascular Research, Partner Site Munich, Munich, Germany Abstract Importance: Cutibacterium acnes, traditionally considered a contaminant, is increasingly recognized as a relevant pathogen of prosthetic valve endocarditis, particularly in men. It is hypothesized that intraoperative transfer from incised hair follicles at the sternal wound margin occurs despite current standard disinfection protocols. Objective(s): To evaluate whether additional intraoperative hygiene measures reduce surgical site contamination with C acnes during cardiac surgery. Design, Setting, and Participant(s): This multicenter, parallel-group, blinded randomized clinical trial was conducted from October 28, 2024, to March 3, 2025, at 1 university hospital and 1 university-affiliated teaching hospital in Munich, Germany. Participants were male patients undergoing first-time cardiac surgery. Patients and laboratory personnel were blinded to group assignments. The analysis was based on a per-protocol design. Six patients were excluded after randomization due to incorrect sampling (n = 4) or incorrectly performed intervention procedures (n = 2). Intervention(s): The intervention group received additional hygiene measures after sternotomy, including changing outer gloves, disinfecting sternal wound margins with iodine, and covering them with sterile absorption pads. The control group received usual care, which included a glove change after sternotomy without additional skin margin treatment. Main Outcomes and Measures: The primary outcome was perioperative C acnes contamination, measured by the number of culture-positive swabs, amount of growth on agar, and pathogen identification via matrix-assisted laser desorption-ionization time of flight mass spectrometry. Result(s): Among 124 male patients (mean [SD] age, 68.5 [9.9] years) included in the analysis, C acnes was detected significantly less frequently in the intervention group (9 of 62 [14.5%]) compared with the control group (38 of 62 [61.3%]; risk ratio [RR], 0.24 [95% CI, 0.13-0.45]; P < .001), representing a relative risk reduction of 76%. Regarding growth intensity in the pericardium, the intervention group showed 100% negative or thioglycolate-only growth, whereas 27 patients (43.5%) in the control group exhibited agar growth (1+ to 3+). Overall bacterial contamination was similarly reduced (10 of 62 [16.1%] vs 44 of 62 [71.0%]; RR, 0.23 [95% CI, 0.13-0.41]; P < .001). Chest hair density was identified as a risk factor for contamination (odds ratio, 1.16 [95% CI, 1.02-1.31]; P = .02). Conclusions and Relevance: In this randomized clinical trial of 124 male patients undergoing cardiac surgery, additional intraoperative hygiene measures targeting the wound margin significantly reduced C acnes transfer to the surgical site. These simple, low-cost strategies should be considered for implementation in standard surgical protocols to potentially prevent prosthetic valve endocarditis. Trial Registration: German Clinical Trials Register: DRKS00035169. <146> Accession Number 2047603922 Title Incidence and Predictors of Postoperative Atrial Fibrillation Following Cardiac Surgery: A Systematic Review. Source Annals of Cardiac Anaesthesia. 29(3) (pp 314-324), 2026. Date of Publication: 01 Jul 2026. Author Prasetyadhi J.; Adil A.; Hisbullah; Arif S.K. Institution (Prasetyadhi) Department of Anesthesiology, Intensive Care, and Pain Management, Kolaka Timur Regional Public Hospital, Kolaka Timur, South Sulawesi, Indonesia (Adil, Hisbullah, Arif) Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo Hospital, South Sulawesi, Makassar, Indonesia Publisher Wolters Kluwer Medknow Publications Abstract Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with an incidence ranging from 10% to 65%, and is associated with increased risks of stroke, prolonged hospitalization, and mortality. This systematic review aimed to evaluate the incidence and identify predictors of POAF in adults undergoing cardiac procedures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Europe PMC, and SAGE databases for English-language studies published between January 2020 and June 2025. Eligible studies included observational and experimental designs involving adults (>18 years) undergoing cardiac surgery. Two reviewers independently screened titles/abstracts, assessed full texts, extracted data, and evaluated quality using the Newcastle-Ottawa Scale and Joanna Briggs Institute tools. From 6598 initial records, 52 studies (32 prospective cohorts, 17 retrospective cohorts, and 3 cross-sectional) were included, encompassing diverse geographies, and surgical types (e.g., coronary artery bypass grafting, valve surgery). POAF incidence varied from 7.9% to 60.9%, highest in combined procedures (40%-50%), and valve surgery (30%-40%). Consistent predictors included advanced