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Total documents retrieved: 143 Results Generated From: Embase <1980 to 2026 Week 21> Embase Weekly Updates (updates since 2026-05-15) - (143 records) <1> Accession Number 2045327399 Title The triglyceride-glucose (TyG) index as an emerging biomarker for delirium: A systematic review and meta-analysis. Source General Hospital Psychiatry. 100 (pp 286-295), 2026. Date of Publication: 01 May 2026. Author Yang Y.-W.; Yu J.; Gong L.; Ge M.-L.; Wan Z. Institution (Yang, Yu, Wan) The Emergency Department, West China Hospital, Sichuan University, Sichuan, Chengdu, China (Gong) Rare Diseases Center, West China Hospital, Sichuan University, Sichuan, Chengdu, China (Gong, Wan) Outpatient Department, West China Hospital, Sichuan University, Sichuan, Chengdu, China (Ge) Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, Chengdu, China Publisher Elsevier Inc. Abstract Background Delirium is a common and serious neuropsychiatric complication among acutely ill and surgical patients. Insulin resistance has been implicated in delirium vulnerability. The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, has shown relevance in metabolic and neurological disorders, but its association with delirium remains unclear. Methods Following PRISMA guidelines, we performed a systematic review and meta-analysis of observational studies identified in PubMed, Embase, and Web of Science up to December 2025. Random-effects models were used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses evaluated robustness, and study quality was assessed using the QUIPS tool. Results Eight cohort studies including 25,462 participants (9739 delirium cases) were analyzed. Elevated TyG index was associated with an increased risk of delirium (pooled OR = 1.37, 95% CI: 1.29-1.46, p < 0.001), and each unit increase in TyG corresponded to a 29% higher risk (OR = 1.29, 95% CI: 1.21-1.37), with negligible heterogeneity (I2 = 0%). The association remained consistent across subgroups defined by surgical status, metabolic conditions, and demographic factors, while a modestly stronger effect was observed in patients with heart failure (p for subgroup difference = 0.009). Sensitivity analyses confirmed the stability of results, and no publication bias was detected. Conclusions Elevated TyG index was associated with delirium risk across the included retrospective cohorts. As an accessible biomarker, TyG may facilitate early identification of patients at risk, reflecting the contribution of insulin resistance-related metabolic dysfunction to delirium pathogenesis. Copyright © 2026. Published by Elsevier Inc. <2> Accession Number 2045264211 Title Comparative Study on Efficacy of Intraperitoneal Instillation of Levo Bupivacaine versus Ropivacaine for Post-Operative Analgesia after Laparoscopic Cholecystectomy - A Randomized Controlled Trial. Source International Journal of Drug Delivery Technology. 16(33 Supplement) (pp 640-645), 2026. Date of Publication: 2026. Author Malepati C.; David S.; Prabhu K.; Asokan A. Institution (Malepati, David, Prabhu, Asokan) Department of Anaesthesiology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Postoperative pain control remains an important part of laparoscopic cholecystectomy. This study compares the efficacy of intraperitoneal instillation of Levobupivacaine to Ropivacaine for postoperative analgesia, evaluating hemodynamic stability, pain scores and analgesic demand. Aim(s): To compare the efficacy of intraperitoneal instillation of Levobupivacaine and Ropivacaine for postoperative analgesia after laparoscopic cholecystectomy. Method(s): A randomized controlled trial was done on sixty individuals who underwent elective laparoscopic cholecystectomy. Patients were randomly divided into two groups: Group R (Ropivacaine) and Group L (Levobupivacaine). Baseline features, hemodynamic parameters, Visual Analogue Scale (VAS) pain levels, duration of analgesia and rescue analgesic requirements were all documented and studied. Result(s): The average age was similar between groups (p = 0.316), while the gender distribution was significantly different (p = 0.012). There were no significant variations in weight (p = 0.629), height (p = 0.478), BMI (p > 0.05), or ASA classification. Group R and Group L are equivalent in duration of surgery (p > 0.05). Heart rate changes showed quicker analgesic decline in Group L (4-12 hours, p < 0.05), whereas systolic and diastolic blood pressure were equivalent between groups (p > 0.05). Group L showed a temporary increase in mean arterial pressure (MAP) (1-4 hours, p < 0.05), which then stabilized. Group R showed significantly lower VAS values at repeated postoperative intervals (p < 0.05), indicating better analgesic efficacy. Ropivacaine resulted in prolonged analgesia (9.13 +/- 0.86 vs. 7.57 +/- 0.50 hours, p < 0.001). Group R had considerably fewer patients who needed rescue analgesia (p < 0.01), with 93.3% requiring no extra analgesia compared to 66.7% in Group L. Conclusion(s): In laparoscopic cholecystectomy, Ropivacaine administered intraperitoneally gives better postoperative analgesia than Levobupivacaine. Ropivacaine improves pain control, extends analgesic duration and reduces the need for rescue analgesia, making it a better choice for postoperative pain management. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <3> Accession Number 2045465383 Title Melatonin Supplementation and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Trials. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3444. Date of Publication: 01 May 2026. Author Ang S.P.; Chia J.E.; Thirupathy U.; Laezzo M.; Jaiswal V.; Varon J.; Halma M.; Lee E.; Davidson G.; Iglesias J. Institution (Ang) Division of Cardiology, Sarver Heart Center, University of Arizona, Tucson, AZ, United States (Chia) Department of Medicine, Texas Tech University Health Science Center, El Paso, TX, United States (Thirupathy) Cheshire Medical Center, Keene, NH, United States (Laezzo, Iglesias) Department of Medicine, Hackensack Meridian School of Medicine, Nutley, NJ, United States (Jaiswal) Endeavor Health Cardiovascular Institute, University of Chicago Pritzker School of Medicine, Chicago, IL, United States (Varon) Department of Medicine, University of Houston College of Medicine, Houston, TX, United States (Varon, Halma) Independent Medical Alliance, Washington, DC, United States (Halma) Open Source Medicine OU, Parnu mnt. 139c, Tallinn, Estonia (Lee, Davidson, Iglesias) Department of Medicine, Rutgers Health Community Medical Center, Toms River, NJ, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Melatonin has antioxidant and anti-inflammatory properties that may attenuate ischemia-reperfusion injury, but randomized cardiovascular trial data remain inconsistent. Objective(s): This study sought to evaluate the association of melatonin supplementation with cardiovascular outcomes across randomized trials. Method(s): We performed a systematic review and meta-analysis of randomized trials comparing melatonin with placebo, usual care, or no melatonin in patients with cardiovascular disease. PubMed, Embase, and CENTRAL were searched from inception to 1 January 2026. Random-effects models with Hartung-Knapp-Sidik-Jonkman confidence intervals were used. Prespecified outcomes included left ventricular ejection fraction (LVEF), change in LVEF, troponin, infarct size by cardiac magnetic resonance, heart failure outcomes, inflammatory and oxidative stress biomarkers, and adverse events. Result(s): A total of 14 randomized controlled trials involving 1027 participants were included. Melatonin significantly improved change in LVEF from baseline to follow-up (mean difference: 3.95 percentage points; 95% CI: 1.70-6.20; p < 0.001), with the most consistent signal in coronary artery bypass grafting studies (mean difference: 4.65 percentage points; 95% CI: 2.56-6.74). Final LVEF was numerically higher with melatonin but not statistically significant. Troponin reduction was not significant. Narrative synthesis suggested lower inflammatory and oxidative stress markers after coronary artery bypass grafting and improvement in heart failure symptoms and quality of life, whereas infarct size findings in ST-segment elevation myocardial infarction were mixed and timing-dependent. Conclusion(s): Melatonin was associated with improved LVEF change, particularly in coronary artery bypass grafting settings, but benefit was not consistently demonstrated across final LVEF, troponin, or infarct size outcomes. Copyright © 2026 by the authors. <4> Accession Number 2045589949 Title Lymphadenectomy and Upstaging in Thoracic Oncology: A Narrative Review. Source European Journal of Cardio-thoracic Surgery. 68(Asia-Pacific Innovative Thoracic Surgery Symposium 2025) (pp i41-i49), 2026. Date of Publication: 01 Apr 2026. Author Ceccarelli I.; Durand M.; Seguin Givelet A. Institution (Ceccarelli) Minimally Invasive and Robotic Thoracic Surgery-Department of Surgical, Medical, Molecular and Critical Care Pathology, University of Pisa, Pisa, Italy (Ceccarelli) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France (Durand) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France (Seguin Givelet) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: To review the historical evolution, current evidence, and future perspectives regarding lymphadenectomy in non-small-cell lung cancer (NSCLC), with a particular focus on its role in accurate staging, nodal upstaging, and therapeutic decision-making. Method(s): This narrative review was conducted through a literature search of PubMed and Scopus from 1950 to March 2025, using the terms non-small-cell lung cancer, lymphadenectomy, nodal upstaging, and mediastinal dissection. Reference lists of relevant studies and guidelines were also screened. Both randomized controlled trials and large observational studies were included, together with international guidelines and recent conference abstracts (Asia-Pacific Innovative Thoracic Surgery Symposium [APITS] 2025). Result(s): Evidence consistently demonstrates that systematic mediastinal lymphadenectomy enhances staging accuracy, increases the detection of occult nodal disease, and improves prognostic stratification. Pathologic upstaging is a frequent and clinically relevant phenomenon in clinically node-negative patients, directly influencing indications for adjuvant systemic therapy. Guideline-based nodal dissection remains a cornerstone of curative-intent surgery, with at least 3 mediastinal stations and 1 hilar station recommended. Comparative studies show that when a station-based approach is rigorously applied, minimally invasive and robotic techniques achieve staging outcomes equivalent to open surgery. Recent technological innovations, including radiomics, deep learning, and artificial intelligence applied to positron emission tomography/computed tomography (PET/CT) and endobronchial ultrasound, hold promise for refining preoperative risk prediction but remain adjuncts to systematic surgical clearance. Conclusion(s): Lymphadenectomy is central to the surgical management of NSCLC. Beyond its role in accurate staging and prognostic assessment, it guides multimodality treatment and underpins long-term outcomes. Future advances are likely to derive not from platform choice but from integrating technology to ensure that systematic, station-based lymphadenectomy is performed safely, consistently, and comprehensively. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <5> [Use Link to view the full text] Accession Number 2044225425 Title Safety and efficacy of protamine use during transcatheter aortic valve implantation: A systematic review and meta-analysis. Source Medicine (United States). 105(6) (pp e47578), 2026. Date of Publication: 06 Feb 2026. Author Khan S.A.; Parajuli S.B.; Marasini A.; Shrestha A.; Khan S.; Umirkulova F.; Anas R.; Urazbaeva D.; Bhandari B.; Kausar H.; Kauser H. Institution (Khan, Bhandari) Birat Medical College Teaching Hospital, Morang, Nepal (Parajuli) Department of Community Medicine, Birat Medical College Teaching Hospital, Morang, Nepal (Marasini) West Virginia University Health System Princeton Community Hospital, Princeton, WV, United States (Shrestha) Department of Internal Medicine, Medstar Health Georgetown University, Baltimore, MD, United States (Khan) Department of Internal Medicine, Liceo de Cagayan University, Cagayan de Oro City, Misamis Oriental, Philippines (Umirkulova) Department of Medicine, Termez University of Economics and Service, Termez, Uzbekistan (Anas) Department of Internal Medicine, Sargodha Medical College, Sargodha, Pakistan (Urazbaeva) Department of Psychology and Medicine, Mamun University, Khiva, Uzbekistan (Kausar) Department of Internal Medicine, Karnali Academy of Health Sciences, Jumla, Nepal (Kauser) Department of Pharmacology, Pokhara University, Pokhara, Nepal Publisher Lippincott Williams and Wilkins Abstract Background: - Bleeding and vascular complications are key safety concerns during transcatheter aortic valve implantation (TAVI). Protamine is routinely administered to reverse unfractionated heparin, yet its efficacy and safety profile remain debated, particularly regarding its influence on bleeding, vascular, and renal outcomes. Method(s): - A meta-analysis of published studies comparing protamine with placebo during TAVI was conducted. Primary outcomes included transfusion requirements, major and life-threatening bleeding, and major vascular complications. Secondary outcomes were acute kidney injury, cerebrovascular events, myocardial infarction, minor vascular complications, and 30-day mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models, and heterogeneity was assessed with the I2 statistic. Result(s): - Protamine administration significantly reduced the need for blood transfusion (OR = 0.70; 95% CI 0.55-0.88; P = .00; I2 = 0%), major bleeding (OR = 0.54; 95% CI 0.31-0.92; P = .02; I2 = 42.6%), life-threatening bleeding (OR = 0.33; 95% CI 0.12-0.87; P = .03; I2 = 26.8%), and major vascular complications (OR = 0.44; 95% CI 0.28-0.67; P = .00; I2 = 0%). There were no significant differences in any bleeding (OR = 0.82; 95% CI 0.50-1.36; P = .45), acute kidney injury (OR = 0.81; 95% CI 0.61-1.07; P = .14), cerebrovascular events (OR = 0.82; 95% CI 0.43-1.59; P = .56), myocardial infarction (OR = 0.47; 95% CI 0.08-2.90; P = .42), minor vascular complications (OR = 0.76; 95% CI 0.51-1.15; P = .19), or 30-day mortality (OR = 1.12; 95% CI 0.68-1.85; P = .65). Heterogeneity was minimal across most analyses (I2 < 50%). Conclusion(s): - Protamine reversal of heparin during TAVI appears safe and confers significant protective effects against transfusion requirements, bleeding, and major vascular complications, supporting its routine use in the absence of contraindications. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <6> Accession Number 2045485220 Title A Systematic Review and Expert Evaluation of Perioperative SGLT2 Inhibitor-Associated Ketoacidosis Case Reports. Source Acta Anaesthesiologica Scandinavica. 70(6) (no pagination), 2026. Article Number: e70254. Date of Publication: 01 Jul 2026. Author Snel L.I.P.; Li X.; Jamaludin F.; Siegelaar S.E.; Holleman F.; Vriesendorp T.M.; DeVries J.H.; Hoekstra J.B.L.; Preckel B.; van Raalte D.H.; Hermanides J.; Hulst A.H. Institution (Snel, Li, Preckel, Hermanides, Hulst) Department of Anesthesiology, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Snel, Holleman, van Raalte) Department of Internal Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Snel, Li, Preckel, Hermanides) Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands (Snel, van Raalte, Hulst) Amsterdam Cardiovascular Sciences Research Institute, VU University, Amsterdam, Netherlands (Li) Center for Cell Lineage and Development, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China (Jamaludin) Amsterdam Medical Library, Amsterdam UMC, Amsterdam, Netherlands (Siegelaar, DeVries, Hoekstra) Department of Endocrinology and Metabolism, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands (Siegelaar, Hulst) Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam UMC, Amsterdam, Netherlands (Vriesendorp) Department of Internal Medicine, Isala Hospital, Zwolle, Netherlands Publisher John Wiley and Sons Inc Abstract Introduction: The use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in the perioperative setting may lead to SGLT2i-associated postoperative ketoacidosis (SAPKA) in patients with type 2 diabetes (T2D). Therefore, cessation of this drug is recommended before surgery. We aimed to study reported cases to assess the causality of SGLT2i, identify common characteristics, potential risk factors, treatment and outcomes of SAPKA. Method(s): We conducted a systematic literature search to identify case reports of patients with metabolic acidosis and the presence of ketones who used SGLT2i in the perioperative setting. Case reports were summarised for common characteristics, assessed for quality and distributed to a panel of diabetes experts, who evaluated the likelihood of SAPKA using a questionnaire. Result(s): Ninety-three papers containing 128 case reports fulfilled the inclusion criteria. The expert panel found SAPKA to be 'likely' in 53 (41%), 'possible' in 38 (30%) and 'unlikely' in 27 (21%) cases; 10 cases (8%) could not be validated due to insufficient data or implausible timing. SAPKA was therefore considered likely or possible in 71% (91/128) of cases. Common factors identified in the SAPKA reports included a diagnosis of T2D mellitus (n = 115), impaired perioperative intake (n = 30) and insufficient insulin supplementation (n = 10). Treatment with insulin was effective, and ketoacidosis resolved in all surviving patients, although significant morbidity, including ICU admission, was reported in a substantial proportion of cases. Discussion(s): Confirming a SAPKA diagnosis is challenging due to the variable reporting quality and numerous confounding factors present during the perioperative period. Clinicians should remain aware of SAPKA given the increasing prevalence of SGLT2i use. Focusing on early recognition and treatment represents a potential alternative strategy to routine preoperative SGLT2i discontinuation, though this requires further prospective evaluation. Editorial Comment: This systematic review presents an overview and discussion of the many, to date, case reports of ketoacidosis thought to be associated with perioperative SGLT2 inhibitor treatment. Copyright © 2026 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. <7> [Use Link to view the full text] Accession Number 2044974063 Title The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular pressure during coronary artery bypass grafting: A prospective, randomized controlled trial. Source Medicine (United States). 105(2) (pp e47110), 2026. Date of Publication: 09 Jan 2026. Author Ucak D.; Ulku H.S.; Ciloglu E.; Badak T.O. Institution (Ucak, Ulku) Department of Anesthesiology and Reanimation, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey (Ciloglu) Department of Ophthalmology, Adana Sevgi Eye Center Hospital, Adana, Turkey (Badak) Department of Cardiovascular Surgery, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey Publisher Lippincott Williams and Wilkins Abstract Intraocular pressure (IOP) is an indirect marker of ocular perfusion and is critical during coronary artery bypass grafting (CABG) due to potential hemodynamic instability. The combined effects of anesthetic modality (sevoflurane vs propofol-based total intravenous anesthesia [TIVA]) and cardiopulmonary bypass (CPB) flow type (pulsatile vs nonpulsatile) on intraoperative IOP during CABG are not well established. This prospective, randomized controlled trial included 160 patients undergoing CABG, randomized into four groups (n = 40 each): Sevoflurane + pulsatile CPB (SP), sevoflurane + nonpulsatile CPB (SN), TIVA + pulsatile CPB (TP), and TIVA + nonpulsatile CPB (TN). Patients with preexisting ocular conditions were excluded. IOP was measured using a Tono-Pen Avia at four time points: before induction, after induction, after CPB initiation, and at the end of surgery. Statistical analysis included one-way analysis of variance, Tukey post hoc testing, and chi-square tests. Baseline characteristics and IOP values were comparable across groups. After induction, the TIVA groups (TP and TN) showed a significant reduction in IOP (mean difference -3.5 mm Hg; P < .001) compared with the sevoflurane groups. Upon CPB initiation, IOP increased in all groups, most prominently in the SN group (P < .01). Pulsatile flow was associated with significantly lower IOP values than nonpulsatile flow (P < .01), irrespective of anesthetic modality. The TP group exhibited the most stable IOP profile throughout surgery (P < .05). No acute glaucoma or serious ocular complications were observed. Propofol-based TIVA produced a greater reduction in IOP after induction, and pulsatile CPB contributed to a more stable intraoperative IOP profile during CABG compared with sevoflurane anesthesia and nonpulsatile CPB, respectively. Although IOP fluctuations remained within subclinical limits, these findings suggest that TIVA combined with pulsatile CPB may offer advantages in maintaining ocular hemodynamic stability, particularly in high-risk patients. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <8> Accession Number 2045220460 Title "Knowing is Not Enough; We Must Apply. Willing is Not Enough; We Must Do.": Johann Wolfgang von Goethe1. Source European Journal of Cardio-thoracic Surgery. 68(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Potapov E.V. Institution (Potapov) Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany (Potapov) Charite-Universitatsmedizin Berlin, Freie Universitat Berlin, Berlin, Germany (Potapov) Humboldt-Universitat zu Berlin, Berlin, Germany (Potapov) DZHK (German Center for Cardiovascular Research), Berlin, Germany Publisher European Association for Cardio-Thoracic Surgery <9> Accession Number 2044190565 Title Avoidance of Hyperoxemia Versus Routine Hyperoxia During Cardiopulmonary Bypass in Children With Cyanotic Congenital Heart Disease-A Systematic Review and Meta-Analysis. Source Paediatric Anaesthesia. 36(6) (pp 607-616), 2026. Date of Publication: 01 Jun 2026. Author Fischer J.; Arobo A.; Almehandi A.; Leidens E.C.; Apostu E.B.; Passos F.S.; Kirov H.; Doenst T.; Kerst G.; Loukanov T.; Caldonazo T. Institution (Fischer, Leidens, Apostu, Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany (Arobo) College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria (Almehandi) Department of Cardiovascular Science, University College London, London, United Kingdom (Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador, Brazil (Kerst) Clinic for Pediatric Cardiology and Congenital Heart Disease, Klinikum Stuttgart, Stuttgart, Germany (Loukanov) Division of Congenital Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany Publisher John Wiley and Sons Inc Abstract Background: Children with cyanotic congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass (CPB) are exposed to varying oxygenation strategies, and the optimal oxygenation strategy and the impact of limiting hyperoxic exposure remain uncertain. This study aimed to compare oxygenation strategies designed to avoid hyperoxemia versus routine hyperoxic management in this population. Method(s): A systematic search was conducted in four databases. The primary outcome was postoperative intubation time. Secondary outcomes included intensive care unit (ICU) length of stay (LOS), hospital LOS, total operative duration, and epinephrine requirement. Standardized mean difference (SMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated for continuous and categorical outcomes, respectively. A random-effects model was applied to all outcomes. Result(s): Seven studies (six randomized controlled trials; one observational) met all the inclusion criteria. Strategies avoiding hyperoxemia did not significantly reduce postoperative intubation time compared with routine hyperoxia (SMD: -0.25; 95% CI: -0.52-0.03; p = 0.077; I2 = 15%). Also, no significant differences were observed for ICU LOS (SMD: -0.04; 95% CI: -0.46-0.38; p = 0.859; I2 = 64%), hospital LOS (SMD: 0.24; 95% CI: -0.01-0.50; p = 0.064; I2 = 0%), operative duration (SMD: -0.66; 95% CI: -1.90-0.58; p = 0.294; I2 = 84%), and epinephrine use (OR: 0.66; 95% CI: 0.28-1.57; p = 0.350; I2 = 0%). Conclusion(s): No significant differences in postoperative outcomes were observed between oxygenation strategies aimed at avoiding hyperoxemia and routine hyperoxic management during CPB. Copyright © 2026 John Wiley & Sons Ltd. <10> Accession Number 2045265450 Title Effect of Power Breath Device on Arterial Blood Gases and Diaphragmatic Excursion After Valve Surgery. Source International Journal of Drug Delivery Technology. 16(32 Supplement) (pp 794-800), 2026. Date of Publication: 2026. Author Hassan H.M.; Zidan M.S.; Obaya H.E.; Naguib A.M.; El Shehy E.M.; Abdel Wahab K.A.M.; Wahba M.N.H.; Ghallab M.A.; Abd El-Wahab M.A.M. Institution (Hassan, Obaya, Ghallab, Abd El-Wahab) Department of Physical Therapy for Cardiovascular/ Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Egypt (Zidan) Department of Physical Therapy, Faculty of Applied Medical Science, Al-Zaytoonah University of Jordan, Amman, Jordan (Naguib) Department of Internal Medicine, Faculty of Medicine, Cairo University, Egypt (El Shehy) Department of Cardio Thoracic Surgery, Faculty of Medicine, Cairo University, Egypt (Abdel Wahab) Department of Anesthesia and Surgical ICU, Faculty of Medicine, Cairo University, Egypt (Wahba) Department of Physiotherapy for Internal Medicine and Geriatrics, Alryada university for Science and Technology, Egypt Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Pulmonary complications are a common result of heart surgeries, even though surgical methods and postoperative care have improved greatly. Pulmonary complications contribute to high rates of morbidity and mortality as well as longer hospital stays and higher health care expenses. Inspiratory muscle training (IMT) is a therapeutic modality that aims to improve inspiratory muscle conditioning via respiratory muscle overload. Respiratory muscle training devices, such as power breath, strengthen the respiratory muscle, improve endurance, and increase exercise capacity (Nora et al., 2018, and Nadia et al., 2016). Aim(s): To evaluate the impact of the power breath device on arterial blood gases as well as diaphragmatic excursion following cardiac valve surgery. Method(s): Fifty female patients aged 25 to 35 years who had undergone valve surgery (either valve replacement or repair via a median sternotomy) were recruited from the Cardiothoracic Surgery Department at Kasr El-Aini Hospital and randomly assigned to two groups. These patients participated in daily inspiratory muscle training sessions, carried out once daily for seven days after surgery, beginning on the second day. group I (intervention group): This group consisted of 30 female patients who performed inspiratory muscle training using a Power Breathe device in addition to treatment by incentive spirometer, beginning the day following surgery, once daily for seven days a week group II (control group): This group consisted of 20 female patients who participated in a diaphragmatic breathing exercise program using an incentive spirometer (IS) only. The training was performed once daily, seven days per week, starting from the second day after surgery as part of inspiratory muscle training. Beginning in December 2022 and ending in February 2024, the study's practical work was conducted. Result(s): After management in both groups, there was no substantial difference among groups at pretreatment (p > 0.05). The post-treatment comparison among groups indicated a substantial elevation in PO levels. (ES (Effect size) = 1.99), diaphragmatic excursion (ES = 0.71), and 6MWT distance (ES = 1.73), and a significant decrease in PCO (ES = 0.84) in group I compared with group II (p < 0.01). There was no substantial difference regarding pH levels (ES = 0.13) as well as SpO2 levels (ES = 0.37) among groups (p > 0.05). Conclusion(s): It was concluded that IMT (inspiratory muscles training) by power breath revealed significant improvements in both PaO and PaCO, as well as enhanced diaphragmatic excursion among the intervention group compared to the control. While there was no statistically significant difference in pH levels as well as SpO2 among groups. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <11> [Use Link to view the full text] Accession Number 649081792 Title Cryoanalgesia Increases Neuropathic Pain in Adults Undergoing Minimally Invasive Surgery: A 1-Year Follow-up of a Randomized Study. Source Annals of surgery. 283(6) (pp 943-949), 2026. Date of Publication: 01 Jun 2026. Author Drake L.; Weksler B.; Specht K.; Kuchta P.; Crist L.; Williams B.A.; Fernando H.C. Institution (Drake) Division of Thoracic and Esophageal Surgery, Cardiovascular Institute, Allegheny Health Network, Pittsburgh, PA, United States Abstract OBJECTIVE: We previously reported results of a randomized trial comparing standard intercostal nerve block (SOC) with SOC plus cryoanalgesia (CRYO) in minimally invasive lung surgery. While no benefit was seen in early postoperative pain or opioid use, CRYO patients had significantly higher Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores at 2 weeks. We now report 1-year follow-up outcomes using LANSS and Visual Analog Scale (VAS). METHOD(S): This randomized trial (NCT05348447) enrolled adults undergoing minimally invasive thoracic surgery. SOC patients received intercostal nerve blocks (INB) with bupivacaine and lidocaine. CRYO patients received the same INB plus cryoablation of 5-6 intercostal nerves (120 seconds each). Patients were followed at 3, 6, and 12 months. LANSS scores >=12 indicated neuropathic pain. Pain severity was assessed using VAS. RESULT(S): Follow-up data were available for 76 patients at 3 months (36 SOC, 40 CRYO), 82 at 6 months (42 SOC, 40 CRYO), and 84 at 12 months (44 SOC, 40 CRYO). Median LANSS scores were higher in CRYO at all timepoints: 10 versus 0.5 ( P =0.003), 8 versus 0 ( P <0.001), and 4.5 versus 0 ( P <0.001). At 3, 6, and 12 months, respectively, more CRYO patients had LANSS >=12 (40% vs. 19%, 33% vs. 10%, 30% vs. 5%; P =0.031, 0.010, 0.002), and higher VAS scores were observed at 3 and 6 months ( P =0.012, 0.028) but not at 12 months ( P =0.168). CONCLUSION(S): Cryoanalgesia increased neuropathic pain incidence and severity through 1 year. Without early clinical benefit, its use in minimally invasive thoracic surgery warrants caution. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <12> Accession Number 2044946820 Title Economic impact of disposable versus reusable instruments in minimally invasive surgery: a systematic review. Source Surgical Endoscopy. 40(5) (pp 3683-3697), 2026. Date of Publication: 01 May 2026. Author Greve P.J.W.; Rahimi M.; Daams F.; Greve J.W.M.; Bonjer J.H.; Horeman T.; Schijven M.P. Institution (Greve, Rahimi, Daams, Bonjer, Schijven) Dept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, Netherlands (Greve, Schijven) Amsterdam Gastroenterology and Metabolism, Amsterdam, Netherlands (Greve, Schijven) Amsterdam Public Health, Digital Health, Amsterdam, Netherlands (Greve, Rahimi, Horeman) Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands (Greve) Maastricht NUTRIM - Institute of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Rahimi, Daams, Bonjer) Cancer Center Amsterdam, Amsterdam, Netherlands (Greve, Rahimi, Daams, Bonjer) Science Hub for ASC Research and Education (SHARE), Amsterdam Skills Centre for Health Sciences (ASC), Amsterdam, Netherlands Publisher Springer Abstract Objective: To systematically evaluate the economic impact of disposable versus reusable instruments in minimally invasive surgery (MIS), and to summarize the limited available evidence on environmental impact. Background(s): The increasing use of disposable instruments in MIS has raised concerns regarding healthcare costs and environmental sustainability. While reusable instruments may reduce per-procedure costs and waste, their economic and environmental performance is influenced by procedure type, workflow, and reprocessing requirements. Evidence integrating these factors across surgical specialties remains limited. Method(s): A systematic review was conducted in accordance with PRISMA guidelines. Studies published since 2014 comparing disposable and reusable instruments in MIS were identified using predefined PICOS criteria. Data extraction focused on cost components, including instrument costs, sterilization, operating room time, and total procedural costs. Environmental outcomes were recorded when available. Result(s): Nine studies encompassing 4,724 procedures across multiple surgical specialties met inclusion criteria. In general surgery, reusable instruments were consistently associated with lower per-procedure costs, with reported savings ranging from $16 to $388. In selected subspecialties, including gynecology, thoracic surgery, and spinal surgery, disposable instruments were associated with reduced operative time, indirectly lowering total costs in specific settings. Only one included study directly assessed environmental impact, providing limited, low-level evidence that reusable instruments may confer environmental benefit primarily when used repeatedly. Conclusion(s): Reusable instruments appear to be associated with lower per-procedure costs in general surgery, while disposable instruments may offer context-specific economic advantages in selected subspecialties. Conclusions regarding environmental impact are limited by the scarcity of primary data. Future studies incorporating standardized cost definitions and robust environmental assessments, including life-cycle analyses, are needed to support evidence-based and sustainable instrument selection in MIS. Copyright © The Author(s) 2026. <13> Accession Number 2042689151 Title Right Ventricular Function After Mitral Valve Surgery: Insights From the United Kingdom Mini Mitral Study. Source Annals of Thoracic Surgery. 121(6) (pp 1404-1412), 2026. Date of Publication: 01 Jun 2026. Author Bayliss C.; Wagnild J.; Maier R.; Ogundimu E.; Graham R.; Zacharias J.; Deshpande R.; Akowuah E. Institution (Bayliss, Graham, Akowuah) Department of Cardiac Surgery, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom (Wagnild) Department of Anthropology, Durham University, Durham, United Kingdom (Maier, Akowuah) Academic Cardiovascular Unit, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom (Ogundimu) Department of Mathematical Sciences, Durham University, Durham, United Kingdom (Zacharias) The Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom (Deshpande) The Cardiac Care Group, King's College Hospital, London, United Kingdom (Akowuah) Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom Publisher Elsevier Inc. Abstract Background Right ventricular (RV) function is frequently reduced after cardiac surgery, with persistent impairment associated with increased mortality. This study aimed to compare RV function after mitral valve repair through right minithoracotomy vs sternotomy. Methods In the UK Mini Mitral trial, patients were randomized to mitral valve repair through right minithoracotomy (small lateral pericardial incision) or sternotomy. Prespecified secondary outcomes included assessment of cardiac function by blinded echocardiography preoperatively and at early (12 weeks) and late (52 weeks) time points. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE). RV to pulmonary artery coupling was determined by the TAPSE to systolic pulmonary artery pressure ratio. Results Of 330 patients randomized, 224 had suitable echocardiographic data for analysis. Baseline demographic, clinical, and echocardiographic data were comparable between groups. Cross-clamp and bypass times were significantly longer in the minithoracotomy group. At 12 weeks, there was a significant reduction in TAPSE from baseline in both groups (TAPSE minithoracotomy, -7.52 mm [95% CI, -8.52 to -6.53; P < .001], vs sternotomy, -8.75 mm [95% CI, -9.80 to -7.71; P < .001]), which recovered, but not to preoperative levels, by 52 weeks. The degree of RV impairment was significantly less in the minithoracotomy group at both early (between-group difference in TAPSE at 12 weeks, 1.47 mm [95% CI, 0.37-2.56; P = .009]) and late time points (between-group difference in TAPSE at 52 weeks, 1.37 mm [95% CI, 0.29-2.45; P = .013]). Conclusions Despite longer cross-clamp and bypass times, mitral valve repair through minithoracotomy was superior to sternotomy at preserving RV function (measured by TAPSE) at 12 weeks and 1 year. Copyright © 2026 The Society of Thoracic Surgeons. <14> Accession Number 2045386639 Title Hand Dysfunction After Intervention via Distal Versus Conventional Transradial Access: A Meta-Analysis of Randomized Trials. Source Clinical Cardiology. 49(5) (no pagination), 2026. Article Number: e70350. Date of Publication: 01 May 2026. Author Fan X.; Zhou T.; Li F.; Shi G.; Gu C.; Chen Z.; Cai G. Institution (Fan, Chen, Cai) Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu Province, Changzhou, China (Zhou, Li, Shi, Gu) Department of Cardiology, Wujin hospital affiliated with Jiangsu University, the Wujin Clinical College of Xuzhou Medical University, Jiangsu Province, Changzhou, China Publisher John Wiley and Sons Inc Abstract Background: Percutaneous coronary intervention (PCI) is an important treatment for coronary artery disease (CAD). Distal transradial access (dTRA) has gained popularity as an alternative to conventional transradial access (TRA) in cardiovascular interventional procedures. However, some patients may experience hand dysfunction after undergoing TRA or dTRA procedures. Method(s): In this study, the literature from the PubMed and Web of Science (WOS) databases was reviewed and 11 randomized controlled trials (RCTs) were selected. Meta-analysis and narrative synthesis were used to evaluate the hand dysfunction and vascular complications. Result(s): A total of 6903 participants were included in the study. The average age was 62.8 years, and 66.9% were male. In terms of hand motor dysfunction, pooled data from two trials showed that the risk of dTRA may be lower than that of TRA. In terms of hand sensory dysfunction, a pooled analysis of two studies showed that the incidence of numbness within 24 h postoperatively may be higher with dTRA than with TRA, but the incidence of persistent pain may be lower with dTRA than with TRA. Only one included study reported the incidence of nerve injury. Additionally, a pooled analysis of ten trials demonstrated that dTRA had a lower risk of radial artery occlusion (RAO) than TRA. Conclusion(s): Compared with TRA, dTRA may be associated with a lower risk of hand clumsiness, persistent pain, RAO, and AVF, but a potentially higher incidence of hand numbness. Copyright © 2026 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC. <15> Accession Number 2045634297 Title Outcomes of Aortic Valve Repair: A Systematic Review and Meta-Analysis Using Reconstructed Individual Patient Data. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Cerqueira R.J.; Mascarenhas J.Q.; Rodrigues M.; Miranda J.O.; Kawczynski M.J.; Vojacek J.; Arabkhani B.; Bidar E.; Leite-Moreira A.; Saraiva F.; Heuts S. Institution (Cerqueira, Mascarenhas, Rodrigues, Miranda, Leite-Moreira, Saraiva) Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, UnIC@RISE, Portugal (Cerqueira, Leite-Moreira) Cardiothoracic Surgery Department, Centro Hospitalar Universitario Sao Joao, Portugal (Kawczynski, Bidar, Heuts) Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Netherlands (Kawczynski, Bidar, Heuts) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Netherlands (Vojacek) Department of Cardiac Surgery, University Hospital Hradec Kralove, Czechia (Arabkhani) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands Publisher SAGE Publications Ltd Abstract Objective: The progressive dissemination of isolated aortic valve repair (AVRep) and valve-sparing root (VSR) procedures has resulted in a cumulative expansion of the available literature. This work aims to synthesize the current knowledge and identify predictors of mortality and reintervention in patients undergoing such valve-preserving procedures. Method(s): A systematic review and meta-analysis were conducted in 2 databases (last search January 2025). Studies with >=200 adult patients undergoing AVRep or VSR with a minimum mean follow-up >=5 years were included. Short-term outcomes were summarized using weighted descriptive statistics. Forest plots, funnel plots, and the Newcastle-Ottawa Scale were used to evaluate the risk of bias. Long-term survival and freedom from reoperation were analyzed through reconstructing individual patient data from Kaplan-Meier curves, and a mixed-effects Cox frailty model was used to identify study-level predictors of these endpoints. Result(s): There were 48 studies included, encompassing 20,914 patients with a mean weighted age of 52.42 (50.28 to 54.57) years. Early outcomes included hospital mortality (1.34% [1.04% to 1.73%]), bleeding (3.77% [2.76% to 5.13%]), myocardial ischemia (0.44% [0.26% to 0.77%]), pacemaker implantation (1.00% [0.63% to 1.59%]), neurologic events (1.27% [0.91% to 1.78%]), and postoperative residual aortic regurgitation (3.48% [1.90% to 6.29%]). Pooled survival at 1, 5, 10, and 20 years of follow-up was 96.8%, 92.5%, 83.8%, and 67%, respectively; freedom from reoperation at the same time points was 97.9%, 93.9%, 88.2%, and 77.5%, respectively. Factors such as older age, female sex, aortic dissection, and isolated valve repair were associated with higher mortality. Conclusion(s): These findings suggest that AVRep and VSR are associated with low early mortality and morbidity and excellent long-term outcomes. However, heterogeneity in definitions and endpoints across studies underlines the need for standardized definitions and conduction of properly designed randomized trials. Copyright © The Author(s) 2026 <16> Accession Number 2045590016 Title Multiport Versus Single-Port Video-Assisted Thoracic Surgery for Pulmonary Resection. Source European Journal of Cardio-thoracic Surgery. 68(Asia-Pacific Innovative Thoracic Surgery Symposium 2025) (pp i12-i18), 2026. Date of Publication: 01 Apr 2026. Author Sihoe A.D.L. Institution (Sihoe) CUHK Medical Centre, Hong Kong (Sihoe) Gleneagles Hong Kong Hospital, Hong Kong Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: There have been many attempts to compare Uniportal Video-Assisted Thoracic Surgery (UVATS) with Multiportal VATS (MVATS) for anatomic lung resection. A review is warranted to appreciate: what has been learnt about the relative benefits of the 2 approaches; what lessons have been learned by the process of comparing approaches; and whether such comparisons should influence surgical practice. Method(s): A narrative review and qualitative analysis of the literature pertaining to UVATS and especially to comparisons between UVATS and MVATS was conducted. Result(s): The balance of currently published evidence suggests that UVATS offers the following when compared to MVATS: equivalent safety; similar or slightly better post-operative outcomes (especially in reducing pain); equivalent treatment outcomes for lung cancer (measured by lymph node yields and medium-term survival); and broadly similar learning curves. There has been a general trend for studies comparing UVATS with MVATS in recent years to exhibit greater scientific rigor and to investigate a broader range of clinically relevant outcome measures. Conclusion(s): Over a decade's worth of comparisons between UVATS and MVATS have validated UVATS as a mainstream approach for minimally invasive pulmonary resections. The direct comparisons have generally suggested non-inferiority vis-a-vis MVATS. However, the true value of the ongoing process of comparison lies in its elevation of good clinical research practices and increasing awareness of those outcome measures most pertinent to patients. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <17> Accession Number 2043072194 Title A Bayesian Meta-Analysis of Renin-Angiotensin System Inhibitors Following TAVR. Source Catheterization and Cardiovascular Interventions. 107(5) (pp 1554-1561), 2026. Date of Publication: 01 Apr 2026. Author Oliveira V.M.R.; Barbosa L.M.; Sousa P.A.D.; Lima A.P.D.; Akabane M.A.C.; Borges A.; Bertoli E.D.; Bulhoes E.; Farias C.A.; Mazetto R.; Tartuce Filho P.R.F.; Alcantara R.W.A.; Bignoto T.; Pileggi B.; Moreira H.G.; Tartuce L.P. Institution (Oliveira, Borges, Moreira) Federal University of Goias, Goiania, Brazil (Oliveira, Tartuce Filho, Tartuce) Instituto de Cardiologia e Radiologia Intervencionista de Rio Verde, Rio Verde, Brazil (Barbosa) Federal University of Minas Gerais, Belo Horizonte, Brazil (Barbosa, Bignoto, Pileggi) Instituto do Coracao-InCor-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Sousa) Federal University of Uberlandia, Uberlandia, Brazil (Lima) University of Rio Verde, Rio Verde, Brazil (Akabane) Federal University of Juiz de Fora, Juiz de Fora, Brazil (Bertoli) Hospital e Maternidade Marieta Konder Bornhausen, Itajai, Brazil (Bulhoes) Universidade da Amazonia Reunida, Redencao, Brazil (Farias) Universidade Nove de Julho, Sao Paulo, Brazil (Mazetto) State University of Amazon, Manaus, Brazil (Alcantara) Clinica Aurus, Oliveira, Brazil (Alcantara) Interventional Cardiology Unit, Hospital Sao Judas Tadeu, Oliveira, Brazil Publisher John Wiley and Sons Inc Abstract Background: Aortic stenosis leads to left ventricular remodeling, hypertrophy, and fibrosis, increasing the risk of heart failure. Renin-angiotensin system (RAS) inhibitors may mitigate these adverse effects and improve clinical outcomes. Despite advancements in transcatheter aortic valve replacement (TAVR), substantial mortality, heart failure readmissions, and other complications persist. Aim(s): This study aimed to evaluate the impact of RAS inhibitor therapy following TAVR on clinical outcomes. Method(s): We conducted a systematic review and Bayesian meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search of PubMed, Embase, and Cochrane was performed to identify studies comparing RAS inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic stenosis. Odds ratios (OR) and 95% credible intervals (CrI) were estimated using a Bayesian random-effects model. Between-study heterogeneity was quantified using the posterior distribution of the heterogeneity parameter (tau). Posterior probabilities (PP) of treatment benefit were calculated, with clinically meaningful effects defined as P (OR < 0.8). All analyses were performed using R version 4.5.0. Result(s): A total of 12 studies comprising 35,988 patients were included, of whom 17,026 (47.3%) received RASi therapy. The mean age ranged from 78.9 to 84.4 years. Post-TAVR RASi use was associated with a 79.4% probability of a clinically relevant reduction in all-cause mortality and a 99.5% probability of a clinically relevant reduction in cardiovascular mortality. There was a 54% probability of a clinically relevant reduction in heart failure hospitalization and a negligible (2.26%) probability of a reduction in the odds of myocardial infarction in the RASi group. Conclusion(s): RASi therapy following TAVR is associated with reduced odds of mortality and heart failure readmission. Copyright © 2026 Wiley Periodicals LLC. <18> Accession Number 2043864036 Title PERSISTENT ORAL INFECTIONS MAY INCREASE THE RISK OF INFECTIOUS COMPLICATIONS IN ORGAN TRANSPLANT RECIPIENTS. Source Journal of Evidence-Based Dental Practice. 26(2) (no pagination), 2026. Article Number: 102232. Date of Publication: 01 Jun 2026. Author Zanjir M.; Azarpazhooh A. Publisher Elsevier Inc. Abstract Article Title and Bibliographic Information Olsson J, Hunfjord S, Braun O, Haggman-Henrikson B, Ljunggren A. Impact of Oral Infection on Organ Transplantation: A Systematic Review. J Evid Based Dent Pract. 2024 Dec;24(4):102035. doi: 10.1016/j.jebdp.2024.102035 . Epub 2024 Sep 5. PMID: 39631966. Source of Funding No grants were received from funding agencies in the public, commercial, or not-for-profit sectors. Type of Study/Design Systematic review Copyright © 2026. Published by Elsevier Inc. <19> Accession Number 2045301348 Title Evaluation of the utility of slow mode for pulmonary vessel resection using a surgical stapler in anatomical pulmonary resection: a prospective randomized controlled trial protocol. Source Journal of Thoracic Disease. 18(4) (no pagination), 2026. Article Number: 425. Date of Publication: 30 Apr 2026. Author Karita R.; Inage T.; Takahashi K.; Sugawara T.; Suzuki H. Institution (Karita, Inage, Suzuki) Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan (Takahashi) Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan (Sugawara) Clinical Research Center, Chiba University Graduate School of Medicine, Chiba, Japan Publisher AME Publishing Company Abstract Background: Intraoperative bleeding from the pulmonary vessel stumps is a well-known complication of anatomical lung resection performed with surgical staplers. While advancements in stapling devices have improved safety, staple line bleeding (SLB) remains a serious concern as it can prolong operative time and increase complications risk. The SigniaTM stapling system features both adaptive firing technology plus mode (AFTM) and manual slow mode (MSM), allowing for adjustable staple firing speed. A retrospective study has suggested that MSM could minimize SLB risk; however, these findings lack confirmation from prospective studies. This study is aimed to investigate the utility of MSM for SLB prospectively. Method(s): A total of 140 patients will be randomized into two groups. One group will undergo pulmonary vessel resection using AFTM and the other using MSM. The primary endpoint is intraoperative observation of SLB on pulmonary vessel stumps. Data analysis is scheduled for the period from 2025 to 2027. Discussion(s): This trial investigates whether MSM lowers the risk of SLB from pulmonary vessels and reduce the need for additional hemostatic procedures. If a slower firing speed is proven to minimize intraoperative SLB, selecting MSM could significantly improve the safety and efficiency of thoracic surgery. This could reduce complications, decrease the need for additional hemostatic interventions, and lower overall medical resource consumption. Copyright © AME Publishing Company. <20> Accession Number 2045475748 Title High-Flow Nasal Oxygen Therapy After Cardiac Surgery: A Randomized Clinical Trial. Source JAMA Network Open. 9(4) (no pagination), 2026. Article Number: e265447. Date of Publication: 08 Apr 2026. Author Litton E.; Parke R.L.; McGuinness S.P.; Dawson S.N.; Villar S.S.; Shetty S.S.; Fox-Rushby J.A.; Coombes J.; Norman R.; Murphy G.J.; Affandi J.S.; Ahmed A.B.; Bottrill F.E.; Chiu Y.