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Total documents retrieved: 183 Results Generated From: Embase <1980 to 2026 Week 37> Embase Weekly Updates (updates since 2026-09-03) - (183 records) <1> Accession Number 2038561655 Title Sternal Closure Techniques Using Steel Wires and Predictors of Sternal Wound Complications: A Randomized Controlled Trial. Source Brazilian Journal of Cardiovascular Surgery. 41(3) (no pagination), 2026. Article Number: e20260056. Date of Publication: 2026. Author Mogahed M.A.; Abdelaal M.M.; Elfeky W.M.; Elghanam A.R.; Elesawy M.M.; Abdelalim M.M. Institution (Mogahed, Abdelaal, Elfeky, Elghanam, Elesawy, Abdelalim) Department of Cardiothoracic Surgery, Faculty of Medicine, Kafr Elsheikh University, Kafr El Sheikh, Egypt Publisher Sociedade Brasileira de Cirurgia Cardiovascular Abstract Introduction: Median sternotomy is the gold standard for cardiac surgery but carries a significant risk of wound complications, including sternal dehiscence and wound infections. Objective(s): This study aimed to compare the early efficacy and complication rates of three distinct steel-wire sternal closure techniques and identify potential risk factors of complications. Method(s): We conducted a randomized controlled study on patients undergoing cardiac surgery. Patients were randomly allocated into three groups of sternal closure techniques: simple interrupted (Group A), figure-of-eight (Group B), or a modified combined technique (Group C). Baseline characteristics, intraoperative parameters, postoperative recovery outcomes, and sternal wound complications including sternal dehiscence and superficial and deep wound infections were evaluated. Binomial logistic regression was performed to determine independent risk factors for complications. Result(s): One hundred sixty-five adult cardiac patients were finally included in the study. All three intervention groups (n = 55) were well-matched regarding baseline characteristics and intraoperative parameters. The incidence of sternal dehiscence (6.1%) and superficial (7.9%) and deep wound infections (3.6%) did not differ significantly among the three wire closure techniques (P > 0.05). However, logistic regression identified numerous factors associated with superficial sternal wound infections including old age, obesity (body mass index > 30), comorbidities, elevated C-reactive protein and HbA1C, prolonged cardiopulmonary bypass time, extended operative time, and longer intensive care unit stay (P < 0.05 for all). Conclusion(s): The three steel-wire closure techniques demonstrated comparable early postoperative stability and similar rates of sternal wound complications. Technique choice may be based on surgeon preference. Copyright © 2026, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved. <2> Accession Number 651589079 Title Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial. Source Critical care (London, England). 30(1) (no pagination), 2026. Date of Publication: 23 Jun 2026. Author Wongtangman K.; Reddy Janga S.; Azimaraghi O.; Khandaker R.; Khera T.; Leff J.; Forest S.J.; Suleiman A.; Tam C.; Spindel S.; DeYoung P.N.; Malhotra A.; Subramaniam B.; Eikermann M. Institution (Wongtangman, Azimaraghi, Khandaker, Leff, Suleiman, Tam, Eikermann) Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th St, Bronx, 10467, NY, USA (Wongtangman) Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Reddy Janga, Khera) Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, Israel (Forest, Spindel) Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States (DeYoung, Malhotra) Division of Pulmonary, Critical Care, Sleep Medicine, Physiology, University of California San Diego, La Jolla, CA, United States (Subramaniam) Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, Israel (Eikermann) Klinik fur Anasthesiologie und Intensivmedizin, Universitat Duisburg- Essen, Essen, Germany Abstract BACKGROUND: Patients recovering from cardiac surgery in the intensive care unit (ICU) do not sleep well. Commonly used sedative-hypnotic medications can disrupt sleep architecture and increase the risk of delirium in critically ill patients after surgery. The orexin receptor antagonist suvorexant, improves sleep onset and duration in patients with chronic insomnia. We hypothesized that suvorexant improves sleep onset and duration while also reducing the incidence of delirium after cardiac surgery. METHOD(S): This multicentric, double-blind, randomized controlled trial was conducted at two university-based cardiac ICUs. One hundred adult patients were enrolled after admission to the ICU following cardiac surgery. Enrollment occurred between March 2020 and February 2025. Participants were randomized to receive either a once daily oral dose of suvorexant 20 mg or placebo. Treatment began on the first night after extubation and continued until hospital discharge or for a maximum of seven days, whichever occurred first. Sleep was recorded using an electroencephalography (EEG) monitor (SedLine, Masimo Corp., California, USA) on the first night after extubation and was scored blindly by an experienced registered polysomnographic technologist. The primary outcome was wakefulness after persistent sleep onset (WASO). Sleep onset was defined as the first 30-second epoch classified by rapid eye movement (REM) or non-REM stages 1, 2, 3 after lights off. Wakefulness was defined as an awake period of 30s or longer. Sleep questionnaires were administered and delirium screenings were conducted every morning until hospital discharge. RESULT(S): One hundred patients were randomized to receive suvorexant (n = 49) or placebo (n = 51). EEG analysis indicated that neither the median [inter-quartile range] nighttime WASO (200.7 [112.1, 328.4] minutes vs. 184.2 [80.4, 304.2] minutes; p = 0.33) nor total sleep time (224.0 [112.0, 379.0] minutes vs. 253.0 [68.0, 420.0] minutes; p = 0.92) differed significantly between the groups. There was no significant difference in rescue medication (melatonin, dexmedetomidine, benzodiazepine) utilization between the groups. Subjective sleep quality, incidence of delirium, and delirium-free days did not differ between the two groups. TRIAL REGISTRATION NUMBER: Clinical Trials Registry no. NCT04092894, Registration Date 09/17/2019. CONCLUSION(S): Among patients recovering in the ICU who underwent cardiac surgery with cardiopulmonary bypass, the suvorexant treatment did not affect wakefulness after sleep onset or post-operative delirium. Copyright © 2026. The Author(s). <3> Accession Number 2048901799 Title Pooled Efficacy and Safety of Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants or Antiplatelets: A Meta-Analysis of the Landmark Randomized Trials. Source Journal of Cardiovascular Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Knijnik L.M.; Rao B.; DeLurgio D.B. Institution (Knijnik, Rao, DeLurgio) Emory University, Atlanta, GA, United States Publisher John Wiley and Sons Inc Abstract Background: Landmark randomized controlled trials (RCTs) comparing left atrial appendage occlusion (LAAO) against direct oral anticoagulants (DOACs) are individually underpowered for small but clinically meaningful differences. We performed a pooled meta-analysis to provide more precise efficacy and safety data. Method(s): Utilizing random-effects models, we pooled data from 5890 patients across four landmark RCTs (PRAGUE-17, CLOSURE-AF, OPTION, and CHAMPION-AF) at their longest follow-up. Result(s): There were no significant differences between LAAO and antithrombotics in cardiovascular mortality (5.3% vs. 4.8%, p = 0.33), all-cause stroke (3.3% vs. 2.8%, p = 0.31), systemic embolism (0.2% vs. 0.1%, p = 0.68), or major bleeding (6.6% vs. 6.8%, p = 0.85). Non-procedural bleeding was significantly lower with LAAO (9.2% vs. 16.7%; RR 0.55; 95% CI 0.47-0.64; p < 0.0001), though there was a numerical trend toward more ischemic stroke events (2.7% vs. 2.0%; RR 1.35; 95% CI 0.97-1.88; p = 0.08). Conclusion(s): LAAO offers similar overall efficacy and safety to modern antithrombotics. It represents a clinical trade-off: accepting a known upfront procedural risk for a robust, long-term reduction in non-procedural bleeding, potentially at the cost of a slight numerical increase in ischemic stroke. Copyright © 2026 Wiley Periodicals LLC. <4> 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. 15(3) (pp 393-406), 2026. Date of Publication: 01 Sep 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. <5> Accession Number 2031489437 Title Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial. Source The Lancet. 403(10439) (pp 1866-1878), 2024. Date of Publication: 11 May 2024. Author Ge Z.; Kan J.; Gao X.; Raza A.; Zhang J.-J.; Mohydin B.S.; Gao F.; Wang Y.; Zeng H.; Li F.; Mengal N.; Cong H.; Wang M.; Chen L.; Wei Y.; Chen F.; Stone G.W.; Chen S.