age (odds ratio 1.05-1.10/year), left atrial enlargement, valve surgery, comorbidities (hypertension, diabetes, renal dysfunction), prolonged cardiopulmonary bypass, inflammation (e.g. C-reactive protein, neutrophil-to-lymphocyte ratio), and oxidative stress markers (e.g. NOX2). Novel biomarkers like MR-proANP and gene panels showed potential. POAF remains multifactorial and burdensome; standardized monitoring and integrated risk models could enhance prediction and prevention, warranting further validation in multicenter trials. Copyright © 2026 Annals of Cardiac Anaesthesia. <147> Accession Number 651709285 Title Heart-Rate Variability and Its Role in Non-Cardiac Surgery Perioperative Care: Scoping Review. Source ANZ journal of surgery. (no pagination), 2026. Date of Publication: 07 Jul 2026. Author Veysey-Smith R.; Bhardwaj A.; Jayne D.G.; Chapman S.J. Institution (Veysey-Smith, Bhardwaj, Jayne, Chapman) Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom Abstract BACKGROUND: Heart rate variability (HRV) is a non-invasive method of assessing autonomic function. Those with autonomic dysfunction may be at heightened risk of peri-operative complications due to sympatho-parasympathetic imbalance. This review summarises the clinical applications of HRV, approaches to how it is measured, and its role in predicting peri-operative complications. METHOD(S): A systematic search of EMBASE and MEDLINE databases was performed, with results screened independently by two reviewers. Primary studies exploring the use of HRV in the context of non-cardiac surgery were eligible. Outcomes of interest were technical parameters involved in assessing autonomic function and peri-operative complications. The data were systematically extracted, charted, and summarised using a narrative synthesis. Due to expected heterogeneity of results, quantitative analysis was not planned. RESULT(S): In total 1513 studies were screened and 63 were eligible for inclusion. Heart rate variability was used to measure autonomic function before surgery (n = 54/63; 85.7%), during surgery (n = 12/63; 19.0%), and after surgery (n = 18/63; 28.6%). HRV indices showed promise for identifying patients at risk of perioperative complications, most commonly comprising mortality, delirium, postoperative pain, myocardial ischaemia, and critical care admission. Measurements of HRV on post-operative day 1 tended to show superior discriminatory value than those performed later during recovery. CONCLUSION(S): Multiple clinical applications of HRV exist in the peri-operative period. If demonstrated definitively, HRV in patients undergoing major non-cardiac surgery could identify those at increased risk of perioperative morbidity and mortality. Copyright © 2026 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. <148> Accession Number 651711118 Title Knowledge gaps among patients with heart diseases in the perioperative context of cardiac surgery: a scoping review. Source Contemporary nurse. (pp 1-14), 2026. Date of Publication: 07 Jul 2026. Author Oliveira W.E.; Araujo M.E.S.; Saraiva C.O.P.O.; Sousa M.M.; De Lima Neto A.V. Institution (Oliveira, Araujo, De Lima Neto) Faculty of Health Sciences of Trairi (FACISA), Federal University of Rio Grande do Norte (UFRN), Santa Cruz, Brazil (Saraiva) Department of Public Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil (Sousa) Department of Clinical Nursing (DENC), Federal University of Paraiba (UFPB), Joao Pessoa, Brazil Abstract BACKGROUND: Cardiac surgery is an effective treatment for cardiovascular diseases but is associated with significant risks. Limited patient knowledge during the perioperative period may negatively affect outcomes. AIM: To map the knowledge gaps among patients with heart diseases in the perioperative context of cardiac surgery. DESIGN: Scoping review developed based on the guidelines of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist (PRISMA-ScR). DATA SOURCES: Evidence selection was conducted between August and September 2025 through searches in the MEDLINE, CINAHL, BDENF, Web of Science, Scopus, LILACS, CAPES Theses and Dissertations Portal, Theses Canada, RCAAP, BDTD, and Trove. METHOD(S): The inclusion criteria comprised studies in Portuguese, English, and Spanish involving individuals aged 18 years or older, with no time restriction, addressing patients' knowledge about their health condition in the perioperative period of cardiac surgery. Studies unavailable in full text, restricted-access documents, and opinion articles were excluded. Data extraction was based on predefined variables, and the information was analyzed using descriptive statistics. RESULT(S): Six studies were included in the final sample, predominantly journal articles with a quantitative approach, originating from Brazil, published in Portuguese, and