-D.; Churchill L.J.; Dash S.K.; Delaney A.P.; Duckworth M.J.P.; Earwaker M.J.; Evans C.R.; Hoppington A.J.; Kunst G.; Maiorana A.J.; Martinez G.; Mcdonald A.; Mohammed A.A.; Orford N.R.; Pilcher D.V.; Ramanan M.; Reid C.M.; Senthuran S.; Shaw M.W.; Shelley B.G.; Singh H.; Steele C.J.M.; Temple E.B.; Veltman-Grisenthwaite M.W.M.; Yadav S.; Zimbler N.; Zochios V.; Klein A.A.; Chaudhari L.; Yusuff H.Y.; Ahmed M.; Chikwanha F.; Ghuhan N.; Hargadon B.; Parsons A.; Raval M.; Aujla H.; Hanson L.; Sum P.; Brand J.; Donnelly A.; Harrison R.; Kipling R.; Neave C.; Patterson H.; Metcalfe S.; Taylor R.; Dymore-Brown L.; Meeks D.; Broderick A.; Clarey E.; Karami F.; Noble H.; O'Reilly K.; Saha S.; Spooner C.; Hedditch K.; Palmer J.; Howells P.; Boot R.; Beddows S.; Clark A.; Dooley C.; Ellis K.; Moody L.; Sheridan C.; Spruce E.; Ul-Rahman S.; Smith H.; Farzad Z.; Kirby K.; Mittoo E.; West A.; Worn O.; Pina S.; Fitzjohn K.; Hodge E.; Holcombe H.; Mackie J.; Moule G.; Pack J.; Pearn C.; Austin M.; Dennis S.; Hodge K.; Malgapo K.; Namasivayah G.; Thorton R.; Arnold G.; Kingstrom R.; Garner L.; Ali T.; Henry M.; John M.; El-Boghdadly K.; Aduse-Poku M.; Colville G.; Radcliffe G.; Zhang X.; Fell E.; Fraser R.; Hughes C.; McCall P.; Aitken C.; Barr J.; Boyd E.; Buckley J.; Griffen P.; Hamilton C.; McLaren R.; Truesdale L.; Valdeavella K.; Ford J.; Sinclair C.; Keeley M.; Houston R.; Cripps F.; Hawkins T.; Healan J.; Kirby J.; Paradowski K.; Patel N.; Wagaarachige Y.; Hutchings A.; Paine H.; Patel M.; Thomas K.; Bass F.; O'Connor A.; Yarad E.; Baker-Pearson I.; White M.; Zaro M.; Adams L.; Chau T.B.; Beaton G.; Board J.; Martin E.; Neylan A.; Robertshaw S.; Ueoka M.; Wallace S.; Young M.; Fitzgerald S.; Hawker S.; Boone J.; Hodge A.; French K.; Robins C.; Anthony N.; Garlett C.; McLean A.; Ferrier J.; Ali F.; Brooks K.; Butler M.; Cowdrey K.-A.; Gilder E.; Gray A.; Koorts S.-Z.; Mason B.; McMahon E.; O'Connor K.; Robertson M.; Vui L.; Weiss L. Institution (Litton) Intensive Care Unit, Fiona Stanley Hospital, Perth, Australia (Litton, Norman, Affandi, Reid) Curtin School of Population Health, Curtin University, Perth, Australia (Parke, McGuinness) Cardiothoracic and Vascular Intensive Care Unit, Te Toka Tumai Auckland, Auckland, New Zealand (Parke) School of Nursing, The University of Auckland, Auckland, New Zealand (Dawson, Villar, Shetty, Fox-Rushby, Bottrill, Chiu, Duckworth, Earwaker, Mohammed, Steele, Temple) Papworth Trials Unit Collaboration, Royal Papworth Hospital NHS (National Health Service) Foundation Trust, Cambridge, United Kingdom (Dawson, Villar) MRC (Medical Research Council) Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom (Shetty, Fox-Rushby) Department of Population Health Sciences, King's College London, London, United Kingdom (Coombes) The George Institute for Global Health, Sydney, Australia (Murphy) College of Life Sciences, University of Leicester, Glenfield Hospital Leicester, Leicester, United Kingdom (Ahmed, Zochios) Department of Anaesthesia & Critical Care, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Churchill, Zochios) Intensive Care Unit and Critical Care Research Group, The Prince Charles Hospital, Metro North Hospital and Health Services, Brisbane, Australia (Dash, Ramanan) Intensive Care Unit, Townsville University Hospital, Townsville, Australia (Delaney, Senthuran) Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia (Delaney) Faculty of Medicine and Health, The University of Sydney, Sydney, Australia (Evans) Department of Anaesthetics, University Hospital of Wales, Cardiff, United Kingdom (Hoppington) United Kingdom (Kunst) Department of Anaesthetics and Pain Therapy, King's College Hospital NHS FT, London, United Kingdom (Kunst) School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, United Kingdom (Maiorana) Curtin School of Allied Health, Curtin University, Perth, Australia (Martinez, Klein) Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, United Kingdom (Mcdonald) Cardiothoracic Unit, James Cook Hospital, Middlesbrough, United Kingdom (Orford) Intensive Care Unit, University Hospital Geelong, Geelong, Australia (Orford) Deakin University School of Medicine, Geelong, Australia (Pilcher) Department of Intensive Care, The Alfred Hospital, Melbourne, Australia (Pilcher) The Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia (Reid) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Shaw) Department of Anaesthetics, Guy's and St Thomas' Hospitals, London, United Kingdom (Shelley) West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (Shelley) Academic Unit of Anaesthesia, Pain and Critical Care, University of Glasgow, Glasgow, United Kingdom (Singh) Department of Anaesthesia, Queen Elizabeth Hospital, Birmingham, United Kingdom (Veltman-Grisenthwaite) Cambridge Cancer Research Hospital, Cambridge Institute, University of Cambridge, Cambridge, United Kingdom (Yadav) Department of Cardiothoracic Surgery, Mater Private Hospital Townsville, Townsville, Australia (Zimbler) Department of Anaesthesia, Royal Brompton Hospital, London, United Kingdom (Zochios) Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom (Chaudhari, Yusuff, Ahmed, Chikwanha, Ghuhan, Hargadon, Parsons, Raval, Aujla, Hanson, Sum) Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicestershire, Leicester, United Kingdom (Brand, Donnelly, Harrison, Kipling, Neave, Patterson, Metcalfe, Taylor) James Cook Hospital, South Tees Hopsitals NHS Foundation Trust, North Yorkshire, Middlesbrough, United Kingdom (Dymore-Brown, Meeks, Broderick, Clarey, Karami, Noble, O'Reilly, Saha, Spooner, Hedditch, Palmer) King's College Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom (Howells, Boot, Beddows, Clark, Dooley, Ellis, Moody, Sheridan, Spruce, Ul-Rahman, Smith) Queen Elizabeth Hospital, University Hospitals Birmingham, West Midlands, Birmingham, United Kingdom (Farzad, Kirby, Mittoo, West, Worn, Pina) Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Fitzjohn, Hodge, Holcombe, Mackie, Moule, Pack, Pearn, Austin, Dennis, Hodge, Malgapo, Namasivayah, Thorton, Arnold, Kingstrom, Garner) Royal Papworth Hospital, Royal Papworth Hospital NHS Foundation Trust, Cambridgeshire, Cambridge, United Kingdom (Ali, Henry, John, El-Boghdadly, Aduse-Poku, Colville, Radcliffe) St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Zhang, Fell) King's College London, London, United Kingdom (Fraser, Hughes, McCall, Aitken, Barr, Boyd, Buckley, Griffen, Hamilton, McLaren, Truesdale, Valdeavella, Ford, Sinclair, Keeley, Houston) Golden Jubilee University National Hospital, NHS Golden Jubilee, Glasgow, United Kingdom (Cripps, Hawkins, Healan, Kirby, Paradowski, Patel, Wagaarachige, Hutchings, Paine, Patel, Thomas) University Hospital of Wales, Cardiff and Vale University Local Health Board, Cardiff, United Kingdom (Bass, O'Connor, Yarad) Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia (Baker-Pearson, White, Zaro) The Townsville Hospital, Townsville Hospital and Health Service, Townsville, QLD, Australia (Adams, Chau, Beaton, Board, Martin, Neylan, Robertshaw, Ueoka, Wallace, Young) The Alfred Hospital, Alfred Health, Melbourne, VIC, Australia (Fitzgerald, Hawker) University Hospital Geelong, Barwon Health, Geelong, VIC, Australia (Boone, Hodge, French, Robins) Curtin School of Population Health, Curtin University, Perth, WA, Australia (Anthony, Garlett, McLean) Fiona Stanley Hospital, South Metropolitan Health Service, Perth, WA, Australia (Ferrier) St John of God Hospital Subiaco, St John of God Healthcare, Perth, WA, Australia (Ali, Brooks, Butler, Cowdrey, Gilder, Gray, Koorts, Mason, McMahon, O'Connor, Robertson, Vui, Weiss) Auckland City Hospital, Te Whatu Ora - Health New Zealand, Auckland, Auckland, New Zealand Publisher American Medical Association Abstract IMPORTANCE High-flow nasal oxygen therapy (HFNOT) is used for noninvasive respiratory support following cardiac surgery despite uncertainty about its clinical effectiveness or associated costs. OBJECTIVE To determine whether prophylactic HFNOT in patients at increased risk of respiratory complications following cardiac surgery has clinical benefits compared with standard oxygen therapy (SOT). DESIGN, SETTING, AND PARTICIPANTS This adaptive, parallel group, randomized clinical trial collected and analyzed data from 17 cardiac surgery centers in 3 countries between October 7, 2020, and June 19, 2024. Eligible participants included adults undergoing nonemergent cardiac surgery with any of the following risk factors for pulmonary complications: chronic obstructive pulmonary disease, asthma, lower respiratory tract infection in the last 4 weeks, a body mass index of 35 or greater, or currently or recently smoking for longer than 10 pack-years. Outcome assessors were blinded. A preplanned sample size re-estimation was conducted after 300 participants completed the 90-day follow-up. INTERVENTION Participants were randomized at a 1:1 ratio with concealed allocation to HFNOT or SOT administered for at least 16 hours immediately after postoperative extubation. MAIN OUTCOMES AND MEASURES The primary effectiveness outcome was days alive and at home (DAH) without increased support compared with baseline in the first 90 days (DAH90). Any day of increased support, including at home, would provide a value of 0 for that day. Secondary outcomes included DAH90 without considering the additional support component. RESULTS A total of 1280 patients were recruited (mean [SD] age, 62.9 [10.5] years; 892 [69.7%] men; 640 in each group), of whom 1224 (95.6%) had complete DAH90 data. The primary outcome of median DAH90 was 0 (IQR, 0-79) for the HFNOT group and 0 (IQR, 0-87) for the SOT group (median difference, 0 [95% CI, 0-0]; P = .75). Secondary clinical outcomes, including DAH90 without considering whether additional support was required, were similar between groups. CONCLUSIONS AND RELEVANCE In this randomized clinical trial of HFNOT in patients at increased risk of postoperative pulmonary complications after nonemergent cardiac surgery, HFNOT did not improve DAH90 without increased support. These findings do not support the implementation of routine prophylactic HFNOT after cardiac surgery. Copyright © 2026 Litton E et al. <21> Accession Number 2043934339 Title The influence of lipoprotein(a) on coronary revascularization after percutaneous coronary intervention. Source Acta Cardiologica. 81(3) (pp 414-423), 2026. Date of Publication: 2026. Author Srikulmontri T.; Pantarote S.; Kulthamrongsri N.; Wattanachayakul P.; Vutthikraivit W.; Amanullah A. Institution (Srikulmontri, Wattanachayakul) Department of Internal Medicine, Jefferson Einstein Hospital, Philadelphia, PA, United States (Srikulmontri, Wattanachayakul, Amanullah) Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Pantarote) Department of Medicine, College of Medicine, Rangsit University, Bangkok, Thailand (Kulthamrongsri) Department of Internal Medicine, University of Hawai'i, Honolulu, HI, United States (Vutthikraivit) Department of Cardiology, Intermountain Health Saint George Regional Hospital, Saint George, UT, United States (Amanullah) Department of Cardiology, Jefferson Einstein Hospital, Philadelphia, PA, United States Publisher Taylor and Francis Ltd. Abstract Background: Lipoprotein(a) (Lp(a)) is a proatherogenic lipoprotein associated with increased cardiovascular risk and is minimally responsive to statins or lifestyle changes. While Lp(a) is linked to adverse cardiovascular events, its role in predicting repeat revascularization after percutaneous coronary intervention (PCI) remains unclear. This review evaluates the relationship between Lp(a) levels and coronary revascularization outcomes. Method(s): A systematic review and meta-analysis of studies from MEDLINE and EMBASE through June 18, 2025, evaluated the association between elevated Lp(a) and revascularization outcomes post-PCI. Random-effects models using the DerSimonian-Laird method were used to pool odds (ORs) and hazard ratios (HRs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test, and publication bias was evaluated with Egger's regression test. Result(s): Twenty studies were included in the systematic review, of which eighteen were included in the meta-analysis. Elevated Lp(a) levels were associated with a higher risk of any repeat revascularization, with pooled OR 1.33 (95% CI: 1.17-1.52) and HR 1.15 (95% CI: 1.05-1.25). High Lp(a) was also linked to increased risk of target vessel revascularization (TVR) (OR 1.42; 95% CI: 1.12-1.81). A non-significant trend towards increased target lesion revascularization (TLR) was observed (OR 1.25; 95% CI: 0.96-1.64). Conclusion(s): Elevated Lp(a) levels were associated with a higher risk of repeat revascularization and TVR, with a non-significant trend towards increased TLR. Further studies are warranted to confirm these findings and explore the potential benefit of Lp(a)-lowering strategies. Copyright © 2026 Belgian Society of Cardiology. <22> Accession Number 2045194753 Title Suture the Future: Evaluating the Impact of Early Surgical Exposure for High School Students. Source Journal of Surgical Education. 83(6) (no pagination), 2026. Article Number: 103962. Date of Publication: 01 Jun 2026. Author Valerio K.; DePamphilis M.A.; Nnamani Silva O.N.; Mirzamohammadi F.; Austen W.G.; Carruthers K.H. Institution (Valerio, DePamphilis, Nnamani Silva, Mirzamohammadi, Austen, Carruthers) Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States Publisher Elsevier Inc. Abstract Background: Early surgical exposure has been emphasized as a strategy to improve applicant preparedness and foster interest among diverse trainees. While such programs have shown promise at the undergraduate and medical school levels, opportunities for high school students remain underexplored. Therefore, this study aimed to review the structure, outcomes, and impact of early surgical exposure programs designed specifically for high school students. Method(s): A PRISMA-compliant systematic review was conducted across the PubMed, Embase, and Web of Science databases. Studies were included if they evaluated the effect of surgical exposure programs for high school students on surgical interest (11/14 studies), understanding of the training pathways (5/14 studies), or self-confidence (8/14 studies). Programs that were ineligible for high school students, nonsurgery focused, or conducted outside the United States were excluded. Result(s): Of 752 reports screened, 14 studies including 1674 high school participants met inclusion criteria. All studies utilized survey data, with responses collected from 1335 students (79.7% response rate). Among respondents, 81% were female, 33% Hispanic, 40% White, 23% African American, 15% Asian, and 22% other race. Eleven programs (79%) were pipeline initiatives. All programs included seminars, 11 (79%) surgical skills workshops, 2 (14%) surgical observation, and 2 (14%) a research component. Following participation, the portion of students expressing interest in surgery increased from 52% to 66%. On average, interest level increased by 27%, understanding of surgical training pathways improved by 34%, and students reported greater confidence in their ability to pursue healthcare careers. Conclusion(s): Early surgical exposure at the high school level was associated with increased interest in surgery or surgical subspecialties, improved understanding of the training pathway, and greater self-confidence among a diverse cohort of students. These findings support broader implementation of structured early exposure programs to improve surgical education access, guide career decision-making and strengthen the future surgical workforce. Copyright © 2026 Association of Program Directors in Surgery <23> Accession Number 2045244607 Title Prophylactic Left Atrial Appendage Occlusion During Mitral Valve Repair in Patients Without Atral Fibrillation: A Meta-Analysis of Time to Event Data. Source Journal of Arrhythmia. 42(3) (no pagination), 2026. Article Number: e70355. Date of Publication: 01 Jun 2026. Author Emara A.; Awashra A.; Elgendy M.S.; Murad M.R.; Emara M.; Nazir A.; Shubietah A.; Megaly M.; Bapat V.N. Institution (Emara, Murad, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Awashra) Department of Medicine, An Najah National University, Nablus, Palestine (Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt (Nazir) Department of Medicine, Mercy Health-The Jewish Hospital, Cincinnati, OH, United States (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States (Megaly) Integris Health Heart Hospital, Oklahoma City, OK, United States (Bapat) Department of Cardiac Surgery, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States Publisher John Wiley and Sons Inc Abstract Background: Mitral valve repair (MVr) is effective for mitral regurgitation, but the benefit of prophylactic left atrial appendage occlusion (LAAO) in patients without prior atrial fibrillation (AF) remains unclear. This meta-analysis aimed to assess the long-term safety and efficacy of LAAO in this understudied population. Method(s): We performed a meta-analysis from four major databases until December 2025. Kaplan-Meier curves data were reconstructed and analyzed using Cox regression models and hazard ratios (HR) for thromboembolic events (mainly stroke). A random-effects meta-analysis was performed with R software to calculate risk ratios (RR), hazard ratios (HR), and mean differences (MD), all with 95% confidence intervals (CIs). Result(s): Three studies with 5048 patients were included. LAAO was associated with a significant reduction in thromboembolic risk at 5 years (HR 0.60, 95% CI 0.46 to 0.77). LAAO reduced in-hospital stroke (RR 0.43, 95% CI 0.25 to 0.72) but increased postoperative AF (RR 1.17, 95% CI 1.09 to 1.26). No significant differences were observed in 30-day mortality (RR 0.56, 95% CI 0.07 to 4.33) or hospital stay (MD -0.16 days, 95% CI - 0.48 to 0.16). Conclusion(s): Prophylactic LAAO during MVr in patients without AF may reduce thromboembolic events risk but appears to increase postoperative AF. Further randomized studies are warranted. Copyright © 2026 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society. <24> Accession Number 2045634658 Title Long-Term Outcomes of Balloon Versus Surgical Aortic Valvuloplasty in Pediatric Patients with Congenital Aortic Valve Stenosis: A Meta-Analysis. Source World Journal for Pediatric and Congenital Heart Surgery. (no pagination), 2026. Date of Publication: 2026. Author Atta K.; Abdelaziz A.; Ramadan S.; Gadelmawla A.F.; Murad M.R.; Sobhy A.; Abdelaziz M.; Elbassiouni H.; Esawy A.; Shirokova A.A.; Samoshkina E.S. Institution (Atta, Abdelaziz, Ramadan, Gadelmawla, Murad, Sobhy, Abdelaziz, Esawy) Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, United States (Atta, Elbassiouni) Institute of Medicine, National Research Mordovia State University (MRSU), Saransk, Russian Federation (Abdelaziz) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Montefiore Medical Center, NY, United States (Ramadan) Faculty of Medicine, Ain Shams University, Ain Shams, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Murad, Abdelaziz) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Sobhy) Faculty of Medicine, Kafr-Elsheikh University, Kafr-Elsheikh, Egypt (Esawy) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Shirokova, Samoshkina) Department of Pediatrics of the Medical Institute, National Research Mordovia State University (MRSU), Saransk, Russian Federation Publisher SAGE Publications Inc. Abstract Background: Congenital aortic valve stenosis (AVS) is the most common cause of ventricular outflow tract obstruction. Surgical aortic valvuloplasty (SAV) and balloon aortic valvuloplasty (BAV) are the most common primary interventions, with conflicting data regarding their long-term outcomes. We aimed to study the long-term clinical outcomes of patients allocated to BAV or SAV. Method(s): We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL through August 2025 for relevant studies reporting long-term outcomes of SAV versus BAV in patients with congenital AVS. The primary outcome was the 10-year rate of aortic valve replacement (AVR). Subgroup analysis was performed for all clinical outcomes according to the age of the included children. Result(s): A total of nine trials including 1704 patients (67%, [1136/1704]) males; median follow-up of 10 years) were included. The pooled estimate showed that SAV was associated with lower long-term reintervention rates (risk ratio 0.76, 95% confidence interval (CI): 0.6 to 0.96, P = .02), and a significant reduction in peak aortic gradient pressure (PAGP) (mean difference (MD) -11.53 mm Hg, 95% CI: -18.66 to -4.41, P < .001) in patients more than 1 year of age. In addition, SAV was associated with a longer time to first reintervention in patients younger than 1 year of age (MD 2.43 years, 95% CI: 0.68 to 4.19, P = .01). There was no significant difference regarding the primary outcome or other studied outcomes. Conclusion(s): In patients with congenital aortic valve stenosis, SAV showed the greatest benefit in children older than 1 year of age with similar AVR and mortality rates; but superior durability, lower reintervention rates, and greater reductions in peak aortic pressure gradient when compared with BAV. Copyright © The Author(s) 2026 <25> Accession Number 2045232710 Title Pregabalin versus dexmedetomidine for prevention of delirium after cardiac surgery: a randomized double-blind non-inferiority trial. Source Minerva Anestesiologica. 92(3) (pp 176-188), 2026. Date of Publication: 01 Mar 2026. Author Morsy I.; Bakr D.M.; Abdelwahab E.H.; Abo Elkhier A.E.; Abdallah M.K.; Rehab O.M. Institution (Morsy, Abdelwahab, Abo Elkhier, Abdallah, Rehab) Department of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Tanta University, Tanta, Egypt (Bakr) Anesthesiology, Surgical Intensive Care and Pain Management Department, Faculty of Medicine, Helwan University, Helwan, Egypt Publisher Edizioni Minerva Medica Abstract BACKGROUND: The incidence of postoperative delirium (POD) has been reported to be up to 53% following cardiac surgery. This trial aimed to determine the effect of perioperative administration of pregabalin versus dexmedetomidine (DEX) on the POD incidence in elderly patients planned for cardiac surgery, together with other secondary outcome measures. We hypothesized that pregabalin, with its sedative analgesic effects, would be non-inferior to DEX regarding POD prevention. METHOD(S): This randomized, double-blind, parallel-controlled, non-inferiority trial was conducted on 60 elderly cases planned for cardiac surgery. The cases were randomly assigned equally into a pregabalin group (group P) and DEX group (group D). The non-inferiority margin was set to 20%. The primary outcome was the POD incidence. Secondary endpoints included analgesic profile, sedation scale, and adverse events. RESULT(S): Pregabalin was non-inferior to DEX regarding the reduction in the incidence of POD (17.86% vs. 21.43%; risk difference, -3.6%; two-sided 95% CI, - 24.25% to 17.41%; meeting non-inferiority criteria). POD onset and duration showed an insignificant difference between the groups. The total morphine consumption in the first 48 hours after surgery was significantly lower in group P (25.64+/-7.04 mg) than in group D (34.66+/-9.25 mg; 95% CI, -13.42 to -4.61; P=0.0001). Both groups were insignificantly different regarding the visual analog scale score, sedation agitation scale measurements, recovery time, and adverse events. CONCLUSION(S): Pregabalin is non-inferior to DEX in terms of delirium prevention after cardiac surgeries with comparable sedative effects, but it has a superior analgesic profile in the form of a significantly lower 48-hour opioid dose. Copyright © 2025 EDIZIONI MINERVA MEDICA. <26> Accession Number 2045412747 Title Accuracy of inflammatory biomarkers in assessing outcomes in Chagas disease: a scoping review. Source Transactions of the Royal Society of Tropical Medicine and Hygiene. 120(5) (pp 425-435), 2026. Date of Publication: 01 May 2026. Author Avila M.R.; de Oliveira L.F.F.; Silva W.T.; de Castro Faria S.C.; Mediano M.F.F.; da Costa Rocha M.O.; Costa H.S.; Menezes-Souza D. Institution (Avila) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (de Oliveira) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Silva) Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (de Castro Faria) School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Mediano) Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (da Costa Rocha) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Costa) Universidade Federal dos Vales do Jequitinhonha e Mucuri, Minas Gerais, Diamantina, Brazil (Menezes-Souza) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Department of Clinical Pathology, COLTEC, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Vaccine Technology Center, Belo Horizonte Technology Park, Minas Gerais, Belo Horizonte, Brazil Publisher Oxford University Press Abstract Chagas disease (CD) is a global health issue with acute and chronic forms that cause severe complications, especially affecting the heart. Inflammatory biomarkers have been proposed as potential predictors of adverse outcomes in CD, however, their clinical utility remains uncertain. We conducted a scoping review of five databases, including observational studies evaluating the diagnostic and/or prognostic accuracy of inflammatory biomarkers in CD. Two reviewers independently screened and extracted data. Of 239 articles screened, 5 met the inclusion criteria. Adiponectin was associated with an increased risk of mortality and heart transplantation (hazard ratio 1.042 [95% confidence interval 1.013 to 1.072], area under the curve [AUC] 0.68, cut-off >38 mug/ml). Tumour necrosis factor alpha (TNF-alpha) and C-C motif chemokine ligand 2 (CCL2) were associated with left ventricular dysfunction (TNF-alpha: AUC 0.90; CCL2: AUC 0.69). Combined hepatocyte growth factor (HGF) and interleukin-12p40 (IL-12p40) predicted 3-y survival (accuracy 81.9%). Other biomarkers, including macrophage migration inhibitory factor, C-X-C motif chemokine ligand 12, monokine induced by interferon gamma (MIG), transforming growth factor beta1 and matrix metalloproteinases 2 and 9, showed limited utility. While TNF-alpha and HGF/IL-12p40 showed promise, most inflammatory biomarkers demonstrated limited accuracy, specifically for outcome prediction in CD; however, this does not preclude their potential usefulness for other clinical or experimental applications. Current evidence does not support the clinical use of this approach and further studies are needed. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/choru s/standard_publication_model) <27> Accession Number 2045469571 Title Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes: Results From the VESALIUS-CV Trial. Source JAMA. 335(16) (pp 1400-1407), 2026. Date of Publication: 28 Apr 2026. Author Marston N.A.; Bohula E.A.; Bhatia A.K.; De Ferrari G.M.; Leiter L.A.; Nicolau J.C.; Park J.-G.; Murphy S.A.; Walsh E.; Liu L.; Verma S.; Sattar N.; Nicholls S.J.; Lopez-Sendon J.; Gouni-Berthold I.; Tokgozoglu L.; Blankstein R.; Cyrille M.; Da Silva Lima G.P.; Giugliano R.P.; Sabatine M.S. Institution (Marston, Bohula, Park, Murphy, Giugliano, Sabatine) TIMI Study Group, Heart and Vascular Institute, Brigham and Women's Hospital, Boston, MA, United States (Bhatia, Walsh, Liu, Cyrille, Da Silva Lima) Amgen Inc, Thousand Oaks, CA, United States (De Ferrari) Cardiology Division, Department of Medical Sciences, University of Torino, Citta della Salute e della Scienza, Torino, Italy (Leiter) Division of Endocrinology and Metabolism, St Michael's Hospital, University of Toronto, Toronto, ON, Canada (Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil (Verma) Division of Cardiac Surgery, St Michael's Hospital-Unity Health Toronto, University of Toronto, Toronto, ON, Canada (Sattar) School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC, Australia (Lopez-Sendon) Idipaz Research Institute, Hospital Universitario La Paz, UAM, Madrid, Spain (Gouni-Berthold) Center for Endocrinology, Diabetes and Preventive Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany (Tokgozoglu) Department of Cardiology, Hacettepe University, Ankara, Turkey (Blankstein) Heart and Vascular Institute, Brigham and Women's Hospital, Boston, MA, United States Publisher American Medical Association Abstract Importance Intensive lowering of low-density lipoprotein cholesterol (LDL-C) levels with PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors for cardiovascular event reduction has largely been reserved for patients with significant atherosclerosis. Objective To investigate whether evolocumab could prevent a first major cardiovascular event (MACE) in patients without known significant atherosclerosis. Design, Setting, and Participants VESALIUS-CV was a randomized, double-blind, placebo-controlled trial of evolocumab conducted across 774 sites in 33 countries and enrolling 12 257 patients with no prior myocardial infarction or stroke, LDL-C level 90 mg/dL or greater, and qualifying atherosclerosis or high-risk diabetes. This prespecified subgroup analysis examined outcomes in patients without known significant atherosclerosis (none of the following: prior arterial revascularization, arterial stenosis >=50%, or coronary artery calcium score >=100 Agatston units), all of whom had diabetes. Enrollment started in June 2019 and the last patient visit was July 2025, with a median follow-up of 4.8 years. Intervention Patients were randomized in a 1:1 ratio to subcutaneous administration of either evolocumab (140 mg every 2 weeks) or matching placebo added to optimally tolerated statin therapy. Main Outcomes and Measures The dual primary end points were composites of coronary heart disease death, myocardial infarction, or ischemic stroke (3-P MACE) and 3-P MACE plus ischemia-driven arterial revascularization (4-P MACE). Secondary end points included all-cause mortality. Results This predefined subgroup included 3655 patients (1849 in the evolocumab group and 1806 in the placebo group) with a median age of 65 years (57% female). Among those in the lipid substudy, the median LDL-C level at 48 weeks was 52 mg/dL in the evolocumab group vs 111 mg/dL in the placebo group (P <.001). A 3-P MACE event occurred in 83 patients (5-year Kaplan-Meier estimate, 5.0%) in the evolocumab group compared with 117 patients (5-year Kaplan-Meier estimate, 7.1%) in the placebo group (hazard ratio [HR], 0.69 [95% CI, 0.52-0.91]; P =.009; between-group difference, 2.1% [95% CI, 0.4%-3.8%]). A 4-P MACE event occurred in 127 patients (5-year Kaplan-Meier estimate, 7.6%) in the evolocumab group compared with 178 patients (5-year Kaplan-Meier estimate, 10.5%) in the placebo group (HR, 0.69 [95% CI, 0.55-0.86]; P =.001; between-group difference, 2.9% [95% CI, 0.9%-4.9%]). There were 136 deaths (5-year Kaplan-Meier estimate, 7.8%) in the evolocumab group compared with 172 deaths (5-year Kaplan-Meier estimate, 10.1%) in the placebo group (HR, 0.76 [95% CI, 0.61-0.95]). Conclusions and Relevance In high-risk patients without known significant atherosclerosis and with diabetes, evolocumab reduced the risk of a first major cardiovascular event. Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <28> Accession Number 2043510213 Title A Randomized Controlled Study on the Impact of Early Urinary Catheter Removal on Postoperative Urinary Retention in Abdominal and Thoracic Surgery Patients with Thoracic Epidural Analgesia. Source Visceral Medicine. 42(2) (pp 48-54), 2026. Date of Publication: 01 Apr 2026. Author Alwali A.; Schafmayer C.; Klar E.; Philipp M.; Leuchter M.; Grambow E. Institution (Alwali, Schafmayer, Klar, Philipp, Grambow) Department of General, Visceral, Thoracic, Vascular and Transplant Surgery, University Medical Center Rostock, Rostock, Germany (Leuchter) Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Rostock, Germany (Grambow) Department of Cardiovascular and Thoracic Surgery, University of Goettingen Medical Center, Goettingen, Germany Publisher S. Karger AG Abstract Background: Thoracic epidural analgesia (TEA) is a key component of Enhanced Recovery After Surgery protocols for major abdominal and thoracic procedures. Despite its benefits for pain management, TEA has been associated with an increased risk of postoperative urinary retention (POUR). Consequently, it is common practice to maintain a urinary catheter (UC) for the duration of TEA. This study aimed to evaluate the impact of early UC removal in patients receiving TEA through a randomized controlled trial. Method(s): In this randomized controlled trial approved by the Rostock University Medical Center Ethics Board (AZ A2018-0220), patients scheduled for elective major abdominal or thoracic surgery with anticipated TEA within 1 year were enrolled. Participants were randomized into two groups: the early removal group (ERG), where the UC was removed within 48 h post-surgery, and the standard group (SG), where the UC was retained until TEA discontinuation. POUR was defined as a residual urine volume of >=400 mL measured by ultrasound, and catheter-associated urinary tract infections (CAUTIs) were assessed. Result(s): Of the 99 patients initially enrolled, 81 patients were available for analysis. In the ERG (n = 43), the UC was removed within 48 h, whereas in the SG (n = 38), the UC was maintained until TEA cessation. The incidence of POUR was similar between the groups, with 1 patient in each group (2.3% in ERG vs. 2.6% in SG, p = 1) requiring recatheterization. CAUTI developed in 4 patients (4.9%), all of whom were in the SG (10.5%), indicating a statistically significant association between the timing of UC removal and CAUTI incidence (p = 0.044). Conclusion(s): Our results suggest that early UC removal under TEA is safe and does not significantly increase the risk of POUR while reducing the incidence of CAUTIs. These findings support the feasibility of early UC removal in this patient population and may inform future guidelines on perioperative UC management in the context of TEA. Copyright © 2026 The Author(s). Published by S. Karger AG, Basel <29> Accession Number 2045033802 Title A Systematic Review of How Cardiopulmonary Bypass Parameters Influence Electroencephalogram Signals. Source Brain Sciences. 16(4) (no pagination), 2026. Article Number: 412. Date of Publication: 01 Apr 2026. Author Bao H.; Wang J.; Cui Z.; Zhu M.; Chen W.; Zhou L.; Northoff G.; Tao T.; Qin P. Institution (Bao, Wang, Cui, Chen, Zhou, Qin) Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China (Zhu) Department of Anaesthesia, Zhujiang Hospital of Southern Medical University, Guangzhou, China (Northoff) Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada (Tao) Center of Sleep and Brain Medicine, Shenzhen Hospital, Southern Medical University, 13 Xinhu Road, Baoan District, Shenzhen, China (Qin) Pazhou Lab, Guangzhou, China Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Cardiopulmonary bypass (CPB) is an essential technique for cardiac surgery but significantly increases the risk of perioperative neurological complications. Electroencephalography (EEG) enables real-time monitoring of brain function and provides sensitive biomarkers for early detection of cerebral injury. However, a systematic synthesis of how CPB-related physiological, pharmacological, and technical factors influence EEG signals, and how these insights can be integrated into clinical decision-making, is still lacking. Objective(s): To systematically review the effects of temperature management, mean arterial pressure (MAP), hemodilution, anesthetic agents, embolization, and systemic inflammatory response during CPB on EEG parameters (including frequency bands, Bispectral Index (BIS), quantitative EEG metrics such as burst suppression ratio (BSR), spectral edge frequency (SEF), etc.), and to evaluate the associations between EEG changes and postoperative delirium (POD) and stroke. Method(s): Following the PRISMA 2020 guidelines, we searched PubMed, Web of Science, and related databases for original English-language articles published between February 1974 and September 2025. Inclusion criteria: adult patients (>=18 years) undergoing cardiac surgery with CPB and intraoperative EEG monitoring (raw or processed). Exclusion criteria: reviews, case reports, animal studies, pediatric populations, and articles with inaccessible full texts. Two reviewers independently screened the literature and extracted data; a narrative synthesis was performed. Result(s): Fifty-one studies were included. Main findings: (1) Hypothermia: BIS decreases linearly with temperature (=1.12 units/degreeC); electrocerebral silence occurs during deep hypothermic circulatory arrest; EEG recovery dynamics during rewarming predict POD. (2) MAP and cerebral perfusion: The rate of MAP decline (>=0.66 mmHg/s) is a stronger predictor of EEG abnormalities than the absolute MAP value; under fixed pump flow, some patients exhibit coexisting cerebral overperfusion and metabolic suppression. (3) Hemodilution: Maintaining hemoglobin >=9.4 g/dL prevents EEG slowing; a drop below 9.2 g/dL significantly increases the risk of slowing. A >=10% decrease in regional cerebral oxygen saturation (rSO<inf>2</inf>) is associated with a 1.5-fold increased risk of burst suppression. (4) Anesthetic agents: Propofol maintains flow-metabolism coupling, and BSR reflects deep anesthesia better than BIS; sevoflurane and isoflurane impair autoregulation and suppress EEG. (5) Embolization and inflammation: EEG epileptiform discharges increase the risk of POD five-fold; a decrease in LIR predicts stroke (AUC 0.771) and POD (AUC 0.779); persistent EEG changes increase the risk of POD 2.65-fold. Conclusion(s): CPB-related factors affect EEG signals through distinct mechanisms, and specific EEG patterns (slowing, burst suppression, asymmetry, epileptiform discharges) are significantly associated with postoperative neurological complications. Multimodal monitoring (EEG + cerebral oximetry + hemodynamics) with clear intervention thresholds facilitates individualized brain protection. Future interventional studies using real-time EEG feedback are needed to confirm improvements in long-term neurological outcomes. Copyright © 2026 by the authors. <30> Accession Number 2042446505 Title Diabetes does not modify the renal-protective effect of intravenous amino acids infusion after cardiac surgery. Source Journal of Endocrinological Investigation. 49(5) (pp 1163-1172), 2026. Date of Publication: 01 May 2026. Author Consonni M.; Fresilli S.; Kotani Y.; Garofalo E.; Bradic N.; Scandroglio A.M.; Ti L.K.; Comis M.; Oriani A.; Pisano A.; Belletti A.; Guarracino F.; Losiggio R.; Redaelli M.B.; Pontillo D.; Arangino C.; Pruna A.; Federici F.; D'Amico F.; Silvetti S.; Labanca R.; Ferrod F.; Pittella G.; Corbo F.; Ranucci M.; Cortegiani A.; Paternoster G.; Bove T.; Longhini F.; Monaco F.; Zangrillo A.; Piemonti L. Institution (Consonni, Fresilli, Scandroglio, Oriani, Belletti, Losiggio, Pontillo, Pruna, D'Amico, Labanca, Corbo, Zangrillo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Kotani) Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan (Garofalo, Longhini) Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy (Bradic) Clinic of Anesthesiology, Resuscitation and Intensive Care, University Hospital Dubrava, Zagreb, Croatia (Bradic) Department of Nursing, University North, Varazdin, Croatia (Ti) Department of Anaesthesia, National University Hospital, Lower Kent Ridge Road, Singapore (Comis, Ferrod) S.C. Anestesia e Rianimazione Cardiovascolare, A.O.Ordine Mauriziano, Umberto I di Torino, Turin, Italy (Pisano) Cardiac Anesthesia and ICU, AORN "Dei Colli", Monaldi Hospital, Naples, Italy (Guarracino) Department of Cardiothoracic Anaesthesia and IC, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Redaelli) General and Neurosurgical Intensive Care Units, ASST Sette Laghi, Ospedale Di Circolo, Varese, Italy (Redaelli) Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy (Arangino) Department of Cardiothoracic Anesthesia and Intensive Care, IRCCS Centro Cardiologico Monzino, Milan, Italy (Federici) UOC Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy (Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS, IRCCS Cardiovascular Network, Genova, Italy (Pittella) Cardiovascular Anaesthesia and ICU, San Carlo Hospital, Potenza, Italy (Ranucci) Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy (Cortegiani) Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy (Cortegiani) Department of Anesthesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Analgesia, Palermo, Italy (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy (Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri- Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Monaco) Departement. of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy (Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria Sant'Orsola, Bologna, Italy (Zangrillo, Piemonti) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Piemonti) Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy (Losiggio) Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, Milan, Italy Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with increased morbidity and mortality. Intravenous amino acids (AA) infusion reduces postoperative AKI. Given the high prevalence of patients with diabetes and their increased susceptibility to renal injury, this study aimed to assess whether the renal-protective effect of AA infusion is maintained in this population. Method(s): This post-hoc subgroup analysis examined patients with diabetes included in the multinational, double-blind, randomized, placebo-controlled PROTECTION trial. Participants were randomized to receive a continuous intravenous infusion of AA (2 g/kg of the ideal body weight per day; up to 72 h) or placebo during the perioperative period of cardiac surgery. Result(s): Among 644 patients with diabetes (AA n = 309; placebo n = 335), the incidence of any-stage AKI was 43.3% in the AA group versus 47.8% in the placebo group, with no significant interaction observed compared to patients without diabetes (interaction p = 0.82). Similarly, stage 3 AKI occurred in 2.3% of patients in AA group versus 4.8% in the placebo group, with no interaction detected (interaction p = 0.65). Conclusion(s): The beneficial effect of perioperative AA infusion has similar magnitude and direction among patients with or without diabetes. These findings support the use of AA infusion as a renal-protective strategy for all patients undergoing cardiac surgery. Trial registration number: ClinicalTrials.gov NCT03709264 - registered on October 17th, 2018. Copyright © The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE) 2026. <31> Accession Number 2045407031 Title The impact of residual tricuspid regurgitation on long-term clinical outcomes, following tricuspid transcatheter edge-to-edge repair. Source Clinical Research in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Patrascu A.; Binder D.; Alashkar I.; der Wische H.I.; Schnabel P.; Al Farwan F.; Weinmann K.; Ott I. Institution (Patrascu, Binder, Alashkar, der Wische, Schnabel, Al Farwan, Weinmann, Ott) Department of Cardiology, Rhythmology, Electrophysiology and Angiology, Helios Hospital Pforzheim, Kanzlerstrasse 2-6, Pforzheim, Germany (Patrascu) Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Success of tricuspid transcatheter edge-to-edge repair (T-TEER) was defined in feasibility studies for specific devices by >= one-grade tricuspid regurgitation (TR) reduction (1 + to 5 + classification). However, the Clinical Trial to Evaluate Cardiovascular Outcomes in Patients Treated With the Tricuspid Valve Repair System (TRILUMINATE) randomized controlled trial (RCT) showed significant quality of life (QoL) improvement only in patients with residual moderate-or-less TR (MTR). We sought to validate this finding in a real-world cohort by comparing long-term T-TEER clinical outcomes between patients with residual severe TR (STR; 3 +) and those with MTR (<= 2). Method(s): Eligible inoperable patients had symptomatic functional TR despite medical therapy. The primary efficacy endpoint was >= one-grade TR reduction, coupled with severe-or-less residual TR (<= 3), by 30-day follow-up. Result(s): Sixty-four patients (mean-age 81.8 +/- 4.9 years; STS Score 10 +/- 5.1%; 92% NYHA III-IV) with >= 3 TR underwent T-TEER at our institution. The primary efficacy endpoint was 94% (60/64) (37 MTR vs 23 STR patients), with 100% technical success. Both MTR (n = 32) and STR (n = 21) 1-year survivors improved their QoL, e.g., KCCQ Score increased by 33.7 +/- 15.5 pts. (p < 0.001) vs 23 +/- 16.1 pts. (p = 0.001) (between-group p = 0.166), with no significant difference in NYHA class reduction (one-grade 56% vs 62%, p = 1.000; two-grade 31% vs 19%, p = 0.544). Predictors of STR on multivariate analysis were periprocedural image quality (OR 1.90, p = 0.003) and main TR jet position (OR 1.55, p = 0.036). Conclusion(s): Although T-TEER should instinctively aim for MTR, considerable reduction is not always possible in multimorbid patients with advanced right heart remodeling. This study indicates that even moderate TR reduction and residual STR can improve QoL. Therefore, echocardiography should not be the only indicator of success. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <32> Accession Number 2040616062 Title Extracorporeal Membrane Oxygenation Cannulation by Intensivists: A Systematic Review and Meta-Analysis. Source Journal of Intensive Care Medicine. 41(6) (pp 502-511), 2026. Date of Publication: 01 Jun 2026. Author Sato R.; Hamahata N.; Hasegawa D.; Paladino J.; Itoman E. Institution (Sato, Paladino, Itoman) Division of Critical Care Medicine, Department of Medicine, The Queen's Medical Center, Honolulu, HI, United States (Hamahata, Paladino) Aloha Critical Care Associates, Honolulu, HI, United States (Hamahata, Paladino) Straub Benioff Medical Center, Honolulu, HI, United States (Hasegawa) Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States Publisher SAGE Publications Inc. Abstract Purpose: To summarize the currently available evidence regarding the effectiveness and safety of extracorporeal membrane oxygenation (ECMO) cannulation performed by intensivists. Method(s): We conducted a systematic search of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for studies of any design in which patients underwent ECMO cannulation by intensivists. The search was updated on Dec 15, 2024. Two independent authors screened titles and abstracts for general applicability, followed by full-text review to determine whether studies met the following criteria: (1) adult patients and (2) ECMO cannulation performed by intensivists. Two independent authors extracted study characteristics and outcomes of interest. The Freeman-Tukey double arcsine transformation was used to stabilize variance. A random-effects model was used to calculate the pooled complication rates. Result(s): A total of 209 studies were screened, and 12 retrospective, single-center studies were included. The pooled complication rate of ECMO cannulations performed by intensivists was 2% per cannula and 5% per patient. In the subgroup of VA ECMO cannulations, the complication rate was 9% per patient, whereas for VV ECMO cannulations, it was 4% per patient. Conclusion(s): ECMO cannulation by intensivists appears to be safe and feasible when supported by adequate training, credentialing processes, and backup support from surgeons in the event of complications such as vascular injury. Copyright © The Author(s) 2025 <33> Accession Number 2033978891 Title Incidence of Acute Kidney Injury (AKI) in Critically Ill Patients Receiving Concomitant Vancomycin with Piperacillin-Tazobactam or Cefepime; a Systemic Review and Meta-analysis. Source Journal of Intensive Care Medicine. 41(6) (pp 447-455), 2026. Date of Publication: 01 Jun 2026. Author Alaradi L.; Albariqi N.; Alanazi M.; Alghassab N.; Aseri T.; Alahmadi L.; Alahmadi A.; Althobaiti A.; Alqarafi Y.; Bokhari H.; Qutob R.A.; Almaimani M. Institution (Alaradi) College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia (Albariqi, Alahmadi) Ibn Sina National College, Jeddah, Saudi Arabia (Alanazi) College of Medicine, University of Tabuk, Tabuk, Saudi Arabia (Alghassab) College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia (Aseri, Althobaiti) College of Medicine, Taif University, Taif, Saudi Arabia (Alahmadi) College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia (Alqarafi) College of Medicine, Hail University, Hail, Saudi Arabia (Bokhari) College of Pharmacy, Taif University, Taif, Saudi Arabia (Qutob) Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia (Almaimani) Department of Internal Medicine, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia Publisher SAGE Publications Inc. Abstract Background: Nephrotoxicity remains a significant concern in the management of critically ill patients receiving antibiotic therapy. The combination of Vancomycin and Piperacillin-Tazobactam (VPT) is frequently employed to combat multidrug-resistant infections. However, emerging evidence suggests a potential increase in the risk of acute kidney injury (AKI) associated with this combination. This study aims to systematically review and analyze the nephrotoxic risk of the VPT combination in comparison to Vancomycin with Cefepime (VC) combination therapy. Methodology: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed in databases including PubMed and Google Scholar for studies published until 2024. Studies that reported AKI incidence in patients treated with VPT, or VC were included. The data were analyzed using random-effects models to estimate pooled incidence rates of AKI. Subgroup analyses were performed based on patient demographics and baseline renal function. Result(s): A total of six studies involving 23 794 patients were included in the analysis. The pooled incidence of AKI in the VPT group was found to be 29.9% (95% CI: 25.3%-38.4%), significantly higher than that of the VC (22.7%) (P < .05). A comparative analysis demonstrated a significantly higher risk of AKI in patients on VPT compared to VC (1.503; 95% CI: 1.221-1.849 P < .001). Conclusion(s): The findings of this study underscore a significant increase in the risk of AKI associated with the Vancomycin and Piperacillin-Tazobactam combination in critically ill patients. Clinicians should exercise caution when prescribing this combination, particularly for patients with pre-existing renal dysfunction. Copyright © The Author(s) 2025 <34> Accession Number 2045023161 Title Ultrasound-Guided Sciatic and Saphenous Nerve Blocks Enhance Perioperative Analgesia in Sheep Undergoing Experimental Orthopaedic Hindlimb Surgery. Source Veterinary Sciences. 