-L.; Li X.; Anjum M.; Ye F.; Jalal A.; Xie P.; Tao L.; Chen X.; Khan H.S.; Javed A.; Shao Y.; Guo X.; Saghir T.; Nie S.; Qu H.; Qian X.; Yang S.; Chen J.; Gao D.; Liu L.; Liu F.; Xu T.; Liu Y.; Gill B.U.A.; Yang Q.; Guo N.; Wen S.; Hong L.; Sheiban I.; Mintz G.S. Institution (Ge, Kan, Gao, Zhang, Chen) Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Raza) Airdale General Hospital, West Yorkshire, United Kingdom (Mohydin) Punjab Institute of Cardiology, Lahore, Pakistan (Gao) Gansu Provincial People's Hospital, Lanzhou, China (Shao) Qingdao Municipal Hospital, Qingdao, China (Wang) Xiamen Heart Center, Xiamen University, Xiamen, China (Zeng) Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li) Affiliated Oriental Huainan General Hospital, Anhui University of Science and Technology, Huainan, China (Khan) Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan (Mengal) National Institute of Cardiovascular Diseases of Pakistan, Karaqi, Pakistan (Cong) Tianjin Chest Hospital, Tianjin University, Tianjin, China (Wang) Puto People's Hospital, Tongji University, Shanghai, China (Chen) Fujian Medical University Union Hospital, Fuzhou, China (Wei) Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China (Chen) School of Public Health, Center of Global Health, Nanjing Medical University, Nanjing, China (Stone) The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Elsevier B.V. Abstract Background: Following percutaneous coronary intervention with stent placement to treat acute coronary syndromes, international clinical guidelines generally recommend dual antiplatelet therapy with aspirin plus a P2Y<inf>12</inf> receptor inhibitor for 12 months to prevent myocardial infarction and stent thrombosis. However, data on single antiplatelet therapy with a potent P2Y<inf>12</inf> inhibitor earlier than 12 months after percutaneous coronary intervention for patients with an acute coronary syndrome are scarce. The aim of this trial was to assess whether the use of ticagrelor alone, compared with ticagrelor plus aspirin, could reduce the incidence of clinically relevant bleeding events without an accompanying increase in major adverse cardiovascular or cerebrovascular events (MACCE). Method(s): In this randomised, placebo-controlled, double-blind clinical trial, patients aged 18 years or older with an acute coronary syndrome who completed the IVUS-ACS study and who had no major ischaemic or bleeding events after 1-month treatment with dual antiplatelet therapy were randomly assigned to receive oral ticagrelor (90 mg twice daily) plus oral aspirin (100 mg once daily) or oral ticagrelor (90 mg twice daily) plus a matching oral placebo, beginning 1 month and ending at 12 months after percutaneous coronary intervention (11 months in total). Recruitment took place at 58 centres in China, Italy, Pakistan, and the UK. Patients were required to remain event-free for 1 month on dual antiplatelet therapy following percutaneous coronary intervention with contemporary drug-eluting stents. Randomisation was done using a web-based system, stratified by acute coronary syndrome type, diabetes, IVUS-ACS randomisation, and site, using dynamic minimisation. The primary superiority endpoint was clinically relevant bleeding (Bleeding Academic Research Consortium [known as BARC] types 2, 3, or 5). The primary non-inferiority endpoint was MACCE (defined as the composite of cardiac death, myocardial infarction, ischaemic stroke, definite stent thrombosis, or clinically driven target vessel revascularisation), with an expected event rate of 6.2% in the ticagrelor plus aspirin group and an absolute non-inferiority margin of 2.5 percentage points between 1 month and 12 months after percutaneous coronary intervention. The two co-primary endpoints were tested sequentially; the primary superiority endpoint had to be met for hypothesis testing of the MACCE outcome to proceed. All principal analyses were assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT03971500, and is completed. Finding(s): Between Sept 21, 2019, and Oct 27, 2022, 3400 (97.0%) of the 3505 participants in the IVUS-ACS study were randomly assigned (1700 patients to ticagrelor plus aspirin and 1700 patients to ticagrelor plus placebo). 12-month follow-up was completed by 3399 (>99.9%) patients. Between month 1 and month 12 after percutaneous coronary intervention, clinically relevant bleeding occurred in 35 patients (2.1%) in the ticagrelor plus placebo group and in 78 patients (4.6%) in the ticagrelor plus aspirin group (hazard ratio [HR] 0.45 [95% CI 0.30 to 0.66]; p<0.0001). MACCE occurred in 61 patients (3.6%) in the ticagrelor plus placebo group and in 63 patients (3.7%) in the ticagrelor plus aspirin group (absolute difference -0.1% [95% CI -1.4% to 1.2%]; HR 0.98 [95% CI 0.69 to 1.39]; p<inf>non-inferiority</inf><0.0001, p<inf>superiority</inf>=0.89). Interpretation(s): In patients with an acute coronary syndrome who had percutaneous coronary intervention with contemporary drug-eluting stents and remained event-free for 1 month on dual antiplatelet therapy, treatment with ticagrelor alone between month 1 and month 12 after the intervention resulted in a lower rate of clinically relevant bleeding and a similar rate of MACCE compared with ticagrelor plus aspirin. Along with the results from previous studies, these findings show that most patients in this population can benefit from superior clinical outcomes with aspirin discontinuation and maintenance on ticagrelor monotherapy after 1 month of dual antiplatelet therapy. Funding(s): The Chinese Society of Cardiology, the National Natural Scientific Foundation of China, and the Jiangsu Provincial & Nanjing Municipal Clinical Trial Project. Translation: For the Mandarin translation of the abstract see Supplementary Materials section. Copyright © 2024 Elsevier Ltd <6> Accession Number 2035523330 Title Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe): a multicentre, randomised, non-inferiority trial. Source The Lancet. 404(10465) (pp 1835-1846), 2024. Date of Publication: 09 Nov 2024. Author Andersen B.K.; Sejr-Hansen M.; Maillard L.; Campo G.; Ramunddal T.; Stahli B.E.; Guiducci V.; Serafino L.D.; Escaned J.; Santos I.A.; Lopez-Palop R.; Landmesser U.; Dieu R.S.; Mejia-Renteria H.; Koltowski L.; Ziubryte G.; Cetran L.; Adjedj J.; Abdelwahed Y.S.; Liu T.; Mogensen L.J.H.; Eftekhari A.; Westra J.; Lenk K.; Casella G.; Belle E.V.; Biscaglia S.; Olsen N.T.; Knaapen P.; Kochman J.; Santos R.C.; Scarsini R.; Christiansen E.H.; Holm N.R. Institution (Andersen, Sejr-Hansen, Dieu, Mogensen, Westra, Christiansen, Holm) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Maillard) GCS ES Axium Rambot, Clinique Axium, Aix-en-Provence, France (Campo, Biscaglia) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Ferrara, Italy (Ramunddal) Department of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden (Stahli) Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland (Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy (Serafino) Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (Escaned, Mejia-Renteria) Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain (Escaned) Centro de Investigacion Biomedica En Red - Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Santos) Hospital Clinico Universitario de Valladolid, Valladolid, Spain (Lopez-Palop) Hospital Universitario Virgen de la Arrixaca, Murcia, Spain (Landmesser, Abdelwahed) Department of Cardiology, Angiology and Intensive Care Medizin, Deutsches Herzzentrum Charite, Charite-Universitatsmedizin Berlin, Berlin, Germany (Landmesser, Abdelwahed) Deutsches Zentrum fur Herz-Kreislaufforschung (DZHK), Partner Site Berlin, Berlin, Germany (Koltowski, Kochman) 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland (Ziubryte) Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania (Ziubryte) Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania (Cetran) Hopital Haut-Leveque, Pessac, Bordeaux, France (Adjedj) Institut Arnault Tzanck, Nice, France (Liu) Department of Cardiology, Hagaziekenhuis, The Hague, Netherlands (Eftekhari) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Lenk) Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Leipzig, Germany (Casella) Cardiology Unit Ospedale Maggiore, AUSL Bologna, Bologna, Italy (Belle) INSERM U1011 and Department of Interventional Cardiology, Lille University, Lille, France (Olsen) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark (Knaapen) VU University Medical Center, Amsterdam, Netherlands (Santos) Hospital Universitario A Coruna, Coruna, Spain (Scarsini) Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy Publisher Elsevier B.V. Abstract Background: Fractional flow reserve (FFR) or non-hyperaemic pressure ratios are recommended to assess functional relevance of intermediate coronary stenosis. Both diagnostic methods require the placement of a pressure wire in the coronary artery during invasive coronary angiography. Quantitative flow ratio (QFR) is an angiography-based computational method for the estimation of FFR that does not require the use of pressure wires. We aimed to investigate whether a QFR-based diagnostic strategy yields