covering the period from 2012 to 2024. Patients' knowledge was found to be deficient mainly regarding the risks and potential complications of cardiac surgery, how the surgical procedure is performed, the specific type of cardiac surgery to be undertaken, the possibility of engaging in physical activity after surgery, and care related to the surgical wound. CONCLUSION(S): Patients' knowledge presents gaps in several aspects related to the perioperative period of cardiac surgery, and that health education interventions are essential to address this issue. IMPACT STATEMENT: This scoping review identifies critical knowledge gaps among cardiac surgery patients in the perioperative period, underscoring the need for targeted nursing-led health education to improve patient safety, recovery, and evidence-based cardiovascular care. <149> Accession Number 2047603892 Title Relationship Between Entropy-Guided Sevoflurane Administration and End Oxygenator Sevoflurane Concentration in Adult Patients Undergoing Cardiopulmonary Bypass Surgery. Source Annals of Cardiac Anaesthesia. 29(3) (pp 378-385), 2026. Date of Publication: 01 Jul 2026. Author Kumar V.; Kumar A.; Gourav K.P.; Devarakonda B. Institution (Kumar, Kumar) Department of Anaesthesia and Critical Care, Armed Forces Medical College, Maharashtra, Pune, India (Gourav) Department of Anaesthesia and Critical Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Devarakonda) Department of Anaesthesia and Critical Care, Army R and R Hospital, New Delhi, India Publisher Wolters Kluwer Medknow Publications Abstract Background: Cardiopulmonary bypass (CPB) during cardiac surgery poses physiological challenges such as altered drug pharmacokinetics. Sevoflurane, a commonly used volatile agent, provides favorable myocardial protection; however, precise dosing during CPB remains difficult. Entropy monitoring, which assesses cerebral and electromyographic activity, offers real-time guidance on anesthetic depth. This study aimed to investigate entropy-guided sevoflurane administration relation with end-oxygenator sevoflurane concentrations, in patients undergoing elective on-pump cardiac surgery. Material(s) and Method(s): A prospective, randomized controlled trial was conducted in a single tertiary care center affiliated with a teaching hospital, enrolling 74 adult patients scheduled for elective on-pump cardiac surgeries. Participants were randomized into two groups: fixed sevoflurane concentration (1.5% v/v) and entropy-guided sevoflurane titration. Depth of anesthesia was monitored with state entropy (SE) and response entropy (RE), end-oxygenator sevoflurane concentrations, and clinical parameters. Result(s): Compared to the fixed-dose group, the entropy-guided group exhibited lower SE and RE values intraoperatively, indicating tighter control of anesthetic depth. Higher sevoflurane dial settings were used initially in the entropy group, resulting in higher end-oxygenator concentrations. Although mean arterial pressure and arterial blood gas parameters remained within acceptable ranges in both groups, VIS was higher in the entropy-guided group, suggesting an increased requirement for vasoactive and inotropic support. There was no statistically significant variation in postoperative mechanical ventilation duration or intensive care unit stay between the two groups. Conclusion(s): Overall, entropy monitoring facilitated a precise titration of sevoflurane without adversely affecting immediate postoperative outcomes. Copyright © 2026 Annals of Cardiac Anaesthesia. <150> Accession Number 651703270 Title AnchorMan versus Watchman 2.5: a randomised comparison in left atrial appendage closure. Source EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 22(13) (pp e715-e716), 2026. Date of Publication: 06 Jul 2026. Author Garot P.; Nielsen-Kudsk J.E. Institution (Garot) Institut Cardiovasculaire Paris-Sud (ICPS), Hopital Jacques Cartier, Massy, France (Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark <151> Accession Number 2047606210 Title Effect of Kinesio Taping on Pain at Thoracic Tube Sites After CABG: A Randomized Study. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of Publication: 2026. Author Yilmaz U.; Ersoy G.G.; Eski N.A.; Tekin K.A.; Bektas O.; Yilmaz E.T. Institution (Yilmaz) Department of Cardiovascular Surgery, Sancaktepe Training and Research Hospital, Istanbul, Istanbul, Turkey (Ersoy, Eski, Yilmaz) Department of Cardiovascular Surgery, Kastamonu Training and Research Hospital, Kastamonu, Kastamonu, Turkey (Tekin) Department of Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Istanbul, Turkey (Bektas) Department of Physical Therapy and Rehabilitation, Kastamonu Training and Research Hospital, kastamonu, Turkey Publisher Georg Thieme Verlag Abstract Background Pain from chest tubes significantly contributes to postoperative discomfort and opioid use after coronary artery bypass grafting (CABG). Nonpharmacological interventions at drain sites may aid recovery and reduce opioid exposure. Methods This randomized controlled study involved 100 adult patients undergoing elective CABG, randomized 1:1 to receive kinesio taping (n = 50) or serve as controls (n = 50). Kinesio tape was applied around mediastinal and thoracic drain sites before extubation, avoiding the incision. Both groups received standard analgesia with paracetamol and tramadol as rescue analgesia. Pain was measured using a visual analog scale (VAS) immediately after extubation and at 24 and 72 hours postoperatively. Opioid requirements, ICU stay, hospital stay, and complications were documented. Results VAS scores at extubation were similar (4.00 +/- 1.25 vs. 3.86 +/- 0.90; p = 0.678). Kinesio taping patients had significantly lower VAS scores at 24 hours (3.76 +/- 1.36 vs. 5.52 +/- 1.20; p < 0.001) and 72 hours (2.60 +/- 0.82 vs. 4.18 +/- 0.83; p < 0.001). Fewer patients in the kinesio taping group required opioid rescue (24% vs. 62%; p < 0.001). The ICU stay was shorter with kinesio taping (2.90 +/- 0.58 vs. 3.42 +/- 0.86 days; p = 0.001), while hospital stay and infection rates were similar. Conclusion Kinesio taping around drain sites post-CABG reduces pain, opioid needs, and ICU stay. This safe approach may enhance early postoperative pain management after cardiac surgery. Copyright © 2026. Thieme. All rights reserved. <152> Accession Number 2047718160 Title Mortality and adverse events of extracorporeal haemoadsorption therapy in cardiac surgery: a systematic review and meta-analysis of randomised controlled trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Pittaway H.C.A.; Kelly J.M.; Price M.J.; Parekh D.; Howells P.A. Institution (Pittaway, Parekh, Howells) Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom (Pittaway, Kelly, Parekh, Howells) University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (Pittaway, Parekh) National Institute of Health Research, Birmingham Biomedical Resource Centre, Birmingham, United Kingdom (Price) Canadian University of Dubai, Dubai, United Arab Emirates (Price) Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom Publisher Elsevier Ltd Abstract Background: Extracorporeal haemoadsorption (HA) therapy has been studied in RCTs for use during cardiopulmonary bypass (CPB). CPB is known to activate a systemic inflammatory response. Haemoadsorption has the potential to mitigate this through the removal of pro-inflammatory mediators. We aimed to examine available RCT data reporting on clinically important outcomes in a systematic review and meta-analysis. Method(s): We performed a systematic review and meta-analysis involving adult patients undergoing cardiac surgery with the use of CPB. The intervention was HA inserted into the CPB circuit, and the comparator was conventional CPB without HA. The primary outcome was mortality, and secondary outcomes included adverse events, requirements for organ support, and length of stay in ICU and hospitals. Result(s): We included 12 RCTs with 713 participants. Only one study had low risk of bias, limiting the strength of findings. Meta-analysis showed no statistically significant benefit of HA during CPB on mortality (odds in the intervention vs control group (odds ratio, 95% confidence interval [CI]=1.08, 0.59-2.01, P=0.75), hospital length of stay (mean difference of the intervention vs control group (pooled mean difference, 95% CI=0.21, -1.89-2.30, P=0.82) and intensive care length of stay (mean difference of the intervention vs control group (pooled mean difference, 95% CI=-0.36, -1.31-0.60, P=0.42) when compared with standard CPB. However, confidence intervals included the possibility of clinically important benefit or harm. There was also no significant difference in adverse events or requirements for ventilation, cardiovascular support or renal replacement therapy. Conclusion(s): This meta-analysis did not show evidence of clinical benefit for routine use of HA during CPB for cardiac surgery, although clinically relevant benefit or harm cannot be excluded on the currently available evidence. Appropriately powered and clinically focused RCTs targeting cases at the highest risk of cytokine burden are required. Copyright © 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <153> Accession Number 2047603947 Title Efficacy of Preincisional Ultrasound Guided Pecto-intercostal Fascial Plane Block with Ropivacaine and Fentanyl in Patients Undergoing Open Heart Surgery by Median Sternotomy - A Prospective Single Blinded Randomized Controlled Study. Source Annals of Cardiac Anaesthesia. 