13(4) (no pagination), 2026. Article Number: 318. Date of Publication: 01 Apr 2026. Author Rodriguez O.; Figueirinhas P.; Vazquez D.; Del-Rosario S.; Brito-Casillas Y.; Martin S.; Paolini A.; Mateo-Cebrian A.; Rodriguez-Trujillo R. Institution (Rodriguez, Figueirinhas, Vazquez, Del-Rosario, Martin) Departamento de Patologia Animal, Universidad de Las Palmas de Gran Canaria, Trasmontana S/N, Arucas, Spain (Brito-Casillas) Instituto Universitario de Investigaciones Biomedicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain (Paolini) Small Animal Surgery and Anaesthesia Service, Department of Veterinary Medicine, University of Teramo, Teramo, Italy (Mateo-Cebrian) Las Palmas de Gran CanariaSpain (Rodriguez-Trujillo) Unit of Reproduction, University Institute of Biomedical Research and Health, University of Las Palmas de Gran Canaria, Transmontana S/N, Arucas, Spain Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract The demand for refined anaesthetic protocols in ovine experimental surgery has increased due to ethical considerations and the need to improve perioperative stability. This study evaluated the analgesic efficacy of ultrasound-guided combined sciatic and saphenous nerve blocks using two different local anaesthetics in Hair Canarian Sheep undergoing invasive orthopaedic hindlimb surgery. Fifteen clinically healthy sheep were randomly assigned to one of three groups: lidocaine (2%), bupivacaine (0.5%), or control (general anaesthesia alone). Intraoperative physiological parameters, including heart rate, respiratory rate, and arterial blood pressure, were recorded, and postoperative pain was assessed using a modified Melbourne Pain Scale. Sheep receiving locoregional anaesthesia showed significantly lower postoperative pain scores compared with control animals. Intraoperatively, a significant difference between groups was observed only for respiratory rate, with lower values in the bupivacaine group. The bupivacaine group exhibited lower and more stable respiratory rates, with a trend towards lower heart rates during surgery, as well as consistently lower pain scores during the early postoperative period. Lidocaine provided limited intraoperative and postoperative effects compared with the control group. Respiratory rate appeared to be more closely associated with pain scores than other physiological parameters. In conclusion, ultrasound-guided sciatic and saphenous nerve blocks were associated with improved perioperative analgesia in sheep undergoing orthopaedic surgery. The use of bupivacaine was associated with lower respiratory rates intraoperatively and reduced postoperative pain scores, suggesting a potential benefit in perioperative analgesia. Copyright © 2026 by the authors. <35> Accession Number 2045389883 Title Impact of pre-operative factors on post-operative atrial fibrillation outcomes after cardiac surgery: systematic review with meta-analysis, trial sequential analysis, and meta-regression. Source Acta Cardiologica. (no pagination), 2026. Date of Publication: 2026. Author Khalil I.; Hrebat M.; Abuawwad T.; Zetawi M.; Yassin B.M.; Amayre S.I.; Amarin H.; Gouda A.G.; Khazbak M.A.; Khatib S.; Mohammed M.H.H.; Okasha A.A.; Hassan Ali A.O.; Tntoush T.; Laouadi N. Institution (Khalil) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Hrebat) Faculty of Medicine, Tanta University, Tanta, Egypt (Abuawwad) Fujian Medical University, Fuzhou, China (Zetawi, Khatib) Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Yassin) Faculty of Medicine, Kuwait University, Kuwait City, Kuwait (Amayre, Amarin) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine (Gouda) Ministry of Health, Kuwait City, Kuwait (Khazbak) Ministry of Health, Muscat, Oman (Mohammed) Faculty of Medicine, University of Khartoum, Khartoum, Sudan (Okasha) Faculty of Medicine, University of Jordan, Amman, Jordan (Hassan Ali) Critical Care Department, Dr. Soliman Fakeeh Hospital, Riyadh, Saudi Arabia (Tntoush) Sidra Medicine, Doha, Qatar (Laouadi) Heart Center, King Abdulaziz Specialized Hospital, Al Jouf, Saudi Arabia Publisher Taylor and Francis Ltd. Abstract Objectives: Post-operative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery. We conducted a systematic review and meta-analysis to quantify the association between POAF and adverse outcomes. Method(s): We searched PubMed, Embase, CENTRAL, and Web of Science through December 2024. Studies comparing outcomes between POAF and non-POAF patients after cardiac surgery were included. Random-effects meta-analysis was performed. Trial sequential analysis, Bayesian analysis, subgroup analyses, and meta-regression were conducted. Evidence certainty was assessed using the GRADE framework. Result(s): Fifty-four studies (623,962 patients) were included. POAF was associated with significantly increased risks of early mortality (RR 1.94; 95% CI 1.89-2.00; I2=0%), late mortality (RR 1.59; 95% CI 1.50-1.69; I2=30%), stroke (RR 1.39; 95% CI 1.34-1.44; I2=12%), and acute kidney injury (RR 1.53; 95% CI 1.49-1.57; I2=0%). Trial sequential analysis confirmed conclusive evidence for all outcomes. Bayesian posterior probability was 100% for all outcomes. GRADE certainty was moderate for early mortality, late mortality, and AKI; low for stroke. Meta-regression identified prior stroke prevalence and chronic kidney disease as significant effect modifiers. Conclusion(s): POAF is associated with substantially increased risks of mortality, stroke, and acute kidney injury following cardiac surgery. These findings support evidence-based prevention strategies and comprehensive management of POAF. Copyright © 2026 Belgian Society of Cardiology. <36> Accession Number 2045512233 Title Association of HLA alleles and mismatches with post-transplant lymphoproliferative disorder in solid organ transplant recipients: a systematic review and meta-analysis. Source Transplant Immunology. 96 (no pagination), 2026. Article Number: 102396. Date of Publication: 01 Jun 2026. Author Assadiasl S.; Yazdani M.; Mojtahedi H.; Safdel S.; Mami S.; Sadr M.; Sadeghi A.; Soleimanifar N.; Nicknam M.H. Institution (Assadiasl, Mojtahedi, Safdel, Sadr, Soleimanifar, Nicknam) Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Assadiasl, Yazdani, Sadeghi) Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mami, Nicknam) Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Sadeghi) Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Elsevier B.V. Abstract Background: Post-transplant lymphoproliferative disorder (PTLD) is a rare but significant complication after solid organ transplantation. Many factors, including viral infections and immunosuppressive drugs, have been shown to predispose transplant recipients to disease; however, the implication of human leukocyte antigens (HLA) has not yet been understood. In this systematic review, the association of HLA alleles and HLA mismatch number with the development of PTLD was evaluated in solid organ transplant recipients. Method(s): A literature search was performed until October 2025 using PubMed/Medline, Scopus, Web of Science, and Cochrane library databases concerning the association of HLA alleles and mismatches with PTLD in kidney, liver, heart, lung, and pancreas transplant recipients. After literature screening, 28 full text articles were included in the systematic review. The statistical analyses were conducted using R software (version 4.3.2) with the meta package for effect size synthesis, heterogeneity assessment, and visualization. Result(s): The study did not show any particular HLA allele that could increase or decrease disease risk in all populations. However, meta-analysis of HLA-B and HLA-DR mismatches in PTLD risk revealed that while both mismatches showed a trend toward increased risk, HLA-DR mismatches demonstrated a more consistent and statistically significant association with HR: 1.65 (95% CI: 1.28 to 2.12) compared to HLA-B with HR:1.78 (95% CI 0.91 - 3.48). Conclusion(s): HLA disparity especially, HLA-DR and HLA-B mismatch between donor and recipient might increase the risk of post-transplant lymphoproliferative disease in solid organ transplant recipients. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <37> Accession Number 2043771077 Title Outcomes of No-Touch Vs Conventionally Harvested Saphenous Veins for Coronary Artery Bypass Surgery: Individual Patient Data Meta-Analysis Protocol. Source CJC Open. 8(5) (pp 550-556), 2026. Date of Publication: 01 May 2026. Author Gregg A.C.; Tian M.; Gaudino M.; Angelini G.; Fremes S.; Jeppsson A.; Modrau I.S.; Redfors B.; Sandner S.; Sartipy U.; Thelin S.; Hu S.; James S. Institution (Gregg, Gaudino, Redfors, Sandner) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Tian, Hu) Department of Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (Angelini) Bristol Heart Institute, University of Bristol, Bristol, United Kingdom (Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada (Jeppsson, Redfors) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Jeppsson, Redfors) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Modrau) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Redfors) Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States (Sandner) Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (Sartipy) Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden (Sartipy) Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden (Thelin) Department of Thoracic Surgery, Uppsala University Hospital, Uppsala, Sweden (James) Department of Medical Sciences, Cardiology, Uppsala University Hospital, Uppsala, Sweden Publisher Elsevier Inc. Abstract The effect of no-touch (NT) vs conventional (CON) saphenous vein graft (SVG) harvesting on SVG patency and clinical outcomes in coronary artery bypass remains unclear. Although prior trial-level meta-analyses have generally reported improved patency with NT SVG, outcomes show variability across studies, and evidence from 2 recent, larger multicentre randomized clinical trials is discordant. This individual patient data meta-analysis (IPDMA) will evaluate the impact of harvesting techniques on graft patency and clinical outcomes. A systematic literature search was conducted for randomized clinical trials comparing NT SVG and CON SVG. Studies were eligible if they included at least 1 year of follow-up evaluation with graft imaging. The primary efficacy outcome will be graft failure, defined as graft-level study SVG occlusion. The secondary outcomes will include leg wound complications, patient-level graft failure, graft malfunction (composite of graft occlusion or stenosis), and major adverse cardiac events (MACE) defined as the composite of all-cause death, myocardial infarction, or any repeat revascularization. A 2-stage IPDMA will be performed. In the first stage, mixed-effects logistic regression models will be fitted separately within each trial. In the second stage, trial-level estimates will be pooled using random-effects models to generate overall effects. Prespecified subgroup analyses will be conducted via a 2-stage framework to evaluate potential effect modification by key patient-level characteristics. This IPDMA will enable more robust evaluation of the effect of harvesting techniques on SVG patency and clinical outcomes, leveraging patient-level datasets for in-depth analyses, particularly among patient subgroups with distinct risk profiles. Copyright © 2026 The Authors <38> Accession Number 2044220004 Title Conduction System vs Biventricular Pacing in Heart Failure: The PhysioSync-HF Randomized Clinical Trial. Source JAMA Cardiology. 11(4) (pp 360-368), 2026. Date of Publication: 08 Apr 2026. Author Zimerman A.; Dal Forno A.; Rohde L.E.; Ternes C.M.; Alves F.D.; Damiani L.P.; Martinelli-Filho M.; Costa R.; Fagundes A.A.; Barbosa R.M.; Gadelha E.B.; Lima C.E.; Silva M.A.; Maldonado J.A.; De Oliveira J.C.; Mallmann F.; Baggio Junior J.M.; Duarte C.E.; De Souza L.A.; Santos J.S.; Silveira A.D.; Decker S.R.R.; Zimerman L.I.; Polanczyk C.A.; D'avila A. Institution (Zimerman, Rohde, Alves, De Souza, Santos, Decker, Polanczyk) MOVE Academic Research Organization, Hospital Moinhos de Vento, Moinhos de Vento Medical School, Porto Alegre, Brazil (Zimerman, Rohde, Silveira, Zimerman, Polanczyk, D'avila) Cardiology Division, Hospital Moinhos de Vento, Porto Alegre, Brazil (Zimerman, Rohde, Alves, De Souza, Silveira, Decker, Polanczyk) Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Zimerman, Rohde, Ternes, Alves, De Souza, Santos, Silveira, Decker, Polanczyk) Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil (Dal Forno, Ternes, D'avila) Hospital SOS Cardio, Florianopolis, Brazil (Rohde, Silveira, Zimerman, Polanczyk) Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil (Damiani) Brazilian Clinical Research Institute, Sao Paulo, Brazil (Damiani) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil (Martinelli-Filho) Department of Cardiology, Instituto do Coracao, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil (Costa) Cardiac Pacing Division, Department of Cardiovascular Surgery, Instituto do Coracao, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil (Costa) Discipline of Cardiovascular Surgery, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil (Fagundes) Hospital Ana Nery, Salvador, Brazil (Barbosa) Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil (Gadelha) Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil (Lima) Hospital Universitario da Universidade Federal do Piaui, Teresina, Brazil (Silva) Hospital Universitario Cassiano Antonio de Moraes, Vitoria, Brazil (Maldonado) Fundacao Hospitalar do Coracao Francisca Mendes, Manaus, Brazil (De Oliveira) Hospital Geral Universitario de Cuiaba, Cuiaba, Brazil (Mallmann) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil (Baggio Junior) Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil (Duarte) Hospital Beneficencia Portuguesa, Sao Paulo, Brazil (Decker) Internal Medicine Division, Hospital Moinhos de Vento, Porto Alegre, Brazil (Decker) Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (D'avila) Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Publisher American Medical Association Abstract Importance: Conduction system pacing (CSP) is a promising and potentially cost-effective alternative to biventricular pacing (BiVP) in patients with heart failure with reduced ejection fraction (HFrEF) and left bundle-branch block (LBBB), but its impact on heart failure (HF) outcomes remains uncertain. Objective(s): To compare CSP vs BiVP on an HF-related outcome in patients with HFrEF and LBBB. Design, Setting, and Participant(s): PhysioSync-HF (Conduction System Pacing Versus Biventricular Resynchronization in Patients With Chronic Heart Failure) was an investigator-initiated, multicenter, noninferiority randomized clinical trial enrolling participants from November 2022 to December 2023 with 12 months of follow-up at 14 hospitals across all regions of Brazil. Adults with symptomatic HFrEF (New York Heart Association NYHA] classes II through III), left ventricular ejection fraction (LVEF) of 35% or less, and LBBB (QRS duration >=130 milliseconds) were eligible for inclusion. Data were analyzed from May to August 2025. Intervention(s): Patients were randomized 1:1 to either CSP (preferentially left bundle-branch area pacing) or BiVP. Main Outcomes and Measures: The primary outcome was a hierarchical composite of death, HF hospitalizations, urgent HF visits, and change in LVEF at 12 months. The prespecified noninferiority margin for the odds ratio (OR) was 1.2. Result(s): A total of 173 patients (median [IQR] age, 62 years [56-68]; 86 female patients [49.7%]; 115 (66.5%) with dilated cardiomyopathy; median [IQR] LVEF, 26% [22%-31%]; median [IQR] QRS, 180 milliseconds [170-200]) were included. At 12 months, CSP failed to meet noninferiority and was inferior to BiVP for the primary end point (OR, 2.36; 95% CI, 1.37-4.06; P =.99 for noninferiority; P =.002 for between-group difference). The time-to-event composite of death, HF hospitalizations, or urgent HF visits was higher in CSP (hazard ratio, 2.35; 95% CI, 0.99-5.61). Mean (SD) LVEF increased to 35% (12%) with CSP and 39% (12%) with BiVP (mean difference, 3.8%; 95% CI, 0.3%-7.3%). Relative to baseline, both groups had comparable improvements in QRS duration, Kansas City Cardiomyopathy Questionnaire Overall Summary Score, NYHA class, and natriuretic peptide levels. Total direct medical cost related to the procedure and heart failure care was the equivalent of $7090 (95% CI, $5779-$8648) lower in patients randomized to CSP at 12 months. Conclusions and Relevance: In patients with HFrEF and LBBB, CSP was inferior to BiVP for a composite of death, HF hospitalizations, urgent HF visits, and change in LVEF at 12 months. These findings do not support the routine use of CSP as the first-line resynchronization strategy in this population. Copyright © 2026 Zimerman A et al. <39> Accession Number 2045353458 Title Effect of different lung recruitment maneuvers on postoperative respiratory outcomes and lung aeration, assessed by lung ultrasound, in patients undergoing thoracoscopic sympathectomy: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 286. Date of Publication: 01 Dec 2026. Author Chen D.; Chen Y.; Wu Y.; Lin X. Institution (Chen, Chen, Wu) Department of Anesthesiology, Quanzhou First Hospital, Fujian, Quanzhou, China (Lin) Department of Anesthesiology, the First Affiliated Hospital of Fujian Medical University, Fujian, Fuzhou, China (Lin) Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, Fuzhou, China (Lin) Anesthesiology Research Institute, the First Affiliated Hospital of Fujian Medical University, Fujian, Fuzhou, China Publisher BioMed Central Ltd Abstract Background: Atelectasis is a primary cause of impaired oxygenation and reduced respiratory compliance during general anesthesia. Recruitment maneuvers (RMs) can effectively counteract atelectasis; however, the optimal protocol regarding pressure, timing, and assessment method remains undefined. Therefore, this study utilized lung ultrasound (LUS) to evaluate the effectiveness of different RM pressures combined with positive end-expiratory pressure (PEEP) in reducing atelectasis and improving oxygenation in surgical patients. Method(s): This prospective, randomized, assessor-blinded, 2 x 2 factorial trial enrolled adult patients undergoing elective thoracoscopic bilateral sympathectomy. Participants were randomized to one of four groups according to recruitment maneuver peak airway pressure (Ppeak 30 or 40 cmHO) and post-recruitment PEEP (0 or 8 cmHO): A (30/0), B (40/0), C (30/8), and D (40/8). A standardized recruitment maneuver (15 s) at the assigned Ppeak was performed after completion of the right- and left-sided procedures. After the second maneuver, patients were ventilated in synchronized intermittent mandatory ventilation (SIMV) with the assigned PEEP until extubation. Primary outcomes were total LUS score and the incidence of postoperative atelectasis (defined as any region with LUS score >= 2), assessed in the PACU 30 min after extubation. Result(s): Among the 116 analyzed patients, the incidence of LUS-assessed postoperative atelectasis decreased across groups: 58.62% in Group A (17/29), 42.86% in Group B (12/28), 35.48% in Group C (11/31), and 21.43% in Group D (6/28). Compared with Group A, Group D had a significantly lower incidence (P = 0.009). Group A also had the highest LUS scores, which were significantly higher than those in each of the other three groups (all P < 0.05). Conclusion(s): A recruitment pressure of 40 cmHO, applied at the end of thoracoscopic bilateral sympathectomy, was superior to 30 cmHO in reducing both the LUS score and the rate of atelectasis. Moreover, applying 8 cmHO PEEP from recruitment until extubation significantly lowered LUS scores compared to no PEEP. Trial registration: ISRCTN31424042; retrospectively registered on 6 February 2026. Copyright © The Author(s) 2026. <40> Accession Number 2045259308 Title Older Patients' Perspectives on Music Intervention to Reduce Preoperative Anxiety in Cardiac Surgical Procedures: Findings from a Clinical Trial. Source Heart and Mind. 10(2) (pp 83-93), 2026. Date of Publication: 01 Mar 2026. Author Yang K.-L.; Detroyer E.; Heyman M.; Hoogma D.F.; Dubois C.; Meuris B.; Meyns B.; Rex S.; Milisen K. Institution (Yang, Detroyer, Heyman, Milisen) Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium (Detroyer, Milisen) Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium (Hoogma, Rex) Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium (Hoogma, Dubois, Meuris, Meyns, Rex) Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium (Dubois) Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium (Meuris, Meyns) Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium Publisher Wolters Kluwer Medknow Publications Abstract Objective: To explore older patients' perspectives on the acceptability and feasibility of a music intervention to reduce preoperative anxiety (PA) before cardiac surgery or Transcatheter Aortic Valve Implantation (TAVI). Method(s): A monocentric, single-arm study was conducted between December 2023 and April 2024, involving patients aged 60 years or older undergoing cardiac surgery or TAVI. Each participant received a 20-30-minute music intervention session on the day before and the day of surgery. Music playlist was tailored to each patient's preferred genres and specific music selections. Primary outcomes were patients' acceptability and feasibility, evaluated through the consent rate, compliance rate and a postoperative interview. PA was measured using validated instruments. Result(s): Of 134 patients approached, 78 (58.2%) consented. Recruitment and follow-up were completed as planned. Music intervention was delivered to 71 patients, with 7 unable to participate for practical reasons. Compliance rates were 98.6% for the first session (n = 70) and 87.3% for the second session (n = 62). Interviews from 63 patients revealed high satisfaction, with 62 (98.4%) satisfied with the intervention, 57 (90.5%) interested in future music interventions, 58 (92.1%) liking the music, and 61 (96.8%) willing to recommend it to others. Approximately half of the participants (47.6%-66.7%) endorsed the key components of music intervention. Significant reductions in instrument-measured PA were observed after the first session, with 84.5% feeling relaxed immediately afterwards. Although reductions were not statistically significant after the second session, 91.1% felt relaxed immediately afterwards. No adverse events were reported. Conclusion(s): Music intervention is acceptable and feasible from the perspective of older patients undergoing cardiac surgery or TAVI. The observed immediate effect on PA should be considered as exploratory given the absence of a comparison group. Copyright © 2026 Heart and Mind. <41> Accession Number 2034538863 Title Ischemic outcomes after left atrial appendage closure following intracerebral hemorrhage: a retrospective inverse probability weighting analysis from the HANSE-LAAC registry. Source Clinical Research in Cardiology. 115(6) (pp 946-954), 2026. Date of Publication: 01 Jun 2026. Author Jurczyk D.; Mezger M.; Lemmer F.; Fatum C.; Gradaus R.; Drochner-Brocks N.-K.; Saraei R.; Frerker C.; Stiermaier T.; Paitazoglou C.; Eitel I. Institution (Jurczyk, Mezger, Lemmer, Fatum, Gradaus, Drochner-Brocks, Saraei, Frerker, Stiermaier, Paitazoglou, Eitel) Medical Clinic II (Cardiology, Angiology, Intensive Care Medicine), University Hospital Schleswig-Holstein, University Heart Center Lubeck, University Schleswig-Holstein (UKSH), Ratzeburger Allee 160, Luebeck, Germany (Jurczyk, Mezger, Lemmer, Fatum, Saraei, Frerker, Stiermaier, Paitazoglou, Eitel) German Center for Cardiovascular Research, Hamburg/Kiel/Lubeck/Greifswald, Partner Site Lubeck, Luebeck, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Intracerebral hemorrhage (ICH) is associated with worse outcomes and subsequent high risk for acute arterial ischemic events. Percutaneous left atrial appendage closure (LAAC) is an established procedure in case of atrial fibrillation and adverse events, such as severe bleeding. Clinical benefits of LAAC in patients with ICH are currently unclear. Method(s): The single-center registry HANSE-LAAC included consecutively treated patients from 2014 to 2022. Index-procedure and standardized follow-ups at 3 and 12 months were analyzed regarding safety and efficacy retrospectively. Mortality, major adverse cardiovascular, and bleeding events were compared between patients with or without ICH. We used Cox proportional hazard models and inverse probability weights to adjust confounders. Result(s): 401 patients received percutaneous LAAC (ICH 15.2%, n = 61 and non-ICH 84.8%, n = 340). The composite endpoint of death, MACE, and bleeding was significantly lower in the ICH group (HR 0.35, confidence interval [CI] 0.05-4.62, p = 0.0044). This clinical benefit was mainly driven by a significant reduction in bleeding events (HR 0.27; CI 0.06-1.15, p = 0.04). Re-hospitalization was significantly lower as well (HR 0.36; CI 0.20-0.64, p < 0.0001). Adjustment for confounders and inverse probability weighting for the probability of ICH showed no statistically significant difference in mortality (HR 0.53, CI 0.15-1.92, p = 0.33), stroke (HR 0.32 CI 0.03-3.13, p = 0.33), bleeding (HR 0.26; CI 0.05-1.29, p = 0.02), and MACE (HR 0.29; CI 0.04-2.36, p = 0.002). Conclusion(s): LAAC in ICH was safe and associated with less MACE, bleeding, and re-hospitalization. Randomized-controlled trials are needed to confirm these first positive signs. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2025. <42> Accession Number 2045101042 Title The prognostic utility of the pulmonary artery pulsatility and aortic pulsatility index in patients with heart failure: A systematic review. Source JRSM Cardiovascular Disease. 15 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author Albdour Z.; Qadri M.; AlAbed Z.A.; Jarrar Z.M.; Bayadreh A.F.; Abu-Shattal O.M.; Albdour K. Institution (Albdour, Qadri, AlAbed, Jarrar, Bayadreh, Abu-Shattal, Albdour) Faculty of Medicine, University of Jordan, Amman, Jordan Publisher SAGE Publications Ltd Abstract Heart failure (HF) continues to pose a major burden worldwide, and risk stratification is important to guide management. Hemodynamic indices such as the pulmonary artery pulsatility index (PAPI) and aortic pulsatility index (API) have gained attention as potential prognostic tools, but their role is still not well established. We conducted a systematic review to assess the prognostic role of PAPI and API in HF patients. We systematically searched PubMed, Web of Science, Scopus, and Cochrane Library for studies assessing PAPI and API in adults (>=18 years) with HF. We included cohort studies and randomized trials reporting outcomes such as mortality, hospitalization, left ventricular assist device implantation, or heart transplantation. Of 601 studies identified, 12 met the inclusion criteria, comprising 3681 patients. Across different HF populations, lower PAPI values were consistently associated with worse outcomes, with reported cutoffs ranging from <=1.9 in cardiogenic shock to around <=2.8-2.95 in broader HF populations, and up to <=3.65 in advanced HF. Aortic pulsatility index showed a similar pattern, but with more consistent performance: values <1.45 were linked to mortality or rapid progression to advanced therapies, while values >2.9 were associated with better event-free survival. In studies that evaluated both indices, API generally showed stronger prognostic value. Overall, PAPI and API provide clinically useful prognostic information, particularly in advanced HF patients undergoing invasive hemodynamic assessment, though further large-scale prospective studies are needed to better define their role. Copyright © The Author(s) 2026 <43> Accession Number 2035000001 Title Comparison of left atrial appendage occlusion with medical treatment for non-valvular atrial fibrillation: systematic review, network and reconstructed individual patient data meta-analysis. Source Clinical Research in Cardiology. 115(6) (pp 955-964), 2026. Date of Publication: 01 Jun 2026. Author Lerman T.T.; Hershenson R.; Greenberg N.; Kheifets M.; Talmor-Barkan Y.; Codner P.; Perl L.; Witberg G.; Rotholz A.; Vons S.; Orvin K.; Eisen A.; Belkin D.; Fishman B.; Golovchiner G.; Kornowski R.; Levi A. Institution (Lerman, Hershenson, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Rotholz, Vons, Orvin, Eisen, Golovchiner, Kornowski, Levi) Department of Cardiology, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel (Lerman, Hershenson, Greenberg, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Rotholz, Vons, Orvin, Eisen, Belkin, Fishman, Golovchiner, Kornowski, Levi) The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Greenberg) Department of Internal Medicine F-Recanati, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel (Fishman) University of Pittsburgh Medical Center, Pittsburgh, PA, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Percutaneous left atrial appendage occlusion (LAAO) is a non-pharmacological strategy to prevent stroke and systemic emboli in patients with non-valvular atrial fibrillation (AF). However, data regarding its safety and efficacy profile compared to different oral anti-coagulant regimens remain limited. Method(s): A network meta-analysis compared LAAO, warfarin, and NOACs (standard dose [SD] and low-dose [LD]). Outcomes included all-cause mortality, stroke or systemic embolism, and bleeding risk. Bayesian models with surface under the cumulative ranking curve (SUCRA) and reconstructed individual patient data (IPD) were utilized. Result(s): Twelve studies, including eight randomized controlled trials, were analyzed (13,049 patients with LD NOAC, 29,513 with SD NOAC, 29,611 with warfarin, and 2811 with LAAO). Warfarin was inferior for all-cause mortality compared to LAAO (OR 1.44 [95% CrI; 1.07-1.89]), LD NOAC (OR 1.13 [95% CrI; 1.01-1.26]), and SD NOAC (OR 1.11 [95% CrI; 1.02-1.20]). SUCRA analysis ranked SD NOAC as the most effective for stroke or systemic emboli prevention, LD NOAC as the most effective in preventing major bleeding and LAAO in preventing hemorrhagic stroke. Conclusion(s): SD NOACs were the most effective for preventing stroke or systemic embolism, while LD NOACs were the safest in terms of major bleeding. LAAO was comparable to NOACs and superior to warfarin in both safety and efficacy. Further studies are needed to clarify LAAO's role in the management of atrial fibrillation. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2025. <44> Accession Number 2041697709 Title The internal mammary artery - use as a free graft in coronary artery bypass grafting - evidence, technical considerations and controversies. Source Perfusion (United Kingdom). (no pagination), 2025. Date of Publication: 2025. Author Navaratnarajah M.; Al-Zubaidi F.I.; Raja S.G. Institution (Navaratnarajah) Department of Cardiac Surgery, St Thomas Hospital, London, United Kingdom (Al-Zubaidi) Department of Cardiac Surgery, John Radcliffe Hospital, Oxford, United Kingdom (Raja) Department of Cardiac Surgery, Harefield Hospital, Middlesex, United Kingdom Publisher SAGE Publications Ltd Abstract Background: In-situ internal mammary artery (IMA) grafting remains the gold standard in coronary artery bypass grafting (CABG), particularly for left anterior descending artery revascularisation. However, the role of free-IMA grafts-especially free right IMA (RIMA) and select cases of free left IMA (LIMA)-has expanded in response to anatomical and technical constraints. This narrative review synthesises current evidence on free-IMA use during CABG. Method(s): A structured literature search was conducted using PubMed (1946-2025) and Embase (1974-2025), supplemented by Web of Science, Google Scholar, and thesis repositories. Studies were included if they reported outcomes related to free-IMA grafting, regardless of pump status or harvesting technique. Of 74 eligible studies, 9 chosen studies specifically reported free-RIMA outcomes and were analysed in detail. Result(s): Free-RIMA grafting demonstrated excellent long-term patency (up to 96%) and favourable survival outcomes when used as composite or direct aorto-coronary grafts. Multi-arterial grafting (MAG) and total arterial grafting (TAG) strategies incorporating free-IMA conduits were associated with reduced major adverse cardiac events (MACE) and improved freedom from repeat revascularisation. Despite these benefits, uptake of free-IMA techniques remains low in Europe and North America, often limited by institutional preferences and operator experience. Conclusion(s): Current evidence supports the selective use of free-IMA grafts in CABG, particularly when in-situ deployment is not feasible. Prospective studies are needed to validate long-term outcomes beyond 10 years, compare free-IMA with radial artery grafts, and define optimal arterial configurations for durable revascularisation. Copyright © The Author(s) 2025. 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). <45> Accession Number 2045452463 Title Effect of Intravenous Lignocaine on Hemodynamic Response to Intubation: A Randomized Controlled Study. Source International Journal of Drug Delivery Technology. 16(39 Supplement) (pp 407-412), 2026. Date of Publication: 2026. Author Anwar M.; Kumari S.; Singh K.; Gupta A.; Serawat S.; Nizamuddin S.; Rahman B.R.; Singh M.V. Institution (Anwar, Serawat, Nizamuddin, Rahman, Singh) Nims College of Allied and Healthcare Sciences, NIMS University Rajasthan, Jaipur, India (Kumari) Department of Anesthesiology, NIMS&R, NIMS University Rajasthan, Jaipur, India (Singh) Department of Nutrition & Public Health, NIMS University Rajasthan, Jaipur, India (Gupta) Department of Anesthesia and Operation Theatre Technology, USAHS, Rayat Bahra University Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Laryngoscopy and endotracheal intubation frequently provoke transient tachycardia and hypertension, which may harm patients with limited cardiovascular reserve. Intravenous lignocaine has been investigated for blunting this response, but evidence remains inconsistent due to methodological limitations. Aim(s): To evaluate whether intravenous lignocaine (1.5 mg/kg) administered 90 seconds before laryngoscopy significantly attenuates the hemodynamic response to endotracheal intubation compared to placebo. Method(s): This double-blind, randomized study enrolled 74 adults (ASA I-II, aged 18-60 years) undergoing elective noncardiac surgery. Patients received either lignocaine 1.5 mg/kg or normal saline 90 seconds before laryngoscopy under a standardized anaesthetic protocol (fentanyl 2 microg/kg, propofol 2 mg/kg, succinylcholine 1.5 mg/kg). Heart rate, systolic, diastolic, and mean arterial pressure were recorded at baseline, after study drug, immediately post-intubation, and at 1, 3, and 5 minutes. Result(s): Seventy-four patients completed the study (37 per group) with comparable baseline characteristics. Following intubation, the lignocaine group demonstrated significantly lower heart rate, systolic, diastolic, and mean arterial pressure than placebo at all post-intubation time points (p < 0.001 for immediate to 3 minutes; p <= 0.007 for 5 minutes). At peak response (immediately post-intubation), lignocaine reduced systolic blood pressure by 13.4 mmHg and heart rate by 10.8 bpm. Hemodynamic values returned closer to baseline more rapidly in the lignocaine group. Oxygen saturation remained stable in both groups, and no adverse events were observed. Conclusion(s): Intravenous lignocaine (1.5 mg/kg) given 90 seconds before laryngoscopy safely and significantly attenuates the hemodynamic response to intubation, providing enhanced cardiovascular stability during general anaesthesia. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <46> Accession Number 2045375984 Title Comments on: "Dexmedetomidine reduces acute kidney injury in high-risk but not low-risk patients after non-cardiac surgery: secondary analysis of a randomized controlled trial". Source Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Hu J.-S.; Lv X.; Liang J.; Wan S. Institution (Hu) Department of Urology, Minda Hospital of Hubei Minzu University, Hubei, Enshi, China (Lv) Department of Urology, Central Hospital of Hefeng County, Hubei, Enshi, China (Liang) Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China (Wan) School of Basic Medical Sciences, Hubei Minzu University, Hubei, Enshi, China Publisher Springer <47> [Use Link to view the full text] Accession Number 2043505328 Title Preoperative and Intraoperative Risk Factors for Postoperative Pneumonia After Cardiac Surgery: An Ancillary Study of the STERNOCAT (Catheter Outcomes With Sternotomy Cardiac Operated) Randomized Trial and a Systematic Review With Meta-Analysis. Source Critical Care Medicine. Publish Ahead of Print (no pagination), 2026. Date of Publication: 11 Feb 2026. Author Dureau P.; Rombi L.; Ouorou R.; Hariri G.; Duceau B.; Amour J.; Bougle A.; Dechartres A. Institution (Dureau, Rombi, Hariri, Duceau, Bougle) GRC 29, Clinical Research Group in Anesthesiology, Critical Care and Perioperative Medicine, ARPE, Sorbonne University, Paris, France (Dureau, Rombi, Hariri, Duceau, Bougle) Department of Anesthesiology and Critical Care, AP-HP, Pitie Salpetriere Hospital, DMU DREAM, Paris, France (Dureau, Hariri, Dechartres) Department of Public Health, Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, AP-HP, Pitie Salpetriere Hospital, AP-HP Center for Pharmacoepidemiology (Cephepi), Paris, France (Ouorou) Public Health Department, Pitie-Salpetriere Hospital, APHP, Paris, France (Amour) Institute of Perfusion, Critical Care and Cardiac Surgery Anesthesia, IPRA, Ramsay Sante, Jacques Cartier Private Hospital, Massy, France Publisher Lippincott Williams and Wilkins Abstract Objective: - Postoperative pneumonia (POP) is a frequent complication after cardiac surgery, which significantly worsens prognosis. This study aimed to identify preoperative and intraoperative factors independently associated with POP in a cardiac surgery cohort, perform a systematic review (SR) and meta-analysis of risk factors, outcomes, and predictive models, and validate these models in the cohort. Design(s): - This is an ancillary study of the STERNOCAT (Catheter Outcomes With Sternotomy Cardiac Operated) trial completed by an SR and meta-analysis. PubMed, Embase, and Cochrane Library were searched (January 2000 to March 31, 2025). Two reviewers independently screened references to identify studies on adult cardiac surgery patients assessing POP risk factors or predictive models, extracted data, and assessed methodological quality. Predictive models identified through the SR were externally validated using the STERNOCAT cohort. Setting(s): - Cardiac surgery units in France (STERNOCAT cohort) and international hospital settings (SR studies). Patient(s): - A total of 1, 470 patients from the STERNOCAT cohort and 172, 079 from 24 studies overall were included in the SR. Intervention(s): - None. Measurements and Main Results: - In the STERNOCAT ancillary study, 78 of 1470 patients developed POP (5.3%). Independent risk factors included ischemic cardiomyopathy (odds ratio [OR] 1.89, 95% CI [1.13-3.16]), cardiopulmonary bypass (CPB) duration (OR 1.10, 95% CI [1.02-1.18]), and catecholamine use (OR 4.07, 95% CI [2.45-6.76]). POP was associated with higher 30-day mortality (14.1% vs. 1.5%, p < 0.0001). The meta-analysis identified 14 significant risk factors for POP. Of these, 10 were non-modifiable (e.g., age, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal disease, previous cardiac surgery, emergency surgery). Four were partially modifiable: active smoking, CPB duration, intraoperative transfusions (presence and amount). Only one model, limited to preoperative variables, could be externally validated and showed poor accuracy. Conclusion(s): - This study highlights the difficulty of predicting and preventing POP, as most identified risk factors are non-modifiable or require long-term preventive strategies. Perioperative optimization, particularly regarding CPB management and transfusion practices, therefore, remains essential to improving patient outcomes. Registration: - PROSPERO (CRD42024555519). Copyright © 2026 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. <48> Accession Number 2045101187 Title A Network Meta-Analysis of Drainage Systems and Suction Strategies After Lung Cancer Surgery. Source European Journal of Cardio-thoracic Surgery. 68(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Geenen L.; Verkoulen K.C.H.A.; Laven I.E.W.G.; Daemen J.H.T.; van Roozendaal L.M.; Franssen C.J.; Franssen A.J.P.M.; Degens J.H.R.J.; Hulsewe K.W.E.; Vissers Y.L.J.; Dunning J.; Brunelli A.; de Loos E.R. Institution (Geenen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Verkoulen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Laven) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Laven) Department of Radiation Oncology (MAASTRO), Maastricht University Medical Center, Maastricht, Netherlands (Daemen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (van Roozendaal) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (van Roozendaal) Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium (Franssen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Franssen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Degens) Department of Respiratory Medicine, Zuyderland Medical Center, Heerlen, Netherlands (Hulsewe) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Vissers) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Dunning) Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom (Brunelli) Department of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom (de Loos) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: Optimizing chest drainage management after lung cancer surgery plays a pivotal role in minimizing drainage time and shortening length of hospital stay (LOHS). Currently, a universally acceptable standard is lacking, and a wide range of drain management strategies are practiced. Therefore, the aim of this systematic review and network meta-analysis (NMA) was to determine an optimal chest drain management strategy following anatomical lung resection on drainage duration, LOHS, and complications, while maintaining patient safety. Method(s): A systematic search was conducted in PubMed, Embase, ClinicalTrials.gov, and Cochrane Library; last search December 2025. Studies were included if they investigated drain management following anatomical lung resection and reported at least one of the following outcomes: drain duration, LOHS, or complications. Network meta-analysis were performed to integrate both direct and indirect comparisons to identify the optimal drain management strategy. Result(s): Seventeen studies (2004-2023), encompassing 2929 patients, were included in the NMA. Eight distinct drainage strategies were identified based on digital or analogue drainage system, and types of suction: continuous, short-term, alternating suction, or water-seal. In general, digital drainage with alternating suction tended to be associated with shorter drainage duration and LOHS when compared with other drainage strategies. Major complications (Clavien-Dindo >=3) were reported in 13 studies, varying from 0% to 21%. Conclusion(s): Digital drainage systems may reduce drainage duration and LOHS compared with analogue systems. Continuous suction appears less effective than water seal or alternating suction. Due to heterogeneity, firm conclusions are limited and should be interpreted with utmost caution, highlighting the need for standardized high-quality studies. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. <49> Accession Number 2041613640 Title Operative outcomes following robotic-assisted and conventional minimally invasive mitral valve surgery: A meta-analysis of propensity-matched studies. Source Asian Cardiovascular and Thoracic Annals. (no pagination), 2025. Article Number: 02184923251394563. Date of Publication: 2025. Author Santos K.; Consoli L.; de Oliveira L.G.A.M.; Donaldy W.; Plonek T. Institution (Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum Twente, Enschede, Netherlands (Santos) School of Medicine, New Vision University, Tbilisi, Georgia (Consoli, de Oliveira) Federal University of Bahia, Salvador, Brazil (Donaldy) New York City Health and Hospitals, New York City, NY, United States Publisher SAGE Publications Inc. Abstract Background: Robotic-assisted mitral valve surgery (RAMVS) has emerged as an alternative to conventional minimally invasive mitral valve surgery (MIMVS). However, previous studies have been limited by small sample sizes, heterogeneous techniques and reliance on unmatched or indirectly compared cohorts, resulting in inconclusive evidence. This meta-analysis focuses exclusively on propensity-matched studies to provide a more robust comparison of RAMVS and MIMVS. Method(s): A comprehensive literature search was performed to identify propensity-matched studies comparing RAMVS and MIMVS. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using RevMan 8.13.0. Subgroup analyses, including mitral valve repair only, non-isolated mitral valve surgery and MIMVS via right minithoracotomy, were conducted to explore heterogeneity. Result(s): Eight studies comprising 3352 patients were included, with 1578 (47.1%) undergoing RAMVS. The RAMVS was associated with a shorter hospital stay (MD -1.8 days; 95% CI -3.0 to -0.5; p = 0.006) but significantly longer cardiopulmonary bypass time (MD 21.8 min; 95% CI 0.8-42.9; p = 0.04), and higher odds of conversion to sternotomy (OR 2.9; 95% CI 1.6-5.4; p = 0.0007) and re-exploration for bleeding (OR 1.86; 95% CI 1.1-3.2; p = 0.02). Intensive care unit stay, operative time and postoperative complications were comparable. All subgroup analyses consistently showed higher conversion rates with RAMVS. Conclusion(s): The RAMVS offers potential recovery benefits but at the cost of greater intraoperative complexity. Careful patient selection and technical expertise are essential to maximise outcomes. Copyright © The Author(s) 2025 <50> Accession Number 2041613608 Title Percutaneous femoral access closure and prognosis following transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Journal of Vascular Access. (no pagination), 2025. Date of Publication: 2025. Author Simonetti F.; Cassese S.; Rheude T.; Alvarez-Covarrubias H.; Pellegrini C.; Kastrati A.; Joner M.; Xhepa E. Institution (Simonetti, Cassese, Rheude, Alvarez-Covarrubias, Pellegrini, Kastrati, Joner, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany (Simonetti) Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (Kastrati, Joner) DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany Publisher SAGE Publications Ltd Abstract Background: The impact of different percutaneous femoral access closure strategies on mortality and bleeding after transcatheter aortic valve replacement (TAVR) has been less studied. The aim of this study is to investigate whether different percutaneous femoral access closure strategies might affect systemic outcomes in patients undergoing TAVR. Method(s): In this systematic review and meta-analysis, randomized trials comparing a suture-based closure (suture group) with a plug-based or suture/plug-based closure (control group) for hemostasis of the femoral access in patients undergoing TAVR were included. The primary endpoint of the study was all-cause death. Secondary endpoints included any bleeding (defined according Valve Academic Research Consortium (VARC) criteria) and unplanned endovascular or surgical repair at the access site. All endpoints were calculated at the longest available follow-up. Result(s): Four studies with a total of 1429 TAVR patients (suture-based group, n = 707; control group, n = 722) were available for quantitative synthesis. There was no statistically significant difference in all-cause death in patients who underwent TAVR with suture-based closure compared to the control group (risk ratio-RR = 1.04, 95% confidence interval-CI 0.60-1.82; p = 0.83). Similarly, there was no statistically significant difference between treatment groups for any bleeding and unplanned endovascular or surgical repair at the access site. However, there was a significant treatment effect for VARC bleeding type 2 associated with the use of a plug-based or suture/plug-based closure in the control group (p for interaction = 0.01). Conclusion(s): In the context of contemporary TAVR procedures, percutaneous closure of the femoral access using any suture or plug-based strategy has no impact on hard clinical outcomes such as death from any cause. Copyright © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <51> Accession Number 650479328 Title Factors influencing postoperative delirium in patients with congenital heart disease: A systematic review and meta-analysis. Source Journal of pediatric nursing. 88 (pp 279-287), 2026. Date of Publication: 01 May 2026. Author Gong Y.-M.; Jin Z.-W.; Zhang Y.-X.; Wang X.-Y.; Huang Y.-L.; Xu Z.-M.; Luo W.