a non-inferior 12-month clinical outcome compared with an FFR-based strategy. Method(s): FAVOR III Europe was a multicentre, randomised, open-label, non-inferiority trial comparing a QFR-based with an FFR-based diagnostic strategy for patients with intermediate coronary stenosis. Enrolment was performed in 34 centres across 11 European countries. Patients aged 18 years or older with either chronic coronary syndrome or stabilised acute coronary syndrome, and with at least one intermediate non-culprit stenosis (40-90% diameter stenosis by visual estimate; referred to here as a study lesion), were randomly assigned (1:1) to the QFR-guided or the FFR-guided group. Randomisation was done using a concealed web-based system and was stratified by diabetes and presence of a left anterior descending coronary artery study lesion. The primary endpoint was a composite of death, myocardial infarction, and unplanned revascularisation at 12 months. The predefined non-inferiority margin was 3.4% and the primary analysis was performed in the intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT03729739) and long-term follow-up is ongoing. Finding(s): Between Nov 6, 2018, and July 21, 2023, 2000 patients were enrolled and randomly assigned to the QFR-guided strategy (1008 patients) or the FFR-guided strategy (992 patients). The median age was 67.3 years (IQR 59.9-74.7); 1538 (76.9%) patients were male and 462 (23.1%) were female. Median follow-up time was 365 days (IQR 365-365). At 12 months, a primary endpoint event had occurred in 67 (6.7%) patients in the QFR group, and in 41 (4.2%) patients in the FFR group (hazard ratio 1.63 [95% CI 1.11-2.41]). The event proportion difference was 2.5% (90% two-sided CI 0.9-4.2). The upper limit of the 90% CI exceeded the prespecified non-inferiority margin of 3.4%. Therefore, QFR did not meet non-inferiority to FFR. A total of 18 (1.8%) patients in each group experienced an adverse procedural event, the most frequent being procedure-related myocardial infarction, which occurred in ten (1.0%) patients in the QFR group and seven (0.7%) in the FFR group. One patient in the QFR group died in relation to the index procedure. Interpretation(s): The results of the FAVOR III Europe trial do not support the use of QFR if FFR is available to guide revascularisation decisions in patients with intermediate coronary stenosis. This finding could have implications for current clinical guidelines recommending QFR for this purpose. Funding(s): Medis Medical Imaging Systems and Aarhus University. Copyright © 2024 Elsevier Ltd <7> 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. 49(9) (pp 1425-1433), 2026. Date of Publication: 01 Sep 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. <8> Accession Number 2047198918 Title Current Advances and Navigating the Complexities of SVG-PCI. Source Catheterization and Cardiovascular Interventions. 108(3) (pp 856-874), 2026. Date of Publication: 01 Sep 2026. Author Attachaipanich T.; Virk H.U.H.; Khawaja M.; Alam M.; Krittanawong C. Institution (Attachaipanich) Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States (Virk) Division of Cardiovascular Disease, Case Western Reserve University, Cleveland, OH, United States (Khawaja) Department of Cardiology, Emory University, Atlanta, GA, United States (Alam) Texas Heart Institute and Baylor College of Medicine, Houston, TX, United States (Krittanawong) HumanX, DE, United States Publisher John Wiley and Sons Inc Abstract Saphenous vein graft (SVG) percutaneous coronary intervention (PCI) remains technically challenging and clinically high risk due to the friable, thrombus-rich nature of SVG lesions, which predispose to distal embolization, no-reflow, and periprocedural myocardial infarction (MI). The role of embolic protection devices in contemporary practice remains unclear. Although early randomized trials demonstrated significant reductions in periprocedural MI and no-reflow, contemporary observational studies and meta-analyses have not shown consistent clinical benefit. Similarly, while intracoronary imaging modalities provide detailed plaque characterization, their clinical application in guiding SVG-PCI remains unclear. Revascularization after prior coronary artery bypass grafting (CABG) requires individualized, multidisciplinary decision-making. Factors favoring PCI include a patent left internal mammary artery (IMA)-left anterior descending artery graft and suitable coronary anatomy, whereas redo-CABG may be preferred in patients with multiple failing grafts or complex anatomy in which an IMA conduit can be used. Although guidelines have historically favored native-vessel PCI when feasible, the only randomized trial comparing SVG-PCI with native-vessel PCI in a contemporary setting demonstrated that SVG-PCI may offer superior outcomes in certain patient populations, particularly when native coronary disease is complex, and the chronic total occlusion burden is high. Predictors of adverse outcomes have been identified across patient-, lesion-, and procedure-related characteristics; however, their integration into clinical decision-making is limited by the lack of validated risk-stratification tools. Future randomized studies in the contemporary PCI era are needed. Additionally, the integration of imaging technologies, together with artificial intelligence and machine-learning-enhanced risk prediction models, may help individualize patient selection and optimize procedural strategy. Copyright © 2026 Wiley Periodicals LLC. <9> Accession Number 2047778587 Title Comparative evaluation of left atrial appendage occlusion and oral anticoagulation: a Bayesian meta-analysis of randomized controlled trials. Source Europace. 28(7) (no pagination), 2026. Article Number: euag163. Date of Publication: 01 Jul 2026. Author Athmakuri K.S.; Nandyal S.R.; Pamreddy H.R.; Vinjamuri S.; Lingamsetty S.S.P.; Mahajan A.V.; Hussain M.; Chaliki H.P.; Srivathsan K. Institution (Athmakuri, Mahajan, Hussain, Chaliki, Srivathsan) Department of Cardiovascular Medicine, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, United States (Nandyal) Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, United States (Pamreddy) Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, United States (Vinjamuri) Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH, United States (Lingamsetty) Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Publisher Oxford University Press Abstract Aims: Randomized trials comparing percutaneous left atrial appendage occlusion (LAAO) with oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation have yielded conflicting results across device generations and anticoagulant eras. This Bayesian meta-analysis of randomized trials aimed to compare LAAO vs. OAC for stroke or systemic embolism (SSE) and non-procedural clinically relevant bleeding (CRB). Methods and Results: We conducted a systematic search across five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane CENTRAL) to identify randomized trials of LAAO vs. OAC. Primary outcomes of stroke or systemic embolism, non-procedural CRB and clinical benefit composite were estimated using a Bayesian hierarchical random effects model and findings confirmed across robust sensitivity and subgroup analyses. Posterior probabilities for superiority, non-inferiority and equivalence were estimated using clinically meaningful margins. Six randomized trials including 7004 participants in the intention-to-treat groups, were analysed. LAAO was not associated with lower SSE vs. OAC (pooled RR, 1.11; 95% CrI, 0.80-1.49), with a 74.6% posterior probability of favouring OAC. The posterior probability of crossing non-inferiority was P(HR < 1.4) of 89%. In contrast, LAAO reduced non-procedural CRB (pooled RR, 0.59; 95% CrI, 0.45-0.78). The net clinical benefit composite, pooling contemporary trials, demonstrated a pooled RR of 0.90 (95% CrI 0.51-1.50), with P(RR < 1) of 76%, with substantial heterogeneity for this outcome. Conclusion(s): This Bayesian meta-analysis found no clear evidence supporting clinically meaningful non-inferiority of LAAO over OAC for stroke prevention. Despite reduced non-procedural bleeding, LAAO did not demonstrate a similar reduction in major bleeding. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <10> Accession Number 2048836089 Title Thyroid Cancer Management in Contemporary Practice: A Systematic Review and Meta-Analysis of Diagnostic Pathways, Surgical Strategies, Airway Challenges, and Mediastinal Extension. Source Clinica Terapeutica. 177(5) (pp 1281-1298), 2026. Date of Publication: 28 Aug 2026. Author Koraitim A.F.I.; Mohamed M.M.; Alwaseef M.A.E.; Mawkili A.; Abdesalam H.A.; Abu Halimah J.H.; Allam K.A.; Ibrahim A.A.A.M.; Ibrahim H.S.E.