29(3) (pp 335-344), 2026. Date of Publication: 01 Jul 2026. Author Malik I.; Ahlawat G.; Budhwar D.; Singh S.; Dalai M.; Kumar V.; Gupta D.; Malhotra N. Institution (Malik, Ahlawat, Budhwar, Dalai, Malhotra) Department of Cardiac Anaesthesia, Pt BD Sharma PGIMS, Haryana, Rohtak, India (Singh) Department of Cardiothoracic Surgery, Pt BD Sharma PGIMS, Haryana, Rohtak, India (Kumar) Department of Anaesthesiology and Critical Care, Pt BD Sharma PGIMS, Haryana, Rohtak, India (Gupta) Department of Cardiac Anaesthesia, Medanta - The Medicity, Haryana, Gurgaon, India Publisher Wolters Kluwer Medknow Publications Abstract Aim: To evaluate the role of ultrasound (USG) guided Superficial Parasternal intercostal plane block (SPIP)/Pecto-Intercostal Fascial Plane Block (PIFB) on post sternotomy pain and postoperative outcomes in patients undergoing cardiac surgery. Method(s): This prospective single-blinded, randomized controlled study was conducted in 75 adult patients of age 18-75 years of ASA II-III undergoing cardiac surgery by median sternotomy. Patients were randomized into three groups with 25 patients in each group. Group I patients did not receive any block. Group II patients received USG guided PIFB with 0.4% ropivacaine+ 25 mug fentanyl on each side. Group III patients received USG guided PIFB with 0.4% ropivacaine+ 50 mug fentanyl. Numeric rating scale (NRS) for pain, Time to extubation, hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure) and SpO<inf>2</inf> at various time points (T0: at extubation, T1: 2 h, T2: 4 h, T3: 8 h, T4: 16 h, T5: 24 h, T6: 48 h post extubation), cumulative fentanyl consumption and rescue analgesia, post operative nausea vomiting (PONV), time to drain removal, catheter removal, ambulation, length of intensive care unit (ICU), and hospital stay were noted. Result(s): Group II and III patients as compared to group I showed lower NRS values, shorter time to extubation, drain and catheter removal, early ambulation, stable hemodynamics, less fentanyl consumption and rescue analgesia requirement, less incidence of PONV, early ICU and hospital discharge. Group II and III had comparable results with no significant difference. Conclusion(s): USG guided SPIP/PIFB provides improved postoperative pain control, reduces the need for perioperative opioids, faster extubation, early ICU and hospital discharge. Copyright © 2026 Annals of Cardiac Anaesthesia. <154> Accession Number 2047603939 Title Effect of Albumin Concentration and Timing on Acute Kidney Injury After Adult Cardiac Surgery: A Systematic Review and Meta-analysis. Source Annals of Cardiac Anaesthesia. 29(3) (pp 325-334), 2026. Date of Publication: 01 Jul 2026. Author Abo T.; Umibe T.; Nakano K.; Tongu Y.; Oya K. Institution (Abo, Umibe, Oya) Department of Surgery, National Center for Global Health and Medicine, Japan Institute for Global Health and Medicine, Tokyo, Japan (Nakano, Tongu) Department of Internal Medicine, National Center for Global Health and Medicine, Japan Institute for Global Health and Medicine, Tokyo, Japan Publisher Wolters Kluwer Medknow Publications Abstract The effect of hyperoncotic (20%-25%) human albumin on cardiac-surgery-associated acute kidney injury (CS-AKI) is uncertain. This study evaluated whether intraoperative or postoperative administration of 20%-25% albumin influences the risk of CS-AKI compared with crystalloids or iso-oncotic (4%-5%) albumin. Systematic review and meta-analysis of randomized controlled trials (RCTs) and risk-adjusted cohort studies were conducted. Risk ratios (RRs) were pooled using random-effects models. Literature search of PubMed, Embase (Ovid), and Cochrane CENTRAL was carried out from January 1, 1995, to July 17, 2025. Adults undergoing on-pump CS. Four eligible studies-two RCTs and two cohort studies, encompassing 6651 patients-were included. About 20%-25% of human albumin was administered either intraoperatively or within 24 h postoperatively. Comparators were crystalloids or 4%-5% albumin. The primary outcome was the incidence of any-stage AKI within 7 days of surgery. Pooled analysis showed 20%-25% albumin increased the risk of CS-AKI (RR 1.10, 95% confidence interval [CI] 1.05-1.16; I2 =0%). Restriction to RCTs yielded a similar result (RR 1.12, 95% CI 1.04-1.20). The increased risk was consistent for both intraoperative (RR 1.09) and postoperative (RR 1.12) administration, but the interaction between infusion timing was non-significant (P = 0.59). Infusion of 20%-25% albumin is associated with a modest but consistent increase in postoperative AKI, independent of infusion timing from intraoperative to postoperative within 24 h. Until adequately powered trials resolve the remaining imprecision, routine perioperative administration of hyperoncotic albumin should be approached with caution. Copyright © 2026 Annals of Cardiac Anaesthesia. �

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