-Y. Institution (Gong) Department of Cardiovascular and Tharacic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Nursing, Shanghai, China (Jin, Zhang) Department of Cardiovascular and Tharacic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Wang) Shanghai Jiao Tong University School of Nursing, Shanghai, China (Huang) Cardiovascular Intensive Care Unit, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fujian, China (Xu) Department of Cardiovascular and Tharacic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Luo) Cardiovascular Intensive Care Unit, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fujian, China; Department of Cardiovascular and Tharacic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China Abstract PROBLEM: Postoperative delirium (POD) is multifactorial and seriously affects prognosis and long-term quality of life in children with congenital heart disease (CHD). In this review, we synthesized evidence on influencing factors for POD in CHD to guide clinical identification and intervention. METHOD(S): We conducted a systematic search of nine databases to identify studies on POD risk factors in CHD. To conduct the meta-analysis, we used fixed-effects and inverse-variance heterogeneity models in STATS 18.0. RESULT(S): This meta-analysis included 12 papers comprising 3169 participants. Narrative synthesis suggested that surgical complexity, pain, benzodiazepines, opioids, and aortic cross-clamp time were potential factors influencing POD in CHD. Meta-analysis results showed that age was a protective factor (weighted mean difference [WMD] = -0.03, 95% confidence interval [CI]: -0.05, -0.00). Age younger than 2 years (odds ratio [OR] = 2.18, 95% CI: 1.93, 2.46), longer duration of mechanical ventilation (WMD = 0.70, 95% CI: 0.19, 1.22), developmental delay (WMD = 0.46, 95% CI: 0.21, 0.70), and cyanotic CHD (WMD = 0.68, 95% CI: 0.25, 0.99) were higher risk factors for POD in CHD. CONCLUSION(S): This study identified 9 critical influencing factors by reviewing current original studies. Meta-analysis of the existing evidence revealed that young age, especially an age under 2 years, mechanical ventilation, developmental delay, and cyanotic CHD were factors influencing POD in children with CHD. IMPLICATIONS: This study provides important basis for future nursing staff to identify high-risk children with delirium as early as possible and implement stratified non pharmacological management. Copyright © 2026 Elsevier Inc. All rights reserved. <52> Accession Number 2045193864 Title Intranasal dexmedetomidine in reducing postoperative delirium among cardiac surgery patients by improving sleep quality in China (DREAMS): study protocol for a single-centre, double-blind, randomised controlled trial. Source BMJ Open. 16(4) (no pagination), 2026. Date of Publication: 21 Apr 2026. Author Zhang Z.; Yang X.; Qin Y.; Gao B.; Wang Y.; Ji J.; Gao J.; Huang M.; Wang L.; Zheng Z.; Lei C. Institution (Zhang, Yang, Qin, Gao, Wang, Ji, Gao, Huang, Wang, Zheng, Lei) Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Shaanxi, Xi'an, China (Zhang, Yang, Gao, Huang, Wang, Zheng, Lei) Key Laboratory of Anesthesiology (the Fourth Military Medical University), Ministry of Education, Shaanxi, Xi'an, China (Zhang, Yang, Qin, Gao, Wang, Ji, Gao, Huang, Wang, Zheng, Lei) Anesthesia Clinical Research Center (ACRC), Xijing Hospital, Shaanxi, Xi'an, China (Qin) Department of Anesthesiology, Shanxi Provincial People's Hospital, Shanxi, Taiyuan, China (Wang) Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (Ji) Department of Anesthesiology, Second Hospital of Shanxi Medical University, Shanxi, Taiyuan, China Publisher BMJ Publishing Group Abstract Introduction: Postoperative delirium (POD) is a common complication following cardiac surgery and is closely associated with adverse clinical outcomes. The effect of perioperative dexmedetomidine on reducing POD remains controversial in the existing literature. In our previous meta-analysis, we obtained preliminary evidence suggesting that dexmedetomidine may reduce the incidence of POD by improving sleep quality, which may partly explain the heterogeneity reported in previous studies. Based on these findings, the present randomised controlled trial aims to test the hypothesis that preoperative intranasal administration of dexmedetomidine reduces the incidence of POD in patients undergoing cardiopulmonary bypass assisted cardiac surgery by enhancing preoperative sleep quality. Methods and analysis: This trial is a single-centre, investigator-initiated, parallel, double-blind, randomised, placebo-controlled trial. Individuals aged 18 years or older who are scheduled for elective cardiopulmonary bypass-assisted cardiac surgery will be enrolled in the study. The planned sample size is 686. Participants will be randomly assigned to either the dexmedetomidine group receiving two doses of dexmedetomidine (1.5 microg/kg according to ideal body weight) administered between 21:00 and 21:30 on the night before surgery and 15 min before anaesthesia induction, or the placebo group, receiving an equivalent volume of normal saline at the same time points. The primary outcome is the incidence of delirium within 7 days after surgery. Secondary outcomes include the severity, subtypes and duration of delirium, length of postoperative hospital stay, in-hospital all-cause mortality, postoperative sleep assessed by the Numerical Rating Scale score, pain intensity, postoperative anxiety and depression scores. Mediation analyses will be conducted using the preoperative Sleep Quality Index to assess whether dexmedetomidine reduces POD by improving preoperative sleep quality. The Baron and Kenny causal steps framework in conjunction with bootstrap resampling will be employed to estimate the direct, indirect and total effects. Ethics and dissemination: The study is approved by the Institutional Review Board of Xijing Hospital (KY20242259). Written informed consent will be obtained from all participants. The results will be submitted for publication in peer-reviewed journals. Trial registration number: NCT06619912. 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/. <53> [Use Link to view the full text] Accession Number 2044973343 Title What Psychiatric Drug Development Can Learn From Cardiology Drug Development: Placebo Can Detect an Increase in the Mortality Rate. Part 3. Source Reviews and Research in Medical Microbiology. 32(1) (no pagination), 2026. Date of Publication: 01 Jan 2026. Author Preskorn S.H. Institution (Preskorn) Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Kansas, Wichita, KS, United States Publisher Lippincott Williams and Wilkins Abstract This column, like the previous 2 columns in this series, shows how placebo is a control for the natural course of an illness. In the study presented in this column, the use of placebo enabled the investigators to detect that active treatment was deleterious to the patient. In the second column in the series, the use of placebo showed that adding a usually effective antibiotic for an infection did not alter the outcome because of the nature of the infection and the value of treatment as usual (TAU). The first column in the series described TAU in a double-blind randomized controlled trial (RCT). Parenthetically, that column also discussed how different TAU is in such studies versus TAU in clinical practice. Those differences likely contribute to why TAU in such trials can be quite effective and why they are frequently negative. That first paper also discussed how the Heisenberg Uncertainty Principle from physics can be applied to psychiatric clinical trials, further emphasizing the difference in care received in an RTC versus clinical practice. Thus, investigators need to take the Heisenberg Principle into account when designing their studies and readers need to consider it when assessing the results. In the studies described in the second and third columns in the series, the focus was on objective and clinically meaningful endpoints (ie, resolution of a localized infection in the second column and death in this third column) in contrast to the often subjective endpoints in many psychiatric clinical trials (eg, improvement on a rating scale of symptoms that are reported by a participant/patient). The field of psychiatry needs to aim to develop such objective and clinically meaningful endpoints for its clinical trials. Finally, all 3 columns in this series emphasize that placebo does not mean nothing but rather involves all the treatment that a patient receives during the trial, except for the investigational treatment being tested, as well as the natural history of the illness, which includes the natural fluctuation in symptoms. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <54> Accession Number 2045352747 Title A systematic review of modeling approaches to evaluate diagnostics programs for stable coronary heart disease: suggestions for future health economic models. Source Health Economics Review. 16(1) (no pagination), 2026. Article Number: 59. Date of Publication: 01 Dec 2026. Author Li W.; Li H.; Tan S.; Cai M.; Han S.; Chen Y. Institution (Li, Chen) School of Public Health, Fudan University, Shanghai, China (Li, Chen) National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China (Li, Li, Tan, Cai, Han) International Research Center for Medicinal Administration, Peking University, Beijing, China (Li, Li, Tan, Cai, Han) Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, China Publisher BioMed Central Ltd Abstract Objective: To critically review health economic models used to evaluate diagnostic strategies for stable coronary artery disease (CAD), with a focus on methodological characteristics in model development. Method(s): A systematic literature review (SLR) was conducted across major electronic databases and health technology assessment (HTA) agency websites from inception to January 2025. Studies were independently screened using predefined criteria. Data extraction focused on general characteristics, model structure, approaches to uncertainty, model validation, and transparency. These aspects were then systematically described to identify common methodological characteristics and potential areas for improvement. Result(s): Seventy articles were included, comprising 67 peer-reviewed publications and three HTA reports. Most studies were model-based (n = 46), and models were structured as decision tree models (n = 27), Markov models (n = 6), or hybrid approaches (n = 13). While only 18 studies explicitly justified their choice of model structure. Substantial heterogeneity was observed in key modeling assumptions, including time horizon, cycle length and data sources. Among studies using long-term Markov models (n = 19), none explicitly reported the use of half-cycle correction. Although most studies conducted sensitivity analyses (n = 56), approaches to uncertainty varied widely, and only seven models incorporated deterministic, probabilistic, and scenario analyses. Model validation was infrequently reported, with only two studies describing any formal validation activities. Overall, transparency was limited, as none of the studies provided sufficient technical documentation and reporting of model implementation tools was also incomplete (n = 28). Conclusion(s): Methodological heterogeneity and incomplete reporting exit in economic evaluation of diagnostic strategies for stable CAD, which may affect their transparency and comparability. Future research may benefit from clearer model justification, more consistent reporting of key technical assumptions, and systematic approaches to uncertainty and validation. Copyright © The Author(s) 2026. <55> Accession Number 2045463247 Title Long term outcomes of different revascularization strategies in left main coronary artery: a network meta-analysis. Source International Journal of Cardiology. 457 (no pagination), 2026. Article Number: 134539. Date of Publication: 15 Aug 2026. Author Lombardi M.; Chiabrando J.G.; Occhipinti G.; Elia E.; Laudani C.; Garibaldi S.; Audo A.; Maj G.; Vergallo R.; Porto I.; Gonzalo N.; Escaned J.; Patti G.; Secco G.G. Institution (Lombardi, Secco) Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Lombardi, Elia, Vergallo, Porto) Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Genova, Italy (Chiabrando, Garibaldi) Interventional Cardiology Unit, UOSD Emodinamica, Ospedale Barone Romeo, Patti, Italy (Occhipinti) Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (Occhipinti) Instituto de Investigaciones Biomedicas Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain (Laudani) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "Rodolico - San Marco", University of Catania, Catania, Italy (Laudani) Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States (Audo) Division of Cardiac Surgery, AOU SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Maj) Division of Cardiothoracic Intensive Care, AOU SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Vergallo, Porto) Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy (Gonzalo, Escaned) Hospital Clinico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Madrid, Spain (Patti) Division of Cardiology, Maggiore della Carita Hospital, Novara, Italy (Patti, Secco) Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy Publisher Elsevier Ireland Ltd Abstract Background: The comparative effectiveness of angiography-guided versus imaging-guided PCI relative to coronary artery bypass grafting (CABG) in left main coronary artery (LMCA) disease remains uncertain. Method(s): We performed a network meta-analysis of randomized controlled trials (RCTs) including patients undergoing LMCA revascularization. Pooled incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were computed. Co-primary endpoints were major adverse cardiovascular events (MACE) by trial definition and all-cause death. Secondary endpoints included myocardial infarction (MI), stroke, target vessel revascularization (TVR), repeat revascularization, and stent thrombosis or graft occlusion. Result(s): Seventeen RCTs encompassing 7700 patients (median follow-up 2 years) were included. Angiography-guided PCI was associated with a higher risk of MACE compared with both imaging-guided PCI (IRR 1.34, 95%CI 1.05-1.72) and CABG (IRR 1.49, 95%CI 1.10-2.03). Compared with imaging-guided PCI, neither CABG (IRR 1.00 95%CI 0.81-1.24) nor angiography-guided PCI (IRR 1.04, 95%CI 0.77-1.40) differed in all-cause death. CABG was associated with a lower risk of MI, TVR and repeat revascularization, but at the expense of an increased stent thrombosis or graft occlusion. Angiography-guided PCI was associated with higher risks of TVR compared with imaging-guided PCI and a lower risk of stroke compared to both CABG and imaging-guidance. Conclusion(s): In patients with LMCA disease, no significant differences in MACE were observed between imaging-guided PCI and CABG, whereas angiography-guided PCI was associated with a higher risk of MACE compared either with imaging-guided PCI and CABG. PCI, regardless of guidance, achieved all-cause death comparable to surgery. Imaging guidance reduced stent thrombosis or graft occlusion, whereas CABG reduced MI and repeat revascularization.PROSPERO registration number: CRD420261283126. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <56> Accession Number 2045310391 Title Renin-angiotensin system inhibitors use and outcomes of aortic valve replacement: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Cheema M.R.S.; Arshad A.; Abbasi S.U.A.M.; Umar M.; Hamid M.; Kashif M.; Chattha R.R.; Babar A.; Khan M.S.; Javed S.; Fatima S.; Ismail Z.; Jain H.; Minhas A.M.K.; Goldsweig A.M. Institution (Cheema, Arshad, Abbasi, Umar, Hamid, Kashif, Chattha, Babar, Khan, Javed, Fatima, Ismail) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Jain) All India Institute of Medical Sciences, Jodhpur, India (Minhas) Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center, and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States Publisher Elsevier Inc. Abstract Background Aortic stenosis leads to adverse left ventricular remodeling; aortic valve replacement (AVR) remains the cornerstone of management. We evaluated clinical and echocardiographic outcomes with renin-angiotensin system inhibitor (RASi) use in patients undergoing AVR. Methods Five electronic databases were systematically queried for studies comparing outcomes with and without RASi post-AVR. Outcomes were pooled using random-effects models to calculate risk ratios (RRs), mean differences, and standardized mean differences with 95% confidence intervals. Outcomes of interest included all-cause and cardiovascular mortality, heart failure, myocardial infarction, stroke/TIA, arrhythmias, pacemaker requirement, acute kidney injury, and echocardiographic parameters. Results Seventeen studies (16 observational, 1 RCT) including 44,935 patients [RASi: 20,723; no RASi: 24,212] were included. RASi use was associated with significantly reduced all-cause mortality (RR: 0.74; 95% CI: 0.65-0.83; p ' 0.0001) and cardiovascular mortality (RR: 0.65; 95% CI: 0.49-0.85; p = 0.002), consistent across TAVR and SAVR subgroups. No significant differences were observed for heart failure, myocardial infarction, stroke, or pacemaker requirement. RASi did not increase acute kidney injury (p = 0.08) or major bleeding (p = 0.67). Echocardiographic outcomes, including peak aortic valve velocity and LV mass index, showed no significant differences between groups. Conclusions In predominantly observational studies, RASi use following AVR is associated with lower all-cause and cardiovascular mortality without increasing major adverse clinical events. Survival benefits were not accompanied by consistent echocardiographic improvements. Given substantial heterogeneity and residual confounding inherent to observational data, prospective randomized trials are needed to confirm these associations. Social media abstract Meta-analysis of 17 studies shows survival benefit with ACEI/ARB in the patients undergoing TAVR/SAVR, with no significant differences in HF, MI, stroke/TIA, AF, pacemaker, or echo outcomes. Copyright © 2026 Elsevier Inc. <57> Accession Number 2045486486 Title Acute normovolaemic haemodilution after cardiac surgery. Comment on Br J Anaesth 2026; 136: 836a"46. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Lamba P. Institution (Lamba) Dr D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Maharashtra, Pune, India Publisher Elsevier Ltd <58> Accession Number 2045590972 Title Multimodal personalised executive function intervention (E-Fit) for school-aged children with complex congenital heart disease in Switzerland: a randomised controlled feasibility study. Source BMJ Open. 16(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Schmid A.S.; Ehrler M.; Bunge S.A.; Kretschmar O.; Landolt M.A.; Rousson V.; Tuura R.O.; Wehrle F.M.; Latal B. Institution (Schmid, Ehrler, Wehrle, Latal) Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland (Schmid, Ehrler, Kretschmar, Landolt, Tuura, Wehrle, Latal) Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland (Ehrler) Department of Forensic and Neurodevelopmental Sciences, King's College London Institute of Psychiatry Psychology & Neuroscience, London, United Kingdom (Bunge) Department of Psychology, Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, United States (Kretschmar) Department of Cardiology, University Children's Hospital Zurich, Zurich, Switzerland (Kretschmar, Tuura, Wehrle, Latal) University of Zurich, Zurich, Switzerland (Landolt) Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland (Landolt) Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland (Rousson) Division of Biostatistics, Center for Primary Care and Public Health (Unisante), University of Lausanne, Lausanne, Switzerland (Tuura) MR Research Centre, University Children's Hospital Zurich, Zurich, Switzerland (Latal) URPP Adaptive Brain Circuits in Development and Learning, University of Zurich, Zurich, Switzerland Publisher BMJ Publishing Group Abstract Objective: To explore the feasibility of a novel multimodal executive function intervention in school-aged children with complex congenital heart disease (cCHD). Design(s): Single-centre, single-blinded, randomised-controlled 8-week multimodal personalised executive function intervention (E-Fit) study. Outcomes were measured throughout the intervention, post-intervention (T1) and at 4-month follow-up (T2). Setting(s): Tertiary care centre between May 2022 and May 2024. Participant(s): Children 10 to 12 years (M=11.0, SD=0.9) with cCHD without a genetic diagnosis with infant open-heart surgery and reported difficulties (T-scores >=60) on any of the summary scales of the parent- or teacher-reported Behavior Rating Inventory for Executive Function (BRIEF). Intervention(s): Children with cCHD were randomly assigned to one of two groups: the intervention or the control group. The 8-week intervention was multimodal including three modalities: (1) computerised executive function (EF) training 3x20 min/week with CogniFit; (2) a weekly, remote standardised 1:1 individual EF strategy coaching; (3) analogue games played at convenience. The control group completed activity logs. Feasibility measures: Acceptability: Acceptance and Feasibility Scale (AFS) and coach-rated engagement during coaching sessions. Demand: Number of completed computerised training, strategy coaching and analogue game sessions. Implementation: E-Fit Fidelity Measurement System, assessing adherence to core components. Practicality: Retention rate. Integration: AFS integration items. Exploratory efficacy: BRIEF, neuropsychological EF testing and psychosocial variables at baseline, post-intervention (8 weeks) and at 4-month follow-up. Result(s): We recruited 42 participants (N<inf>female</inf>=20). Acceptability: The intervention was acceptable, with moderate observed engagement. Demand: median number of computerised training sessions completed was 16 of 24 sessions (67%, (IQR; 6 to 19)), all children attended all scheduled coaching sessions, analogue games were played in total a median of 9 times (IQR 4 to 14). Implementation: Coaching sessions could be implemented by the coaches as intended. Practicality: Overall retention rate was 90%. Integration: E-Fit was well integrable into the home setting. Exploratory efficacy favoured the intervention group with improvements in the parent-rated Behavioral Regulation Index of the BRIEF (adjusted Hedge's (g<inf>A1</inf>) = -0.408 to -0.903) and in social responsiveness (g<inf>A1</inf> = -0.427 to -0.521) at T1 and at T2. Conclusion(s): E-Fit is a feasible intervention suggesting EF and social responsiveness improvements in children with cCHD. Motivational strategies to improve adherence to computerised training should be refined before a full-scale efficacy trial. Trial registration number: NCT05198583. 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/. <59> Accession Number 650972831 Title Cardiovascular Outcomes in Patients With Deferred and Performed Coronary Revascularization Based on Intracoronary Physiology: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(9) (pp e042044), 2026. Date of Publication: 05 May 2026. Author Lombardi M.; Travieso A.; Cerrato E.; Mohammad M.A.; Gotberg M.; Davies J.; Escaned J. Institution (Lombardi, Travieso, Escaned) Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC) and Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV) Complutense University of Madrid Madrid Spain, Spain (Lombardi) Department of Internal Medicine University of Genova Genoa Italy, Italy (Cerrato) Interventional Cardiology Unit San Luigi Gonzaga University Hospital, Rivoli Infermi Hospital, Orbassano, Italy (Mohammad, Gotberg) Cardiology Unit, Department of Clinical Sciences Lund Lund University Lund Sweden, Sweden (Mohammad, Gotberg) Department of Cardiology Skane University Hospital Lund Sweden, Sweden (Davies) National Heart and Lung Institute Imperial College London London United Kingdom, United Kingdom Abstract BACKGROUND: Although large studies and pooled analyses of individual patient data have demonstrated the safety of deferring coronary revascularization based on a nonischemic intracoronary pressure index result, conflicting findings have emerged in specific patient subsets and with varying follow-up. Thus, we conducted an updated comprehensive systematic review and meta-analysis to investigate the cardiovascular outcomes associated with deferred or performed coronary revascularization based on intracoronary physiology. METHOD(S): Available studies were identified through a systematic search of PubMed, EMBASE, and CENTRAL. Efficacy outcomes investigated were major adverse cardiovascular events, all-cause death, cardiovascular death, noncardiovascular death, myocardial infarction, and unplanned revascularization. RESULT(S): A total of 24 studies enrolling 24 285 patients were included in the meta-analysis. After a mean+/-SD follow-up of 2.6+/-1.6 years, patients undergoing physiology-guided deferred revascularization show consistently better outcomes than patients who underwent revascularization, including all-cause death (incidence rate ratio [IRR], 1.14 [95% CI, 1.00-1.30]; P=0.05), cardiovascular death (IRR, 1.53 [95% CI, 1.17-2.00]; P=0.002), and unplanned revascularization (IRR, 1.38 [95% CI, 1.06-1.79]; P=0.01). For major adverse cardiovascular events (IRR, 1.15 [95% CI, 0.99-1.34]; P=0.07) and myocardial infarction (IRR, 1.24 [95% CI, 0.95-1.61]; P=0.11), the associations did not reach statistical significance. CONCLUSION(S): Patients in whom revascularization was deferred based on intracoronary physiology show lower risk of adverse cardiovascular events compared with those who underwent revascularization. These findings suggest that pressure wire assessment has prognostic implications besides the indication for revascularization. <60> Accession Number 2032791717 Title Long-term Cardiovascular and All-Cause Mortality following Elective Infrarenal Repair of the Abdominal Aortic Aneurysm: A Systematic Review and Meta-analysis. Source Journal of Endovascular Therapy. 33(3) (pp 1115-1125), 2026. Date of Publication: 01 Jun 2026. Author van Knippenberg S.E.M.; Fenelli C.; van Dieren S.; Delewi R.; Balm R.; Yeung K.K. Institution (van Knippenberg, Fenelli, van Dieren, Balm) Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands (van Knippenberg, Delewi) Microcirculation, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands (Delewi, Balm, Yeung) Atherosclerosis & Ischemic Syndromes, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands (Yeung) Department of Surgery, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands Publisher SAGE Publications Inc. Abstract Background: Patients with abdominal aortic aneurysms (AAAs) have poor survival rates after aneurysm repair compared with the general population, potentially due to increased cardiovascular risk. This systematic review and meta-analysis aimed to assess the long-term incidence of all-cause and cardiovascular mortality after elective, infrarenal AAA repair. Method(s): The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed (PROSPERO ID: CRD42022344547). Studies published in PubMed, Web of Science, and COCHRANE databases between January 2013 and May 2023 with a mean follow-up time of >=5 years were included. A weighted linear regression analysis was performed to determine the annual incidence of all-cause and cardiovascular mortality five years after AAA repair. A random effects model calculated the overall incidence rates per 1000 person-years (PY). Endovascular aneurysm repair (EVAR) and open surgical repair (OSR) were compared. Result(s): Nineteen studies with 84 212 patients (mean follow-up: 68.9 [+/-13.3] months) were included. Common preoperative cardiovascular comorbidities included hypertension (74.4%), dyslipidemia (43.6%), and coronary artery disease (27.6%). At five years, the mean all-cause mortality was 29.78%, and cardiovascular mortality was 11.98%, with an annual increase of 6.59% and 2.46%, respectively (R2=0.809, p<0.001 and R2=0.824, p<0.001). The random effects model showed an all-cause mortality rate of 62.99 events (95% CI=57.53-68.96; I2=93%) per 1000 PY and a cardiovascular mortality rate of 24.19 events per 1000 PY (95% CI=21.69-26.98; I2=66%). Patients undergoing an EVAR had a significant higher incidence of all-cause and cardiovascular mortality than patients undergoing an OSR (B-coefficient 4.10 and 2.39, both p<0.001, respectively). Conclusion(s): The long-term all-cause and cardiovascular mortality remain high following elective, infrarenal AAA repair. These findings highlight a much needed optimization and emphasis of cardiovascular risk management, to minimize the long-term incidence of cardiovascular mortality in patients with AAA following surgical intervention. Clinical Impact: This study evaluated the long-term outcomes of cardiovascular and all-cause mortality rates following elective repair of the infrarenal abdominal aortic aneurysm. The results of this systematic review and meta-analysis emphasizes the suboptimal cardiovascular risk profile observed in this patient population. Futhermore, it highlights the importance of optimization and emphasis of cardiovascular risk management, including in the long-term after surgical intervention. Copyright © The Author(s) 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 Lficense (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 pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <61> Accession Number 650379212 Title Effectiveness of hypotension prediction index in reducing postoperative organ hypoperfusion-related complications in non-cardiac surgery: a meta-analysis of randomized controlled trials. Source Minerva anestesiologica. 92(4) (pp 340-349), 2026. Date of Publication: 01 Apr 2026. Author Ding Y.; Jia H.; Xu J.-S.; Liao Q.-G.; Dai J.-Y.; Wei X.; Pan C.; Fu H.-L. Institution (Ding, Jia, Xu, Liao, Dai, Wei, Pan) Department of Anesthesiology, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China (Fu) Department of Anesthesiology, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China Abstract BACKGROUND: Intraoperative hypotension during non-cardiac surgery is associated with postoperative complications such as acute kidney injury (AKI), myocardial injury, and stroke, which may increase mortality and severe adverse outcomes. Although the Hypotension Prediction Index (HPI) may help reduce intraoperative hypotension, its clinical value in lowering the incidence of these complications remains uncertain. This meta-analysis evaluates whether HPI-guided hemodynamic management reduces major postoperative complications (including AKI, cardiorenal, and cerebrovascular events) in adult patients undergoing non-cardiac surgery. METHOD(S): A systematic search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science, to identify RCTs assessing HPI in non-cardiac surgery. The outcomes encompassed the incidence of postoperative complications such as AKI, myocardial injury after non-cardiac surgery (MINS), stroke and 30-day mortality. Pooled effect estimates, including odds ratios (ORs) with 95% confidence intervals (95% CIs), were calculated using either fixed-effects or random-effects models based on heterogeneity assessments. Sensitivity analyses were performed by excluding trials with a high or unclear risk of bias to evaluate the robustness of the findings. RESULT(S): A total of 10 RCTs involving 1746 participants were included. The results revealed no statistically significant difference in incidence of AKI (OR: 0.85; 95%CI: 0.65 to 1.10; P=0.21), MINS(OR: 0.62; 95%CI: 0.36 to 1.06; P=0.08), stroke (OR: 0.63; 95%CI: 0.20 to 1.98; P=0.42), and 30-day mortality (OR: 0.87; 95%CI: 0.32 to 2.34; P=0.78) between HPI group and control group. CONCLUSION(S): Hemodynamic management guided by the HPI in adults undergoing non-cardiac surgery does not significantly reduce the incidence of major postoperative complications compared to standard care. <62> Accession Number 651031166 Title Long-Term Outcomes of Transcatheter Aortic Valve Replacement in Low-Flow Low-Gradient Aortic Stenosis: A Reconstructed Time-to-Event and Multivariate Meta-Analysis. Source Journal of the American Heart Association. 15(9) (pp e044431), 2026. Date of Publication: 05 May 2026. Author Soltani Moghadam A.; Kazemian S.; Soltani Moghadam S.; Nasiri P.; Mojahedi A.; Geraiely B.; Larti F.; Latib A.; Scotti A.; Kuno T.; Kolte D. Institution (Soltani Moghadam, Kazemian, Soltani Moghadam) Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran, Iran, Islamic Republic of (Nasiri) School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran, Iran, Islamic Republic of (Mojahedi) Department of Internal Medicine Stony Brook University Hospital Stony Brook NY USA (Geraiely, Larti) Cardiology Department, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran Iran, Iran, Islamic Republic of (Latib, Scotti) Division of Cardiology Montefiore Medical Center The Bronx NY USA (Kuno, Kolte) Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA USA (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center Harvard Medical School Boston MA USA, Israel Abstract BACKGROUND: There are uncertainties regarding long-term outcomes of low-flow, low-gradient (LFLG) severe aortic stenosis (AS) following transcatheter aortic valve replacement (TAVR). This study investigates long-term outcomes of TAVR for high-gradient (HG), classical LFLG, and paradoxical LFLG AS. METHOD(S): We systematically searched PubMed, Embase, Scopus, and Cochrane Library databases until January 2025 for studies comparing HG, classical LFLG, and paradoxical LFLG AS outcomes following TAVR. The primary outcome was all-cause mortality, analyzed using reconstructed individual patient data meta-analysis. Secondary outcomes included cardiovascular mortality, heart failure hospitalization, acute kidney injury, bleeding events, stroke, myocardial infarction, permanent pacemaker implantation, and echocardiographic outcomes, analyzed using multivariate meta-analysis. RESULT(S): We included 19 observational studies comprising 20 493 patients who underwent TAVR for severe AS. Time-to-event meta-analysis indicated a higher risk of 5-year all-cause mortality in patients with classical and paradoxical LFLG AS compared with HG AS (hazard ratio [HR], 1.92 [95% CI, 1.62-2.27] and HR, 1.20 [95% CI, 1.07-1.34], respectively). Multivariate meta-analysis indicated an increased risk of cardiovascular mortality in patients with LFLG versus HG AS (classical LFLG HR, 1.94 [95% CI, 1.74-2.16]; paradoxical LFLG HR, 1.40 [95% CI, 1.25-1.57]). Classical and paradoxical LFLG AS were also associated with a higher risk of heart failure hospitalization (HR, 4.12 [95% CI, 2.16-7.83]; HR, 1.80 [95% CI, 1.14-2.85], respectively) compared with HG AS. CONCLUSION(S): Classical and paradoxical LFLG AS were associated with higher all-cause and cardiovascular mortality following TAVR compared with HG AS. Future studies are needed to determine strategies to improve outcomes following TAVR in patients with LFLG AS. <63> Accession Number 649323642 Title Efficacy and safety of dexmedetomidine infusion without induction dose on postoperative delirium in geriatric patients undergoing major noncardiac surgeries: a randomized controlled clinical trial. Source Minerva anestesiologica. 92(4) (pp 286-297), 2026. Date of Publication: 01 Apr 2026. Author Youssef M.M.; Jaccoub V.F.; Atalla M.G.; Alkonaiesy R.M.; Abdelhalim M.A. Institution (Youssef) ICU & Pain Management, Department of Anesthesia, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt - mora.magdy.mm@gmail.com (Jaccoub, Atalla, Alkonaiesy, Abdelhalim) ICU & Pain Management, Department of Anesthesia, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt Abstract BACKGROUND: The impact of dexmedetomidine on postoperative delirium (POD) remains a subject of debate in elderly patients undergoing noncardiac surgeries. This study aimed to assess the efficacy and safety of dexmedetomidine infusion without an induction dose in reducing the incidence of POD while maintaining hemodynamic stability in geriatric patients undergoing major surgeries. The loading dose was omitted based on the hypothesis that continuous dexmedetomidine infusion without a loading dose would lower the incidence of POD while preserving cardiovascular safety. METHOD(S): This randomized, double-blind clinical trial was conducted on 122 elderly patients, belonging to the American Society of Anesthesiologists I or II physical status, who were scheduled for major noncardiac surgeries. Patients were randomly allocated into two equal groups. Patients in Group I received 0.5 mug/kg/h of dexmedetomidine, diluted in 50 mL of isotonic normal saline, while patients in Group II received 50 mL of isotonic normal saline as a placebo. The primary outcome was the incidence of POD. Secondary outcomes included intraoperative and postoperative hemodynamics. RESULT(S): Postoperative delirium was observed in only one (1.64%) patient in Group I on the first postoperative day, whereas 21 (34.4%) patients in Group II experienced POD with a statistically significant difference (P<0.001). Furthermore, patients in group I exhibited a significant reduction in intraoperative mean arterial pressure and heart rate, along with a notably high incidence of intraoperative hypotension but without bradycardia. Postoperatively, the mean heart rates, the incidence of hypotension, and bradycardia were comparable between groups without the need for rescue hypotensive medications (all P>0.05). CONCLUSION(S): In elderly patients undergoing non-cardiac surgery, dexmedetomidine infusion without an induction dose effectively and safely reduces the incidence of POD. Dexmedetomidine significantly preserves postoperative hemodynamics. <64> Accession Number 2045456044 Title Hemodynamic Response to Intubation With 4 Different Laryngoscopes in Coronary Artery Bypass Graft Surgery: A Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mermer H.A.; Yildiz M.; Tutar M.S.; Yazar M.A.; Kozanhan B. Institution (Mermer, Yildiz, Tutar, Yazar, Kozanhan) Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkey Publisher W.B. Saunders Abstract Objectives: To evaluate whether different laryngoscope types influence the hemodynamic stress response to tracheal intubation in adult patients undergoing elective coronary artery bypass graft (CABG) surgery. Design(s): Prospective, randomized, controlled clinical trial. Setting(s): University-affiliated tertiary care hospital. Participant(s): A total of 112 adult patients scheduled for elective CABG surgery with no anticipated difficult airway. Intervention(s): Patients were randomly assigned to tracheal intubation using a Macintosh laryngoscope, C-MAC videolaryngoscope, EzVision videolaryngoscope, or McGrath videolaryngoscope under a standardized deep anesthesia protocol. Measurements and Main Results: Hemodynamic parameters were recorded at predefined time points. The primary outcome was the hemodynamic stress response as changes in mean arterial pressure (DELTAMAP) and heart rate (DELTAHR) between measurements obtained after anesthesia induction but before neuromuscular blockade (T2) and those obtained 1 minute after tracheal intubation (T4). Mean DELTAMAP values were 20.8 +/- 19.4 mmHg in the Macintosh group, 26.3 +/- 13.6 mmHg in the C-MAC group, 21.8 +/- 12.4 mmHg in the EzVision group, and 28.4 +/- 11.9 mmHg in the McGrath group (p = 0.168). Corresponding DELTAHR values were 7.4 +/- 8.2 bpm, 6.1 +/- 10.6 bpm, 8.6 +/- 16.4 bpm, and 7.5 +/- 7.7 bpm, respectively (p = 0.844). When hemodynamic stress response was defined as an increase of >=10 mmHg in MAP and/or >=10 beats per minute in heart rate, its incidence was 28.5%, 37.0%, 42.8%, and 42.8% in the Macintosh, C-MAC, EzVision, and McGrath groups, respectively (p = 0.653). Intubation time differed significantly among the groups (median [interquartile range]: 15 [11-18], 19 [12-22], 22 [15-28], and 16 [12-19] seconds, respectively; p < 0.001), whereas intubation success rates and complication profiles were similar across groups. Conclusion(s): Videolaryngoscopes conferred no hemodynamic advantage over direct laryngoscopy during intubation in deeply anesthetized patients undergoing CABG. Adequate anesthesia depth and pharmacologic modulation likely play a more prominent role than device type in blunting intubation stress. Copyright © 2026 Elsevier Inc. <65> Accession Number 651003445 Title Frailty and postoperative complications in elderly patients undergoing cardiac surgery: a systematic review and meta-analysis. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 24 Apr 2026. Author Zhang X.; Li Y.; Zhang L.; Xiao Y.; Huang H.; Feng F.; Chen J.; Wang S.; Chen X.; Wang L. Institution (Zhang, Chen, Chen) Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China (Zhang, Zhang, Xiao, Wang) Faculty of Medicine, Macau University of Science and Technology, SAR, Macau, China (Li, Wang) Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Huang) Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (Feng) College of Public health, Zhengzhou University, Zhengzhou, Henan, China <66> Accession Number 651089447 Title Valve-in-Valve Transcatheter Mitral Valve Replacement Versus Redo Surgical Mitral Valve Replacement: Meta-Analysis of Early and Late Outcomes. Source Journal of the American Heart Association. 15(9) (pp e050299), 2026. Date of Publication: 05 May 2026. Author Sa M.P.; Neves G.; Consoli L.; Iqbal A.; Dexheimer L.; da Hora D.A.B.; Camarotti T.; Jacquemyn X.; Napoli F.; Polanco A.; Brozzi N.A.; Navia J.L. Institution (Sa, Napoli, Polanco, Brozzi, Navia) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute Cleveland Clinic Florida Weston FL USA (Neves) Universidade do Estado do Para (UEPA) Belem Para Brazil (Consoli) Universidade Federal da Bahia (UFBA) Salvador Brazil, Brazil (Iqbal) Bacha Khan Medical College Mardan Pakistan, Pakistan (Dexheimer) Universidade de Sao Paulo (USP) Sao Paulo Brazil, Brazil (da Hora) Universidade Federal do Amazonas (UFAM) Manaus Brazil (Camarotti) Universidade de Pernambuco Recife Brazil, Brazil (Jacquemyn) UPMC Heart and Vascular Institute University of Pittsburgh Pittsburgh PA USA Abstract BACKGROUND: Bioprosthetic mitral valve degeneration is traditionally treated with redo surgical mitral valve replacement (redo-SMVR), but valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) offers a less invasive alternative. METHOD(S): Systematic review and meta-analysis of studies comparing ViV-TMVR and redo-SMVR. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Meta-analyses were conducted with random-effects models to assess patient-relevant outcomes; Kaplan-Meier-derived time-to-event data were pooled to assess late outcomes. RESULT(S): Thirteen observational studies met our eligibility criteria, including 15 941 patients (ViV-TMVR: 5465; redo-SMVR: 10476). In comparison with redo-SMVR, ViV-TMVR was associated with lower risk of in-hospital mortality (risk ratio [RR], 0.72 [95% CI, 0.57-0.90]; P=0.004), stroke (RR, 0.49 [95% CI, 0.29-0.83]; P=0.008), bleeding (RR, 0.43 [95% CI, 0.20-0.94]; P=0.035), acute kidney injury (RR, 0.57 [95% CI, 0.42-0.77]; P<0.001), permanent pacemaker implantation (RR, 0.30 [95% CI, 0.19-0.49]; P<0.001), and shorter hospital length of stay (mean difference,-5.09 days [95% CI, -6.56 to -3.63]; P<0.001). There was no statistically significant difference between the groups in terms of 5-year survival (hazard ratio [HR], 0.92 [95% CI, 0.81-1.05]; P=0.256); however, the landmark analysis revealed that ViV-TMVR was associated with lower risk of death in the initial 6 months (HR, 0.69 [95% CI, 0.58-0.83]; P<0.001) but a higher risk beyond 6 months (HR, 1.47 [95% CI, 1.20-1.79]; P<0.001). CONCLUSION(S): In patients amenable to ViV-TMVR, this procedure shows a lower initial risk of death and complications, but higher mortality after 6 months in comparison with redo-SMVR. These findings highlight the importance of striking a balance between upfront surgical risk and estimated life expectancy when selecting interventions. <67> Accession Number 2045473165 Title Change in Frailty After Transcatheter and Surgical Aortic Valve Replacement for Aortic Stenosis-A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Mohiaddin H.; Hayes J.; Chotalia R.; Sze S.; Squire I.B. Institution (Mohiaddin, Sze, Squire) NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom (Mohiaddin, Hayes, Chotalia, Sze) University Hospitals of Leicester NHS Trust, Leicester, United Kingdom Publisher Elsevier Ltd Abstract Background: Frailty is common among patients awaiting intervention for aortic stenosis (AS) by transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Although the association between pre-procedure frailty and poor outcomes is well-established, it remains unclear whether aortic valve interventions can lead to changes in frailty. Method(s): Ovid MEDLINE, SCOPUS, CINAHL and Cochrane databases were searched for studies that reported frailty assessments before and after TAVI and/or SAVR. Data from these studies were used to calculate a standardised score for change in frailty following either TAVI or SAVR, as part of a pooled random effects meta-analysis, with Hedges' adjusted g value. Result(s): Of 4,093 records screened, nine relevant studies were identified. Among 1,598 TAVI and 200 SAVR patients, no overall changes to frailty were observed, although there was considerable heterogeneity among studies. Improvements to frailty were observed in a sensitivity analysis of lower-risk TAVI cohorts (Society of Thoracic Surgeons predicted risk of mortality [STS-PROM] <=5%). Higher-risk TAVI and SAVR cohorts (STS-PROM >5%) did not show improvements in frailty post-aortic valve intervention. Conclusion(s): Overall, neither TAVI nor SAVR leads to significant changes in frailty measurements, although data are highly heterogeneous. Further research into the possible role of additional frailty interventions, particularly in higher-risk patients with AS undergoing TAVI or SAVR, should be considered. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <68> Accession Number 2044195579 Title Comprehensive Options for Pediatric Donation After Circulatory Death Donors. Source Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual. 29 (pp 102-108), 2026. Date of Publication: 01 Jan 2026. Author Kucera J.A.; Wolf S.E.M.; Skalla L.; Turek J.W.; Overbey D.M. Institution (Kucera, Wolf, Turek, Overbey) Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, North Carolina, United States (Skalla) Duke University Medical Center Library & Archives, Duke University School of Medicine, Duke University, Durham, North Carolina, United States (Turek, Overbey) Duke Children's Pediatric and Congenital Heart Center, Durham, North Carolina, United States Publisher W.B. Saunders Abstract Cardiac transplant represents the only definitive strategy for children with end-stage heart failure. Pediatric patients face significant wait-list times and resultant mortality due to a worsening shortage of hearts available for transplant. Donation after circulatory death (DCD) represents an opportunity to increase the number of hearts available to pediatric recipients by 30%. DCD donation has been historically limited in application due to logistical challenges and ethical concerns. A systematic review was carried out using the Cochrane Handbook. Eligible studies were identified using MEDLINE (via OVID), Embase (Elsevier), Cochrane Library/Cochrane Central Register of Controlled Trials (CENTRAL; Wiley), and Web of Science Core Collection (Clarivate). This search was conducted by a professional medical librarian in consultation with the author team and validated against a set of pre-selected articles. This resulted in 438 articles, which were screened based on title and abstract by 2 independent authors. Full-text review was subsequently performed, resulting in 21 articles. Agreement for inclusion included pediatric DCD, published in English, and complete manuscript availability. Four principal techniques were identified for pediatric DCD: rapid procurement and static cold storage, organ care systems, normothermic regional perfusion, and on-table reanimation. These all portend unique advantages and disadvantages and have largely evolved due to limitations of prior techniques. Providing a comprehensive approach to pediatric cardiac DCD is the most effective method to ensure organ stewardship, minimize wait list mortality, and mitigate ethical concerns associated with pediatric DCD. Copyright © 2025 <69> Accession Number 2045449222 Title A minimally invasive anaesthetic approach for transcatheter aortic valve implantation: is this really supported by the evidence?. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Heringlake M.; Muras L.H.; Schemke S. Institution (Heringlake, Muras, Schemke) Department of Anaesthesiology and Intensive Care Medicine, Heart and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg Hospital, Karlsburg, Germany Publisher Elsevier Ltd Abstract In association with growing operator experience and increasingly sophisticated delivery systems and valve prostheses, the anaesthetic management of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) has changed in many centres from general anaesthesia with invasive monitoring to local anaesthesia with conscious sedation or solely local anaesthesia. In a recent issue of the British Journal of Anaesthesia, a group of Italian experts in cardiac anaesthesia, cardiology, and cardiac surgery present an interdisciplinary consensus on the anaesthetic management of TAVI patients, recommending that a minimally invasive approach should be favoured in most cases. We critically evaluate the observational data supporting this consensus in comparison with the evidence from the available randomised controlled trials and highlight the need for an individual approach for anaesthetic management best suited to ensure safe and successful TAVI procedures. Copyright © 2026 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <70> Accession Number 2043104458 Title Dalbavancin for infective endocarditis: A systematic review of effectiveness, safety, and dosing. Source European Journal of Clinical Microbiology and Infectious Diseases. 