-S.; Abdelaziz S.M.M.E.; Abdalgaleel M.A.; Barakat M.; Bukas S.G.; Omar A.; Mobasher M.A. Institution (Koraitim) Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt (Mohamed) Department of anaesthesia and ICU, Faculty of medicine, Assiut University, Egypt (Alwaseef, Omar) Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Mawkili, Abu Halimah) Department of Surgery, college of Medicine, Jazan University, Jazan, Saudi Arabia (Abdesalam) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Allam) Department of general surgery, Ahmad Maher Teaching Hosp., GOTHI, Cairo, Egypt (Ibrahim) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt (Ibrahim, Abdelaziz) Department of Anesthesiology, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushait, Saudi Arabia (Abdelaziz) Department of Anesthesiology, The Memorial Institute for Ophthalmic Research, Giza, Egypt (Abdalgaleel) Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Barakat) Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Bukas) Cheeloo College of Medicine, Shandong University, Shandong, Jinan, China (Mobasher) Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt Publisher Societa Editrice Universo Abstract Background. Thyroid cancer is the most common endocrine malignancy worldwide, with a clinically significant subset of patients presenting with locally advanced disease involving the trachea, recurrent laryngeal nerve, esophagus, and superior mediastinum. However, evidence describing the integrated burden of diagnostic limitations, airway complications, surgical outcomes, and mediastinal involvement remains fragmented across small and heterogeneous studies. Objectives. This study aimed to systematically evaluate and quantitatively synthesize evidence on diagnostic performance, perioperative airway management, surgical outcomes, and mediastinal extension in thyroid cancer, with emphasis on locally advanced and complex disease reported between January 2021 and January 2026. Methods. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and the MOOSE framework. PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase were searched. Studies reporting surgical outcomes, airway complications, mediastinal extension, recurrent laryngeal nerve injury, and imaging diagnostic accuracy in thyroid cancer were included. Secondary systematic reviews and meta-analyses were excluded from quantitative pooling to avoid data duplication. Risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane RoB 2 tool where applicable. Random-effects meta-analyses were performed using the DerSimonian-Laird method. Results. Eleven primary studies published between 2021 and 2026, comprising 6,142 patients, were included. The pooled incidence of difficult airway was 9.4% (95% CI: 6.1-14.2%; I2 = 61.3%), while overall surgical morbidity was 21.3% (95% CI: 16.8-26.5%; I2 = 72.6%). Tracheal invasion was present in 28.7% (95% CI: 21.4-37.3%) of locally advanced cases. Mediastinal extension requiring thoracic surgical access occurred in 18.3% (95% CI: 12.7-25.7%) of retrosternal cases. Recurrent laryngeal nerve injury ranged from 2.8% to 5.9% (transient) and 0.5% to 1.4% (permanent) across studies. Computed tomography demonstrated a pooled sensitivity of 61.4% and specificity of 90.8% for tracheal invasion detection. Conclusion. This meta-analysis provides the most comprehensive and up-to-date quantitative synthesis of surgical complexity in thyroid cancer across diagnostic, airway, surgical, and mediastinal domains. Locally advanced disease is consistently associated with increased rates of difficult airway management, tracheal invasion, and requirement for thoracic surgical access, highlighting its substantially elevated perioperative risk profile. These findings underscore the importance of structured multidisciplinary preoperative assessment, advanced airway planning, and the routine use of intraoperative neuromonitoring in high-risk cases to optimise surgical safety and outcomes. Copyright © 2026 Societa Editrice Universo (SEU), Roma, Italy. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0). <11> Accession Number 2048534087 Title Robotic Coronary Revascularization: Current Evidence, Training, and Future Directions. Source European Journal of Cardio-thoracic Surgery. 68(8) (no pagination), 2026. Article Number: ezag205. Date of Publication: 01 Aug 2026. Author AlJamal Y.N.; Balkhy H.H. Institution (AlJamal) Department of Surgery, Mayo Clinic, Rochester, MN, United States (Balkhy) Section of Cardiac Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, IL, United States Publisher European Association for Cardio-Thoracic Surgery <12> Accession Number 2046873894 Title Coagulopathy in Cardiac Surgery: A Scoping Review of Prothrombin Complex Concentrate. Source Heart Lung and Circulation. 35(9) (pp 1214-1223), 2026. Date of Publication: 01 Sep 2026. Author Vander Zwaag S.; Kukel I.; Fassl J. Institution (Vander Zwaag, Kukel, Fassl) Institute of Cardiac Anaesthesiology, Heart Centre and Medical Faculty, TUD Dresden University of Technology, Dresden, Germany Publisher Elsevier Ltd Abstract Background: Coagulopathy after cardiopulmonary bypass substantially contributes to postoperative bleeding, transfusion requirements, morbidity, and mortality. The traditional treatment option is fresh frozen plasma (FFP), but prothrombin complex concentrate (PCC) has become an alternative in the past years. Aim(s): This study aimed to systematically map the current evidence and identify critical knowledge gaps regarding the efficacy, optimal timing, dosing regimens, point-of-care testing guidance, administration order, cost-effectiveness, and safety of 4-factor PCC in adult patients undergoing on-pump cardiac surgery, thereby informing future research priorities. Method(s): A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search of several databases was conducted on 8 April 2025 without restrictions on the language or date of the publications. Study selection, data extraction, and charting were performed independently by two mutually blinded reviewers. Result(s): A total of 57 primary studies (seven randomised controlled trials, 36 retrospective cohorts, five prospective cohorts, and nine experimental investigations) and 15 reviews with or without meta-analyses were identified. Evidence consistently indicates that PCC reduces postoperative chest tube output and transfusion requirements compared with FFP, although the effect sizes vary. Reported dosing ranged from fixed 500-4000 IU to weight-based 15-30 IU kg-1. Viscoelastic testing guides PCC administration; however, standardised thresholds are lacking. Limited data suggest that PCC may be more cost-effective than FFP, and serious adverse events appear to be rare. No study has directly compared different PCC dosing regimens or prophylactic use in high-risk patients. Conclusion(s): Substantial evidence gaps remain concerning the optimal dose, timing, viscoelastic targets, sequencing with fibrinogen concentrate, and health economic analyses of PCC use in cardiac surgery. High-quality randomised trials addressing these unanswered questions are warranted to refine the clinical guidelines. Copyright © 2026 The Author(s) <13> Accession Number 2048778107 Title Effect of protective ventilation throughout the intubation period on perioperative oxygenation in patients undergoing MIDCABG: a randomised controlled trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2720367. Date of Publication: 2026. Author Qian M.; Cong Z.; Yang N.; Li B.; Liu W.; Wu C.; Xu M. Institution (Qian, Cong, Yang, Li, Liu, Wu, Xu) Department of Anaesthesiology, Peking University Third Hospital, Beijing, China (Qian, Cong, Yang, Li, Liu, Wu, Xu) Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Peking University Third Hospital, Beijing, China Publisher Taylor and Francis Ltd. Abstract Introduction: Minimally invasive direct coronary artery bypass grafting (MIDCABG) requires prolonged one-lung ventilation (OLV), increasing postoperative pulmonary complications (PPCs) risk. We investigated whether protective lung ventilation (PLV) throughout intubation benefits MIDCABG patients. Method(s): In this single-center randomized study, MIDCABG patients received PLV (low tidal volume of 6-8 mL.kg-1, PEEP of 6 cm H<inf>2</inf>O, alveolar recruitment maneuvers) or conventional mechanical ventilation (CMV, tidal volume of 8-10 mL.kg-1, without PEEP or maneuvers) from tracheal intubation to extubation. The primary outcome was perioperative oxygenation, assessed by the PaO<inf>2</inf>/FiO<inf>2</inf> ratio. Result(s): Sixty patients (n = 30 per group) were enrolled. Compared with CMV, PLV improved PaO<inf>2</inf>/FiO<inf>2</inf> ratios (mean difference at OLV<inf>60</inf>: 34.56 mmHg; 95% CI: 11.78-57.33; p < 0.01), shortened median durations of postoperative mechanical ventilation (median difference: -4.5 h, 95% CI: -8.5 to -0.5; p = 0.013) and hospital stay (median difference: -3.0 days, 95% CI: -5.0 to -1.0; p = 0.019). PLV also reduced driving pressure, airway pressure and intrapulmonary shunt during OLV (all p < 0.05). Desaturation occurred in 23.3% of CMV patients and 13.3% of PLV patients (p = 0.506). Hemodynamic parameters were generally comparable between groups, except for lower MPAP and PVRI in the PLV group during OLV and after ICU admission (p < 0.05). The incidence of PPCs did not differ between groups. Conclusion(s): In patients undergoing MIDCABG, PLV applied throughout intubation improved perioperative oxygenation and shortened the duration of postoperative mechanical ventilation and hospital stay, but did not reduce PPCs. Clinical trial registration: ChiCTR1900022005. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <14> [Use Link to view the full text] Accession Number 2045462723 Title Management and Outcomes of Postmyocardial Infarction Left Ventricular Pseudoaneurysm: A Case-level Systematic Review. Source Critical Pathways in Cardiology. 25(3) (no pagination), 2026. Article Number: e0424. Date of Publication: 01 Sep 2026. Author Karimanasseri C.; Rahimov D.; Sankisa D.; Nasher N.; Mustafa M.; Allimulla A.; Vizzeswarapu S.; Plestis K.A.; Entwistle J.W.; Bavaria J.E.; Tchantchaleishvili V. Institution (Karimanasseri, Sankisa, Mustafa, Allimulla, Vizzeswarapu) The Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Rahimov, Nasher, Plestis, Entwistle, Bavaria, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States Publisher Lippincott Williams and Wilkins Abstract Left ventricular pseudoaneurysm (LVPA) is a rare mechanical complication of acute myocardial infarction (MI) associated with significant mortality. Given the paucity of available data in the literature, we sought to pool existing evidence to better understand the current management strategies and outcomes. Electronic search was performed in February 2025 to identify all studies reporting management of post-MI LVPA. A total of 158 reports, with a total of 159 patients, were included. Patient-level data were extracted for analysis. A total of 159 patients were included in the analysis. The median age was 65 years [Interquartile range (IQR), 57-75], and 70% (106/159) of patients were male. The most frequent site of MI was the inferior wall (31.4%, 49/156), and the most common method of MI management was thrombolysis (49%, 64/131). The median time from MI to presentation signs/symptoms of LVPA was 21 days (IQR, 0-152). The most common LVPA location was the anterior/apical wall (27.7%, 44/159). Sixty-six percent of patients (105/159) underwent surgical repair, while 22% of patients (35/159) were managed medically, and 5.7% (9/159) of patients underwent transcatheter repair. In-hospital/30-day mortality was 10% (16/159), with operative mortality after surgical repair of 4.8% (5/105). Mortality from reoperative surgery was 18.8% (3/16) as opposed to 2.2% (2/89) in patients without redo sternotomy (P = 0.004). Periprocedural mortality among patients treated with transcatheter intervention occurred in a single case (11.1%), involving a patient with prior coronary artery bypass grafting. At a median follow-up of 6 months (IQR, 1-12), overall survival was 86.1% (137/159). Surgery remains the standard therapy of LVPA, with acceptable operative risk; however, reoperative sternotomy carries a higher surgical risk. In carefully selected patients, percutaneous repair may serve as a viable alternative to surgery. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <15> Accession Number 2048838988 Title Oral Anticoagulation Monotherapy vs Dual-Pathway Antithrombotic Therapy in Chronic Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Clinical and Applied Thrombosis/Hemostasis. 32 (no pagination), 2026. Article Number: 10760296261476817. Date of Publication: 01 Jan 2026. Author Liang S.; Chen X.; Wang D.; Zhu W.; Qiu K. Institution (Liang, Chen, Qiu) Department of Cardiology, Sanming First Affiliated Hospital of Fujian Medical University, Sanming, China (Liang, Wang) Faculty of Medicine, Macau University of Science and Technology, Macau SAR, China (Zhu) Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Publisher SAGE Publications Inc. Abstract Background: This study aimed to systematically review randomized controlled trials (RCTs) comparing oral anticoagulant (OAC) monotherapy with combination therapy of OAC plus single antiplatelet therapy (SAPT) in patients with chronic coronary syndrome (CCS) and an indication for long-term anticoagulation. Method(s): A systematic screening of the PubMed, EMBASE and Cochrane Central databases was conducted until 12 Mar 2026 to identify RCTs comparing OAC monotherapy with OAC plus SAPT in CCS patients. The primary endpoints were all-cause mortality and net adverse clinical events (NACE). Secondary endpoints included major bleeding, cardiovascular death, myocardial infarction, ischemic stroke and stroke. End point data were pooled using random-effect models, to generate hazard ratios (HR) and odds ratios (OR) and corresponding 95% confidence intervals (CI). Result(s): Six RCTs involving 5048 patients were included. Pooled analysis showed that OAC monotherapy significantly reduced the risk of NACE compared to combination therapy (HR, 0.66; 95% CI, 0.44-0.77). There was no significant difference in all-cause mortality overall (HR, 0.75; 95% CI, 0.51-1.10). OAC monotherapy substantially decreased major bleeding (HR, 0.47; 95% CI, 0.32-0.70) and cardiovascular death (HR, 0.69; 95% CI 0.50-0.95) and there was no statistically significant difference in other secondary outcomes. Conclusion(s): Current evidence suggests that OAC monotherapy is a safer alternative to combination therapy in anticoagulated patients with CCS, without increasing ischemic risk. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <16> Accession Number 2038518838 Title Home-Based Vs. Usual and Center-Based Cardiac Rehabilitation: Effects on Aerobic Fitness and Quality of Life. Source International Journal of Cardiovascular Sciences. 39 (no pagination), 2026. Article Number: e20250274. Date of Publication: 2026. Author Mota C.T.; Forjaz C.L.M. Institution (Mota, Forjaz) Escola de Educacao Fisica e Esporte, Universidade de Sao Paulo, SP, Sao Paulo, Brazil Publisher Sociedade Brasileira de Cardiologia Abstract Home-based cardiac rehabilitation has been proposed as an alternative to expand access to treatment for patients with cardiovascular diseases. This systematic review evaluated the effects of home-based cardiac rehabilitation, with emphasis on physical exercise, on aerobic fitness, quality of life, and adverse events compared with usual cardiac rehabilitation and center-based cardiac rehabilitation. A literature search was conducted in the PubMed database, including only randomized controlled clinical trials involving adults and older adults with coronary artery disease or heart failure. Twenty-three studies conducted in different countries were identified; however, none was performed in Brazil. The total sample comprised 2,298 participants, of whom 24% were women. All studies implemented aerobic training, either alone or combined with resistance training, and the vast majority maintained remote contact with participants every one to two weeks. Comparisons between pre-and post-intervention outcomes showed that home-based cardiac rehabilitation improved aerobic fitness and/or quality of life in 22 studies, with greater improvements than those observed with usual cardiac rehabilitation and outcomes comparable to those achieved with center-based cardiac rehabilitation. Furthermore, the incidence of adverse events was low and similar across the three rehabilitation models. Overall, home-based cardiac rehabilitation improves aerobic fitness and quality of life more effectively than usual cardiac rehabilitation and provides benefits comparable to those of center-based cardiac rehabilitation without increasing the risk of adverse events, supporting its use in the treatment of cardiovascular diseases. Nevertheless, the absence of studies conducted in Brazil highlights the need for further research on this rehabilitation model in the Brazilian context. Copyright © 2026, Sociedade Brasileira de Cardiologia. All rights reserved. <17> Accession Number 2048440054 Title Comparative Efficacy and Safety of Ivabradine vs. Beta Blockers in Heart Transplant Patients: A Systematic Review and Meta-Analysis. Source Health Science Reports. 