45(4) (pp 931-941), 2026. Date of Publication: 01 Apr 2026. Author Chaldoupis A.E.; Petrakis V.; Ioannou P.; Tsante K.A.; Tsakri D.; Domouchtsidou A.; Baliou S.; Vlachaki M.; Mpakosi A.; Fortis S.P.; Samonis G.; Sokou R.; Bonovas S.; Siasos G.; Tsantes A.G. Institution (Chaldoupis, Siasos) Department of Cardiology, Medical School, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Athens, Greece (Petrakis) Department of Medicine, Infectious Diseases Unit, University General Hospital ofAlexandroupolis, Evros, Greece (Ioannou, Samonis) School of Medicine, University of Crete, Heraklion, Greece (Tsante) Department of Biomedical Sciences, University of West Attica, Athens, Greece (Tsakri, Vlachaki) Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Domouchtsidou, Tsantes) Microbiology Department, Saint Savvas Oncology Hospital, Athens, Greece (Baliou) Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece (Mpakosi) Department of Microbiology, General Hospital of Nikaia Agios Panteleimon, Piraeus, Greece (Mpakosi) Department of Immunology, General Hospital of Nikaia Agios Panteleimon, Piraeus, Greece (Fortis) Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health & Caring Sciences, University of West Attica (UniWA), Egaleo, Greece (Samonis) First Department of Medical Oncology, Metropolitan Hospital of Neon Faliron, Athens, Greece (Sokou) Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece (Bonovas) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Bonovas) IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy (Tsantes) Laboratory of Haematology and Blood Bank Unit, School of Medicine, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Infective endocarditis (IE) requires prolonged intravenous antibiotic therapy, leading to extended hospitalization and increased morbidity. Dalbavancin, a long-acting antibiotic with excellent tissue penetration and a favorable safety profile, can be a promising alternative. This systematic review aimed to investigate the current literature regarding the use of dalbavancin for infective endocarditis. Method(s): A systematic search of PubMed and Scopus was conducted according to PRISMA guidelines. Eligible studies included adult patients (>= 18 years) with IE diagnosed by the modified Duke criteria, treated with dalbavancin as monotherapy or sequential/consolidation therapy. Data extraction included demographics, type of IE, causative pathogen, dosing regimen, surgical intervention, adverse events, and outcomes. Descriptive analyses were performed. Result(s): Thirty-eight studies including 565 patients were analyzed. The overall cure rate was 88.0%, with a similar success rate across native valve (90.1%), prosthetic valve (90.0%), and cardiac device-related IE (86.0%). Staphylococcus aureus, Coagulase-negative staphylococci (CNS), Streptococcus spp., and Enterococcus faecalis were the most common pathogens. Cure rates were comparable among most pathogens, though a lower cure rate was evident in infections due to Enterococcus faecalis compared to Streptococcus spp. (80.7% vs. 96.6%, p = 0.008). An effective antimicrobial exposure of 2 weeks had similar success rate compared to a longer period of effective antimicrobial exposure (p = 0.31). Adverse events were rare (2.9%), with mild rash being the most common. Conclusion(s): Dalbavancin demonstrates high cure rates and excellent tolerability in IE, and could offer an attractive alternative to conventional prolonged intravenous therapy. Further randomized controlled trials are warranted to define standardized protocols. Copyright © The Author(s) 2026. <71> Accession Number 2045086734 Title Effect of maternal voice on sleep quality in children following cardiac surgery: protocol for a randomized controlled trial. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1760057. Date of Publication: 2026. Author Shi S.; Wang X.; Wang R.; Du F.; Wang H.; Yu Y.; Shen B. Institution (Shi, Wang) Department of Cardiothoracic Surgery, Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Shi, Wang) School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Wang) Department of Pediatrics, Suzhou Xiangcheng People's Hospital, Suzhou, China (Du) Department of Nursing, Suzhou Xiangcheng People's Hospital, Suzhou, China (Yu) Department of Anesthesiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Shen) Department of Nursing, Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Publisher Frontiers Media SA Abstract Background - Children with congenital heart disease (CHD) frequently experience postoperative sleep disturbances, which can adversely affect recovery and overall postoperative outcomes. Maternal voice has been suggested as a soothing auditory stimulus with the potential to improve sleep quality in children. This study aims to evaluate the effect of auditory intervention centered on the maternal voice on sleep quality in children undergoing cardiac surgery. Methods - This prospective, randomized controlled trial will enroll 132 children with CHD undergoing open-heart surgery. Participants will be randomly assigned to either the control group or the maternal voice-based intervention group. The primary outcome is the overall sleep efficiency across the night of surgery, postoperative Day 1, and postoperative Day 2. Secondary outcomes include additional sleep parameters, pain scores, sedation scores, delirium scores, B-type natriuretic peptide (BNP) levels, cardiac troponin I (cTnI) levels, dosages of dexmedetomidine and sufentanil, cardiac intensive care unit (CICU) length of stay, total hospital length of stay, and parental satisfaction. Discussion - This trial aims to provide high-quality evidence on maternal voice to improve postoperative sleep quality in children with CHD. Trial registration numbers - Chinese Clinical Trial Registry (https://www.chictr.org.cn) ChiCTR2500111004. Copyright © 2026 Shi, Wang, Wang, Du, Wang, Yu and Shen. <72> Accession Number 2045455061 Title Cryoanalgesia in Thoracic Surgery. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Drake L.; Weksler B. Institution (Drake, Weksler) Division of Thoracic and Esophageal Surgery, Cardiovascular Institute, Allegheny Health Network, PA, United States Publisher SAGE Publications Ltd Abstract Cryoanalgesia is a technique for reducing postoperative pain that involves freezing peripheral nerves while preserving their ability to regain function over time. The technique has been used for decades, and randomized trials have shown a reduction in pain and opioid use in some patients undergoing thoracotomy and pectus excavatum repair. In these trials, outcomes were highly dependent on the control groups. Randomized studies of patients undergoing minimally invasive thoracic surgery have failed to show the same results. Furthermore, several studies have reported chronic pain and neuropathic-type pain in patients treated with cryoanalgesia. In this review, we discuss the electrophysiologic and histopathologic basis of cryoanalgesia, highlight randomized trials of cryoanalgesia in thoracic surgery, and outline potential pitfalls, such as chronic pain, to offer insight into which patients may benefit most from cryoanalgesia and potential future directions of study. Copyright © The Author(s) 2026 <73> Accession Number 2039683426 Title Patent foramen ovale closure vs medical therapy in secondary prevention of stroke and TIA: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. 85 (pp 1-9), 2026. Date of Publication: 01 Apr 2026. Author Hammad A.; Ahmad A.; Khraisat O.; Kumar V.; Munshi H.; Khalid N.; Al Rayess N.; Ashkar H.; Muhammad H.; Challita R.; Bikkina M.; Shamoon F.; Sommer R.; Vasudev R. Institution (Hammad, Khraisat) Department of Internal Medicine, Englewood Hospital Medical Center, Englewood, NJ, United States (Ahmad, Munshi, Khalid, Al Rayess, Ashkar, Challita, Bikkina, Shamoon, Vasudev) Department of Cardiology, St. Joseph's University Medical Center, Paterson, NJ, United States (Kumar) Anesthesia and Critical Care, George Washington University, Washington, DC, United States (Muhammad) Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ, United States (Sommer) Department of Cardiology, Columbia University Irving Medical Center, New York, NY, United States Publisher Elsevier Inc. Abstract Importance Percutaneous Patent Foramen Ovale (PFO) closure reduces recurrent ischemic stroke and transient ischemic attack (TIA) in cryptogenic stroke patients. The publication of additional studies and the inclusion of a larger patient population necessitate an updated analysis to evaluate its efficacy and safety compared to medical therapies and across different age groups. Objective To compare the efficacy and safety of PFO closure versus medical therapy for the secondary prevention of stroke and TIA. Data sources A systematic literature search was performed using PubMed, CENTRAL, and EMBASE from inception to August 2024. Study selection Included studies involved adults (>=18) with ischemic neurological events and confirmed PFO, comparing percutaneous PFO closure to medical therapy, and reporting outcomes of interest. Data extraction and synthesis Data were independently extracted by 2 reviewers following PRISMA guidelines. Quality assessment utilized the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies. Odds ratios (ORs) with 95 % confidence intervals (CIs) were pooled using random or fixed effects models. Subgroup analyses were conducted based on age, shunt size, and presence of ASA. Main outcome(s) and measure(s) Primary outcomes included recurrent ischemic stroke and/or TIA, and all-cause mortality. The safety outcomes were atrial fibrillation/flutter and major bleeding. Results A total of 32 studies (6 randomized controlled trials and 26 observational studies) comprising 16,698 patients met the inclusion criteria. PFO closure significantly reduced the risk of recurrent ischemic stroke/TIA compared to medical therapy (OR 0.52, P < 0.001), with greater benefits over antiplatelet therapy (OR 0.33, P < 0.001) and anticoagulant therapy (OR 0.42, P < 0.001). Additionally, PFO closure reduced all-cause mortality (OR 0.49, P < 0.001) but was associated with an increased risk of atrial fibrillation (OR 3.45, P < 0.001). Subgroup analyses demonstrated similar significant benefits in recurrent stroke prevention for both older patients (>=60 years, OR 0.39) and younger patients (<60 years, OR 0.56). Conclusions and relevance This meta-analysis suggests that PFO closure is associated with lower risk of recurrent ischemic events and all-cause mortality compared to medical therapy. However, outcomes such as TIA and mortality were predominantly observed in observational studies. These findings are hypothesis-generating and support further investigation in selected patient populations. Copyright © 2025 Elsevier Inc. <74> Accession Number 2045302003 Title Prehabilitation in thoracic surgery: strong signal or surgical confounding?. Source Journal of Thoracic Disease. 18(4) (no pagination), 2026. Article Number: 451. Date of Publication: 30 Apr 2026. Author Lai V.; Reeve J.; Boden I. Institution (Lai, Reeve) School of Allied Health, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand (Lai) Physiotherapy Department, Auckland City Hospital, Auckland, New Zealand (Boden) School of Health Sciences, University of Tasmania, Launceston, Australia (Boden) Department of Physiotherapy, Launceston General Hospital, Launceston, Australia Publisher AME Publishing Company <75> Accession Number 2045101780 Title Weight-based dosing of surgical antibiotic prophylaxis in patients with obesity: meta-analysis. Source BJS Open. 10(2) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Huisman H.; Huinink K.; Bontekoning N.; de Jonge S.W.; Hannink G.; Salminen P.; Boermeester M.A. Institution (Huisman) Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands (Huisman) Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands (Huinink) Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands (Huinink) Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands (Bontekoning) Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands (Bontekoning) Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands (de Jonge) Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands (de Jonge) Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands (Hannink) Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands (Salminen) Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland (Salminen) Department of Surgery, University of Turku, Turku, Finland (Boermeester) Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands (Boermeester) Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands Publisher Oxford University Press Abstract Background: The use of preoperative surgical antibiotic prophylaxis is effective in preventing surgical site infection. However, obesity, a major risk factor for surgical site infection, affects the pharmacokinetics and effectiveness of surgical antibiotic prophylaxis. Evidence for weight-based surgical antibiotic prophylaxis in patients with obesity is inconsistent. Method(s): MEDLINE (PubMed), Embase, CENTRAL, and CINAHL were searched up to 21 October 2025 for eligible studies on weight-based surgical antibiotic prophylaxis and surgical site infection. This systematic review and random-effects meta-analysis compared weight-based dosing of surgical antibiotic prophylaxis with standard surgical antibiotic prophylaxis, in terms of surgical site infection rates in patients with obesity. The certainty of evidence was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials, the Risk Of Bias in Non-randomized Studies-of Interventions tool for observational studies, and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Result(s): Of 2782 potentially relevant articles, 33 studies were eligible (3 randomized clinical trials, 30 observational). A total of 99 211 patients were included, of whom 2362 (2.4%) developed a surgical site infection. Risk of bias varied from 'low' to 'some concerns' in randomized trials, and 'some concerns' to 'serious' in observational studies. Meta-analysis of 3 randomized trials with only 1 surgical site infection among 103 patients (1.0%) showed no significant reduction in surgical site infection rates in patients receiving weight-based dosing of cefazolin versus standard dosing (risk difference 2.02 (95% confidence interval -3.15 to 7.19)%). Meta-analysis of 6 observational studies with 45 554 patients and 610 surgical site infections (1.3%) showed significantly reduced surgical site infection rates in patients receiving weight-based dosing of cefazolin versus standard dosing (risk difference -1.93 (-2.84 to -1.02)%), with most studies focusing on orthopaedic surgery. GRADE assessments showed very low certainty of evidence. Conclusion(s): Based on observational data, the use of weight-based dosing of surgical antibiotic prophylaxis may reduce the risk of surgical site infection in patients with obesity compared with standard dosing, but the existing evidence is very uncertain. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. <76> Accession Number 2045091170 Title Therapeutic drug monitoring and the role of pharmacokinetics/pharmacodynamics in optimizing beta-lactam antibiotic dosing for deep-seated infections: a systematic review. Source Journal of Antimicrobial Chemotherapy. 81(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Vale C.; Sime F.B.; Cotta M.O.; Eriksson L.; Roberts J.A.; Horvath R.; Abdul-Aziz M.H. Institution (Vale) Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland, Brisbane, QLD, Australia (Vale) Department of Pharmacy, The Prince Charles Hospital, Brisbane, QLD, Australia (Sime) Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland, Brisbane, QLD, Australia (Cotta) Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland, Brisbane, QLD, Australia (Eriksson) UQ Library, The University of Queensland, Brisbane, QLD, Australia (Roberts) Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland, Brisbane, QLD, Australia (Roberts) Herston Infectious Diseases Institute (HeIDI), Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (Roberts) Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (Horvath) Department of Infectious Diseases, The Prince Charles Hospital, Brisbane, QLD, Australia (Horvath) Department of Microbiology, Pathology Queensland, Brisbane, QLD, Australia (Abdul-Aziz) Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland, Brisbane, QLD, Australia Publisher Oxford University Press Abstract Background: Therapeutic drug monitoring (TDM) may help optimize beta-lactam antibiotic dosing in patients with deep-seated infections. However, its impact on clinical outcomes remains unclear. Objective(s): The objective of this review was to evaluate the existing evidence on the role of TDM and pharmacokinetic/pharmacodynamic (PK/PD)-guided optimization of beta-lactam antibiotic dosing in achieving PK/PD targets, and improving clinical outcomes in patients with deep-seated infections. Method(s): We conducted a systematic review of studies reporting on beta-lactam TDM, PK/PD target attainment, and clinical outcomes in adult (>=18 years) patients with confirmed deep-seated infections, including complex bacteraemias with a suspected or proven deep-seated source, infective endocarditis, bone and joint infection, and epidural abscess. The search was conducted using MEDLINE (via PubMed), Embase, CINAHL and CENTRAL from inception to June 2025. Result(s): Twelve studies were included in the final analysis. Considerable variability was observed in PK/PD target definitions and attainment, dosing adjustments and outcome reporting. Eleven of the twelve studies were rated as poor quality on the Newcastle-Ottawa Scale due to lack of comparability. Only one study included a non-TDM comparator group and the authors reported no significant difference in clinical outcomes. Three studies showed a trend towards improved clinical outcomes with TDM-guided dosing. TDM frequently led to dose reductions due to concerns of beta-lactam antibiotic toxicity with standard dosing. Conclusion(s): Current evidence supporting beta-lactam antibiotic TDM in deep-seated infections is limited by methodological heterogeneity and poor study quality. Well-designed trials are needed to establish the clinical utility of TDM in this setting. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. <77> Accession Number 2044730641 Title Systematic Review and Meta-Analysis of the Frequency of Thromboembolic Events, Bleeding, and Mortality in Patients with Atrial Fibrillation and End-Stage Renal Disease Undergoing Percutaneous Left Atrial Appendage Closure. Source Journal of Clinical Medicine. 15(7) (no pagination), 2026. Article Number: 2641. Date of Publication: 01 Apr 2026. Author Martinez-Arango J.M.; Rojas-Echavarria L.M.; Garcia-Mejia C.; Castrillon-Spitia J.D.; Higuita-Gutierrez L.F. Institution (Martinez-Arango, Garcia-Mejia, Castrillon-Spitia) Internal Medicine, School of Medicine, Universidad Cooperativa de Colombia, Medellin-Envigado Campus, Medellin, Colombia (Rojas-Echavarria) Medicine, School of Medicine, Universidad CES, Medellin Campus, Medellin, Colombia (Higuita-Gutierrez) Research Unit, School of Medicine, Universidad Cooperativa de Colombia, Medellin-Envigado Campus, Medellin, Colombia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Atrial fibrillation (AF) and end-stage renal disease (ESRD) are closely related conditions that increase the risk of disability, stroke, and mortality. Anticoagulation management in patients with ESRD and AF is challenging due to the high risk of bleeding. Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative to reduce thromboembolic events; however, evidence in this specific population remains limited. Therefore, we aimed to evaluate the frequency of thromboembolic events, bleeding complications and mortality in patients with AF and ESRD undergoing LAAC through a systematic review and meta-analysis. Method(s): A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420250640241). A structured search was performed in Medline, EMBASE, Web of Science, SCOPUS, LILACs and institutional repositories through September 2024, with no language restrictions. We included original studies reporting frequencies of thromboembolic events, bleeding and mortality in patients with AF and ESRD undergoing LAAC. A random-effects model was used and heterogeneity was assessed using the I2 statistic. Result(s): Fourteen studies were included in the qualitative analysis and seven in the quantitative synthesis, comprising a total of 2433 patients with AF and ESRD undergoing LAAC. In the qualitative analysis, the mean age was 74 +/- 7.6 years; the most common comorbidities were hypertension (74%), diabetes mellitus (47%), and dyslipidemia (53%). WatchmanTM devices predominated in North America, whereas AmuletTM devices were more frequently used in Europe and Latin America. Procedural success was 98.4%, with infrequent periprocedural complications: major bleeding in 1.6% and device embolization in 0.5%. In the quantitative analysis, the pooled frequency of thromboembolic events was 3% (95% CI: 1-7%; I2 = 81.1%), pooled bleeding frequency was 6% (95% CI: 4-10%; I2 = 76.9%), and pooled mortality was 5% (95% CI: 1-22%; I2 = 97.8%). After excluding studies with extreme values, adjusted mortality was 2% (95% CI: 1-5%; I2 = 76.6%). Despite high heterogeneity, the findings suggest that LAAC may offer protection against embolic events with an acceptable bleeding risk. Conclusion(s): LAAC in patients with AF and ESRD is associated with a low frequency of thromboembolic events and bleeding when compared with standard anticoagulation therapy and no treatment. Overall mortality is moderate and appears to be primarily attributable to underlying comorbidity rather than the procedure itself. This meta-analysis provides evidence that LAAC may be a safe and effective therapeutic strategy in patients with contraindications or high risk for chronic anticoagulation. However, prospective and comparative clinical trials are needed to confirm these findings and inform future clinical practice guidelines. Copyright © 2026 by the authors. <78> Accession Number 2043652095 Title Low-density lipoprotein cholesterol lowering and risk of major adverse cardiovascular events in primary prevention trials: A meta-analysis. Source Journal of Clinical Lipidology. 20(4) (pp 738-749), 2026. Date of Publication: 01 Apr 2026. Author Kalra D.K.; Ray K.K.; Bajaj A.; Kushner P.R.; Wilcox M.L.; Dicklin M.R.; Kirkpatrick C.F.; Maki K.C. Institution (Kalra) Lipid Clinic and Division of Cardiology, University of Louisville School of Medicine, (Kalra), Louisville, KY, United States (Ray) Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, (Ray), London, United Kingdom (Bajaj) Department of Medicine, Perelman School of Medicine, University of Pennsylvania, (Bajaj), Philadelphia, PA, United States (Kushner) Department of Family Medicine, University of California Irvine Medical Center, (Kushner), Orange, CA, United States (Wilcox, Dicklin, Kirkpatrick, Maki) Midwest Biomedical Research, (Wilcox, Dicklin, Kirkpatrick, and Maki), Addison, IL, United States (Kirkpatrick) Kasiska Division of Health Sciences, Idaho State University, (Kirkpatrick), Pocatello, ID, United States (Maki) Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, (Maki), Bloomington, IN, United States Publisher Elsevier Ltd Abstract BACKGROUND Analyses of statin trials by the Cholesterol Treatment Trialists' Collaboration have suggested larger relative risk reduction (RRR) for major adverse cardiovascular events (MACE) per 1 mmol/L (38.7 mg/dL) low-density lipoprotein cholesterol (LDL-C) lowering in primary prevention than in secondary prevention. However, controversy remains about the value of LDL-C lowering in primary prevention. OBJECTIVE This meta-analysis examined the relationship between LDL-C reduction and MACE risk in primary prevention with statin and nonstatin LDL-C-lowering therapies in cardiovascular outcomes trials (CVOTs). METHODS PubMed and Cochrane Central Register of Controlled Trials were searched from inception through August 26, 2025. The primary endpoint was the pooled RRR vs controls for 4-point composite MACE (coronary heart disease death, nonfatal myocardial infarction, fatal and nonfatal stroke, and coronary revascularization) per 1 mmol/L LDL-C lowering. RESULTS Eleven CVOTs of solely primary prevention participants (n = 74,466) and 3 in which '80% of participants were primary prevention (n = 24,071) were identified (11 statin, 1 bempedoic acid, 1 ezetimibe, 1 statin+ezetimibe). In 13 trials, the pooled mean difference between groups in LDL-C reduction was 1.00 mmol/L (95% CI: 0.82-1.18 mmol/L) with a pooled estimate of 30% (relative risk: 0.70; 95% CI: 0.67-0.74) RRR for 4-point MACE per 1 mmol/L LDL-C reduction vs control. CONCLUSION In CVOTs of solely or predominantly primary prevention participants, each 1 mmol/L reduction in LDL-C was associated with a 30% RRR in 4-point MACE. These results strengthen the evidence and rationale for the benefits of LDL-C lowering in primary prevention. Copyright © 2026 The Authors. <79> Accession Number 2044936741 Title Continuous Erector Spinae Plane Block versus Thoracic Epidural Analgesia After Thoracotomy: A Randomized Controlled Assessor-Blinded Non-Inferiority Trial. Source Journal of Pain Research. 19 (no pagination), 2026. Article Number: 585519. Date of Publication: 2026. Author Cho S.; Lee H.-J.; Yoon S.-H.; Park S.-Y.; Park S.; Lee H.J.; Park I.K.; Kang C.H.; Na K.J.; Yoon S.; Kim Y.T.; Bahk J.-H. Institution (Cho, Lee, Yoon, Park, Yoon, Bahk) Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, South Korea (Lee, Yoon, Yoon, Bahk) Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, South Korea (Park, Lee, Park, Kang, Na, Kim) Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea (Park, Lee, Park, Kang, Na, Kim) Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea (Na, Kim) Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea Publisher Dove Medical Press Ltd Abstract Purpose: Thoracic epidural analgesia (TEA) remains the current gold standard for postoperative pain control after thoracotomy, but is associated with significant complications and contraindications. This study evaluated whether continuous erector spinae plane block (ESPB) provides non-inferior analgesia to TEA. Patients and Methods: Adult patients scheduled for elective thoracotomy were randomized 1:1 to receive continuous TEA or ESPB. Outcome assessors were blinded to group allocation. In the TEA group, an epidural catheter was inserted at T6-7 under fluoroscopic guidance with tip confirmation at T5. In the ESPB group, a catheter was placed under ultrasound guidance at the T5 transverse process. Both groups received 0.2% ropivacaine boluses before incision, followed by patient-controlled analgesia for three days. The primary endpoint was resting numeric rating scale pain score on postoperative day 1 with a 2-point non-inferiority margin. Secondary endpoints included pain scores on days 2-3, opioid consumption, QoR-15K scores, and chronic pain assessments at 3 and 6 months. Result(s): Fifty-three patients were enrolled; 44 were included in the modified intention-to-treat analysis (ESPB n=23; TEA n=21). Mean resting NRS scores on postoperative day 1 were 4.22+/-1.93 (ESPB) versus 4.81+/-1.78 (TEA). The between-group difference was -0.59 (95% CI, -1.72-0.54; P=0.296), meeting the predefined non-inferiority margin. Secondary outcomes, including pain scores, opioid consumption, Quality of Recovery-15 scores, and chronic pain assessments at 3 and 6 months, were comparable between groups. No major complications occurred. Conclusion(s): Continuous ESPB demonstrated analgesic efficacy comparable to TEA for postoperative pain control after thoracotomy. Combined with its superior safety profile and technical simplicity, ESPB may serve as an effective alternative to TEA in thoracic surgery. Copyright © 2026 Cho et al. <80> Accession Number 2041375770 Title Transcatheter procedures for tricuspid regurgitation in advanced heart failure: A systematic review. Source Trends in Cardiovascular Medicine. 36(4) (pp 204-215), 2026. Date of Publication: 01 May 2026. Author Kourek C.; Sicouri S.; Magouliotis D.E.; Xanthopoulos A.; Ramlawi B. Institution (Kourek) Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens, Greece (Sicouri, Magouliotis, Ramlawi) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States (Xanthopoulos) Department of Cardiology, University Hospital of Larissa, Larissa, Greece (Ramlawi) Department of Cardiac Surgery, Lankenau Medical Center, Wynnewood, PA, United States Publisher Elsevier Inc. Abstract Tricuspid regurgitation (TR) in advanced heart failure (HF) is associated with poor prognosis, functional decline, and increased morbidity. This systematic review synthesizes current evidence of transcatheter device tricuspid transcatheter approaches in advanced HF patients. A comprehensive search of PubMed, Embase, Scopus, CINAHL, and the Cochrane Library identified studies evaluating transcatheter procedures for moderate-to-severe TR in advanced HF, and reporting procedural outcomes, survival, and functional measures. A total of 37 studies encompassing approximately 2,372 patients were included, spanning edge-to-edge repair systems (TriClip, PASCAL), annuloplasty devices (Cardioband, Trialign, TriCinch), transcatheter valve replacement (Evoque, LuX-Valve, NaviGate, Intrepid), heterotopic caval valve implantation (TricValve, Tricento), and leaflet spacers (FORMA). Most patients were in NYHA class III-IV with high surgical risk scores. Across techniques, procedural success rates were high, with consistent reductions in TR severity and improvements in NYHA class, 6-minute walk distance, and quality-of-life scores. Edge-to-edge repair was the most frequently studied, showing favorable safety and symptom improvement. Mortality rates varied, with limited long-term follow-up data. Transcatheter interventions for TR in advanced HF offer promising improvements in symptoms, functional status, and quality of life. Given patient and anatomical heterogeneity, an individualized approach is essential. Copyright © 2025 Elsevier Inc. <81> Accession Number 2045455419 Title Impact of Restrictive Versus Liberal Oxygenation on Pulmonary Decline After Cardiac Surgery: A Substudy of the GLORIOUS Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mikkelsen A.D.; Wiberg S.; Schultz H.H.L.; Moller-Sorensen P.H.; Hofsten D.; Kober L.; Chemtob R.A.; Jakobsen P.C.H.; Nilsson J.C.; Moller C.H.; Hassager C.; Kjaergaard J. Institution (Mikkelsen, Hofsten, Kober, Hassager, Kjaergaard) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic Anaesthesiology and Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Schultz, Chemtob, Jakobsen) Section for Heart and Lung Transplant, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Moller) Department of Cardiac Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Hassager, Kjaergaard) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher W.B. Saunders Abstract Objectives: Pulmonary dysfunction is a known complication of cardiac surgery. High fractions of inspired oxygen (FiO<inf>2</inf>) during the critical pulmonary reperfusion phase of cardiopulmonary bypass (CPB) weaning is a proposed pathophysiological contributor yet remains sparsely investigated. Design(s): Predefined, exploratory substudy of the GLORIOUS randomized, clinical trial. Setting(s): Single tertiary center with cardiothoracic surgery expertise. Participant(s): Adult patients undergoing nonemergent coronary artery bypass grafting (CABG) and/or surgical aortic valve replacement. Intervention(s): Restrictive (FiO<inf>2</inf> 50%) versus liberal (FiO<inf>2</inf> 100%) oxygenation during CPB and the first hour after weaning or until patient transfer from the operating table. Pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, and diffusion capacity of carbon monoxide) was measured preoperatively and 3 months postoperatively. Measurements and Main Results: A total of 878 patients were included in the study. Postoperatively, at the 3-month mark, pulmonary function declined across all parameters in the overall study population (median FEV1 [% predicted] by 8.3 percentage points [95% CI 6.6 to 8.3], FVC [% predicted] by 6.1 percentage points [95% CI 5.2 to 7.0], FEV1/FVC by 1.6 percentage points [95% CI 1.0 to 2.1], and diffusion capacity of carbon monoxide [% predicted corrected] by 7.7 percentage points [95% CI 6.2 to 9.1], all p< 0.001). However, no significant between-group differences in decline were observed (all p > 0.3), including in subgroup analyses. Conclusion(s): While pulmonary function exhibited a mild-to-moderate decline 3 months after cardiac surgery, a restrictive (FiO<inf>2</inf> 50%) oxygenation strategy during CPB did not attenuate this decline compared with a liberal (FiO<inf>2</inf> 100%) strategy. Findings are hypothesis-generating. Copyright © 2026 The Author(s) <82> Accession Number 2045768766 Title Organizational perspectives on barriers and facilitators to an integrated care model for opioid use disorder and serious injection-related infections. Source Journal of Substance Use and Addiction Treatment. 189 (no pagination), 2026. Article Number: 210025. Date of Publication: 01 Oct 2026. Author Surratt H.L.; Lofwall M.R.; Nelson E.O.; Thornton A.C.; Cari E.V.; Walsh S.L.; Fanucchi L.C. Institution (Surratt) UKCOM, Department of Behavioral Science, Center on Drug and Alcohol Research, Lexington, KY, United States (Lofwall, Walsh) UKCOM, Departments of Behavioral Science and Psychiatry, Center on Drug and Alcohol Research, Lexington, KY, United States (Nelson) UKCOM, Department of Behavioral Science, Lexington, KY, United States (Thornton, Cari) UKCOM, Department of Internal Medicine, Division of Infectious Diseases, Lexington, KY, United States (Fanucchi) UKCOM, Department of Internal Medicine, Division of Infectious Diseases, Center on Drug and Alcohol Research, Lexington, KY, United States Publisher Elsevier Inc. Abstract Background: Rising rates of serious injection-related infections (SIRI) and hospitalizations have been documented nationally in the context of the ongoing opioid and polysubstance use epidemic in the United States. This qualitative interview study assessed multi-level facilitators and barriers to the implementation of an integrated inpatient opioid use disorder (OUD) and SIRI care intervention among organizational stakeholders in the healthcare setting as a secondary aim of a randomized clinical trial. Method(s): The PRISM (Practical, Robust, Implementation, and Sustainability Model) implementation science framework guided stakeholder interviews. Eligible stakeholders were at least 18 years old and employed in an inpatient or outpatient care setting that served the study patient population. Qualitative interviews assessed contextual factors that supported or hindered the implementation of the novel study intervention and priorities for sustainability and future investment. Interviews lasted approximately 60 min. Qualitative coding and analysis were conducted in NVivo. Result(s): Overall, thirteen stakeholders were interviewed, including clinicians from cardiothoracic surgery, hospital medicine, infectious disease, and addiction medicine, hospital administrators, social work and case management staff, pharmacists, Bridge Clinic staff, and staff from home infusion. Within the four overarching PRISM domains thirteen critical elements were activated by the study intervention that represented key barriers and facilitators to implementation, including: Intervention (Coordination across departments, Strength of the evidence base, Burden, Barriers of frontline staff, SUD stigma); Recipients (Clinical leadership, Organizational health and culture; Patient disease burden, Patient demographics); External Environment (Community Resources, Reimbursement); and Implementation and Sustainability Infrastructure (Dedicated team, Plan for sustainability). Conclusion(s): Examination of implementation determinants highlighted organizational and external barriers and facilitators. Barriers centered on the complexities of care coordination across departments, the inpatient-outpatient transition, and specialized training needs; these appeared modifiable through adoption of specific implementation strategies. The presence of critical clinical infrastructure to support this transitional OUD-SIRI integrated care model was an essential facilitator, which could represent a challenge for other health systems. External factors, including low resource availability, and SUD-related stigma that excludes patients from opportunities to receive care in the community, collectively pose challenges to wider implementation and sustainability. Copyright © 2026 <83> Accession Number 2045747094 Title Two-Lung Ventilation Attenuates Systemic Inflammatory and Oxidative Stress Responses During Thoracic Surgery: A Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Ballester E.; Frandoloso M.; Mendes R.A.; Helene M.K.; Ballester M.E.; Effting P.S.; Dominguini D.; Ritter C.; Rocco P.R.M.; Dal-Pizzol F. Institution (Ballester, Effting, Dominguini, Ritter, Dal-Pizzol) Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciuma, Brazil (Ballester, Frandoloso, Mendes, Ballester) Department of Thoracic Surgery, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Helene) Department of Anesthesiology, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Rocco) Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Ritter, Rocco, Dal-Pizzol) National Science and Technology Institute for Precision Critical Care Medicine - INCT PCCM, Criciuma, Brazil Publisher W.B. Saunders Abstract Objective: To evaluate whether two-lung ventilation (TLV) attenuates perioperative inflammatory and oxidative responses compared with one-lung ventilation (OLV). Design(s): A randomized, open-label clinical trial. Setting(s): Thoracic Surgery Department of a general hospital in Southern Brazil. Participant(s): Forty adults (age >=18 years) undergoing thoracic surgery between July and November 2023 were enrolled. Exclusion criteria included pregnancy, preoperative mechanical ventilation, American Society of Anesthesiologists class IV status, inability to place a double-lumen tube, and prior lung resection. Intervention(s): Patients were randomized to receive OLV or TLV during surgery. Measurements & Main Results: Bronchoalveolar lavage (BAL) fluid from the operated and nonoperated lungs and plasma samples were collected preoperatively and postoperatively. Cytokines (interleukin [IL]-6, IL-1beta, IL-8, IL-4, IL-10, and tumor necrosis factor alpha) and oxidative stress markers (thiobarbituric acid reactive substances, protein carbonyls, and DCFH-DA [2',7'-dichlorodihydrofluorescein diacetate]) were quantified. Group-by-time effects were analyzed using generalized mixed-effects models adjusted for age, sex, and surgical duration. BAL fluid cytokine levels, including the primary outcome, IL-6 (p = 0.57), did not differ between groups. However, TLV was associated with reduced postoperative IL-1beta (p = 0.04) and oxidative damage (p = 0.02) in the operated lung. Systemically, TLV markedly attenuated inflammatory and oxidative responses, with lower circulating cytokines and oxidative stress markers and significant group-by-time interactions for multiple mediators. Conclusion(s): Although TLV did not modify local IL-6 concentrations, it consistently dampened systemic inflammatory and oxidative activation induced by thoracic surgery, supporting its potential as a protective perioperative ventilatory strategy. Copyright © 2026 The Author(s) <84> Accession Number 651181295 Title Effect of anti-fibrotic therapy on regression of myocardial fibrosis after TAVI: Design and rationale of the Reduce-MFA DZHK25 trial. Source ESC heart failure. (no pagination), 2026. Date of Publication: 12 May 2026. Author Puls M.; Zeisberg E.M.; Placzek M.; Beuthner B.E.; Jacob C.F.; Steinhaus K.E.; Lange T.; Tostmann R.; Schnelle M.; Schuster A.; Hasenfuss G.; Friede T. Institution (Puls, Zeisberg, Beuthner, Jacob, Steinhaus, Lange, Schuster, Hasenfus) Department of Cardiology and Pneumology, University Medical Centre Gottingen, 37075 Gottingen, Germany (Puls, Zeisberg, Placzek, Beuthner, Jacob, Steinhaus, Lange, Schnelle, Schuster, Hasenfus, Friede) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, 37075 Gottingen, Germany (Placzek, Friede) Department of Medical Statistics, University Medical Centre Gottingen, 37073 Gottingen, Germany (Tostmann) Clinical Trials Unit, University Medical Centre Gottingen, 37075 Gottingen, Germany (Schnelle) Department of Clinical Chemistry, University Medical Centre Gottingen, 37075 Gottingen, Germany (Schuster) FORUM Medicine, Cardiology, Rosdorf, Germany Abstract AIMS: Myocardial fibrosis (MF) represents a key player in transition to heart failure in aortic stenosis (AS), and AS patients with high baseline MF are at increased risk to die within 12 months after TAVI. Therefore, the objective of the Reduce-MFA DZHK25 trial is to assess the impact of anti-fibrotic therapy on regression of AS-induced MF after TAVI in patients with high baseline fibrotic burden. Key secondary objectives include reverse LV remodelling, symptomatic improvement, and reduction of mortality and cardiac hospitalisations. METHOD(S): Reduce-MFA represents a national, prospective, randomized, parallel group, controlled, open-label interventional multi-centre trial with blinded outcome assessment (PROBE design) enrolling patients with severe AS scheduled for TAVI. The anti-fibrotic principles employed are Spironolactone and low-dose Dihydralazine (epigenetic reactivation of anti-fibrotic genes). Baseline burden and course of MF are assessed by cardiac MRI (CMR). Since CMR-derived extracellular volume fraction (ECV%) >=25.9% emerged as independent mortality predictor, only patients above this cut-off are randomized into 3 parallel groups: 1. Standard of Care alone, 2. + Spironolactone, 3. + Spironolactone + low-dose Dihydralazine, each for 12 months. To assess MF regression, CMR is repeated after 12 months. MF is assessed by quantification of the ECV-derived LV matrix volume using T1 mapping. Additionally, measures of heart failure (KCCQ, 6MWT, NT-proBNP, NYHA class) and reverse cardiac remodelling are evaluated at 6 and 12 months. Mortality and cardiac hospitalisations are recorded. The recruitment was recently completed with 384 enrolled and 153 randomised patients. CONCLUSION(S): The study findings have the potential to inform the development of a novel adjuvant therapy to improve the prognosis of specific AS patients. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. <85> Accession Number 2045529296 Title Concordance of Large Language Model Recommendations with Multidisciplinary Heart Team Decisions in Coronary Revascularization and Aortic Valve Intervention: A Systematic Review and Pooled Analysis. Source Cardiology and Therapy. (no pagination), 2026. Date of Publication: 2026. Author Rouhi A.D.; Menon S.V.; Ghanem Y.K.; Han J.J. Institution (Rouhi) Washington University in St. Louis School of Medicine, St. Louis, MO, United States (Menon) Cooper Medical School of Rowan University, Camden, NJ, United States (Ghanem) Department of Surgery, Cooper University Hospital, Camden, NJ, United States (Han) Division of Cardiac Surgery, Department of Surgery, Cooper University Hospital, 24 S 6th Street, Camden, NJ, United States Publisher Adis Abstract Introduction: The multidisciplinary heart team (HT) remains the cornerstone of decision-making for complex cardiovascular disease. Large language models (LLMs) and other generative artificial intelligence models have recently emerged as potential decision support tools across diverse clinical settings. We sought to synthesize current evidence and quantitatively estimate concordance between LLM recommendations and HT decisions. Method(s): A literature search was performed using PubMed, Scopus, and Web of Science for primary studies published between November 2022 and February 2026 that evaluated recommendations by LLMs against multidisciplinary HT decisions. Studies reporting overall agreement were included for quantitative pooling. Random-effects meta-analysis was performed to determine proportion of agreement. Result(s): Four retrospective concordance studies were included regarding decision-making in coronary revascularization and aortic valve intervention. LLM-HT concordance ranged from 65% to 82% for coronary revascularization and was 77% for aortic valve intervention. In random-effects meta-analysis, the pooled agreement between LLM recommendations and HT decisions was 0.73 (95% CI 0.60-0.83) with substantial heterogeneity. Discordance stemmed from LLM reliance on outdated trial evidence and limited transparency regarding utilized data, with misclassifications observed in cases of octogenarians with aortic stenosis. Detailed prompts generally improved accuracy and reliability of LLM recommendations. Conclusion(s): These preliminary findings suggest LLMs may have potential as adjunctive decision support tools for multidisciplinary HTs. There remains potential for misclassification when patient-specific factors and conflicting guidelines complicate decision-making. Further prospective evaluation across diverse LLMs is essential before clinical deployment can be recommended. Copyright © The Author(s) 2026. <86> Accession Number 2045496576 Title Short-Term, Weight-Adjusted Colchicine to Prevent Post-CABG Arrhythmias: A Randomized, Double-Blind, Controlled Trial. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Farzaneh A.H.; Abbaspour H.; Habibi V.; Sadraei S.J.; Darayi M.; Moradi S.; Nataj A.H. Institution (Farzaneh, Abbaspour) Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Habibi, Sadraei, Darayi) Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Moradi) Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Nataj) Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Postoperative arrhythmias are common after coronary artery bypass graft (CABG) surgery and are linked to adverse outcomes. Colchicine, an anti-inflammatory agent, has shown inconsistent results in prior studies, possibly due to dosing and timing variations. Objective(s): To evaluate the efficacy and safety of short-term, weight-adjusted colchicine initiated preoperatively for preventing postoperative arrhythmias after CABG. Method(s): In this randomized, double-blind, placebo-controlled trial, 172 adults scheduled for on-pump CABG received colchicine or placebo. The regimen included a preoperative loading dose (1 mg twice daily) followed by a weight-based maintenance dose (0.5 mg daily if <70 kg; 1 mg daily if >=70 kg) for 14 days. The primary outcome was incidence of postoperative atrial fibrillation (POAF). Secondary outcomes included early (<=48 h) and late (>48 h) POAF, other arrhythmias, inflammatory markers (CRP, ESR), length of stay, and adverse events. Result(s): Of 163 analyzed patients (81 colchicine, 82 placebo), POAF incidence was significantly lower in the colchicine group (17.3% vs. 46.3%; RR 0.37, 95% CI 0.21-0.66; p < 0.001), with an absolute risk reduction of 29.0% and number needed to treat (NNT) of 4. Colchicine reduced both early and late POAF (p < 0.001 and p = 0.002). No significant reduction was seen in other arrhythmias. Gastrointestinal events, primarily diarrhea, were more common with colchicine (25.9% vs. 8.5%, p = 0.003), but were manageable and without serious adverse events. Conclusion(s): Short-term perioperative weight-adjusted colchicine is effective and safe for preventing POAF after CABG, with a low NNT and manageable side effects, though it did not significantly affect other arrhythmias. Trial Registration: Iranian Registry of Clinical Trials, IRCT20200328046886N6. Copyright © 2026 Wiley Periodicals LLC. <87> [Use Link to view the full text] Accession Number 651181762 Title Therapeutic effectiveness of specialized core mobilization exercise on cardiopulmonary function in open-heart surgery patients: A randomized control trial with single-blind study. Source Medicine. 105(19) (pp e48313), 2026. Date of Publication: 08 May 2026. Author Lee J.J.; You J.S.H. Institution (Lee) Department of Physical Therapy, Eulji University, Seongnam, South Korea (You) Department of Physical Therapy, Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Yonsei University, Wonju, South Korea (You) Department of Physical Therapy, Yonsei University, Wonju, South Korea Abstract BACKGROUND: To compare the effects of conventional cardiopulmonary physical therapy (CCPT) and specialized core mobilization exercise (SCME) on cardiopulmonary function and functional difficulties in patients after open-heart surgery. METHOD(S): This randomized controlled, single-blind study used repeated-measures analysis of variance to examine time and group interaction effects across multiple postoperative assessment points. A post hoc Tukey test was performed when significant effects were identified. The study was conducted at the Myongji Hospital Cardiac Rehabilitation Center from June 2022 to July 2023 and included 37 patients (mean age = 66.1 +/- 11.4 years) who were randomly assigned to the CCPT or SCME group. RESULT(S): Compared with CCPT, SCME resulted in greater improvements in peak oxygen consumption, metabolic equivalents, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation (P < .05), and Functional Difficulties Questionnaire scores (P < .01). CONCLUSION(S): SCME demonstrated superior effects on peak oxygen consumption, selected pulmonary function parameters, and functional thoracic mobility compared with CCPT in patients after open-heart surgery. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <88> Accession Number 2045682996 Title Prevalence of dysglycemia following paediatric cardiac surgery: a systematic review and meta-analysis. Source BMJ Paediatrics Open. 10(1) (no pagination), 2026. Date of Publication: 2026. Author Abera E.G.; Sime H. Institution (Abera) Department of Public Health, Jimma University, Oromia, Jimma, Ethiopia (Abera) Clinical Trial Unit, Jimma University, Oromia, Jimma, Ethiopia (Sime) King Faisal Hospital Rwanda, Kigali, Rwanda (Sime) Africa Health Science University, Kigali, Rwanda Publisher BMJ Publishing Group Abstract Background: Postoperative dysglycemia is a common but under-recognised complication in paediatric cardiac surgery, driven by physiologic stress, hormonal changes and cardiopulmonary bypass. Reported prevalence varies widely, and no meta-analysis has synthesised the evidence. Therefore, this study aimed to estimate the pooled prevalence of postoperative dysglycaemia and describe associated postoperative outcomes, such as intensive care unit (ICU) stay and mechanical ventilation duration. Method(s): We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines and the Joanna Briggs Institute (JBI) methodology for prevalence studies. Eligible studies included paediatric patients (<=18 years) undergoing cardiac surgery reporting postoperative dysglycaemia (hyperglycaemia or hypoglycaemia). A random-effects model was used to calculate pooled prevalence and 95%CIs, with logit transformation applied to prevalence proportions and heterogeneity assessed using I2 statistics. Subgroup analyses were performed by region/continent, study design, age group and glycaemic threshold. All included studies were critically appraised using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias 2 tool for randomised trials. The protocol was registered with PROSPERO (CRD420251161893). Result(s): 22 studies involving 3864 patients were included. The pooled prevalence of postoperative dysglycemia was 68.6% (95% CI 52.8 to 81.0), with hyperglycaemia accounting for most cases (71.2%) and hypoglycaemia observed in 8.1%. Prevalence was higher in Asia and North America (~75%) than in Europe (45.2%), though not statistically significant. Studies using lower hyperglycaemia thresholds (126-139 mg/dL) reported significantly the highest prevalence (82.3%, p<0.032). The pooled mean ICU stay among dysglycemic patients was 180.3 hours (95% CI 82.3 to 279.3), and mean mechanical ventilation duration was 94.6 hours (95% CI 5.2 to 184.1). Sensitivity analyses showed that no single study disproportionately influenced the overall pooled estimates, and no publication bias was detected. The certainty of evidence assessed using the GRADE approach was moderate for overall dysglycemia prevalence. Conclusion(s): Dysglycaemia is highly prevalent following paediatric cardiac surgery, particularly hyperglycaemia, with prolonged ICU and mechanical ventilation times observed among affected patients. These findings underscore the need for vigilant perioperative glucose monitoring, standardised definitions of dysglycaemia, and evidence-based glycaemic management protocols. Future multicentre studies are warranted to establish optimal glycaemic thresholds and evaluate targeted interventions to improve postoperative outcomes in this vulnerable population. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <89> Accession Number 2045492044 Title Ultrasound-Guided Superficial Parasternal Intercostal Plane Block for Early Pain Management in Patients Undergoing Cardiac Surgery-A Randomized Controlled Trial. Source Acta Anaesthesiologica Scandinavica. 70(6) (no pagination), 2026. Article Number: e70253. Date of Publication: 01 Jul 2026. Author Kalli A.-J.; Makela P.; Huhtala H.; Mennander A.A.; Jarvela K.M. Institution (Kalli, Makela, Jarvela) Department of Cardiac Anesthesia and Intensive Care, Tays Heart Hospital, Tampere University Hospital, Tampere, Finland (Huhtala) Faculty of Social Sciences, Tampere University, Tampere, Finland (Mennander) Department of Cardio-Thoracic Surgery, Tays Heart Hospital, Tampere University Hospital, Tampere, Finland (Mennander, Jarvela) Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland Publisher John Wiley and Sons Inc Abstract Background: Sternotomy causes substantial postoperative pain. Recently, several less invasive nerve blocks have been described that are safer to use even on anticoagulated patients. This study aims to evaluate early pain management using ultrasound-guided superficial parasternal intercostal plane block (SPIP) in patients undergoing aortic valve replacement via full sternotomy. Method(s): This was a randomized, placebo-controlled trial performed in a tertiary referral hospital. Seventy-four elective patients scheduled for aortic valve replacement via full sternotomy were included. Patients were randomized to receive a preoperative SPIP block using either 40 mL of ropivacaine 7.5 mg/mL or 40 mL of 0.9% saline. Cumulative oxycodone consumption during the first 24 postoperative hours was recorded and analyzed as the primary outcome. Pain at rest was assessed using the numerical rating scale (NRS) scores 48 h postoperatively. Additional secondary outcomes included the need for vasopressors and antiemetics, recovery of bowel function, time spent in the intensive care unit (ICU), and nerve block-related complications. Result(s): The 24-h cumulative consumption was not significantly different between groups (93.8 mg +/- 33.3 vs. 109.4 mg +/- 37.9, p = 0.066). NRS pain scores at rest were reduced in the patients with SPIP at 4 (5.0 +/- 1.8 vs. 3.3 +/- 2.4, p = 0.002). No differences were found in additional secondary outcomes. Conclusion(s): In this randomized controlled trial a single-shot SPIP block did not reduce the 24-h cumulative opioid consumption after cardiac surgery. Editorial Comments: This trial in a cardiac surgical cohort tested for possible benefit of a single injection superficial parasternal intercostal plane block for post-operative analgesia for post-sternotomy pain. The study found no post-op opioid treatment reduction with the treatment, but some analgesia effect cannot be ruled out. Copyright © 2026 Acta Anaesthesiologica Scandinavica Foundation. <90> Accession Number 2045712229 Title CytoSorb haemoadsorption in high-risk cardiac surgery: A focused review with proposed tiered patient selection. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Ohri S.K. Institution (Ohri) Department of Cardiac Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom Publisher SAGE Publications Ltd Abstract Cardiopulmonary bypass (CPB) activates a well-characterised systemic inflammatory response that contributes substantially to postoperative morbidity and mortality, particularly in high-risk patient subgroups. CytoSorb (CytoSorbents Corporation, Princeton, NJ) is a polystyrene-divinylbenzene copolymer haemoadsorption device capable of removing hydrophobic molecules of up to 55 kDa, including pro-inflammatory cytokines, myoglobin, bilirubin, and direct oral anticoagulants (DOACs) from whole blood during CPB. Whilst aggregate meta-analyses have not demonstrated consistent benefit across unselected surgical populations, subgroup analyses and targeted clinical series consistently identify meaningful benefit in high-risk phenotypes: infective endocarditis (IE), complex aortic surgery under hypothermic circulatory arrest, heart transplantation, emergency surgery in patients on antiplatelet or anticoagulant therapy, and patients developing vasoplegia or septic shock. This focused narrative review critically appraises the current evidence base, examines the mechanistic rationale, and proposes a clinically applicable patient-selection framework to guide rational integration of CytoSorb into high-risk cardiac surgical practice. Regulatory considerations including the recent United States Food and Drug Administration (FDA) De Novo denial for the related DrugSorb-ATR device are discussed in context. Copyright © The Author(s) 2026 <91> Accession Number 2045735534 Title Microcirculatory effects of cardiopulmonary bypass primings in coronary artery bypass graft surgery the prime randomised clinical trial for a physiological proof-of-principle. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Beukers A.M.; Seegers J.C.; van Haasteren N.; Brouwers M.; Bosch R.J.; Tuip-de Boer A.M.; van den Brom C.E.; Eberl S.; Mansvelder F.J.; Kunst G.; van Meenen D.M.P.; Bulte C.S.E.; Loer S.A.; Vonk A. Institution (Beukers, Seegers, van Haasteren, Brouwers, van den Brom, Eberl, Mansvelder, van Meenen, Bulte, Loer) Department of Anaesthesiology, Amsterdam University Medical Centre, Amsterdam, Netherlands (Seegers, Tuip-de Boer, van den Brom, van Meenen) Department of Intensive Care Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands (Seegers, Vonk) Department of Cardiothoracic Surgery, Amsterdam University Medical Centre, Amsterdam, Netherlands (Bosch) Department of Clinical Perfusion, St. Antonius Hospital, Nieuwegein, Netherlands (Tuip-de Boer, van den Brom) Laboratory for Experimental Intensive Care and Anaesthesiology (LEICA), Amsterdam University Medical Centre, Amsterdam, Netherlands (Kunst) Department of Anaesthesiology, King's College Hospital, The United Kingdom, London Publisher SAGE Publications Ltd Abstract Objectives: Cardiopulmonary bypass (CPB) impairs endothelial function, causing oedema and disturbed microcirculatory perfusion, that contribute to organ dysfunction following cardiac surgery. We hypothesised that the composition of CPB prime fluids with either albumin or gelofusine preserves sublingual microcirculatory perfusion in patients undergoing coronary artery bypass graft surgery. Method(s): Thirty-four patients were subjected to CPB primed with 1500 ml of either albumin/ringers (n = 8, gelofusine/ringers (n = 11), or solely ringers plus retrograde autologous priming (RAP) (n = 15). All solutions included 100 ml of mannitol. The primary outcome was perfused vessel density (PVD) assessed after anaesthesia induction, aortic cross-clamping, weaning from CPB, upon intensive care unit (ICU) arrival and 24 h after ICU arrival. Result(s): CPB immediately impaired PVD across all groups, persisting until ICU arrival. The decrease in PVD was most profound with albumin/ringers (estimated mean difference between baseline and ICU arrival -7.56 [95% CI -11.53 to -3.59] mm.mm-2), compared to gelofusine/ringers (-4.10 [-7.53 to -0.67] mm.mm-2), and ringers/RAP (-3.77 [-6.64 to -0.90] mm.mm-2), without differences between groups (p = 0.41). In patients receiving gelofusine/ringers COP was preserved after aortic cross clamping. Concentration of inflammatory (interleukin-6) and endothelial damage markers (angiopoietin-2) were increased with albumin/ringers compared with gelofusine/ringers and ringers plus RAP. Conclusion(s): In this exploratory physiological study, all of the three CPB priming strategies, albumin/ringers, gelofusine/ringers or ringers plus RAP, similarly induced perioperative microcirculatory dysfunction in patients undergoing CABG surgery. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <92> Accession Number 2038150714 Title Improved Cardiac Function and Glycemic Control in Elderly Diabetic Patients Through Structured Case Management After CABG. Source Medical Science Monitor. 32 (no pagination), 2026. Article Number: e952109. Date of Publication: 2026. Author Zhai W.; Yu H.; Li Y.; Zhang L.; Li Q. Institution (Zhai, Yu, Li, Zhang, Li) Department of Cardiovascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China Publisher International Scientific Information, Inc. Abstract Background: Elderly patients with both coronary heart disease (CHD) and diabetes mellitus (DM) undergoing off-pump coronary artery bypass grafting (CABG) face high risks of perioperative glucose fluctuations and impaired recovery. We evaluated the impact of a structured, multidisciplinary case management model on cardiac function and glycemic control in this population. Material/Methods: This single-center, randomized controlled trial enrolled 168 elderly (365 years) patients with CHD and type 2 DM scheduled for off-pump CABG. Patients were randomized (1: 1) to a control group (CG, n=84; routine care) or an observation group (OG, n=84). The OG received routine care plus a 6-month multidisciplinary intervention including individualized cardiac rehabilitation, modified Mediterranean diet, psychological support, and intensified follow-up. The primary endpoint was 6-month left ventricular ejection fraction (LVEF); HbA1c was a key secondary endpoint. Result(s): All 168 randomized patients were analyzed. At 6 months, the observation group demonstrated significantly superior primary outcomes. LVEF was significantly higher in the OG (mean difference: 6.2%, P<0.001), and HbA1c was significantly lower (mean difference: 1.3%, P<0.001). The intervention group also showed significant improvements in secondary endpoints, including reduced left ventricular diameters (LVESD, LVEDD), an improved lipid profile (P<0.05), longer 6-minute walk test distance, and higher Diabetes-Specific Quality of Life (DSQL) and Activity of Daily Living (ADL) scores (P<0.0001). Conclusion(s): Structured, multidisciplinary case management significantly improved cardiac function, metabolic control, and functional capacity in elderly diabetic patients after off-pump CABG, validating its efficacy for this high-risk group. Copyright © Med Sci Monit, 2026; 32. <93> Accession Number 2045495810 Title Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial. Source European Urology. (no pagination), 2026. Date of Publication: 2026. Author Brassetti A.; Tuderti G.; Anceschi U.; Bove A.M.; Bologna E.; Capecchi L.; Chiacchio G.; D'annunzio S.; Ferriero M.; Flammia R.S.; Guaglianone S.; Iuculano S.; Denaro C.; Luzio A.D.; Leonardo C.; Licari L.C.; Mastroianni R.; Misuraca L.; Proietti F.; Sperduti I.; Simone G. Institution (Brassetti, Tuderti, Anceschi, Bove, Bologna, Capecchi, Chiacchio, D'annunzio, Ferriero, Flammia, Guaglianone, Iuculano, Denaro, Luzio, Leonardo, Licari, Mastroianni, Misuraca, Proietti, Simone) Uro-Oncology Program, IRCCS Regina Elena National Cancer Institute, Rome, Italy (Sperduti) Clinical Trial Center-Biostatistics & Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy Publisher Elsevier B.V. Abstract Background and objective The sutureless (SL) purely off-clamp robotic partial nephrectomy (ocRPN) technique has been proposed to minimize postoperative functional damage. We assessed whether this approach is noninferior to renorrhaphy (RR) in terms of surgical quality. Methods Patients with cT1-2N0M0 renal tumors were randomly assigned to SL or RR-ocRPN within a single-center, single-surgeon randomized controlled trial (NCT06846112). A covariate-adaptive 1:1 randomization algorithm ensured balance between treatment arms for age, sex, baseline renal function, and tumor surgical complexity. The primary endpoint was Trifecta achievement at discharge. A prespecified noninferiority test (margin -10%) compared Trifecta rates using one-sided testing and confidence intervals. Secondary outcomes were descriptively analyzed and compared between study arms. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. Key findings and limitations Among 248 patients, baseline characteristics were balanced. Trifecta was achieved in 93% and 95% of cases (absolute difference -2.4%; 90% confidence interval [CI] -7.4%-2.6%), meeting the criterion for noninferiority (one-sided p = 0.006). Blood transfusions (2.4% vs 0%) and acute kidney injury (1.6% in both groups) were rare. Nine urinary fistulae occurred overall, all managed with temporary stenting; rates were higher in the SL group but not statistically significant ( p = 0.08). Renal function remained stable up to 12 mo, and 1-yr RFS was 99% in all cohorts. Limitations include single-center design, surgeon expertise, and short oncologic follow-up. Conclusions and clinical implications SL-ocRPN is safe and effective and represents a feasible alternative to RR-ocRPN in selected cT1-2N0M0 renal tumors. Copyright © 2026 The Author(s). <94> Accession Number 651164058 Title Equity In Left Atrial Appendage Occlusion: Utilization and Outcomes by Race/Ethnicity and Sex - A Systematic Review and Meta-Analysis Of Real-World Data. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S30), 2026. Date of Publication: 01 Mar 2026. Author Wulandari P.; Sharma V.; Sharma S. Institution (Wulandari, Sharma, Sharma) The Guthrie Clinic, Robert Packer Hospital, Sayre, PA, United States Publisher Elsevier Inc. Abstract BACKGROUND Percutaneous left atrial appendage occlusion (LAAO) may be underused in women and racially/ethnically minoritized patients with atrial fibrillation (AF), and real-world outcomes by group remain uncertain. METHODS We searched major databases and U.S. registries/claims (NCDR LAAO Registry, National Inpatient Sample, Medicare) through November 2025 for adults with AF undergoing LAAO with outcomes reported by race/ethnicity and/or sex, comparing non-Hispanic White patients and men with other groups. Outcomes included LAAO utilization vs the AF population, in-hospital complications, 1-year mortality, stroke, major bleeding, and post-LAAO dual antiplatelet therapy (DAPT) vs direct oral anticoagulant (DOAC) use. RESULTS Across several million AF patients and >100,000 LAAO procedures, minoritized groups were underrepresented. Black patients had 55% lower odds of receiving LAAO than White patients (OR 0.45, 95% CI 0.40-0.50). Women (~40% of LAAO recipients) had more periprocedural complications and bleeding than men. Among LAAO recipients, Black patients had higher 1-year mortality (HR 1.26, 95% CI 1.06-1.50) and major bleeding (HR 1.36, 95% CI 1.15-1.60) with similar stroke risk vs White patients. DOAC-based post-LAAO regimens were used less often in Black patients. CONCLUSION Real-world data show sizable inequities in LAAO utilization and safety by race/ethnicity and sex. Equity-focused referral pathways and standardized DOAC-first post-LAAO strategies are needed to narrow these gaps.(Figure presented) <95> Accession Number 651164068 Title Cognitive Outcomes After Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S31), 2026. Date of Publication: 01 Mar 2026. Author Wulandari P.; Sharma V.; Sharma S. Institution (Wulandari, Sharma, Sharma) The Guthrie Clinic, Robert Packer Hospital, Sayre, PA, United States Publisher Elsevier Inc. Abstract BACKGROUND Atrial fibrillation (AF) is linked to dementia via clinical and silent brain injury. Whether left atrial appendage occlusion (LAAO) improves cognition versus oral anticoagulation (OAC) remains unclear. METHODS We searched major databases through February 2025 for studies reporting cognitive outcomes after percutaneous or surgical LAAO in adults with AF, compared with warfarin, direct oral anticoagulants (DOACs), or standard care. Outcomes were incident dementia or cognitive impairment, change in Montreal Cognitive Assessment (MoCA) or Mini-Mental State Examination (MMSE), and peri-procedural or follow-up silent cerebral emboli (SCE) on MRI. RESULTS Six observational studies (>4,800 patients; ~2,500 LAAO) met inclusion. In a TriNetX emulation, LAAO was associated with lower 3-year dementia risk than DOACs (HR 0.57, 95% CI 0.38-0.85). In a post-ablation cohort, 1-year MoCA declined on OAC but was preserved after LAAO (adjusted mean difference +3.4 points). Peri-procedural SCE after percutaneous LAAO was common (=5-55%), and one cohort linked SCE to ~5-point MMSE decline at 1 year. CONCLUSION Limited real-world data suggest LAAO may reduce dementia and attenuate cognitive decline compared with chronic OAC, yet percutaneous LAAO frequently causes SCE that appear cognitively harmful. Randomized trials with standardized neurocognitive testing and serial MRI are needed to define the net cognitive impact of LAAO.(Figure presented) <96> Accession Number 651164124 Title Impact Of Transcatheter Tricuspid Valve Replacement on Clinical Outcomes and Quality of Life in Patients with Severe Tricuspid Regurgitation: A Meta-Analysis of Randomized Controlled Trials. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S77), 2026. Date of Publication: 01 Mar 2026. Author Obi O.S.; Darkwah M.; Nweze U.; Asonye P.; Unegbe C.; Lajczak P. Institution (Obi, Darkwah) New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, United States (Nweze) Kaiser Permanente Fontana Medical Center, Fontana, CA, United States (Asonye) University of Illinois, Chicago College of Pharmacy, Chicago, IL, United States (Unegbe) University of Sunderland, Sunderland, United Kingdom (Lajczak) Medical University of Silesia, Katowice, Poland Publisher Elsevier Inc. Abstract BACKGROUND Severe tricuspid regurgitation (TR) is linked to debilitating symptoms and a heightened risk of mortality. Data regarding the impact of transcatheter tricuspid valve replacement (TTVR) on clinical outcomes and quality of life in patients with severe tricuspid regurgitation are limited. METHODS PubMed, Embase, and Cochrane Library were systematically searched for randomized controlled trials (RCTs) comparing the impact of TTVR to control in patients with severe TR, with the primary outcome of interest being all-cause mortality. We pooled risk ratio (RR) along with its 95% confidence interval. Heterogeneity was examined using I2 statistics and studies with high heterogeneity were examined using the random-effect model. RESULTS We included 3 randomized controlled trials consisting of 1264 patients of which 696 (55.1%) patients were treated with TTVR. The mean age of the included studies was 78.5% and 37.9% of the included studies were males. There were no significant differences between groups for the outcomes of all-cause mortality (RR = 1.12; 95% CI [0.77, 1.65]; I2 = 0%; p = 0.55; Figure 1), cardiovascular death (RR = 1.08; 95% CI [0.65, 1.77]; I2 = 11%; p = 0.78), hospitalization for heart failure (HHF) (RR = 0.94; 95% CI [0.66, 1.36]; I2 = 0%; p = 0.75) and permanent pacemaker implantation (PPM) (RR = 3.51; 95% CI [0.74, 16.72]; I2 = 76%; p = 0.12). However, TTVR significantly improved 6MWD (MD = 29.68; 95% CI [22.34, 37.01]; I2 = 97%; p < 0.00001), NYHA functional class (RR = 1.65; 95% CI [1.36, 2.01]; I2 = 72%; p < 0.00001) and KCCQ-OS (MD = 13.51; 95% CI [13.28, 13.74]; I2 = 0%; p < 0.00001). CONCLUSION TTVR did not reduce all-cause mortality, cardiovascular death, HHF and PPM in patients with severe TR. However, TTVR significantly improved 6MWD, NYHA functional class and KCCQ-OS. (Figure Presented) <97> Accession Number 651163991 Title Redo-TAVR Versus Surgical Explantation After Failed Transcatheter Aortic Valve Replacement: A Pooled Analysis. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S64-S65), 2026. Date of Publication: 01 Mar 2026. Author Magouliotis D.; Sicouri S.; Baudo M.; Xanthopoulos A.; Androutsopoulou V.; Ramlawi B. Institution (Magouliotis, Sicouri, Baudo) Lankenau Institute for Medical Research, Wynnewood, PA, United States (Xanthopoulos, Androutsopoulou) University of Thessaly, Larissa, Greece (Ramlawi) Lankenau Medical Center, Wynnewood, PA, United States Publisher Elsevier Inc. Abstract BACKGROUND As transcatheter aortic valve replacement (TAVR) expands to younger and lower-risk patients, transcatheter heart valve (THV) failure requiring reintervention is increasingly encountered. Redo-TAVR (TAVR-in-TAVR) and surgical explantation with surgical aortic valve replacement (SAVR) are the two main strategies, yet comparative outcome data remain limited. Although registry reports suggest higher early mortality with explantation, a consolidated synthesis is lacking. This study compares early and mid-term outcomes of redo-TAVR versus surgical explantation after failed TAVR. METHODS A systematic search of PubMed, Embase, Scopus, and Cochrane databases (2010-2025) was conducted following PRISMA guidelines. Primary endpoints were 30-day and 1-year mortality; secondary endpoints included stroke, conduction disturbances, and major adverse cardiac events (MACE). Random-effects meta-analyses (DerSimonian-Laird) generated odds ratios (OR) and 95% confidence intervals (CI). RESULTS Four studies met inclusion criteria; three provided extractable comparative outcomes (474 patients total; 263 redo-TAVR, 211 explant). Structural valve degeneration (58%) and para-valvular leak (31%) were the predominant mechanisms of failure, followed by malposition and thrombosis; active endocarditis accounted for a minority of cases and was primarily treated with explantation. Redo-TAVR was associated with significantly lower 30-day mortality (OR 4.88; 95% CI 2.01-11.85) and 1-year mortality (OR 1.93; 95% CI 1.13-3.27), indicating higher mortality with surgical explantation. In-hospital mortality also favored redo-TAVR (OR 4.24; 95% CI 1.80-9.97). There were no significant differences in 30-day stroke (OR 1.92; 95% CI 0.09-39.06), 1-year stroke (OR 0.99; 95% CI 0.17-5.95), or permanent pacemaker implantation (OR 1.59; 95% CI 0.84-2.99). Thirty-day MACE was higher with explantation (OR 14.51; 95% CI 1.60-131.67), with no difference at 1 year. Qualitative findings highlighted increasing national utilization of both strategies and reinforced the central role of anatomical feasibility, especially coronary obstruction risk and aortic root involvement, in determining treatment selection. C O N C L U S I O N Redo-TAVR is associated with significantly lower early and mid-term mortality versus surgical explantation after failed TAVR, without increased neurological or conduction complications. Redo-TAVR should be preferred when anatomically feasible. <98> Accession Number 651164175 Title Sex-based Differences in Long-term Outcomes Following TAVR Versus SAVR In Patients With Symptomatic Severe Aortic Stenosis. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S61-S62), 2026. Date of Publication: 01 Mar 2026. Author Cilingiroglu M.; Marmagkiolis K.; Iliescu C. Institution (Cilingiroglu) UT Houston MD Anderson Cancer Center, San Diego, CA, United States (Marmagkiolis, Iliescu) UT Houston MD Anderson Cancer Center, Houston, TX, United States Publisher Elsevier Inc. Abstract BACKGROUND Women with severe aortic stenosis (AS) differ anatomically and physiologically from men, yet are often underrepresented in valve trials. Understanding sex-specific outcomes following transcatheter versus surgical valve replacement is critical for personalized care. Our study objective was to compare long-term outcomes of TAVR versus SAVR in men and women with symptomatic severe AS. METHODS Pooled analysis of 13,247 patients (7,020 TAVR and 6,227 SAVR) from four multicenter registries and three randomized controlled trials, stratified by sex and intervention. Primary endpoint was 5-year all-cause mortality. Secondary endpoints included stroke, rehospitalization, prosthesis durability, and major bleeding. RESULTS At 5-year follow-up, women undergoing TAVR had significantly lower mortality (21.4% vs. 25.7%, HR: 0.84, p<0.001) and stroke (3.9% vs. 5.5%, HR: 0.71, p=0.001) compared to women undergoing SAVR. They also had substantially reduced major bleeding (10.7% vs. 18.4%, HR: 0.55, p<0.001). In contrast, men experienced slightly worse mortality with TAVR compared to SAVR (26.3% vs. 24.1%, HR: 1.09, p=0.03), though stroke rates were similar. Major bleeding was still significantly reduced in men after TAVR (HR: 0.71, p<0.001), but no significant difference was observed in rehospitalization or valve durability between sexes. CONCLUSION TAVR offers superior long-term outcomes for women with symptomatic severe AS, particularly in reducing mortality, stroke, and bleeding events. In men, TAVR shows increased bleeding benefit but slightly higher long-term mortality compared to SAVR. These findings support sex-specific clinical decision-making in valve replacement strategy, particularly favoring TAVR in appropriately selected women.(Table Presented) <99> Accession Number 2045464374 Title The Prognostic Value of Exercise Stress Echocardiography in Asymptomatic Moderate and Severe Aortic Stenosis: A Systematic Review of Stress-Derived Hemodynamic and Functional Markers. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3247. Date of Publication: 01 May 2026. Author Sonaglioni A.; Lombardo M.; Gramaglia G.F.; Nicolosi G.L.; Baravelli M. Institution (Sonaglioni, Lombardo, Baravelli) Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico, MultiMedica, Milan, Italy (Gramaglia) Department of Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (Nicolosi) Division of Cardiology, Policlinico San Giorgio, Pordenone, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Risk stratification of patients with asymptomatic aortic stenosis (AS) remains challenging, as symptom-based assessment may underestimate disease severity. Exercise stress echocardiography (ESE) provides a comprehensive evaluation of valvular, ventricular, and cardiopulmonary responses under physiological stress and may improve prognostic assessment. Method(s): A systematic review was conducted according to PRISMA guidelines to evaluate the prognostic value of ESE in asymptomatic moderate and severe AS. Electronic databases (PubMed, Scopus, and EMBASE) were searched from inception to March 2026. Studies were included if they assessed adult patients with asymptomatic moderate or severe AS undergoing exercise-based stress echocardiography and reported clinical outcomes. Studies using exclusively pharmacological stress or lacking outcome data were excluded. Data were extracted and synthesized qualitatively. Continuous variables were summarized as weighted medians and interquartile ranges. Result(s): A total of 11 studies were included, encompassing a heterogeneous population of patients with moderate-to-severe and severe AS. During follow-up, a substantial proportion of patients experienced adverse events, including symptom onset, aortic valve replacement, or death. Across studies, exercise-derived parameters consistently showed strong prognostic value. In particular, exercise-induced increases in mean transvalvular gradient, an elevated E/e' ratio, the development of pulmonary hypertension, and reduced functional capacity emerged as the most reproducible predictors of adverse outcomes. Notably, thresholds such as an increase in mean transvalvular gradient >= 18-20 mmHg, peak exercise E/e' >= 15, and systolic pulmonary artery pressure >= 60 mmHg were consistently associated with a higher risk across multiple studies. Myocardial deformation parameters and biomarkers such as exercise-induced BNP further contributed to risk stratification in selected studies. In contrast, resting parameters alone were less consistently predictive. Conclusion(s): ESE provides incremental prognostic information in asymptomatic moderate and severe AS by unmasking subclinical hemodynamic and myocardial abnormalities. The integration of stress-derived parameters, including reproducible threshold values, into clinical assessment may improve risk stratification and support more individualized management strategies. Further studies are needed to validate these cut-offs and define their role in guiding clinical decision-making. Copyright © 2026 by the authors. <100> Accession Number 651164062 Title Left Atrial Appendage Occlusion in Atrial Fibrillation Patients with Advanced Chronic Kidney Disease and Prior Intracranial Hemorrhage: A Systematic Review and Meta-Analysis. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S30-S31), 2026. Date of Publication: 01 Mar 2026. Author Wulandari P.; Sharma V.; Sharma S. Institution (Wulandari, Sharma, Sharma) The Guthrie Clinic, Robert Packer Hospital, Sayre, PA, United States Publisher Elsevier Inc. Abstract BACKGROUND Atrial fibrillation (AF) with advanced chronic kidney disease (CKD) (eGFR <30 or dialysis) and prior intracranial hemorrhage (ICH) combines extreme stroke and bleeding risk and often precludes oral anticoagulation; left atrial appendage occlusion (LAAO) is used in CKD or ICH, but data in this dual-risk phenotype are limited. METHODS We searched major databases and trial registries through 21 November 2025 for studies of percutaneous or surgical LAAO in adults with AF and advanced CKD and/or prior ICH. RESULTS Of 1,379 records, 13 studies met criteria: 1 CKD registry (n=186), 2 dialysis cohorts (n=399 LAAO; n=2,165 comparators) and 10 prior-ICH cohorts/reviews (n=1,000). No study reported outcomes for patients with both, though in the CKD registry 12/186 (6.5%) had prior intracranial bleeding and 30/186 (16.1%) CKD IV-V. In dialysis cohorts LAAO reduced major/recurrent bleeding (pooled HR 0.69, 95% CI 0.53-0.90) and mortality (pooled HR 0.53, 95% CI 0.39-0.72). One multicenter study gave HR 0.19 vs warfarin and 0.16 vs no OAC for stroke/systemic embolism; a US registry gave HR 1.18 (95% CI 0.76-1.81). A 2020 review of 727 post-ICH LAAO patients found recurrent ICH 1.5%, ischemic stroke 1.6%, device thrombus 1.3% and mortality 3.6% over 3 months-3.6 years. CONCLUSION LAAO in AF with advanced CKD/dialysis or prior ICH appears to lower bleeding and mortality with acceptable stroke rates, but no study isolates patients with both; dedicated registries and individual-patient-data meta-analyses are needed to define net benefit.(Figure presented) <101> Accession Number 651165283 Title Left Atrial Appendage closure in patients with non-valvular atrial fibrillation and end stage chronic KIDNEY disease: Rationale and design of the prospective randomized LAA-KIDNEY trial. Source American heart journal. (pp 107474), 2026. Date of Publication: 08 May 2026. Author Saraei R.; Heine G.; Osmancik P.; Schewel J.; Sandri M.; Landmesser U.; Schwenger V.; Latus J.; Bekeredjian R.; Chun J.; Haeusler K.G.; Paitazoglou C.; Sigusch H.; Thiele H.; Skurk C.; Rychlik I.; Schmidt B.; Stiermaier T.; Schneider S.; Eitel I. Institution (Saraei, Paitazoglou, Stiermaier, Eitel) University Heart Center Lubeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lubeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lubeck, Lubeck, Germany (Heine) Saarland University Medical Center, Internal Medicine IV, Department of Nephrology and Hypertension, Homburg, Germany.; Agaplesion Markus Hospital, Medical Clinic II, Department of Nephrology and Hypertension, Frankfurt am Main, Germany (Osmancik) Department of Cardiology, Charles University of Prague, Czechia, Prague, United States (Schewel) Department of Cardiology, Marienkrankenhaus Hamburg, Hamburg, Germany (Sandri, Thiele) Heart Center Leipzig - University Hospital, Department of Internal Medicine/Cardiology, Leipzig, Germany (Landmesser, Skurk) Department of Cardiology, Charite-University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany; German Center for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany (Schwenger) Department of Nephrology, Klinikum Stuttgart, Stuttgart, Germany (Latus) Department of Internal Medicine and Nephrology, Robert-Bosch-Krankenhaus, Stuttgart, Germany (Bekeredjian) Department of Cardiology and Angiology, Robert Bosch Hospital, Bosch Health Campus, Stuttgart, Germany (Chun, Schmidt) Cardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany (Haeusler) Department of Neurology, Universitatsklinikum Ulm, Ulm, Germany (Sigusch) Department of Cardiology, Zwickau, Germany (Rychlik) 1st Department of Internal Medicine, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, Prague, Czechia (Schneider) Institut fur Herzinfarktforschung, Ludwigshafen, Germany Abstract BACKGROUND: Patients with atrial fibrillation (AF) and kidney failure are at particularly high risk of both thromboembolic and bleeding complications. The safety and efficacy of oral anticoagulation in this population remain uncertain, as pivotal direct oral anticoagulant (DOAC) trials excluded patients with kidney failure and warfarin has been associated with excess bleeding risk. Left atrial appendage (LAA) closure may provide an alternative strategy in stroke prevention, but has not been tested in randomized trials in dialysis-dependent patients. METHODS/DESIGN: The LAA-KIDNEY trial is a prospective, multicenter, randomized controlled clinical trial comparing percutaneous LAA closure with best medical care (including DOAC therapy whenever considered feasable) in patients with non-valvular AF and kidney failure at high risk of both, ischemic stroke and bleeding. A total of 272 patients will be randomized 1:1 across ~35 centers in Germany and the Czech Republic. The primary efficacy endpoint is net clinical benefit defined as time to a composite of first stroke (including ischemic or hemorrhagic strokes), systemic embolism, cardiovascular or unexplained death or major bleeding (BARC 3-5). Secondary endpoints include individual components of the composite outcome, myocardial infarction, cardiovascular hospitalization, cognitive function, quality of life, and device-related complications. Analysis will be performed in the intention-to-treat population. CONCLUSION(S): LAA-KIDNEY is the first randomized trial to evaluate LAA closure versus best medical care in AF patients with kidney failure. This trial will address a major evidence gap and is expected to inform clinical practice and guideline recommendations for stroke prevention in this high risk population. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT05204212. Copyright © 2026. Published by Elsevier Inc. <102> Accession Number 651164135 Title Transcatheter Edge-to-Edge Repair Vs Medical Therapy in Secondary Mitral Regurgitation: A Focused Meta-Analysis of COAPT-Like Populations. Source JACC: Cardiovascular Interventions. Conference: Cardiovascular Research Technologies, CRT 2026. Washington United States. 19(5 Supplement) (pp S57), 2026. Date of Publication: 01 Mar 2026. Author Ginghina E.R.; Failla Mulone M. Institution (Ginghina, Failla Mulone) Sapienza University of Rome, Latina, Italy Publisher Elsevier Inc. Abstract BACKGROUND The benefit of transcatheter edge-to-edge mitral valve repair (TEER) in secondary mitral regurgitation (SMR) remains debated after conflicting evidence from randomized trials. While the COAPT trial demonstrated a significant reduction in mortality and heart failure (HF) hospitalizations with TEER plus guideline-directed medical therapy (GDMT), the MITRA-FR trial failed to confirm these results. We aimed to perform a focused meta-analysis to clarify whether the benefit of TEER is driven by specific "COAPT-like" anatomical and clinical profiles. METHODS A systematic review and quantitative synthesis were performed including randomized and prospective controlled studies comparing TEER versus optimal medical therapy (OMT) in patients with SMR and HF (COAPT, MITRA-FR, MITRA-CRT). The primary endpoint was the composite of all-cause death or HF hospitalization. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model (REML). Meta-regression analyses explored the impact of "COAPT-like" or disproportionate MR profiles on treatment effect. RESULTS A total of 917 patients were included (478 TEER vs 487 OMT). TEER reduced the composite endpoint versus OMT (RR 0.75, 95% CI 0.49-1.15), with substantial heterogeneity (I2=88.7%). Inclusion of smaller prospective trials (MITRA-CRT) yielded consistent results (RR 0.80, 95% CI 0.61-1.04; I2=81.0%). Meta-regression showed that a COAPT-like profile-characterized by disproportionate MR relative to LV dilation-accounted for 85% of total heterogeneity (p=0.01). In COAPT-like populations, TEER reduced adverse events by approximately 38% compared with OMT alone. CONCLUSION TEER confers significant clinical benefit primarily in patients with COAPT-like, disproportionate secondary MR, whereas outcomes are neutral in patients with proportionate MR and larger ventricles. Identifying the anatomical and functional MR-LV relationship is key to patient selection and may explain divergent results among TEER trials. <103> [Use Link to view the full text] Accession Number 2045462967 Title 138: RENAL PROTECTION WITH AMINO ACID INFUSION AFTER CARDIAC SURGERY: REVIEW AND META-ANALYSIS OF RCTS. Source Critical Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Jena A.; Singh A.; Merchant K.; Antar M.; Rodriguez Ferreira E.; Navarrete Rios A.; Banker H.; Sarangi S.; Hamza Shah S.; Kumar U.; Ghosh S. Institution (Jena, Singh, Ghosh) WorcesterMAUnited States (Merchant) Mayo Clinic, Jacksonville, United States (Antar, Rodriguez Ferreira, Navarrete Rios, Hamza Shah) Ascension St. Joseph, United States (Banker) Tuscon Medical Center, United States (Sarangi) UIC-Peoria, United States (Kumar) Aga Khan University, Pakistan Publisher Lippincott Williams and Wilkins <104> Accession Number 651160420 Title Improved Cardiac Function and Glycemic Control in Elderly Diabetic Patients Through Structured Case Management After CABG. Source Medical science monitor : international medical journal of experimental and clinical research. 32 (pp e952109), 2026. Date of Publication: 11 May 2026. Author Zhai W.; Yu H.; Li Y.; Zhang L.; Li Q. Institution (Zhai, Yu, Li, Zhang, Li) Department of Cardiovascular Surgery, Second Hospital of Tianjin Medical University, Tianjin, China Abstract BACKGROUND Elderly patients with both coronary heart disease (CHD) and diabetes mellitus (DM) undergoing off-pump coronary artery bypass grafting (CABG) face high risks of perioperative glucose fluctuations and impaired recovery. We evaluated the impact of a structured, multidisciplinary case management model on cardiac function and glycemic control in this population. MATERIAL AND METHODS This single-center, randomized controlled trial enrolled 168 elderly (>=65 years) patients with CHD and type 2 DM scheduled for off-pump CABG. Patients were randomized (1: 1) to a control group (CG, n=84; routine care) or an observation group (OG, n=84). The OG received routine care plus a 6-month multidisciplinary intervention including individualized cardiac rehabilitation, modified Mediterranean diet, psychological support, and intensified follow-up. The primary endpoint was 6-month left ventricular ejection fraction (LVEF); HbA1c was a key secondary endpoint. RESULTS All 168 randomized patients were analyzed. At 6 months, the observation group demonstrated significantly superior primary outcomes. LVEF was significantly higher in the OG (mean difference: 6.2%, P<0.001), and HbA1c was significantly lower (mean difference: 1.3%, P<0.001). The intervention group also showed significant improvements in secondary endpoints, including reduced left ventricular diameters (LVESD, LVEDD), an improved lipid profile (P<0.05), longer 6-minute walk test distance, and higher Diabetes-Specific Quality of Life (DSQL) and Activity of Daily Living (ADL) scores (P<0.0001). CONCLUSIONS Structured, multidisciplinary case management significantly improved cardiac function, metabolic control, and functional capacity in elderly diabetic patients after off-pump CABG, validating its efficacy for this high-risk group. <105> Accession Number 2045655104 Title Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial. Source BMJ. 393 (no pagination), 2026. Date of Publication: 31 Mar 2026. Author Yuan X.; Li J.; Lei L.; Chen K.; Chu Q.; Feng W.; Xu F.; Yang Y.; Wang X.; Wang H.; Dong A.; Cheng Z.; Guo H.; Zhou T.; Chen X.; Ge J.; Zhang L.; Liu S.; Shen Z.; Wang J.; Wang Y.; Li W.; Hu S. Institution (Yuan, Chen, Chu, Feng, Wang, Wang, Xu, Liu, Yang, Hu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Li, Lei, Zhang, Li, Hu) National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Wang) Yunnan Fuwai Cardiovascular Hospital, Yunnan Province, Kunming City, China (Wang) General Hospital of Northern Theatre Command, Liaoning Province, Shenyang City, China (Dong) The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China (Cheng) Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou City, China (Guo) Guangdong Provincial People's Hospital, Guangdong Province, Guangzhou City, China (Zhou) Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, Wuhan, China (Chen) Nanjing First Hospital, Nanjing Medical University, Jiangsu Province, Nanjing City, China (Ge) The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Anhui Province, Hefei City, China (Zhang) Anhui Provincial Chest Hospital, Anhui Province, Hefei City, China (Liu) The Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang City, China (Shen) The First Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou City, China (Wang) The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou City, China (Wang, Li) Medical Research and Biometrics Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China Publisher BMJ Publishing Group Abstract Objectives: To evaluate the efficacy of dual antiplatelet therapy (DAPT) for three months versus 12 months in saphenous vein graft occlusion while reducing bleeding risk. Design(s): Multicentre, non-inferiority, double blind, randomised controlled trial. Setting(s): 13 cardiac surgery centres in China, with enrolment between February 2023 and July 2024. Participant(s): 2300 participants aged 18 to 80 years who underwent elective primary coronary artery bypass grafting with >=1 saphenous vein graft. Intervention(s): Participants were randomly assigned (1:1) to receive DAPT (ticagrelor 90 mg twice daily plus aspirin 100 mg once daily) for 12 months or the same dual antiplatelet regimen for the first three months, followed by placebo plus aspirin for nine months. Main Outcome Measure(s): The primary outcomes were saphenous vein graft occlusion at one year (non-inferiority) and Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding (superiority). Secondary outcomes were major adverse cardiovascular events (MACCE), saphenous vein graft failure, venous or arterial graft stenosis, and venous or arterial graft occlusion. Result(s): 2290 patients (mean age 61.5 (standard deviation (SD) 8.4) years, 20.6% (n=472) women) were included in the modified intention-to-treat set. The mean number of saphenous vein graft segments was 2.5 (SD 0.8). 2070 patients (90.4%) with a total of 5125 saphenous vein graft segments were assessed at one year. Saphenous vein graft occlusion occurred in 280 of 2596 (10.8%) in the three month DAPT group and 283 of 2529 (11.2%) in the 12 month DAPT group (absolute difference -0.31%, 95% confidence interval (CI) -3.13% to 2.52%; P=0.008 for non-inferiority). During a median follow-up of 368 (interquartile range 358-382) days, BARC type 2, 3, or 5 bleeding occurred in 95 patients (8.3%) in the three month DAPT group and 149 patients (13.2%) in the 12 month DAPT group (absolute difference -4.67%, 95% CI -7.18% to -2.16%; P<0.001). The number needed to treat to prevent one bleeding event was 21 (95% CI 13 to 46). MACCE occurred in 26 (2.3%) patients in the three month DAPT group and 27 (2.7%) in the 12 month DAPT group (absolute difference -0.11%, 95% CI -1.48% to 1.26%). The findings for other secondary outcomes were also similar between the two groups. Conclusion(s): A three month DAPT strategy was non-inferior to the 12 month DAPT strategy in saphenous vein graft occlusion and was superior in reducing bleeding risk. Trial registration: ClinicalTrials.gov NCT05380063. Copyright © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. <106> Accession Number 2045634068 Title What factors are associated with work after cardiothoracic transplant? A systematic review. Source Transplantation Reviews. 40(3) (no pagination), 2026. Article Number: 101025. Date of Publication: 01 Jul 2026. Author Tomic D.; Khillan A.; Hopper I.; Mobarki Y.; O'Dwyer M.; MacFarlane E.; Paraskeva M.; Patel H.; Walker-Bone K.; Keegel T. Institution (Tomic, Mobarki, O'Dwyer, MacFarlane, Walker-Bone, Keegel) Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Khillan) Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, VIC, Australia (Hopper, Patel) Cardiology Department and General Medical Unit, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Hopper) School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Paraskeva) Department of Respiratory Medicine, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Paraskeva) Medicine Alfred Hospital, Monash University, Melbourne, VIC, Australia (Patel) Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, VIC, Australia (Keegel) Heart and Lung Transplant Trust, PO Box 25036, Melbourne, VIC, Australia Publisher Elsevier Inc. Abstract Cardiothoracic transplantation is a lifesaving intervention for end-stage cardiopulmonary disease, however true recovery requires comprehensive social reintegration, including the opportunity for work participation. This systematic review (PROSPERO CRD42025634363) reports rates of work and characterises factors associated with working post-cardiothoracic transplant. Research questions were informed through consultation with the cardiothoracic transplant community and guided by a work and health perspective. Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, Web of Science, PsycINFO) were searched for studies published 2000-2024. Quantitative and mixed-methods studies reporting post-transplant work outcomes were included. Screening, data extraction, and risk of bias assessment were conducted independently by two reviewers, with discrepancies resolved by consensus. Thirty-five manuscripts, representing 32 unique studies and 23,511 cardiothoracic transplant recipients (12,062 heart; 11,400 lung; 49 heart and lung), were included. Post-transplant employment rates at one year were 22-44% for heart and 28% for lung transplant recipients. At five years, 29.4-30% heart and 48% lung transplant recipients were employed. Return-to-work rates varied widely (heart 28-88%; lung 18-83%), with median time to return ranging from 5 to >31 months. Factors associated with higher work participation included pre-transplant employment, younger age, higher education, and male sex. Lower participation was associated with post-transplant complications, fatigue, and depression. Other work-related outcomes including work ability, absenteeism, and employer support were inconsistently reported. Methodological limitations were common, particularly reliance on self-reported, unvalidated work outcome measures and heterogeneous follow-up time points. Addressing modifiable determinants through targeted interventions is critical to improving work participation among cardiothoracic transplant recipients. Copyright © 2024 <107> Accession Number 2045345630 Title From Caging to Uncaging With Bioadaptors: A Novel Paradigm in Coronary Revascularization. Source Journal of the American Heart Association. 15(8) (no pagination), 2026. Article Number: e041843. Date of Publication: 09 Apr 2026. Author Mazzone P.M.; Spagnolo M.; Finocchiaro S.; Mauro M.S.; Leo G.D.; Capodanno D. Institution (Mazzone, Spagnolo, Finocchiaro, Mauro, Leo, Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria "G. Rodolico - San Marco", Via Santa Sofia, Catania, Italy Publisher American Heart Association Inc. Abstract The evolution of percutaneous coronary intervention has improved the outcomes of patients with coronary artery disease, but conventional drug-eluting stents remain limited by late adverse events, reduced vessel compliance, and the inability to restore physiological function. The DynamX coronary bioadaptor aims to address these issues by combining the mechanical performance of drug-eluting stents with a bioadaptive mechanism that restores natural vessel motion. The device features a cobalt-chromium scaffold connected by bioresorbable polymer elements that degrade 6 months after implantation. This process unlocks helical strands, enabling vessel pulsatility, compliance, and adaptive remodeling while maintaining lumen integrity. Preclinical studies demonstrated reduced vessel stress and restored physiological rotational motion. In the DYNAMIX (12-Month Clinical and Imaging Outcomes of the Uncaging Coronary DynamX Bioadaptor System) study, patients exhibited increased vessel area without lumen loss, optimal strut apposition, and complete neointimal coverage at 12 months. The small BIOADAPTOR-RCT (Randomized Controlled Trial of Sirolimus-Eluting Bioadaptor Versus Zotarolimus-Eluting DrugEluting Stent) showed noninferiority to drug-eluting stents with superior late lumen preservation and reduced neointimal hyperplasia. The larger INFINITY-SWEDEHEART (Percutaneous Coronary Intervention With a Bioadaptor Compared to a Contemporary Drug-Eluting Stent) trial confirmed low target-l esion failure rates and a plateauing of adverse events after 6 months, highlighting the benefits of vessel motion restoration. The DynamX coronary bioadaptor may represent a significant advancement in percutaneous coronary intervention by providing early mechanical support and restoring vessel function. Further studies on complex anatomy and long-term outcomes are needed to further define its role in interventional cardiology. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. <108> Accession Number 2045675540 Title Impact of Prosthesis-Patient Mismatch After Surgical Mitral Valve Replacement: Systematic Review and Meta-Analysis. Source American Journal of Cardiology. 270 (pp 88-96), 2026. Date of Publication: 01 Jul 2026. Author Jacquemyn X.; Ganduboina R.; Sa M.P.; Serna-Gallegos D.; Hasan I.; Ogami T.; Bonatti J.; Sultan I. Institution (Jacquemyn, Serna-Gallegos, Hasan, Ogami, Bonatti, Sultan) UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Jacquemyn, Serna-Gallegos, Hasan, Ogami, Bonatti, Sultan) Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United States (Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (Ganduboina) Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Sa) Cleveland Clinic Florida, Florida, Weston Publisher Elsevier Inc. Abstract The long-term clinical impact of mitral prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) remains incompletely defined. We aimed to systematically assess the prevalence of mitral PPM and its association with long-term mortality, cardiac death, and heart failure-related hospitalizations. We conducted a systematic review and meta-analysis of observational studies reporting Kaplan-Meier time-to-event data in patients with and without mitral PPM. Sixteen studies, including 10,872 patients, were analyzed. The pooled prevalence of any mitral PPM was 43% (95% confidence interval [CI], 29% to 59%), with significant heterogeneity (I2 = 100%). All-cause mortality was higher with PPM (hazard ratio [HR], 1.32; 95% CI, 1.20 to 1.45; p < 0.001; RMST difference, -3.35 years; 95% CI, -3.98 to -2.71; p < 0.001), as was cardiac mortality (HR, 1.96; 95% CI, 1.54 to 2.51; p < 0.001) and risk of heart failure hospitalization (HR, 2.82; 95% CI, 1.86 to 4.29; p < 0.001). Risk-adjusted analyses confirmed these associations for all-cause and cardiac mortality. Severity-stratified analyses demonstrated a gradient effect: moderate PPM showed a trend toward higher mortality (HR, 1.12; 95% CI, 0.98 to 1.27; p = 0.08), whereas severe PPM significantly increased mortality risk (HR, 1.36; 95% CI, 1.15 to 1.60; p < 0.001). Sensitivity analyses according to PPM quantification method (in vivo vs Doppler) and leave-one-out testing confirmed the robustness of the results. In conclusion, mitral PPM is common and independently associated with increased long-term all-cause mortality, cardiac death, and heart failure hospitalizations after MVR, with a dose-response relationship according to PPM severity. These findings highlight the importance of preventive strategies to avoid PPM when planning MVR. Copyright © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <109> Accession Number 651138926 Title AI-enabled digital wound monitoring after cardiac surgery: a randomised controlled feasibility, safety and acceptability trial. Source The Journal of hospital infection. (no pagination), 2026. Date of Publication: 04 May 2026. Author Rochon M.; Tanner J.; Cariaga K.; Jurkiewicz J.; Beckhelling J.; Harris R.; Wilson K.; Dhoonmoon L.; Bolton S.; Davis D.; Bouttell J.; Shipolini M.A.; Magboo R.; Oezalp F.; Chester V. Institution (Rochon, Cariaga) Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Tanner) University of Nottingham, Nottingham, United Kingdom (Jurkiewicz) LondonUnited Kingdom (Beckhelling) Derby Clinical Trials Support Unit, Derby, United Kingdom (Harris) Advisor in Translational Research, NIHR Research Support Service (RSS) Hub delivered by the University of Leicester and Partners, Nottingham, United Kingdom (Wilson) Patient and Public Involvement Lead, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom (Dhoonmoon) London North West University Healthcare, London, United Kingdom (Bolton) Centre for Healthcare Equipment and Technology Adoption (CHEATA), Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom (Davis) Health Economist, Centre for Healthcare Equipment and Technology Adoption (CHEATA), Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom (Bouttell, Chester) Derby Clinical Trials Support Unit, Derby, United Kingdom (Shipolini) Consultant Cardiothoracic Surgeon, Barts Health NHS Trust, London, United Kingdom (Magboo) Matron for Intensive Care Unit, Barts Health NHS Trust, London, United Kingdom (Oezalp) Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom Abstract BACKGROUND: Surgical site infection after cardiac surgery is a common cause of morbidity and unplanned healthcare use, with most infections developing after hospital discharge. Remote wound monitoring using smartphone technology and artificial intelligence (AI) may support earlier identification of complications. AIM: To evaluate the feasibility, acceptability, and safety of an AI-enabled digital wound monitoring platform plus usual care (Isla-AI) compared with usual care (UC) alone. DESIGN, SETTING, AND PARTICIPANTS: This multi-centre, two-arm randomised controlled feasibility trial was conducted at two UK hospitals between August 2024 and January 2025. Adults undergoing cardiac surgery were randomised to receive Isla-AI or UC. The study was not powered to assess effectiveness. RESULT(S): 120 patients were randomised and participated (Isla-AI n=62; UC n=58). Feasibility targets were exceeded: 60% of eligible patients approached consented, 95% of Isla-AI participants submitted at least one image, and 92% completed the study. 98% of images were suitable for clinical assessment. Clinician agreement with AI priority flags was 87%. AI prioritisation performance was slightly better for patients with darker skin tones. More than half of participants required assistance to capture or submit wound images. Patient and staff acceptability of AI was largely favourable. Adverse and serious adverse event rates were similar across both groups. The proportion of patients accessing NHS resources for wound-related problems and antibiotics was lower in the Isla-AI group. CONCLUSION(S): These findings support progression to a large, definitive multi-centre effectiveness trial, with further attention to equity, usability, and workflow integration. TRIAL REGISTRATION: IRAS 338141; local project UHDB/2022/024. ISRCTN16900119 CLINICALTRIALS.GOV: NCT06475703 Date registered: 20/06/2024. Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved. <110> Accession Number 651144144 Title Transcatheter Tricuspid Valve Intervention Versus Optimal Medical Therapy in Symptomatic Tricuspid Regurgitation: A Systematic Review and Meta-Analysis of Randomized and Observational Studies. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 06 May 2026. Author Banga A.; Bansal V.; Rathore S.S.; Yadav A.; Jain H.; Misra S.; Agrawal A.; Ganatra S.; Yadav K.; Deedwania P.; Dhingra R.; Goldsweig A.M.; Dani S.S. Institution (Banga) Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States (Bansal) Department of Research, WellSpan Hospital, York, PA, United States (Rathore) Department of Medicine, Ascension Columbia St. Mary's Hospital, Milwaukee, WI, United States (Yadav) Department of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA (Jain) Department of Medicine, All India Institute of Medical Science, Jodhpur, India (Misra) Department of Surgery, University of Texas Southwestern Medical Center, San Antonio, TX, United States (Agrawal, Yadav) Department of Cardiovascular Medicine, University of Arkansas, Little Rock, AR, United States (Ganatra, Dani) Division of Cardiovascular Medicine, Lahey Hospital & Medical Center, Burlington, MA, United States (Deedwania) Department of Cardiovascular Medicine, University of California San Francisco, Fresno, CA, United States (Dhingra) Division of Cardiovascular Medicine, Medical College Wisconsin, Milwaukee, WI, United States (Goldsweig) Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, United States Abstract BACKGROUND: Severe symptomatic tricuspid regurgitation (TR) is associated with a poor prognosis, and many patients are ineligible for surgical intervention. Transcatheter tricuspid valve intervention (TTVI) has emerged as a less invasive alternative, but its impact on clinical outcomes compared with optimal medical therapy (OMT) remains uncertain. METHOD(S): We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies comparing TTVI (transcatheter edge-to-edge repair or valve replacement) with OMT. Databases were searched from inception through December 31, 2025. Outcomes included all-cause and cardiovascular mortality, heart failure (HF) hospitalization, myocardial infarction, stroke, bleeding, and new permanent pacemaker (PPM) or implantable cardioverter-defibrillator (ICD) implantation. Random-effects models were used to calculate pooled odds ratios (ORs). RESULT(S): Thirteen studies encompassing 6732 patients (3240 TTVI; 3492 OMT) were included. In pooled analyses of randomized and observational studies, TTVI was associated with a significant reduction in all-cause mortality compared with OMT (OR 0.70; p=0.009). However, this benefit was not observed in an RCT-only analysis. No significant differences were noted in cardiovascular mortality, HF hospitalization, myocardial infarction, severe bleeding, or stroke. A non-significant trend toward increased PPM/ICD implantation (p=0.06) was primarily driven by valve replacement devices. CONCLUSION(S): In symptomatic TR, TTVI was associated with reduced all-cause mortality in pooled analyses incorporating both randomized and observational data; however, this benefit was not confirmed in RCT-only analyses, likely reflecting residual confounding in non-randomized studies which may overestimate treatment effects. These findings support TTVI as an effective therapeutic option for appropriately selected high-risk patients. Copyright © 2026 Elsevier Inc. All rights reserved. <111> Accession Number 651130060 Title Randomized trial of tricuspid flexible band versus rigid ring in patients with moderate tricuspid regurgitation or greater: results of the JPH2019 trial. Source The Journal of thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 04 May 2026. Author Xu X.; Gu J.; Liu H.; Du J.; Gu W.; Ni B.; Shao Y. Institution (Xu, Gu, Liu, Du, Gu, Ni, Shao) Department of Cardiovascular Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China Abstract OBJECTIVE: To compare the efficacy and clinical outcomes of flexible band versus rigid ring annuloplasty for the correction of moderate TR or greater. METHOD(S): In this single-center randomized trial, adult patients with moderate or greater TR were assigned to receive either a flexible band or a rigid ring. The primary outcome was recurrent TR during follow-up. Secondary outcomes included death, permanent pacemaker implantation (PPI), and other adverse events. RESULT(S): 400 patients were randomized with a 1:1 ratio, and 321 were included in the final analysis (flexible band, N =156; rigid ring, N = 165). Baseline characteristics were balanced between arms. At discharge, recurrent TR was significantly higher in the flexible band arm than the rigid ring arm (10.1% vs. 3.8%, P = 0.03). However, the significance was no longer significant during follow-up (6.1%/patient-year [PY] vs. 4.7%/PY, P = 0.21). Multivariable analysis identified female sex (sHR:2.16, 95%CI:1.1-4.22, P = 0.025), preoperative severe TR (sHR:2.09, 95%CI:1.06-4.11, P = 0.033) and massive TR (sHR:4.63, 95%CI:1.29-16.61, P = 0.019), and preoperative PPI (sHR:3.69, 95%CI:1.35-10.09, P = 0.011) as independent risk factors for recurrent TR. Subgroup analyses based on these factors showed no significant between-arm difference in the primary outcome. secondary outcomes were also comparable between the arms during follow-up. CONCLUSION(S): Both annuloplasty devices provided acceptable TR correction with similar adverse event rates over a median 3-year follow-up. Copyright © 2026. Published by Elsevier Inc. <112> Accession Number 2045345304 Title Incidence and Outcomes of Intraluminal Frozen Elephant Trunk Stent Graft Thrombosis After Aortic Arch Surgery: Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(7) (pp 1-11), 2026. Article Number: e047425. Date of Publication: 2026. Author Sa M.P.; Consoli L.; Neves G.; Camarotti T.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A. Institution (Sa, Napoli, Brozzi, Navia, Polanco) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute, Cleveland Clinic Florida, Weston, FL, United States (Consoli) School of Medicine of Universidade Federal da Bahia (UFBA), Salvador, Brazil (Neves) School of Medicine of Universidade Estadual do Para (UEPA), Belem, Brazil (Camarotti) School of Medicine of Universidade de Pernambuco (UPE), Recife, Brazil Publisher American Heart Association Inc. Abstract BACKGROUND: Intraluminal thrombosis (ILT) has been observed in endografts in the thoracic aorta after frozen elephant trunk (FET) for aortic arch pathologies. This study aimed to evaluate the incidence and clinical outcomes associated with ILT. METHOD(S): Systematic review of studies reporting incidence of ILT after FET and comparing outcomes of patients with and without ILT. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Single-arm meta-analysis was conducted to determine ILT incidence and 2-arm meta-analyses between groups with ILT and without with a random-effects model to assess patient-relevant outcomes. RESULT(S): Five observational studies, including 999 patients, met our eligibility criteria. Pooled incidence of ILT after FET was 9.24% (95% CI, 6.32-13.31). Although we did not find statistically significant associations between ILT and postoperative stroke (odds ratio [OR], 0.93 [95% CI, 0.46-1.88]; P=0.845), we found statistically significant associations with embolic events (OR, 6.94 [95% CI, 1.01-47.46]; P=0.048) and early mortality (OR, 3.59 [95% CI, 1.69-7.60]; P<0.001). We found positive correlations between proportion of female patients in the populations and incidence of ILT (coefficient, 0.08 [95% CI, 0.02-0.14]; P=0.011). Meta-regression coefficients were statistically significant for embolic events and female sex (coefficient, 0.12 [95% CI, 0.06-0.18]; P<0.001), aortic aneurysm (coefficient, 0.08 [95% CI, 0.04-0.13]; P<0.001), and mean age (coefficient, 0.66 [95% CI, 0.33-0.99]; P<0.001), which means that associations differ across populations with varying mean levels of these covariates. CONCLUSION(S): Because ILT after FET seems to be associated with embolic events and early mortality, close follow-up is warranted-especially for women, older people, and patients with aortic aneurysms-and anticoagulation should be considered. Copyright © 2026 The Author(s). <113> 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. (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). <114> Accession Number 2045414655 Title Incidence and Outcomes of Unstable Angina in Patients with Low High-Sensitivity Cardiac Troponin I Values-A Substudy of the RACE-IT Trial. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3208. Date of Publication: 01 May 2026. Author Fadel R.; Miller J.; Cook B.; Nguyen F.; Alqarqaz M.; Fuller B.; Basir M.B.; Frisoli T.; Villablanca P.; Jabri A.; Alaswad K.; Khandelwal A.; Lingam N.; O'Neill B.; Kim H.; Gonzalez P.E.; Pielsticker E.; Koenig G.; Krupp S.; Mills N.L.; Mahler S.; Levy P.; Brennan B.; Bole S.; Parikh S.; Nour K.; Hudson M.; Zweig B.; Abuzahrieh O.; Gondolfo C.; McCord J. Institution (Fadel, Nguyen, Alqarqaz, Fuller, Basir, Frisoli, Villablanca, Jabri, Alaswad, Lingam, O'Neill, Kim, Gonzalez, Pielsticker, Koenig, Krupp, Parikh, Nour, Hudson, Zweig, Gondolfo, McCord) Henry Ford Heart and Vascular Institute, Detroit, MI, United States (Miller, Cook, Levy, Brennan, Bole, Abuzahrieh) Henry Ford Hospital, Detroit, MI, United States (Cook) School of Medicine, Wayne State University, Detroit, MI, United States (Khandelwal) Allegheny Health Network & Allegheny General Hospital, Pittsburgh, PA, United States (Mills) The Usher Institute, University of Edinburgh, Edinburgh, United Kingdom (Mahler) School of Medicine, Wake Forest University, Winston-Salem, NC, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Unstable angina has become an exceedingly rare diagnosis in the era of high-sensitivity cardiac troponin (hs-cTn). Objective(s): We sought to identify the incidence of unstable angina and characterize patients with low hs-cTn in emergency departments (EDs). Method(s): A prespecified secondary analysis of the Rapid Acute Coronary Syndrome Exclusion using high-sensitivity cardiac Troponin I (RACE-IT) trial was conducted. RACE-IT was a stepped-wedge randomized trial comparing two rule-out protocols (0/1- and 0/3 h) for myocardial infarction (MI) in nine EDs from July 2020 to April 2021. All patients had hs-cTnI (Beckman Coulter) concentrations below or equal to the 99th percentile upper reference limit of 18 ng/L. The primary outcome was unstable angina, based on the ISCHEMIA trial definition, which required electrocardiographic changes or findings at coronary angiography (angiographic evidence of plaque rupture or thrombus). Result(s): Of the 32,608 patients in the trial, 60 patients (0.2%) met the definition of unstable angina, of whom 46 (77%) had obstructive disease at coronary angiography and 17 (28%) had an ischemic electrocardiogram. Coronary revascularization was performed in 45 (75%) patients and seven (12%) had left main or 3-vessel coronary artery disease. There were seven (12%) patients with non-obstructive coronary artery disease, and seven (12%) who had angiographically unremarkable coronary arteries. Patients with unstable angina were older (p = 0.015), more likely to be male (p = 0.005), with a higher prevalence of hypertension (p < 0.001), known coronary artery disease (p < 0.001), peripheral vascular disease (p = 0.035), and a higher serum creatinine (p = 0.018). At 30 days, two patients had a type 1 MI and there were no deaths. Conclusion(s): Unstable angina was diagnosed in 1 in 500 patients with a low hs-cTnI value at presentation to the ED and these patients had an excellent prognosis at 30 days. These patients tend not to have high-risk anatomy and one in four had non-obstructive coronary artery disease or angiographically unremarkable coronary arteries. Copyright © 2026 by the authors. <115> Accession Number 2045453730 Title LB15. Single or Bilateral Internal Thoracic Artery Grafts: The 15 Year Outcomes of the Arterial Revascularization Trial (ART). Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S364), 2026. Date of Publication: 01 May 2026. Author Taggart D.; Gaudino M.; Gerry S.; Gray A.; Jasinski M.; Zamvar V.; Flather M. Institution (Taggart, Gerry, Gray) University of Oxford, Oxfordshire, Oxford, United Kingdom (Gaudino) Weill Cornell Medicine/NYP Hospital, New York, NY, United States (Jasinski) Wroclaw Medical University, Katowice, Poland (Zamvar) Royal Infirmary of Edinburgh, Scotland, Edinburgh, United Kingdom (Flather) University of East Anglia, East Anglia, Norwich, United Kingdom Publisher Elsevier Inc. Abstract Abstract: Objective: Multiple observational studies report that multiple arterial grafts (MAG), as compared with single arterial grafts (SAG), improve coronary artery bypass graft (CABG) survival but randomized evidence is lacking. We report 15-year follow-up results of the Arterial Revascularization Trial (ART). Method(s): Patients undergoing CABG were randomly assigned to bilateral (BITA) or single (SITA) internal thoracic arterial grafts. Supplemental arterial or vein grafts were used as necessary. Consistent with the 10 years analysis, the primary outcome was all-cause mortality at 15 years. The secondary outcome was the composite of all-cause mortality, myocardial infarction, or stroke. As around 30% of patients received a potentially different treatment than originally intended, a pre-specified as treated (AT) analysis comparing MAG and SAG patients was also performed. Result(s): A total of 1548 patients were randomized to BITA and 1554 to SITA grafts. Vital status was known for 96% of patients at 15 years. In the BITA group, 14% received only a SITA graft, while in the SITA group 22% also received a radial-artery graft. In the intention-to-treat (ITT) analysis at 15 years, there were 579 deaths (37.4%) and 572 deaths (36.8%) respectively in the BITA and SITA groups (hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.90-1.14; p=0.84). For the secondary outcome event rates were 43.5% and 45.0% in the BITA and SITA groups respectively (HR 0.95; 95% CI 0.86-1.06). In the prespecified AT analysis at 15 years 34.3% had died in the MAG group compared to 40.5% in the SAG group (HR 0.82; 95% CI 0.73-0.92, p<0.001). For the composite outcome the HR was 0.83 (95% CI 0.74-0.92, p=<0.001). Although not randomized, the MAG and SAG groups were very well matched for 20 baseline characteristics. Conclusion(s): Patients undergoing CABG were randomly assigned to either BITA or SITA grafting. In the ITT analysis there were no significant differences in rates of all-cause mortality at fifteen years between the two groups. In a prespecified analysis of patients who received multiple or single arterial grafts there was a significant survival benefit of multiple arterial grafts. Further trials are needed to confirm if multiple arterial grafts provide better outcomes than a single internal-thoracic-artery graft. (ISRCTN46552265.) Category: Adult Cardiac Copyright © 2026 <116> Accession Number 651133265 Title Meta-analysis of perioperative amiodarone for prevention of postoperative atrial fibrillation (POAF) in cardiac surgery patients: update and reevaluation of timing, route, and dosage. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 07 May 2026. Author Li Z.; Wang S.; An L.; Chen C.; Zhang G.; Chen L.; Du J. Institution (Li, Wang, Chen, Du) Department of Surgical Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China (An, Chen) Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Zhang) Department of Neurology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Abstract BACKGROUND: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, and perioperative amiodarone is recommended for POAF prophylaxis, while the optimal timing, route, and dosage remain unclear. The purpose of this study is to evaluate the efficacy of perioperative amiodarone for the prevention of POAF in patients undergoing cardiac surgery and to reevaluate the impact of its timing, route, and dosage. METHOD(S): Data were collected through searching PubMed, Embase, and the Cochrane Library from inception until September 30, 2025, for randomized controlled trials (RCTs). Data were pooled using a random-effects model. RESULT(S): Forty RCTs involving 6,166 patients were included. Amiodarone was associated with a substantial reduction in the incidence of POAF (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.31 to 0.49, P < 0.00001, I2 = 57%). The preventive efficacy may be primarily influenced by the combination of administration timing and route, rather than by the cumulative dose alone. Notably, a significant dose-response relationship was observed within the preoperative through postoperative oral strategy. Statistically significant differences were found in length of hospital stay (mean difference -1.33 days, P < 0.0001) and cerebrovascular accident (OR = 0.59, P = 0.04), and an increased risk of bradycardia (OR = 2.33, P < 0.00001). No statistically significant differences were found in mortality, heart block, or hypotension. CONCLUSION(S): Prophylactic perioperative amiodarone may be associated with a reduced incidence of POAF, consistent with current guideline recommendations, and the timing and route of administration appear to play a more important role than the dose alone. While an increased risk of bradycardia was observed, no clear association with major adverse outcomes was identified. These results should be interpreted cautiously and may help optimize prophylactic strategies in appropriate clinical contexts. Copyright © 2026. The Author(s). <117> Accession Number 2045453728 Title LB3. Superficial Parasternal Intercostal Plane Block for Post-Sternotomy Analgesia After Cardiac Surgery: Primary Results of the Randomized, Double-Blind EPOCH CardioLink-10 Trial. Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S356-S357), 2026. Date of Publication: 01 May 2026. Author Verma S.; Alli A.; Mazer D.; Dennis F.; Teoh H.; Ali Hassan S.M.; Quan A.; Chin K.; Tran J.D.; Ghiringhelli J.P.; Papa F.; Lee Y.; Ricci M.; Szarek M.; Dhingra N.; Verma R.; Derry K.L.; George T.; Krishnaraj A.; Hess D.A.; Cook R.C.; Hassan A.; Yau T.; Spence J.; Martinka P.M.; Sutherland K. Institution (Verma, Alli, Mazer, Dennis, Ali Hassan, Tran, Ghiringhelli, Papa, Lee, Ricci, Dhingra, Derry, George, Krishnaraj) University Of Toronto, Toronto, ON, Canada (Teoh, Quan, Chin) St. Michael's Hospital, Toronto, ON, Canada (Szarek) CPC Clinical Research, Aurora, CO, United States (Verma) Royal College Of Surgeons Ireland, Toronto, ON, Canada (Hess) Western University, London, ON, Canada (Cook, Martinka) University Of British Columbia, Vancouver, BC, Canada (Hassan) MaineHealth Maine Medical Center Portland, Portland, ME, United States (Yau) Toronto General Hospital, University Health Network, Toronto, ON, Canada (Spence) McMaster University, Hamilton, ON, Canada (Sutherland) Royal Columbian Hospital, New Westminster, BC, Canada Publisher Elsevier Inc. Abstract Abstract: Objective: Optimizing pain management while minimizing opioid exposure is a central goal of enhanced recovery after cardiac surgery (ERAS Cardiac). Although chest wall regional anesthesia techniques are a potential part of an opioid-sparing analgesic strategy, robust randomized evidence supporting their efficacy is lacking. To address this critical evidence gap, we conducted the first multicenter RCT to determine if superficial parasternal intercostal plane (SPIP) blocks reduce post-op pain and opioid requirements after cardiac surgery. Method(s): EPOCH CardioLink-10 (ClinicalTrials.gov NCT06028126) is a multicenter, randomized, double-blind, placebo-controlled, parallel-group Canadian trial of adults undergoing cardiac surgery via median sternotomy. Key exclusions were redo sternotomy, emergency procedures, clinical instability, chronic opioid use, infective endocarditis, active infection, and local anesthetic allergy. Participants were randomized 1:1 to receive intermittent boluses of 0.2% ropivacaine or placebo for 48 hours following surgery via bilateral ultrasound-guided SPIP catheters placed after skin closure. All other perioperative care, including multimodal analgesia, followed local standards. Data are collected during hospitalization and up to 6 months post-op. The primary endpoint is cumulative post-op opioid consumption at 72 hours, expressed as morphine milligram equivalents. Secondary endpoints include post-op pain, cumulative opioid use to discharge, delirium, and quality of recovery (QOR-15). Tertiary endpoints include time to extubation, mobilization, length of stay, post-op nausea and vomiting, post-discharge opioid use, chronic pain and patient-reported outcomes (PROMIS-29). Result(s): A total of 340 patients were randomized with the final primary outcome expected to be available by the end of February. Primary results will be presented at a Late-Breaking Scientific Session of the AATS meeting, with plans for simultaneous publication in a top-tier journal. Baseline characteristics are shown in the Table. We will analyze efficacy in the modified intention-to-treat population that includes all participants who received >=1 dose of study treatment. Conclusion(s): EPOCH CardioLink-10 is the first ERAS Cardiac RCT to rigorously evaluate continuous SPIP blocks for post-sternotomy pain. By addressing a long-standing evidence gap, this trial provides high-quality data on opioid-sparing perioperative analgesia to inform clinical practice and guidelines. [Formula presented] Category: Adult Cardiac Copyright © 2026 <118> Accession Number 651133255 Title Efficacy and safety of perioperative magnesium on postoperative pain in adult patients undergoing cardiothoracic surgeries- a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 07 May 2026. Author Swetha R.K.; Gayathri B.; Haridoss M.; Kuppuraman D.; Karthikeyan S. Institution (Swetha, Kuppuraman) Department of Anesthesiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Gayathri) Department of Anesthesiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Haridoss) Division of Medical Research, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Karthikeyan) Division of Medical Research, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India Abstract BACKGROUND: Cardiothoracic surgeries such as CABG, valve replacement, and thoracotomy are associated with significant postoperative pain, for which opioids remain the primary treatment despite notable adverse effects and tolerance. Magnesium, an NMDA receptor antagonist with analgesic and cardioprotective properties, has been suggested as a perioperative adjuvant to improve pain control. This systematic review and meta-analysis examined the efficacy and safety of perioperative magnesium for postoperative pain relief in adult cardiothoracic surgery patients. METHOD(S): The review followed PRISMA guidelines and was registered with PROSPERO (CRD420251049449). A search was conducted in PubMed, EMBASE, Scopus, and CENTRAL up to 14 May 2025 for randomized controlled trials comparing perioperative magnesium with placebo or other analgesics in adult patients undergoing cardiothoracic surgery. Pain scores, opioid consumption (MME), time to rescue analgesia, length of hospital stay, and adverse events were analyzed. Random-effects meta-analyses were performed using R Studio (v4.3.2) with mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CI). RESULT(S): Ten RCTs involving 1,140 participants were included. Magnesium significantly reduced pain intensity compared with placebo at 24 h postoperatively (MD - 0.85, 95% CI: -1.53 to - 0.16), although the effect did not reach the minimal clinically important difference. No significant differences were observed when magnesium was compared with active analgesics. For all other outcomes, including opioid consumption (MME), time to first rescue analgesia, and length of hospital stay, no significant differences were found in pooled analyses versus either placebo or other analgesics. Heterogeneity was substantial across most outcomes (I2 > 75%), and no major adverse events were reported. CONCLUSION(S): Perioperative magnesium shows small and safe analgesic effects after cardiothoracic surgery, but the clinical relevance remains uncertain due to substantial heterogeneity and variable dosing. Further robust trials are needed to define its efficacy and optimal use. Copyright © 2026. The Author(s). <119> Accession Number 651131254 Title 2026 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in cardiac surgery patients. Source The Journal of thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 04 May 2026. Author Chatterjee S.; Girardi N.I.; Crow J.; Wieruszewski P.M.; Grant M.C.; Cuker A.; Warkentin T.E.; Mims M.P.; Arora R.C.; Martin M.; Moon M.R.; Cangut B.; Sultan I.S.; Parker A.; Holler J.F.; Balsam L.B.; Engelman D.T. Institution (Chatterjee) Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, United States (Girardi) Department of Anesthesiology, Weill Cornell Medicine, New York, NY (Crow) Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Md, Liberia (Wieruszewski) Department of Pharmacy, Department of Anesthesiology, Mayo Clinic, Minn, Rochester, United Kingdom (Grant) Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, Liberia (Cuker) Department of Medicine and Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa, United States (Warkentin) Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (Mims) Section of Hematology and Oncology, Department of Medicine, Baylor College of Medicine, Houston, United States (Arora) Department of Surgery, Northwestern University, Feinberg School of Medicine, Ill, Chicago, Mexico (Martin) Redline Perfusion & Consulting, LLC, Gainesville, Fla (Moon) Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex; The Texas Heart Institute at Baylor College of Medicine, Houston, Tex (Cangut) Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY (Sultan) Division of Cardiac Surgery, Heart and Vascular Institute, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa, United States (Parker) Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada (Holler) Department of Congenital Perfusion, Atrium Health Levine Children's Hospital, Charlotte, NC (Balsam) UMass Memorial Medical Center, Mass, Worcester, United Kingdom (Engelman) Department of Surgery, Baystate Medical Center, University of Massachusetts Chan Medical School-Baystate, Mass, Springfield, United Kingdom Abstract BACKGROUND: Heparin-induced thrombocytopenia (HIT) in cardiac surgical patients presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence of critical illness in this population. Current guidelines do not fully address these cardiac surgical-specific features, leading to practice variation in screening, diagnosis, anticoagulation management, and perioperative planning. Consolidated, practical, and evidence-based recommendations are needed that are tailored to cardiac surgery and to temporary mechanical circulatory support after cardiac surgery. METHOD(S): The American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee convened a multidisciplinary panel of 16 experts in cardiac surgery, hematology, critical care, anesthesiology, perfusion, and pharmacology. A comprehensive literature review was performed with medical librarian support. Using a modified Delphi methodology, the panel evaluated the evidence, developed clinical statements, and assigned a class of recommendation and a level of evidence to each recommendation. RESULT(S): Consensus was achieved for 32 recommendations across 5 domains: (1) epidemiology and natural history of HIT after cardiac surgery; (2) diagnostic evaluation, including appropriate Thrombocytopenia, Timing, Thrombosis, oTher cause (4Ts) score use, time-dependent platelet count patterns, and integration of immunoassay and functional testing; (3) therapeutic management with nonheparin anticoagulants, including the selection of direct thrombin inhibitors, factor Xa inhibitors, and adjunctive therapies; (4) perioperative management of patients with HIT who require cardiac surgery, including the timing of surgery, intraoperative anticoagulation strategy, and adjunctive therapies; and (5) screening, testing, and anticoagulation strategies for patients supported by extracorporeal membrane oxygenation or temporary mechanical circulatory support after cardiac surgery. Additional best practices are included for cardiopulmonary bypass circuit management for patients with HIT. CONCLUSION(S): This AATS expert consensus document provides practical, cardiac surgery-specific guidance for the diagnosis and management of HIT across the continuum of cardiac surgical care. By addressing the complexities unique to cardiac surgery, high-risk anticoagulation environments, and extracorporeal and temporary mechanical circulatory support, these recommendations aim to improve diagnostic accuracy, standardize care, reduce complications, and support safe heparin re-exposure or alternative anticoagulation strategies when surgery is required. Copyright © 2026 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. <120> Accession Number 2045453737 Title LB16. Ravulizumab for Prevention of Cardiac Surgery-Associated Acute Kidney Injury & Major Adverse Kidney Events in Chronic Kidney Disease:Interim Results from Phase 3 Randomized Controlled Trial (ARTEMIS). Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S365), 2026. Date of Publication: 01 May 2026. Author Engelman D.; Mehta R.; Corteville D.; Solinsky C.; Baykal T.; Li G.; Lamy A. Institution (Engelman) University of Massachusetts, Longmeadow, MA, United States (Mehta) University of California San Diego, San Diego, CA, United States (Corteville) Rochester Regional Health, Rochester, NY, United States (Solinsky, Li) Alexion, AstraZeneca Rare Disease, Boston, MA, United States (Baykal) Alexion, AstraZeneca Rare Disease, Catalunya, Barcelona, Spain (Lamy) McMaster University, Hamilton, ON, Canada Publisher Elsevier Inc. Abstract Abstract: Objective: Cardiac procedures, especially those involving cardiopulmonary bypass (CPB), are strongly linked to cardiac surgery-associated acute kidney injury (CSA-AKI) and related outcomes, which are driven by systemic inflammation and dysregulated complement activation. ARTEMIS was designed to evaluate whether terminal complement inhibition with a single intravenous infusion of Ravulizumab (RAV) administered prior to CPB reduces the risk of major adverse kidney events (MAKE) and AKI in patients with chronic kidney disease (CKD) undergoing cardiac surgery. Method(s): ARTEMIS, phase 3, randomized, double-blind, placebo-controlled, multicenter trial (NCT05746559), initiated in April 2023. Adults with CKD (estimated glomerular filtration rate >=20 to <60 mL/min/1.73 m2), stable cardiac disease undergoing non-emergent cardiac surgery with CPB, and an STS Renal Failure Risk Score of >=2.8%, were randomized 1:1 to receive a single intravenous infusion of RAV or placebo (PBO) administered within 7 days prior to surgery. Patients were stratified by CKD stage (3A, 3B, and 4) and surgery type (mitral valve replacement or combined procedures vs other single procedure). The primary endpoint was major adverse kidney events at 90 days following CPB (MAKE90), defined as a composite of a >=25% decrease from baseline in eGFR, initiation of kidney replacement therapy (KRT), or death. A prespecified interim analysis was performed after 50% of randomized participants completed the 90-day primary endpoint assessment. Result(s): Overall, 368 participants (randomized to RAV [n=185] and PBO [n=183]) were assessed at interim analysis. Baseline characteristics and results of the interim analysis, including operative variables, MAKE90 and its individual components, and safety outcomes, will be presented (Table 1). Conclusion(s): Interim results from this phase 3 randomized controlled trial evaluating terminal complement inhibition for the prevention of CSA-AKI in patients with CKD will be presented. [Formula presented] Category: Perioperative Care Copyright © 2026 <121> Accession Number 2045453724 Title LB5. Carbon dioxide insufflation for brain protection in patients undergoing planned left-sided open heart valve surgery: a multicenter, placebo-controlled, blinded, randomized controlled trial. Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S358), 2026. Date of Publication: 01 May 2026. Author Gibbison B.; Lazaroo M.; Pufulete M.; Culliford L.; Hamilton L.; Robinson B.; Pretorius P.; Voets N.; Akowuah E.; Sayeed R.; Kaur S.; Bendetto U.; Angelini G.; Rogers C. Institution (Gibbison, Lazaroo, Pufulete, Culliford, Hamilton, Robinson, Kaur, Angelini, Rogers) University of Bristol, Bristol, United Kingdom (Pretorius, Sayeed) Oxford University Hospitals, Oxford, United Kingdom (Voets) University of Oxford, Oxford, United Kingdom (Akowuah) Newcastle University, Middlesbrough, United Kingdom (Bendetto) University G D'Annunzio, Chieti, Italy Publisher Elsevier Inc. Abstract Abstract: Objective: To evaluate the efficacy and safety of carbon dioxide insufflation (CDI) in the surgical field for reducing acute ischemic brain injury in patients undergoing planned left-sided open heart valve surgery. Method(s): This multicenter, placebo-controlled blinded randomized controlled trial recruited patients aged >=50 years undergoing left-sided valve repair or replacement. Participants were randomized 1:1 to receive CDI (intervention) or medical air insufflation (placebo) during cardiopulmonary bypass, in addition to standard de-airing. The primary outcome was acute ischemic brain injury detected by diffusion-weighted MRI or clinical stroke within 10 days post-surgery. Secondary outcomes included number and volume of lesions, volume, delirium (Confusion Assessment Method), neurocognitive and functional performance (NIH Stroke Score, Addenbrooke's Cognitive Evaluation and Barthel Index), quality of life (SF-12), postoperative complications, and survival to 3 months. Analyses are by intention-to-treat. Result(s): Between Nov 2021 and Dec 2025, 530 participants were recruited in 10 UK cardiac surgery centers; 262 patients were randomized to placebo and 268 to CDI. 275 patients underwent valve surgery only and 255 had valve surgery with another procedure. The mean age was 70 years, and 402/530 (76%) patients were male. There was one reported cross-over from placebo to CDI. The primary outcome was complete for 389/530 (74%) patients. The primary reason for missing data was lack of an MRI scan due to pacing wires in situ (32/530, 6%), patient refusal (28/530, 5%), patient not well enough/died (32/530, 6%), or other reason including MRI unavailability (49/530, 9%). Primary outcome frequency was 108/194 (56%) in the placebo group and 100/195 (51%) in the CDI group. Clinical evidence of stroke within 10 days was reported in 9 patients (6 placebo group, 3 CDI group) and brain injury on MRI was identified in 204 patients (105 placebo group, 99 CDI group). After imputing missing data, the estimated risk difference (CDI - placebo) was -2.3% (95% CI -11% to +6%). Restricting the analysis to those with complete data did not change the conclusion. Conclusion(s): There was no evidence to suggest that CDI during cardiopulmonary bypass significantly reduces the incidence of acute ischemic brain injury. Category: Adult Cardiac Copyright © 2026 <122> Accession Number 2045453731 Title LB11. A Randomized Controlled Trial Evaluating the Safety and Performance of a Novel Rigid Sternal Stabilization System Following Median Sternotomy. Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S361-S362), 2026. Date of Publication: 01 May 2026. Author Sadaba R.; Fernandez F.M.; Eschenhagen M.; Guijosa C.M.; Borrego J.M.; Sanchis I.; Coso C.; Alonso A.; Dieguez J.A.; Diab N.; Domenech B.; Sanchez M.; Castella M. Institution (Sadaba, Fernandez) Hospital Universitario De Navarra, Pamplona, Spain (Eschenhagen, Diab) Universitatsklinikum Freiburg, Freiburg, Germany (Guijosa, Coso, Alonso) Hospital Universitario 12 De Octubre, Madrid, Spain (Borrego, Sanchis) Hospital Universitario Virgen Del Rocio, Sevilla, Spain (Dieguez, Domenech, Sanchez, Castella) Hospital Clinic De Barcelona, Barcelona, Spain Publisher Elsevier Inc. Abstract Abstract: Objective: To compare the safety and performance of a novel rigid sternal stabilization system versus standard wire cerclage for sternal closure in patients undergoing full median sternotomy during cardiothoracic surgery. Method(s): This was a multicenter, randomized, controlled, double-blind (patient and primary endpoint assessor) clinical trial. A total of 90 patients undergoing full median sternotomy were randomized to either rigid carbon fiber sternal fixation (investigational device group) or conventional wire cerclage (control group). Follow-up was conducted at 1 and 6 months postoperatively. The primary endpoint was sternal stability, assessed using the Sternal Instability Scale (SIS; range 0-3). Secondary endpoints included length of hospital stay, pain assessed by visual analog scale (VAS; 0-10), upper limb function evaluated by the Upper Limb Functional Index (ULFI; 0-100%), postoperative complications potentially related to sternal closure, and radiological sternal healing assessed by computed tomography at 6 months. Result(s): Forty-two patients were allocated to the investigational device group (mean age 64.5 +/- 9.0 years; 85% male) and 48 to the control group (65.8 +/- 9.8 years; 85% male). At 1 month postoperatively, all patients in the investigational device group demonstrated stable sternums (SIS <= 1), whereas 2 patients in the control group showed sternal instability (SIS > 1). Postoperative pain was comparable between groups (VAS 3.0 +/- 2.5 vs 2.8 +/- 2.6; P = 0.771). Upper limb function was superior in the investigational device group, with fewer patients reporting difficulty lifting or moving heavy objects (7.7% vs 33.3%; P = 0.007). The number of complications potentially related to sternal closure was lower in the investigational device group (4 vs 12). Length of hospital stay did not differ significantly between groups (8.9 +/- 4.4 vs 15.9 +/- 30.8 days; P = 0.287). At 6 months, computed tomography demonstrated improved sternal consolidation in the investigational device group, with a smaller intersternal gap (1.03 +/- 0.87 mm vs 1.97 +/- 1.31 mm; P = 0.001) (Figure 1). Conclusion(s): Rigid sternal fixation using a carbon fiber system improved clinical and radiological sternal stability and was associated with enhanced functional recovery compared with conventional wire closure following median sternotomy. [Formula presented] Category: Perioperative Care Copyright © 2026 <123> Accession Number 2045254582 Title Paravertebral Block for Postoperative Pain Management After Open Thoracotomy: A Review of Efficacy and Risks. Source Current Pain and Headache Reports. 30(1) (no pagination), 2026. Article Number: 62. Date of Publication: 01 Dec 2026. Author Duplechin D.P.; Wentling J.G.; Apgar T.L.; Cazayoux E.J.; Ahmadzadeh S.; Allampalli V.; Shekoohi S.; Eng M.R.; Kaye A.D. Institution (Duplechin, Cazayoux) School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States (Wentling) School of Medicine, Louisiana State University Health Sciences Center at New Orleans, 433 Bolivar St, New Orleans, LA, United States (Apgar) Department of Biochemistry, Vanderbilt University, Nashville, TN, United States (Ahmadzadeh, Allampalli, Shekoohi) Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States (Eng) Department of Anesthesiology, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States (Kaye) Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States Publisher Springer Abstract Purpose of Review: Paravertebral block (PVB) is an increasingly utilized regional anesthesia technique for managing postoperative pain in patients undergoing open thoracotomy. Effective pain control following thoracic surgery is crucial for optimizing patient recovery, reducing opioid consumption, and minimizing respiratory complications. Recent Findings: PVB provides unilateral analgesia by delivering local anesthetic to the paravertebral space, effectively blocking somatic and sympathetic nerve fibers. PVB has gained popularity as an alternative to epidural analgesia due to its efficacy and improved safety profile. While epidural analgesia remains the traditional gold standard for thoracic procedures, it is associated with complications such as hypotension, urinary retention, motor blockade, and the need for catheter placement. In contrast, PVB is easier to administer, produces less hemodynamic instability, and reduce systemic side effects. Recent literature suggests that PVB offers similar or improved pain control, reduced opiod requirements, and fewer postoperative complications. Risks such as vascular puncture, local anesthetic systemic toxicity, and incomplete spread persists; however, ultrasound guidance has iproved block reliability. Summary: Given its favorable safety profile and efficacy, PVB is emerging as a preferred option for postoperative pain control in open thoracotomy patients. Further research and randomized trials are needed to standardize technique, dosing, and peroperative protocols. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <124> Accession Number 2045426832 Title Aortopathy in Bicuspid Aortic Valve: Pathophysiology, Risk Stratification and Surgical Decision-Making-A Narrative Review. Source Journal of Clinical Medicine. 