9(8) (no pagination), 2026. Article Number: e73068. Date of Publication: 01 Aug 2026. Author Hassan A.; Amir M.; Naeem M.; Ali E.F.; Ullah U.; Jahangir M.A.; Hassaan M.U.; Aman R.; Rifat H.R.; Nazir M.F.; Awais M.N.; Alizai A.; Gul S.; Asif A. Institution (Hassan, Amir, Naeem, Ullah, Jahangir, Hassaan) King Edward Medical University, Mayo Hospital, Punjab, Lahore, Pakistan (Ali) Sargodha Medical College, Faisal Masood Teaching Hospital, Punjab, Sargoadha, Pakistan (Aman, Rifat, Alizai, Gul) Gomal Medical College, KMU Peshawar, DHQ hospital DIKhan, Pakistan (Nazir) Rawalpindi Medical University, Holy Family Hospital, Rawalpindi, Pakistan (Awais) Shaheed Ziaur Rahman Medical College & Hospital, Bogura, Bangladesh (Asif) Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan Publisher John Wiley and Sons Inc Abstract Background and Aims: Elevated resting heart rate in heart transplant (HTx) recipients due to graft denervation is associated with adverse outcomes. Ivabradine and beta blockers are commonly used for heart rate control post-HTx, but their comparative effectiveness and safety remain unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of ivabradine versus beta blockers in heart transplant recipients. Method(s): Following PRISMA guidelines, a comprehensive literature search was conducted in April 2025 across PubMed, Cochrane, Embase, and Google Scholar. Original studies, including cohort studies and randomized controlled trials (RCTs) comparing ivabradine to beta blockers in heart transplant patients were considered eligible. The primary outcome was mean heart rate. Secondary outcomes were left ventricular mass, left ventricular mass index, and ejection fraction; adverse events (phosphenes, dizziness, fatigue, sepsis); and mortality and survival. Risk of bias was assessed using Cochrane RoB 2 for the randomized trial and ROBINS-I for the non-randomized studies, and statistical analyses were performed using Review Manager 5.4. Result(s): Four studies, including one RCT and three cohort studies, met the inclusion criteria. Ivabradine demonstrated a statistically significant reduction in left ventricular mass index at 24 months (MD -8.82; 95% CI -14.05 to -3.59; p = 0.001) and heart rate at 24 months (MD -11.70; 95% CI -23.36 to -0.05; p = 0.05). Other efficacy parameters, including left ventricular mass, ejection fraction, and heart rate at 12 months, showed no significant differences. Adverse effects and survival outcomes were similar between groups. Sensitivity analysis revealed reduced heterogeneity when one high-bias study was excluded. Conclusion(s): Ivabradine may offer improved heart rate control and favourable changes in left ventricular mass index compared with beta blockers in heart transplant recipients, with a comparable safety and mortality profile. Given the small evidence base, the predominance of observational studies, and the substantial heterogeneity observed across several outcomes, these findings should be regarded as exploratory and hypothesis-generating. Further large-scale RCTs are warranted to confirm these findings and guide clinical decision-making. Copyright © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC. <18> Accession Number 2043950097 Title Intravenous Lidocaine in Video-Assisted Thoracoscopic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3396-3404), 2026. Date of Publication: 01 Oct 2026. Author Mamun M.A.; Saleem Y.; El-Tahlawy Y.; Mahmood W.U.; Lubbad O.; Kabir T. Institution (Mamun, Saleem, El-Tahlawy, Mahmood, Lubbad) Brighton and Sussex Medical School, Brighton, United Kingdom (Kabir) Queen Elizabeth The Queen Mother Hospital, Margate, United Kingdom Publisher W.B. Saunders Abstract Effective postoperative recovery after video-assisted thoracoscopic surgery (VATS) remains a significant challenge, with patients frequently experiencing moderate to severe pain, pulmonary decline, and postoperative nausea and vomiting (PONV) despite modern multimodal analgesia. Intravenous lidocaine has been proposed as an opioid-sparing adjunct with systemic analgesic and antihyperalgesia properties, but its role in VATS is uncertain. This systematic review and meta-analysis identified a total of 31 studies, of which 9 randomized controlled trials involving 672 patients met the inclusion criteria and were included in the final quantitative and qualitative synthesis. Five trials (n = 328) assessing 24-hour opioid use and 3 trials (n = 242) assessing 48-hour use showed no reduction in postoperative morphine consumption with lidocaine. Similarly, pooled movement pain scores at 24 and 48 hours (3 trials, n = 200 each) demonstrated no significant difference between groups. Although 4 trials (n = 272) reported a marked reduction in intraoperative remifentanil requirements, this did not translate into improved postoperative analgesia. In contrast, lidocaine produced a consistently favorable antiemetic effect: 5 trials (n = 360) showed a significant reduction in PONV with negligible heterogeneity. Limitations included small sample sizes, varying bolus and infusion regimens, heterogeneity in background analgesic protocols, and incomplete reporting of outcomes such as inflammatory markers and pulmonary physiology, all of which reduce confidence in effect estimates. Overall, current evidence indicates that while intravenous lidocaine is safe and offers a reproducible reduction in PONV, it does not improve postoperative pain or opioid consumption following VATS. Larger, standardized trials are required to determine whether specific subgroups or dosing strategies may yield a greater benefit in thoracic minimally invasive surgery. Copyright © 2026 The Author(s) <19> Accession Number 651551090 Title Computed tomography-derived low muscle status and clinical outcomes after isolated coronary artery bypass grafting: A systematic review and meta-analysis with implications for perioperative nutrition risk stratification. Source Nutrition and health. 32(5) (pp 1511-1523), 2026. Date of Publication: 01 Sep 2026. Author Zhou Z.; Sun T.; Zhao J.; Wang Y.; Wu W. Institution (Zhou, Sun, Zhao, Wang, Wu) Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China Abstract Background and aimsComputed tomography (CT)-derived measures of low muscle quantity and quality may indicate reduced physiologic reserve, but their prognostic value after isolated coronary artery bypass grafting (CABG) is uncertain. We conducted a PRISMA-guided systematic review and conservative meta-analysis of adjusted estimates to examine associations between preoperative CT-derived low muscle status and outcomes after isolated CABG.MethodsWe searched PubMed, Embase, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov from inception to December 23, 2025. Cohort studies of adults undergoing isolated CABG were eligible if they assessed preoperative low muscle status using CT (dual-energy X-ray absorptiometry eligible) and reported mortality and/or postoperative complications. Overlapping cohorts were excluded. Adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis (restricted maximum likelihood) with the Hartung-Knapp-Sidik-Jonkman adjustment.ResultsFour independent cohorts (n = 3931) met inclusion criteria and used CT-based definitions spanning lumbar and thoracic muscle quantity/quality measures. Three cohorts (n = 3452) contributed adjusted estimates for long-term mortality. Across studies, the direction of association was unfavorable, but quantitative synthesis was exploratory and highly uncertain (pooled HR 2.71, 95% confidence interval 0.38-19.40; I2 = 92.3%; approximate 95% prediction interval 0.47-15.6). Secondary outcomes were too heterogeneous for pooling and were summarized narratively.ConclusionsPreoperative CT-derived low muscle status may serve as a pragmatic vulnerability flag in isolated CABG when CT is already available, but current pooled evidence for long-term mortality remains exploratory, highly heterogeneous, and statistically imprecise. Standardized measurement, more comparable adjustment strategies, and harmonized outcome reporting are needed before broader clinical translation. <20> Accession Number 2046132495 Title Does a Digital Prehabilitation Solution Informed by Evidence-Based Interventions Reduce the Healthcare Burden and Improve Outcomes for Patients Awaiting Cardiac Surgery?-A Systematic Review. Source Heart Lung and Circulation. 35(9) (pp 1224-1244), 2026. Date of Publication: 01 Sep 2026. Author Hines C.; Farragher J.; Vlahos R.; Denehy L.; Doull L.; El-Ansary D. Institution (Hines, Farragher, Vlahos, El-Ansary) School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia (Hines, Farragher, El-Ansary) Shanghai University of Medicine and Health Sciences, Shanghai, China (Hines) Royal Melbourne Hospital, Melbourne, VIC, Australia (Denehy) Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia (Denehy) Department of Health Services Research: Allied Health, Peter MacCallum Cancer Centre, Parkville, VIC, Australia (Denehy) School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom (Doull) Department of Surgery, The University of Melbourne, Parkville, VIC, Australia (El-Ansary) Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia Publisher Elsevier Ltd Abstract Background and Aims: Prehabilitation before cardiac surgery targets modifiable risk factors to enhance surgical readiness and recovery. It can reduce complications, mortality, and hospital stay; however, remains underused in routine cardiac care. As digital health gains traction, remote delivery of prehabilitation offers a promising way to expand access and equity to cardiac patients. This review examines the delivery, outcomes, and effectiveness of digital prehabilitation for adults awaiting cardiac surgery. Method(s): This review followed the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Analyses 2020 guidelines and was registered with PROSPERO (ID: 452250). Seven databases were searched, identifying studies which evaluated digital prehabilitation in cardiac surgery patients. Screening, selection, and data extraction were performed, and outcomes were categorised by feasibility, health outcomes, and healthcare utilisation. Result(s): Analysis showed significant findings in favour of digital prehabilitation over standard care in terms of feasibility, efficacy, complications, and costs/healthcare utilisation. Interrogation of the results data via meta-analysis was unsuitable due to the heterogeneity of the methodologies and evaluation time points. Conclusion(s): Digital prehabilitation is a safe, feasible and potentially effective strategy to improve outcomes and reduce healthcare burden in cardiac surgery. Copyright © 2026 The Author(s) <21> Accession Number 2046086501 Title Incidence and Associations of Acute Kidney Injury After Lung Resection Surgery: A Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3386-3395), 2026. Date of Publication: 01 Oct 2026. Author Shan X.