15(9) (no pagination), 2026. Article Number: 3542. Date of Publication: 01 May 2026. Author Krych S.; Gniewek J.; Jurkiewicz M.; Kowalczyk P.; Waniczek D.; Hrapkowicz T. Institution (Krych, Hrapkowicz) Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, School of Medical Sciences in Zabrze, Medical University of Silesia, Marii Sklodowskiej-Curie 9, Zabrze, Poland (Krych, Gniewek) Student's Scientific Society, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, School of Medical Sciences in Zabrze, Medical University of Silesia, Marii Sklodowskiej-Curie 9, Zabrze, Poland (Jurkiewicz) Student's Scientific Society, III Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Marii Sklodowskiej-Curie 9, Zabrze, Poland (Kowalczyk) Department of Animal Nutrition, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, Jablonna, Poland (Waniczek) Department of Oncological Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Bicuspid aortic valve (BAV) is one of the most common congenital heart defects, introducing significant hemodynamic disturbances to the circulatory system. This narrative review analyzed articles published between 2012 and 2025 and indexed in PubMed. The aim was to synthesize key information on the etiopathogenesis of BAV, its potential complications and associated risks, as well as available pharmacological and surgical treatment strategies, with emphasis on indications and contraindications for specific surgical techniques. Analyses demonstrate that isolated BAV with typical valvular aortopathy is associated with a more favorable prognosis compared to valvular aortopathy syndromes. Valve phenotype shows important sex-related relationships in its presentation and progression. From a hemodynamic perspective, BAV alters blood flow angles, which may contribute to weakening of the aortic wall and secondary valve changes. BAV is also frequently associated with genetic disorders such as Marfan syndrome. The heterogeneity of aortopathies linked to BAV creates significant challenges for echocardiographers, cardiologists and cardiac surgeons, particularly in determining the optimal timing and strategy for surgical intervention. Copyright © 2026 by the authors. <125> Accession Number 651129792 Title The 2026 American Association for Thoracic Surgery (AATS) expert consensus document: Surgical management of primary chest wall malignancies. Source The Journal of thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 04 May 2026. Author Raymond D.P.; Abdelsattar Z.M.; Brown L.M.; Campbell S.R.; Guerra J.J.; Mangla A.; Meguid R.A.; Mesko N.W.; Moran S.L.; Rocco G.; Shen K.R.; Towe C.W.; Tong B.C.; Walsh G.L.; Donington J.S. Institution (Raymond) Cleveland Clinic, Department of Thoracic and Cardiovascular Surgery, Division of Thoracic Surgery, Center for Chest Wall Disease, Cleveland, OH, United States (Abdelsattar) Loyola University Medical Center and Edward Hines Veterans Affairs Hospital, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Maywood, IL, United States (Brown) UC Davis Health, Department of Surgery, Division of General Thoracic Surgery, Sacramento, CA, United States (Campbell) Cleveland Clinic, Department of Radiation Oncology, Cleveland, OH, United States (Guerra, Walsh) University of Texas MD Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, Houston, TX, United States (Mangla) University Hospitals Seidman Cancer Center, Department of Hematology and Oncology, Division of Sarcoma and Cutaneous Oncology, Cleveland, OH, United States (Meguid) University of Colorado Anschutz Medical Campus, Department of Surgery, Division of Cardiothoracic Surgery, Section of General Thoracic Surgery, Aurora, CO, United States (Mesko) Cleveland Clinic, Department of Orthopaedic Surgery, Cleveland, OH, United States (Moran) Mayo Clinic, Department of Surgery, Division of Plastic and Reconstructive Surgery, Rochester, MN, United States (Rocco) Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, Department of Surgery, Thoracic Service, New York, NY (Shen) Mayo Clinic, Department of Surgery, Division of General Thoracic Surgery, Rochester, MN, United States (Towe) Case Western Reserve School of Medicine, Department of Surgery, Division of Thoracic and Esophageal Surgery, University Hospitals, Cleveland, OH, United States (Tong) Duke University School of Medicine, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, NC, United States (Donington) University of Chicago Medicine, Department of Surgery, Section of Thoracic Surgery, Chicago, IL, United States Abstract OBJECTIVE: The management of chest wall primary malignancies is challenging for thoracic surgeons due to the rarity and diversity of disease processes requiring nuanced knowledge. This document reviews the existing literature and provides multidisciplinary consensus recommendations for evaluation and treatment of chest wall primary malignancies. METHOD(S): The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary panel of medical oncologists, radiation oncologists, orthopedic surgeons, plastic and reconstructive surgeons and thoracic surgeons with significant expertise in the management of chest wall malignancies. A focused literature review was performed with the assistance of a medical librarian. The panel used a modified Delphi method to develop expert consensus statements with a class of recommendations and level of evidence for 6 themes: 1) diagnosis and staging, 2) tumors treated with primary resection, 3) tumors treated with resection following induction therapy, 4) tumors not treated with primary surgical resection, 5) technical surgical principles, and 6) postoperative management. RESULT(S): Consensus was achieved on 34 statements based on extensive literature review and current clinical experience spanning 11 high-volume institutions. These statements provide a standard for initial evaluation of a suspected chest wall neoplasm, histology directed management of a diverse group of malignancies, surgical management principles, and postoperative management. CONCLUSION(S): This multidisciplinary expert consensus document provides a framework upon which thoracic surgeons can approach the management of primary chest wall malignancies. Accurate diagnosis and staging, multidisciplinary treatment planning and careful attention to surgical techniques to achieve an R0 (microscopically negative margin) resection are all vital elements. Further, multi-institutional efforts are required to advance our understanding of chest wall malignancies. Copyright © 2026. Published by Elsevier Inc. <126> Accession Number 2045453735 Title LB2. AMIOMEND: Pilot Safety and Efficacy Trial of CardiaMendTM - Amiodarone Infused Biatrial Patches to Prevent New-Onset Postoperative Atrial Fibrillation. Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S355-S356), 2026. Date of Publication: 01 May 2026. Author Slaughter M.; Crane J.; Endo T.; Vaidya Y.; Gallo M.; Pahwa S.; Trivedi J. Institution (Slaughter, Crane, Endo, Vaidya, Gallo, Pahwa, Trivedi) University Of Louisville, Louisville, KY, United States Publisher Elsevier Inc. Abstract Abstract: Objective New-onset postoperative atrial fibrillation (POAF) occurs in approximately 25-40% of patients undergoing heart surgery and is associated with increased perioperative morbidity and mortality. We evaluated the safety and exploratory efficacy of CardiaMendTM-Amiodarone infused biatrial patches in preventing POAF. Methods A single center randomized clinical trial (NCT# 06730828) using CardiaMendTM patches (porous acellular matrix derived from fetal bovine dermis) infused with Amiodarone was performed in patients undergoing heart surgery to assess its safety, feasibility and efficacy in POAF prevention. Patient exclusions included transplant, mechanical circulatory support device, reoperations, history of atrial fibrillation/flutter, anti-arrhythmic or QT prolongation drugs, and ejection fraction<35%. Forty patients were randomized, 1:1, to receive 70 mg Amiodarone infused CardiaMend (n=20) patches (on both right and left atria) or standard of care (n=20). The primary study endpoint was safety, defined as major adverse cardiovascular and cerebrovascular events (MACCE). Secondary endpoints were POAF, hospital length of stay (LOS), 30-day readmission, and POAF duration. Results The study groups had similar demographics, pre-operative risk factors, and procedures performed (Fig 1A). First 3 patients in the treatment group had post-op CT scans confirming no patch migration. Pharmacokinetic studies demonstrated no detectable systemic drug or metabolite levels (<0.1ug/ml). There were 2 MACCE events: 1 embolic stroke (full recovery before discharge) in the control group and 1 death from an acute abdominal event (unrelated to the study device) in the treatment group. The treatment group had lower incidence of POAF (20% (4) v 40% (8), p=0.16, Fig 1B) and shorter POAF duration (median days 1 v 2 in control). Median LOS was shorter in the treatment group (6.0 vs 6.5 days). At 30 days, POAF was 0% v 15% (3) and readmissions were 5% (1) v 15% (3) in the treatment and control groups respectively. Conclusions In this pilot randomized safety and efficacy trial, the CardiaMendTM-Amiodarone infused biatrial patches, were safe without any systemic amiodarone toxicity and demonstrated a reduction in POAF and LOS. These findings warrant further investigation in a larger randomized clinical trial. [Formula presented] Category: Adult Cardiac Copyright © 2026 <127> Accession Number 2045484623 Title From fantasy to clinical reality: The evolution and future directions of heart transplantation. Source Global Cardiology Science and Practice. 2026(S1) (pp 1-5), 2026. Date of Publication: 01 Jan 2026. Author Yacoub M. Institution (Yacoub) Imperial College, London, United Kingdom Publisher HBKU Press Abstract Heart transplantation, once dismissed as fantasy, became one of the major medical achievements of the latter half of the twentieth century. Its development was driven by foundational advances in immunology, scientific innovation, and the courage and compassion of clinical pioneers. Despite remarkable progress-including survival exceeding 40 years in selected recipients-significant challenges persist, notably donor organ shortage and the absence of specific immune tolerance. Emerging strategies, such as xenotransplantation and tissue engineering, now offer realistic prospects for further advancement. This review examines the historical foundations, present limitations, and future directions of heart transplantation. Copyright © (2026), (HBKU Press), All Rights Reserved. <128> Accession Number 651131050 Title The 2026 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Management of Atrial Functional Mitral Regurgitation. Source The Journal of thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 04 May 2026. Author Mori M.; Ailawadi G.; Bolling S.F.; Hahn R.T.; Kaneko T.; Killu A.M.; Lee A.M.; McCarthy P.; Mick S.; Praz F.; Tang G.H.L.; Gillinov M.; Geirsson A. Institution (Mori) Yale School of Medicine, Division of Cardiac Surgery, New Haven, CT, United States (Ailawadi, Bolling) University of Michigan, Department of Cardiac Surgery, Ann Arbor, MI, United States (Hahn) Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA (Kaneko) Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, MO, United States (Killu) Mayo Clinic, Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Rochester, MN, United States (Lee) Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, United States (McCarthy) Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine Bluhm Cardiovascular Institute, Chicago, IL, United States (Mick) Weill Cornell Medicine, New York, NY, USA (Praz) Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland (Tang) Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA (Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States (Geirsson) Columbia University Vagelos College of Physicians and Surgeons, Department of Surgery, Division of Cardiac Surgery, New York, NY, USA Abstract OBJECTIVE: Atrial functional mitral regurgitation (AFMR) represents a distinct pathophysiologic entity characterized by mitral regurgitation secondary to left atrial dilation and annular remodeling, in the absence of significant left ventricular disease. With the increasing prevalence of atrial fibrillation and heart failure with preserved ejection fraction, AFMR has emerged as an important and potentially underrecognized etiology of mitral regurgitation. This expert consensus statement provides an evidence- and experience-based framework for the evaluation and management of AFMR, encompassing diagnosis, medical and rhythm therapy, surgical and transcatheter interventions, and postoperative management. METHOD(S): The American Association for Thoracic Surgery convened an international multidisciplinary panel of cardiac surgeons, cardiologists, and electrophysiologists with expertise in atrial and mitral valve disease. The panel conducted a systematic literature review and iterative Delphi consensus process to develop recommendations, graded according to class of recommendation (CoR) and level of evidence (LoE). RESULT(S): Consensus was achieved on 18 statements, organized into five sections: (1) Definition, pathophysiology, and diagnostic evaluation of AFMR. (2) Medical and rhythm management strategies. (3) Surgical treatment and concomitant procedures. (4) Transcatheter and hybrid interventions. (5) Postoperative rhythm and anticoagulation management CONCLUSION(S): AFMR represents a distinct form of secondary mitral regurgitation driven by atrial remodeling. This document summarizes current expert consensus to guide diagnosis, timing, and choice of intervention, and highlights the need for multidisciplinary collaboration and prospective research to optimize outcomes. Copyright © 2026. Published by Elsevier Inc. <129> Accession Number 2045453745 Title LB7. Prospective Randomized Evaluation of DIabetics for Graft Patency and Outcomes following Coronary Artery Bypass Grafting using One versus Two or More Arterial Grafts (PREDICT Trial): Interim Analysis. Source Journal of Thoracic and Cardiovascular Surgery. Conference: Journal of Thoracic and Cardiovascular Surgery. Chicago United States. 171(4 Supplement 1) (pp S360), 2026. Date of Publication: 01 May 2026. Author Sajja L.; Sarkar K.; Mannam G.; Padmanabhan C.; Peter S.; Meharwal Z.S.; Koppula A.; Shah D.; Kumar Kodali V.K.; Nagalla B.; Sreeramula S.; Kapoor L.; Doshi C.; Mulay A.; Mohanraj A.; Hote M.; Mishra Y.; Jawali V.; Velayudhan B.; Narayan P. Institution (Sajja, Mannam) Star Hospitals, Telangana, Hyderabad, India (Sarkar) Medica Superspeciality Hospital, West Bengal, Kolkata, India (Padmanabhan) GKNM Hospital, Tamil Nadu, Coimbatore, India (Peter) DDMM Heart Institute, Gujarat, Nadiad, India (Meharwal) Fortis Escorts Heart Institute, New Delhi, India (Koppula, Sreeramula) Sajja Heart Foundation, Telangana, Hyderabad, India (Shah) Care Institute Of Medical Sciences (CIMS), Gujarat, Ahmedabad, India (Kumar Kodali) Krishna Institute Of Medical Sciences (KIMS), Telangana, Hyderabad, India (Nagalla) Apollo Hospitals, Telangana, Hyderabad, India (Kapoor, Narayan) Rabindranath Tagore International Institute Of Cardiac Sciences, West Bengal, Kolkata, India (Doshi) U. N. Mehta Institute Of Cardiology & Research Centre, Gujarat, Ahmedabad, India (Mulay) Reliance Foundation Hospital, Maharashtra, Mumbai, India (Mohanraj) Medway Heart Institute, Tamil Nadu, Chennai, India (Hote) All India Institute Of Medical Sciences, New Delhi, India (Mishra) Manipal Hospitals, New Delhi, India (Jawali) Fortis Hospitals, Karnataka, Bangalore, India (Velayudhan) SIMS Hospitals, Tamil Nadu, Chennai, India Publisher Elsevier Inc. Abstract Abstract: Objective: Diabetic patients undergoing coronary artery bypass grafting (CABG) are at increased risk of adverse outcomes, yet multiple arterial grafting (MAG) remains underutilized. This randomized study evaluates short-term safety, 1-year graft patency, and long-term survival at 5 years of MAG compared with single arterial grafting (SAG). This interim analysis reports mortality, morbidity, and graft patency at 1 year. Method(s): A total of 950 diabetic patients with multivessel coronary artery disease were randomized in a multicenter, prospective, randomized trial enrolled between February 2022 through January 2025 at 15 hospitals across 7 states in India. Patients were randomized to SAG (n=477) and MAG (n=473). Major adverse cardiac and cerebrovascular events and graft patency assessed by CT coronary angiography at 1 year were analyzed (CTRI/2020/09/027692). Result(s): The mean number of distal grafts constructed was comparable between groups (SAG: 3.28 +/- 0.79 vs MAG: 3.17 +/- 0.85, p = 0.056). Thirty-day mortality was low and comparable (SAG 1/475 [0.2%] vs MAG 4/471 [0.8%], p=0.37). One-year mortality was similar (SAG 3/474 [0.6%] vs MAG 4/467 [0.9%], p=0.72). Myocardial infarction occurred in one patient in each group (p=1.0). Stroke rates were comparable (SAG 2/475 [0.4%] vs MAG 1/471 [0.2%], p=1.0). None required repeat revascularization. Sternal wound infection occurred in 7 SAG patients (1.5%) and 12 MAG patients (2.6%) (p=0.23). Sternal reconstruction was required in 3 MAG patients (0.6%) and in none of the SAG patients (p=0.12). 350 patients underwent CT coronary angiography for graft assessment (SAG: n=171, MAG: n=179), total of 1139 grafts evaluated. Off-pump surgery was performed in 154/179 (86.03%) MAG patients and 88/171 (51.46%) SAG patients. Overall graft patency was lower with off-pump compared with on-pump CABG (89.8% vs 93.7%, p=0.034). Circumflex territory graft patency was reduced with the off-pump technique (84.8% vs 92.8%, p=0.022). Saphenous vein graft patency was also lower with off-pump CABG (85.1% vs 91.1%, p=0.039), while arterial graft patency was similar between off- and on-pump groups (Figure). Conclusion(s): Interim results from the PREDICT trial demonstrate similar 1-year clinical outcomes for SAG and MAG, including mortality, myocardial infarction, stroke, and sternal wound complications. Overall graft patency, circumflex territory grafts, and saphenous vein graft patency were lower with off-pump CABG, while no difference was observed in the arterial graft patency. [Formula presented] Category: Adult Cardiac Copyright © 2026 <130> Accession Number 651112440 Title Postoperative pain management after VATS for spontaneous pneumothorax - a systematic review. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 05 May 2026. Author van Steenwijk Q.C.A.; Janssen L.; Hoogendoorn I.; Dickhoff C.; Braun J.; van den Broek F.J.C. Institution (van Steenwijk, Janssen) Department of Surgery, Maxima Medical Center, Veldhoven, Netherlands (Hoogendoorn) Department of Science and Medical Innovation, Maxima Medical Center, Veldhoven, Netherlands (Dickhoff, Braun) Department of Cardiothoracic Surgery, Location VU Medical Center, Cancer Center Amsterdam, Amsterdam, Netherlands (Braun) Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands (van den Broek) Department of Surgery, Maxima Medical Center, Veldhoven, Netherlands Abstract BACKGROUND: Historically, thoracic epidural analgesia has been the standard for postoperative pain management after surgery for spontaneous pneumothorax. With the advent of enhanced recovery after thoracic surgery protocols, less invasive locoregional analgesic techniques are increasingly considered. Due to lack of high-quality evidence, current guidelines do not address optimal analgesic strategies in this population. This systematic review evaluated the effectiveness of various analgesic techniques following video-assisted thoracoscopic surgery for spontaneous pneumothorax. METHOD(S): Medline, Embase and Cochrane databases were searched until May 2025. Inclusion criteria were patients undergoing video-assisted thoracoscopic surgery for spontaneous pneumothorax, with clearly described postoperative analgesic management (e.g. epidural, locoregional, systemic) and pain scores (visual analgesic score or numeric pain rating score) within 48 h. The primary outcome was pain scores within 48 h postoperatively; secondary outcomes included adjunct analgesic use and complications. Risk of bias was assessed for the primary outcome. RESULT(S): Thirty studies comprising 3,203 patients were assessed: risk of bias was low in 3, moderate/some concerns in 24 and high in 3 studies. There were 10 comparative studies and 20 single-arm cohort studies applying solely systemic analgesia (n = 14) or locoregional analgesia (n = 6). No single-arm cohort study applied solely epidural analgesia. Postoperative pain scores within 48 h were higher after systemic analgesia only, compared to the addition of locoregional or epidural analgesia. No clear differences were observed in analgesia-related complications between the analgesic techniques. CONCLUSION(S): Locoregional or epidural analgesia as part of a multimodal regimen was associated with the lowest postoperative pain scores, although differences were small. Substantial heterogeneity and low certainty of evidence precluded definitive recommendations. This review provides a foundation for future research investigating optimal analgesic strategies following surgery for spontaneous pneumothorax. Copyright © 2026. The Author(s). <131> Accession Number 651117625 Title Clinical Utility of Electrical Cardiometry-Based Parameters for Prevention of Low Cardiac Output Syndrome in Children Undergoing Cardiac Surgery - A Randomised Controlled Trial. Source Indian Journal of Anaesthesia. Conference: 73rd Annual National Conference of the Indian Society of Anaesthesiologists, ISA 2026. Kovalam India. 70(Supplement 2) (pp S101), 2026. Date of Publication: 01 Apr 2026. Author Das S. Institution (Das) AIIMS, New Delhi, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Electrical cardiometry (EC) is a non-invasive cardiac output (CO) monitor. It is safe, portable, and particularly advantageous in children. The present study evaluates whether EC-guided management prevents low cardiac output syndrome (LCOS). The aim was to evaluate the clinical utility of EC in preventing postoperative LCOS in congenital heart disease (CHD) patients. Method(s): The study was conducted after ethical approval and informed consent. Patients with CHD undergoing surgeries were enrolled. The study was registered in Clinical Trials Registry [CTRI/2023/11/060316]. Sixty patients were randomised using a sealed opaque envelope technique into either EC group (Group 1, n = 30) or control group (Group 2, n = 30). EC monitoring was initiated after placing four electrodes as recommended, and baseline parameters were recorded. Subsequent readings were obtained post-induction, post-sternotomy, off CardioPulmonary Bypass, after sternal closure, and after transfer to ICU and at 8 h, 16 h, 24 h, and 48 h of surgery. Parameters including CO, CI, stroke volume, thoracic fluid content, index of contractility, and stroke volume variation were used to guide management in Group 1. Group 2 patients were managed using routine monitoring. Data were analysed using Stata-16. A p-value <0.05 was considered significant. Result(s): Sixty children completed the study. LCOS occurred in 33.3% of patients in Group 1 compared to 53.3% in Group 2, corresponding to an absolute risk reduction of 20% (NNT = 5). By 48 hours, the benefits of EC-guided management were most evident. The heart rate was markedly lower (p = 0.002), MAP remained higher in Group 1, but the difference did not reach statistical significance (p = 0.08). Lactate clearance was complete (p < 0.001) in Group 1. Vasoactive Inotrope Score remained significantly lower (p = 0.041). Conclusion(s): EC facilitated timely interventions optimised tissue perfusion and reduced the incidence of LCOS. The present study strongly supports the integration of EC into perioperative monitoring, although larger multicentre studies are needed to validate the results. <132> Accession Number 651117666 Title A Prospective Randomised Controlled Trial to Study the Advantage of Implementation of Recovery After Surgery (ERAS) Protocol in Cardiac Surgery. Source Indian Journal of Anaesthesia. Conference: 73rd Annual National Conference of the Indian Society of Anaesthesiologists, ISA 2026. Kovalam India. 70(Supplement 2) (pp S103-S104), 2026. Date of Publication: 01 Apr 2026. Author Satwik M.; Karigar S.; Biradar P.A. Institution (Satwik, Karigar, Biradar) Shri B M Patil Medical College and Hospital, Karnataka, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Cardiac surgery patients often experience prolonged hospital stays, increased opioid use, and higher postoperative complication rates. Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care pathway that aims to improve clinical outcomes through standardised, evidence-based practices. This study aimed to evaluate the effectiveness of ERAS protocol implementation compared to conventional postoperative care in cardiac surgery patients. Method(s): This prospective randomised controlled trial enroled 52 patients undergoing elective cardiac surgery. Patients were randomly assigned to either the ERAS group (n = 26) or the routine protocol group (n = 26). Standard preoperative, intraoperative, and postoperative measures were employed based on group assignment. Primary outcomes included length of hospital stay and postoperative opioid consumption. Secondary outcomes included time to extubation, ambulation, enteral feeding, and postoperative complications. Statistical analysis included independent t-tests, Mann-Whitney U test, and Chi-square tests. Result(s): Patients managed with the ERAS protocol showed significantly faster recovery than those under the routine protocol. The ERAS group had shorter postoperative stay, earlier extubation, faster ambulation, and quicker enteral feeding initiation (p < 0.001). Both groups had similar analgesic requirements and gender distribution. Overall, the ERAS protocol proved superior in enhancing postoperative recovery outcomes compared to the routine protocol. Conclusion(s): Implementing ERAS protocols in cardiac surgery is expected to significantly reduce hospital stay, opioid usage, and postoperative complications. This approach promotes early recovery, enhances patient satisfaction, and potentially lowers healthcare costs, supporting its broader adoption in perioperative cardiac care. <133> Accession Number 651117814 Title Comparison of Neostigmine Versus Sugammadex for Recovery of Muscle Function after Neuromuscular Blockade by Means of Diaphragm Ultrasonography in Non-Cardiac Surgery: A Randomised Control Trial. Source Indian Journal of Anaesthesia. Conference: 73rd Annual National Conference of the Indian Society of Anaesthesiologists, ISA 2026. Kovalam India. 70(Supplement 2) (pp S115), 2026. Date of Publication: 01 Apr 2026. Author Kumar P.; Rout A.K.; Rao P.B. Institution (Kumar, Rout, Rao) AIIMS, Odisha, Bhubaneswar, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Neuromuscular blocking agents play a vital role in general anaesthesia. However, postoperative residual curarisation (PORC) is a major concern. Ultrasonography-guided diaphragmatic thickening fraction is a new modality still being explored to estimate PORC. Method(s): A randomised controlled trial was done to compare Neostigmine and Sugammadex as reversal agents and to assess their differential effect on the incidence of PORC {Diaphragm Thickness Fraction (DTF) <0.36}, time to extubation, loss of lung aeration, and incidence of postoperative pulmonary complications (PPCs) after general anaesthesia. Result(s): A total of 76 patients were randomised into two groups who were similar in the baseline characteristics. Incidence of PORC in the Sugammadex and Neostigmine groups was not found to be significantly different (5% Vs 8%, p > 0.05). Recovery of muscle function defined as DTF gradient (11.45% Vs 20.8%, p = 0.001), loss of lung aeration (7.4% Vs 34.5%, p = 0.02), time required to extubate since the administration of reversal (2.14 Vs 4.71 minutes, p = 0.001), and incidence of PPCs (2.6% Vs 21.2%) were better in the Sugammadex as compared to the Neostigmine group. Patients with PORC at extubation were found to have 20 times higher odds of developing PPCs than those without PORC (Adjusted OR: 19.73; 95% CI: 2.49-458.69, p = 0.016). Conclusion(s): Sugammadex was associated with better recovery of muscle function, lung aeration, time to extubation, and incidence of PPCs after major non-cardiac surgeries as compared to Neostigmine, but we did not find any difference in the incidence of PORC between the groups. <134> [Use Link to view the full text] Accession Number 651123339 Title The Use of Methadone in Adult Cardiac Surgery: A Systematic Review With Narrative Synthesis. Source Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 05 May 2026. Author Kumar N.; Bardia A.; Hussain N.; Gerner P. Institution (Kumar, Bardia, Gerner) From the Department of Anesthesia, Critical Care Medicine, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and (Hussain) Department of Anesthesiology, Ohio State University Wexner Medical Center, Columbus, OH, United States Abstract Methadone is a long-acting opioid with multifaceted analgesic properties that is under increasing investigation as an intraoperative analgesic in cardiac surgery. A systematic search of United States National Library of Medicine Database (MEDLINE) and Excerpta Medica Database (EMBASE) databases identified publications investigating the use of intraoperative methadone in adult cardiac surgical patients. The risk of bias and quality of evidence of these studies were assessed, and data from these reports were extracted and presented in a narrative format. Sixteen eligible publications were included. Although the quality of the studies was moderate to high, the certainty of the evidence is low due to the limited available data regarding optimal dosing strategies, timing of administration in relation to cardiopulmonary bypass, and long-term safety outcomes. The composite data suggest that a single dose of intraoperative methadone results in less postoperative pain and opioid consumption postoperatively without any increased risk for QTc prolongation or respiratory depression. Doses of 0.1 to 0.3 mg/kg are reported in the cardiac surgery literature; however, there is evidence of a dose-response relationship with methadone's analgesic benefits and increased deliriogenic side effects. Studies using 0.1 mg/kg reveal equivocal analgesia, whereas the studies administering >=0.2 mg/kg consistently report lower postoperative pain scores and opioid consumption compared to short-acting intravenous (IV) opioids. Crucially, the use of cardiopulmonary bypass significantly impacts methadone's plasma concentrations and must be considered when determining the optimal dose and timing of administration. Further, recent observational studies offer valuable insight into methadone's role in multimodal enhanced recovery after cardiac surgery protocols. Additional trials are needed to refine methadone usage in this population. Copyright © 2026 International Anesthesia Research Society. <135> Accession Number 2045396714 Title Tube or tubeless? Non-intubated VATS as a contemporary strategy in thoracic surgery. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 23. Date of Publication: 01 Dec 2026. Author Elmaleh Y.D.; Guessous K.; Kattou F.; Delvaux B.; Zanoun N. Institution (Elmaleh, Guessous, Kattou, Delvaux, Zanoun) Quincy Anesthesie, Private Hospital Claude Galien, Ramsay Sante, Quincy-sous-Senart, France (Elmaleh, Guessous, Kattou, Delvaux, Zanoun) HoopCare, Paris, France Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Video-assisted thoracic surgery (VATS) is traditionally performed under general anesthesia with endotracheal intubation and one-lung ventilation. Renewed interest in non-intubated VATS (NIVATS) has refocused attention on thoracic surgery performed under spontaneous ventilation with regional anesthesia and carefully titrated sedation. This review examines the evolution, rationale, current evidence, and practical limits of NIVATS in modern thoracic surgery. Main body: We summarize the terminology and development of NIVATS and discuss its physiological basis, indications, contraindications, patient selection, regional anesthesia, cough-control strategies, oxygenation adjuncts, and conversion pathways. Recent randomized syntheses and propensity-matched meta-analyses suggest that, in carefully selected patients managed in experienced centers, NIVATS can reduce airway-related morbidity, postoperative nausea and vomiting, chest-tube duration, and length of stay, with signals toward fewer postoperative pulmonary complications and faster recovery. These potential advantages are counterbalanced by specific intraoperative challenges, including respiratory motion, cough, permissive hypercapnia, and the need for immediate conversion to intubated anesthesia in cases of hypoxemia, bleeding, or inadequate surgical conditions. Successful implementation therefore depends on strict patient selection, high-quality regional analgesia, close surgeon-anesthesiologist coordination, and a predefined conversion strategy. Conclusion(s): NIVATS should not be viewed as a universal replacement for intubated anesthesia, but as a complementary, precision-based approach for selected thoracic procedures. In experienced centers, current evidence supports its feasibility, safety, and clinical value, while broader adoption will depend on standardization, training, and robust long-term outcome data. Copyright © The Author(s) 2026. <136> Accession Number 2045568314 Title To evaluate the analgesic efficacy of serratus anterior plane block and local infiltration with 0.25% bupivacaine in patients undergoing modified radical mastectomy. Source International Journal of Life Sciences Biotechnology and Pharma Research. 15(5) (pp 37-42), 2026. Date of Publication: 01 May 2026. Author Singh S.; Awasya S.; Pandey V. Institution (Singh) Gandhi Medical College, Bhopal, India (Awasya) Gandhi Medical College, Bhopal, India (Pandey) Gandhi Medical College, Bhopal, India Publisher International Journal of Life Sciences Biotechnology and Pharma Research Abstract Background: Effective postoperative pain management following modified radical mastectomy (MRM) is essential for early recovery and reduction of complications. The serratus anterior plane (SAP) block has emerged as a promising regional anesthesia technique for thoracic surgeries. This study aimed to compare the analgesic efficacy of ultrasound-guided SAP block with local infiltration in patients undergoing MRM. Method(s): This prospective comparative study included 64 female patients (ASA I-II) undergoing MRM, who were allocated into two groups: Group A (SAP block, n=32) and Group B (local infiltration, n=32). At the end of surgery, Group A received ultrasound-guided SAP block with 20 mL of 0.25% bupivacaine, while Group B received local infiltration with the same volume and concentration. Postoperative pain was assessed using the Visual Analog Scale (VAS) at predefined intervals up to 24 hours. Time to first rescue analgesia, total analgesic consumption, hemodynamic parameters, and adverse effects were also recorded. Result(s): VAS scores were significantly lower in Group A during the early postoperative period (30 minutes to 4 hours) (p< 0.001), with no significant differences thereafter. The time to first rescue analgesia was significantly prolonged in Group A (471.2 +/- 49.8 min) compared to Group B (140.6 +/- 20.8 min) (p< 0.0001). Total analgesic consumption was lower in the SAP block group, with reduced diclofenac and tramadol requirements. Hemodynamic parameters remained comparable between groups. The incidence of postoperative nausea and vomiting was significantly lower in Group A (p< 0.05). Conclusion(s): Ultrasound-guided SAP block provides superior early postoperative analgesia, prolongs analgesic duration, reduces analgesic consumption, and offers a favorable safety profile compared to local infiltration in patients undergoing MRM. It can be effectively incorporated into multimodal analgesia protocols for breast surgery. Copyright ©2026 Int. J. Life Sci. Biotechnol. Pharma. Res. <137> Accession Number 2045520952 Title Efficacy of positive expiratory pressure in the prevention and treatment of postoperative pulmonary complications following thoracic and abdominal surgery. A systematic review and meta-analysis. Source Monaldi Archives for Chest Disease. 96(2) (no pagination), 2026. Article Number: 3735. Date of Publication: 2026. Author Dolic D.; Salvitti S. Institution (Dolic, Salvitti) Department of Medicine, University of Udine, Italy (Salvitti) Unit of Cardiorespiratory Physiotherapy, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy Publisher Page Press Publications Abstract Postoperative pulmonary complications (PPCs), including atelectasis, pneumonia, and respiratory failure, are common after thoracic and upper abdominal surgery and are associated with increased morbidity, longer hospital stays, and higher costs. This systematic review and meta-analysis investigated whether positive expiratory pressure (PEP) devices reduce PPCs after thoracic or upper abdominal surgery compared with continuous positive airway pressure (CPAP), usual care/no intervention, or other non-CPAP respiratory treatments. We searched major databases and included randomized controlled trials. A total of 12 studies were included, and 7 contributed to the meta-analysis. Across comparator-stratified analyses, PEP did not demonstrate a consistent reduction in PPCs. Compared with usual care/no intervention, pooled estimates showed no significant benefit, and results were similarly inconclusive when PEP was compared with other non-CPAP treatments; evidence vs. CPAP was limited to a single small trial. The overall certainty of evidence was low due to methodological limitations and heterogeneity in outcome definitions and intervention protocols. Overall, current evidence does not support routine use of PEP devices as a primary strategy to prevent PPCs after thoracic or upper abdominal surgery. Further well-designed trials are needed to clarify whether specific patient subgroups or standardized protocols may benefit. ©Copyright: the Author(s), 2026. <138> Accession Number 2045565207 Title Induction strategies for preventing hemodynamic changes after intubation in non-cardiac surgery patients: a network meta-analysis of randomized controlled trials. Source Frontiers in Medicine. 12 (no pagination), 2026. Article Number: 1694700. Date of Publication: 22 Jan 2026. Author Gan Y.; Yang X.; Wang W.; Zhang H.; Luo X.; Wang M.; Xu Z.; Su S.; Wu J. Institution (Gan, Yang, Wang, Zhang, Wang, Xu, Wu) Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China (Luo, Su) Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China Publisher Frontiers Media SA Abstract Background - Tracheal intubation and laryngoscopy during general anesthesia induce significant hemodynamic changes. Although generally transient, these physiological perturbations may precipitate critical cardiovascular events in high-risk populations. Anesthesiologists have used various drug combinations to suppress this response. This network meta-analysis (NMA) aimed to identify a drug combination that can better suppress hemodynamic fluctuations caused by tracheal intubation in non-cardiac surgical patients. Methods - We searched 3 different medical literature databases. A NMA was performed on the included randomized controlled trials (RCTs). RCTs were evaluated using the Cochrane risk of bias tool. A random effects network meta-analysis was performed within a frequentist framework. The effects of each pharmacological strategy on intraoperative hemodynamics in patients undergoing non-cardiac surgery were compared. Endpoints included DELTAMean Arterial Pressure (DELTAMAP) and DELTAHeart Rate (DELTAHR). Results - The network meta-analysis included 10 studies and 791 patients. According to the surface under the cumulative ranking curve, Oxycodone-Propofol-Lidocaine (87.4%) demonstrated superior efficacy in controlling fluctuations in MAP, followed by Fentanyl-Propofol-Dexmedetomidine (82.9%) and Fentanyl-Propofol-Clonidine (81.6%). Fen-Pro-Dex (94.8%) demonstrated superior efficacy in controlling fluctuations in HR, followed by Fentanyl-Propofol-Lidocaine (Epidural) (83.3%), Fentanyl-Propofol-Remifentanil (79.1%). Conclusion - Among patients undergoing non-cardiac surgery, Oxy-Pro-Lid was preferred for attenuating post-intubation changes in MAP, whereas Fen-Pro-Dex provided superior control of HR fluctuations. These findings may help guide the selection of induction pharmacological strategies, although more randomized controlled trials are needed to confirm these results and clarify optimal dosing. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD42024591333, identifier CRD42024591333. Copyright © 2026 Gan, Yang, Wang, Zhang, Luo, Wang, Xu, Su and Wu. <139> Accession Number 651116981 Title Impact of ERAS protocol anesthesia on cardiac surgical patients. Source European Journal of Clinical and Experimental Medicine. Conference: Rzeszow International Medical Students' Association Congress, RIMSA 2024. Rzeszow Poland. 2025(Supplement) (pp 43), 2025. Date of Publication: 01 Jan 2025. Author Pasko M. Institution (Pasko) Surgery Department, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rzeszow, Poland Publisher Rzeszow University Press Abstract Introduction and aim. The benefit of enhanced recovery after surgery (ERAS) protocol over standard anesthesia procedure. ERAS protocol consists of the following guidelines: restricted fluid supply, preventing excess starvation, lack of preparation of the intestines, preventing PONV, preventing hypothermia, keeping catheters awhile, and fast rehabilitation afterward. Material and methods. All patients included in the study were patients of the Intensive Care Cardiac Surgery Clinic of the Provincial Hospital No. 2. Saint Jadwiga the Queen in Rzeszow, who underwent minimal access heart valve surgery. The study group consisted of 100 patients after cardiac surgery in the ICU, half of whom were anesthetized according to the ERAS protocol, and half anesthetized according to the standard procedure. They were divided into groups of fifty patients randomly. The description was performed separately for each group. The age of patients was between 18 and 81. There was 48% of women and 52% of men. Risk factors taken into account among all patients were hypertension(19%), diabetes (18%), hypercholesterolemia (13%) and smoking cigarettes (12%). Results. Patients anesthetized with ERAS protocol spent less time in ICU after an operation (medium time 24.1+/-10.89 hours with median 21) compared with a standard protocol (55+/-31.50 hours with median 45). Analogically ventilation time: ERAS medium time 216.3+/-218.82 minutes with median 153 vs. 626.2+/-261.29 minutes with median 560. Conclusion. Applying the ERAS protocol was more beneficial for both female and male patients at every stage of the perioperational period. It considerably shortened the time spent in the intensive care ward after an operation and ventilation time likewise. <140> Accession Number 651117633 Title To Evaluate the Effect of Combination of Lidocaine and Ketamine Infusion on Attenuation of Haemodynamic Response to Intubation, Skin Incision, and Sternotomy in Open Adult Valvular Heart Surgeries. A Double-Blinded Randomised Controlled Study. Source Indian Journal of Anaesthesia. Conference: 73rd Annual National Conference of the Indian Society of Anaesthesiologists, ISA 2026. Kovalam India. 70(Supplement 2) (pp S101-S102), 2026. Date of Publication: 01 Apr 2026. Author Naik M.M.; Khalbande J.; Kumar S. Institution (Naik, Khalbande, Kumar) AIIMS, Chhattisgarh, Raipur, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Open valvular heart surgery involves intense noxious stimuli such as laryngoscopy, intubation, skin incision, and sternotomy that elicit marked sympathetic responses, leading to tachycardia, hypertension and increased myocardial oxygen demand. These fluctuations may precipitate ischaemia, arrhythmias, or organ dysfunction in patients with compromised cardiac reserve. The study aimed to evaluate whether a combination of intravenous lidocaine and ketamine infusion attenuates perioperative haemodynamic responses compared to placebo. Method(s): This prospective, randomised, double-blinded controlled trial enrolled 62 patients (ASA II-III, age 18-75 years) undergoing elective open valvular heart surgery with ejection fraction >40%. Patients were randomly allocated into two groups: Group LK received lidocaine (1.5 mg/kg bolus, 1.5 mg/kg/h infusion) plus ketamine (0.2 mg/kg bolus, 0.2 mg/kg/h infusion), while Group P received normal saline. The primary outcome was comparison of haemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, peripheral oxygen saturation) between two groups at baseline, intubation, skin incision, sternotomy, and post-sternotomy. The secondary outcome was comparison of propofol and fentanyl requirement. Data was analysed using SPSS v23 with p < 0.05 considered significant. Result(s): Group LK demonstrated a significantly attenuated rise in heart rate and blood pressure at intubation, skin incision, and sternotomy compared to placebo (p < 0.05). The mean arterial pressure remained more stable in Group LK. Additionally, total propofol and fentanyl consumption was lower in Group LK (p < 0.05). No major adverse effects attributable to the study drugs were observed. Conclusion(s): The combination of lidocaine and ketamine infusion effectively attenuates haemodynamic responses to critical intraoperative stimuli in open valvular heart surgery while reducing anaesthetic and opioid requirements, without significant adverse effects. This strategy may enhance perioperative stability and improve outcomes. <141> Accession Number 651117569 Title ISA 2026. Source Indian Journal of Anaesthesia. Conference: 73rd Annual National Conference of the Indian Society of Anaesthesiologists, ISA 2026. Kovalam India. 70(Supplement 2) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Anonymous Publisher Wolters Kluwer Medknow Publications Abstract The proceedings contain 116 papers. The topics discussed include: comparison of split-type postman and C-MAC video laryngoscopes for ease of intubation in simulated restricted neck mobility: a randomized clinical trial; effect of phenylephrine on body temperature during elective delivery under spinal anesthesia: a randomized clinical trial; comparison of ultrasound-guided external oblique intercostal plane block versus subcostal transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy surgeries: a randomized controlled clinical study; postoperative pain relief in abdominal surgery: USG-guided transversus abdominis plane block versus quadratus lumborum block: a comparative analysis; use of chatbot to assist pre-anesthetic clinic: a feasibility study; correlation of preoperative phase angle with postoperative quality of recovery in patients undergoing elective major non-cardiac surgeries: a prospective, observational single-center study; evaluation of predictive ability of sonography- based airway assessment parameters and clinical parameters as predictors of difficult laryngoscopy and intubation: an observational study; effect of Propofol Versus Ketofol infusions on transcranial motor evoked potentials in patients undergoing cerebellopontine angle tumor surgeries - a prospective randomized blinded clinical study; analysis of noise levels in neurosurgical operation theatres and its effects on anesthesia residents: an observational cohort study; and modulation of MRNA expression of mTORC1 and IL-6 genes following mindfulness-based intervention and pregabalin for the management of neuropathic pain in postherpetic neuralgia: a randomized controlled study. <142> Accession Number 651119868 Title REPORTING QUALITY OF ANTITHROMBOTICS NETWORK META-ANALYSES AND ITS COMPLIANCE WITH RECOMMENDATIONS OF REPORTING GUIDELINES. Source Infarma - Pharmaceutical Sciences. Conference: 3. Congresso Brasileiro de Ciencias Farmaceuticas. Foz do Iguacu Brazil. 36(Supplement 3) (pp 341), 2026. Date of Publication: 01 Mar 2026. Author de Sousa P.G.; Mainka F.F.; Tonin F.S.; Pontarolo R. Institution (de Sousa, Mainka, Tonin, Pontarolo) Universidade Federal Do Parana, Brazil Publisher Conselho Federal de Farmacia Abstract The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement is a guideline on the minimum set of items that authors should report. In 2015, the PRISMA Network Meta-Analysis (NMA) was published as an extension of the PRISMA with new or redesigned criteria for NMAs of health care interventions (PRISMA-NMA). We aimed to determine the report quality of NMAs of antithrombotics and their compliance with recommendation for reporting a systematic review. A overview of NMAs comparing the clinical effects of antithrombotic therapies was performed (searches in PubMed and Scopus). We included NMAs comparing any antithrombotic therapy for the treatment or prophylaxis of heart diseases or during cardiac surgical procedures. Studies protocols, studies evaluating antithrombotic agents in non-cardiac conditions and articles written in non-Roman characters were excluded. Data extraction and reporting quality assessment of the included studies were performed by a single reviewer and checked by another trained researcher. Overall characteristics of the NMAs were extracted and their reporting quality was evaluated using the PRISMA-NMA checklist. The total score was calculated by the sum of compliance with the items on this checklist (maximum score: 32). Descriptive statistical analysis was performed for all variables. Continuous variables were expressed as mean and standard deviation and were compared using Student's t-test. The difference was considered significant when p<0.05. All analyses were conducted in SPSS Statistics v. 25.0. This study was registered in PROSPERO (CRD42020166468). We found 86 NMAs published between 2007 and 2022. The mean score was 20.8 +/- 5.3 and 64 (74.4%) NMAs reported following some recommendation for reporting a systematic review. The mean score obtained was 24.8 +/- 4.1 for NMAs who followed PRISMA-NMA (n=24; 2015-2022), 21 .0 +/- 8.6 for NMAs who followed PRISMA-2020 (n=3; 2021), 19.9 +/- 5.2 for NMAs that followed PRISMA-2009 (n=30; 2012-2022), 15.7 +/- 4.5 for NMAs that followed QUORUM (n=3; 2010-2021), and 15.0 +/- 3 .7 for NMAs that followed PRISMA-P (n=4; 2016-2019). For the NMAs that followed some recommendation for reporting (n=64; 2010-2022), the mean score was 21.6 +/- 5.4 and in those who did not follow any recommendation for reporting (n=22; 2007-2021), the mean score was 18.73 +/- 4.4 (p=0.03). Authors have disregarded recommendations for reporting updated NMAs. Approximately a quarter of NMAs on antithrombotics do not follow reporting recommendations. Journal editors and authors of these studies must improve the quality of reporting to ensure transparency and accessibility of evidence. <143> Accession Number 2045562812 Title Letter to the Editor: HTK Solution Cardioplegia in Pediatric Patients: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Article Number: tcs-04-2026-7780-L. Date of Publication: 2026. Author Momin S.M.; Shah S.U.; Akbar H.; Hussain S.H. Institution (Momin, Shah, Akbar, Hussain) Nowshera Medical College, Khyber Pakhtunkhwa, Nowshera, Pakistan Publisher Georg Thieme Verlag �

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