-S.; Yan J.; Wang Y.-Q.; Zhang Y.; Li X.-Y.; Koutentis C.; Popescu W.M.; Ji F.-H.; Liu H. Institution (Shan, Yan, Zhang, Li, Ji) Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China (Shan, Yan, Zhang, Li, Ji) Institute of Anesthesiology, Soochow University, Suzhou, China (Shan, Liu) Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, United States (Wang) Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China (Koutentis) Department of Anesthesiology, One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY, United States (Popescu) Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States Publisher W.B. Saunders Abstract The incidence and clinical implications of acute kidney injury (AKI) following thoracic lung resection surgery remain insufficiently characterized. The authors conducted a systematic review to determine the incidence of AKI, identify risk factors for AKI, evaluate preventive interventions for AKI, and assess the associations of AKI with key postoperative outcomes. A systematic search of PubMed, Embase, and the Cochrane Library was conducted through June 25, 2025. The authors included observational and interventional studies that reported the incidence of AKI following lung resection, defined according to Risk, Injury, Failure, Loss, End-stage (RIFLE), Acute Kidney Injury Network (AKIN), or Kidney Disease: Improving Global Outcomes (KDIGO) consensus-based criteria. The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (CRD420251142075). Twenty studies involving 19,918 patients were included. The pooled incidence of AKI was 5.31% (95% confidence interval [CI], 3.61%-6.70%), with mild AKI and moderate to severe AKI occurring in 5.51% and 0.96% of patients, respectively. AKI was significantly associated with prolonged hospital stay (mean difference, 0.92 days; 95% CI, 0.52-1.30 days) and increased short-term mortality (risk ratio, 5.60; 95% CI, 1.66-18.83). Goal-directed fluid therapy did not significantly reduce the risk of AKI (risk ratio, 0.64; 95% CI, 0.32-1.27). AKI is a common complication following thoracic lung resection surgery and is strongly associated with a broad spectrum of severe adverse postoperative outcomes. In patients undergoing lung resection, AKI should be considered as a highly significant prognostic indicator that requires early risk stratification and proactive preventive strategies. Copyright © 2026 Elsevier Inc. <22> Accession Number 2048897325 Title Soluble PD-1/PD-L1 biomarkers in NSCLC: prognostic and diagnostic value. Source Molecular and Cellular Probes. 90 (no pagination), 2026. Article Number: 102087. Date of Publication: 01 Dec 2026. Author Vachlas K.; Fatouros C. Institution (Vachlas) Department of Thoracic Surgery, Sotiria Chest Hospital, Athens, Greece (Fatouros) Institute of Bioinnovation, Biomedical Sciences Research Center "Alexander Fleming,", Vari, Greece Publisher Academic Press Abstract Background Tissue-based immunohistochemistry (IHC) for programmed death-ligand 1 (PD-L1) remains the clinical standard for guiding immunotherapy selection in non-small cell lung cancer (NSCLC) but is constrained by intratumoral spatial heterogeneity and procedural sampling risks. Circulating soluble PD-1 (sPD-1) and soluble PD-L1 (sPD-L1) generated either through alternative mRNA splicing or by ADAM10/17-mediated proteolytic shedding offer minimally invasive liquid-biopsy alternatives that capture systemic immune dynamics in real time. Methods This review synthesizes clinical and translational data from prospective validation cohorts, surgical trials, and multi-center meta-analyses to evaluate the stage-stratified diagnostic utility, prognostic reliability, and treatment-response predictive value of sPD-1 and sPD-L1 across diverse therapeutic contexts. Results Cross-sectional baseline assessments show modest standalone diagnostic sensitivity due to significant absolute concentration overlaps between oncological cohorts and healthy controls. However, elevated pre-treatment sPD-L1 functions as a robust independent negative prognostic indicator of overall survival (OS) and a predictor of primary resistance to immune checkpoint inhibitors (ICIs) across advanced stages, while demonstrating no prognostic relevance under conventional cytotoxic chemotherapy. Longitudinally, an acute postoperative sPD-L1 increase of >=20% at four months marks micro-metastatic persistence and predicts disease recurrence in early-stage surgical cohorts (Odds Ratio = 10.29). Conversely, sPD-1 demonstrates distinct stage-specific volatility; pre-treatment profiles lack stable prognostic indicators, but an early on-treatment plasma surge during anti-PD-1 monotherapy independently maps to prolonged progression-free survival and superior OS (Hazard Ratio = 0.24). Finally, composite liquid biosignatures (e.g., sCombo or joint bsPD-L1/MMP screening) significantly optimize predictive resolution over single-analyte measurements. Conclusions Circulating sPD-L1 serves as a reliable negative indicator of therapeutic efficacy and surgical durability, whereas on-treatment tracking of sPD-1 captures protective host T-cell clonal reactivation. Cross-platform assay standardization and predefined cutoff validation remain essential thresholds before these liquid biomarkers can be implemented into standard clinical practice and thoracic surgery. Integrating these circulating checkpoints into high-throughput multi-omics platforms and AI-based analytics is a promising next step toward reproducible predictive signatures that could guide personalized treatment in thoracic oncology. Copyright © 2026 The Authors. <23> Accession Number 2047778575 Title Long-term efficacy and safety of left atrial appendage closure vs. oral anticoagulation in atrial fibrillation: a meta-analysis of randomized controlled trials. Source Europace. 28(7) (no pagination), 2026. Article Number: euag159. Date of Publication: 01 Jul 2026. Author Karakasis P.; Tzeis S.; Samaras A.; Vlachos K.; Pamporis K.; Theofilis P.; Tzikas A.; Antoniadis A.P.; Jais P.; Fragakis N. Institution (Karakasis, Samaras, Tzikas, Antoniadis, Fragakis) Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Tzeis) Department of Cardiology, Mitera Hospital, 6, Erythrou Stavrou Str., Marousi, Athens, Greece (Vlachos, Jais) Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Universite and Universite de Bordeaux, INSERM U1045, Pessac, France (Vlachos, Jais) Cardiac Arrhythmia Department, INSERM U1045, CHU de Bordeaux, Pessac, France (Vlachos) Electrophysiology Department, Hygeia Hospital, Athens, Greece (Pamporis, Theofilis) First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece Publisher Oxford University Press Abstract Aims: Left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF), but its long-term comparative efficacy remains uncertain. This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) comparing LAAC with OAC in AF. Methods and Results: MEDLINE, Embase, Scopus, and the Cochrane Database of Systematic Reviews were searched through 8 April 2026. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models. Certainty of evidence (CoE) was assessed using GRADE. Six RCTs involving 7004 participants were included (3681 assigned to LAAC and 3323 to OAC). Compared with OAC, LAAC resulted in a significantly higher risk of ischaemic stroke or systemic embolism (134 vs. 80 events; RR 1.41, 95% CI 1.07-1.86; moderate CoE). No significant differences were observed for any stroke or systemic embolism (RR 1.10, 95% CI 0.87-1.39; moderate CoE), all-cause mortality (RR 0.92, 95% CI 0.77-1.10; high CoE), cardiovascular mortality (RR 0.90, 95% CI 0.67-1.21; moderate CoE), non-cardiovascular mortality (RR 0.92, 95% CI 0.75-1.12; moderate CoE), major bleeding (RR 0.91, 95% CI 0.77-1.08; high CoE), or haemorrhagic stroke (RR 0.58, 95% CI 0.28-1.17; moderate CoE). LAAC reduced the risk of nonprocedural clinically relevant bleeding compared with OAC (RR 0.50, 95% CI 0.43-0.59; high CoE). Conclusion(s): In patients with AF, LAAC results in a higher risk of ischaemic stroke or systemic embolism than an OAC-based strategy. Compared with OAC, LAAC has no effect on major bleeding or mortality and does not reduce haemorrhagic stroke. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <24> Accession Number 2048024980 Title Comparison of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with prior chest radiation: a systematic review and meta-analysis of 11,572 patients. Source Future Cardiology. 22(8) (pp 865-874), 2026. Date of Publication: 2026. Author Ntoumaziou A.; Xenos D.; Sagris M.; Chatziioannou A.; Krokidis M.; Tzoumas A. Institution (Ntoumaziou) Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States (Xenos) Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States (Sagris) 1st Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Chatziioannou, Krokidis) 1st Department of Radiology, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Athens, Greece (Tzoumas) Division of Cardiovascular Health and Disease, University of Cincinnati Medical Center, Cincinnati, OH, United States Publisher Taylor and Francis Ltd. Abstract Background: Cardiac complications from prior oncologic therapies and radiation are being increasingly recognized and patients with symptomatic severe aortic valve disease and a history of prior chest radiation represent a high-risk group in which the best management approach has not yet been established. Method(s): A systematic search of PubMed, Scopus, and Cochrane identified studies comparing outcomes of transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) in patients with a history of prior chest radiation. Result(s): Nine studies comprising 11,572 patients were included in this meta-analysis. There were no significant differences between TAVR and SAVR in postoperative mortality (OR: 0.70; 95% CI 0.44-1.13, p = 0.147) or 1-year mortality (OR: 1.04; 95% CI 0.71-1.53, p = 0.84). TAVR was associated with significantly lower rate of postoperative major bleeding (OR: 0.38; 95%CI: 0.25-0.57, p < 0.01), acute kidney injury (AKI) (OR: 0.51; 95%CI: 0.27-0.97, p: 0.04), postoperative atrial fibrillation (OR: 0.20 95%CI: 0.16-0.24, p: <0.01) and respiratory complications (OR: 0.39; 95%CI: 0.24-0.63, p < 0.01) compared to SAVR. The incidence of postoperative permanent pacemaker insertion (OR: 2.27; 95%CI: 1.79-2.87, p < 0.01) and at least moderate aortic regurgitation (OR: 4.44 (95%CI: 2.93-6.73), p < 0.01) were higher among the patients undergoing TAVR. Conclusion(s): TAVR in patients with a history of prior radiation was associated with a lower risk for postoperative complications albeit at an increased risk for pacemaker insertion in the postoperative period compared to SAVR. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <25> Accession Number 2046455211 Title Scar-specific outcomes following minimally invasive versus conventional median sternotomy in cardiac surgery: A systematic review and meta-analysis. Source Perfusion (United Kingdom). 41(6) (pp 814-828), 2026. Date of Publication: 01 Sep 2026. Author Chhatwal K.; On Chun Siu A.; Arab S.; Salih A.; Shah A.; Arjomandi Rad A.; Chong G.L.W.; Showkat M.; Punjabi S.; Punjabi P. Institution (Chhatwal, Arab, Salih, Showkat) School of Medicine, Imperial College London, London, United Kingdom (Chhatwal) National Heart and Lung Institute, Imperial College London, London, United Kingdom (On Chun Siu) Department of Cardiology, Royal Berkshire Hospital Foundation Trust, NHS England, London, United Kingdom (Arab) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Shah) Division of Medicine, University College London Medical School, London, United Kingdom (Arjomandi Rad) Department of Cardiothoracic Surgery, Oxford University Foundation Trust, NHS England, Oxford, United Kingdom (Chong) School of Medical Sciences, University of Birmingham, Birmingham, United Kingdom (Punjabi) Department of Dermatology, London North West Hospitals NHS Trust, London, United Kingdom (Punjabi) Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom Publisher SAGE Publications Ltd Abstract Background: With improved cardiac surgical outcomes, attention has shifted to patient-centred outcomes, including cosmetic appearances of surgical scars. Minimally invasive cardiac surgery (MICS) is often promoted for its cosmetic benefits, yet empirical evidence remains limited. This study aimed to systematically evaluate scar-specific outcomes comparing MICS to conventional full median sternotomy (FMS) in adult cardiac surgery. Method(s): A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, Embase, Central, and Scopus were searched from inception to August 2025. Studies comparing MICS to FMS, reporting scar-related patient-reported outcomes, wound complications, or cosmetic satisfaction, were included. The primary outcome was scar assessment using validated instruments. Random-effects models calculated standardised mean differences (SMD) and risk ratios (RR) with 95% confidence intervals. Result(s): Twenty-two studies comprising 3131 patients (1459 MICS, 1672 FMS) met inclusion criteria. MICS demonstrated significantly better scar assessment scores (SMD -0.74, 95% CI -1.27 to -0.22; p < 0.01; I2 = 88%, six studies), higher patient satisfaction rates (RR 1.42, 95% CI 1.21-1.66; p < 0.001; I2 = 84%, 12 studies), and reduced wound complications (RR 0.31, 95% CI 0.20-0.47; p < 0.001; I2 = 0%, nine studies). Only six studies reported validated scar assessment scores, highlighting limited integration of these measures. Substantial heterogeneity was observed due to diverse assessment tools and surgical techniques. Conclusion(s): MICS can offer significant advantages in scar-specific outcomes compared to FMS in carefully selected patient populations. Cosmetic outcomes should be interpreted within the context of overall effectiveness and may support shared decision making only when clinical outcomes between surgical approaches are comparable. The lack of standardised scar assessment protocols and limited reporting of cosmetic outcomes represent critical gaps. Future research should prioritise standardised scar evaluation tools and expand cosmetic outcome reporting across all cardiac surgical procedures. Copyright © The Author(s) 2026 <26> Accession Number 2040185860 Title The role of acute normovolemic hemodilution and retrograde autologous priming in reducing intraoperative packed red blood cell transfusion needs in coronary artery bypass surgery: A randomized controlled trial. Source Perfusion (United Kingdom). 41(6) (pp 1033-1041), 2026. Date of Publication: 01 Sep 2026. Author Boom C.E.; Cintyandy R.; Widodo H.; Putri A.; Givano M.R.; Parmana I.M.A. Institution (Boom, Cintyandy, Givano, Parmana) Department of Anesthesiology and Intensive Care, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia (Widodo, Putri) Department of Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia Publisher SAGE Publications Ltd Abstract Background: Acute normovolemic hemodilution (ANH) and retrograde autologous priming (RAP) are blood conservation techniques designed to reduce transfusion requirements. Purpose(s): This study evaluated the impact of combining ANH and RAP compared to RAP alone on intraoperative packed red blood cell (PRBC) transfusion and postoperative outcomes in coronary artery bypass grafting (CABG) surgery. Research design: A single-center randomized controlled trial. Study sample: 72 patients scheduled for CABG surgery from July 2024 to December 2024 at the National Cardiovascular Center Harapan Kita in Indonesia. Patients were randomly assigned to ANH + RAP group (n = 36) and RAP group (n = 36). Data analysis: Multivariate analysis assessed factors influencing final hemoglobin levels and intraoperative PRBC transfusion needs. Result(s): The ANH + RAP group experienced a significant reduction in the transfusion rate (19.4% vs 47.2%, p = 0.024) and the intraoperative allogeneic packed red blood cell units (0.2 +/- 0.4 vs 0.5 +/- 0.6, p = 0.012). The optimal ANH volume reduces intraoperative allogeneic PRBC transfusion was 380 mL (ROC area 0.862, 95% CI 0.703-1.000, p = 0.003). Single RAP procedure approaches were less effective when compared to the combination procedure for achieving higher final hemoglobin levels (beta = -0.824, 95% CI -1.314 to -0.334, p = 0.001) and reducing the likelihood of intraoperative allogeneic PRBC transfusion (OR = 13.370, 95% CI 2.206 to 81.026, p = 0.005). Postoperative outcomes did not differ between groups. Conclusion(s): The combined use of ANH and RAP significantly reduces intraoperative allogeneic PRBC needs compared to RAP alone without affecting postoperative outcomes. Copyright © The Author(s) 2025 <27> Accession Number 652003198 Title Sex Differences in Postoperative Recovery and Mortality After High-Risk Cardiac Surgery: A Propensity Score-Matched Post Hoc Analysis of the SUSTAIN-CSX Trial. Source Journal of the American Heart Association. 15(17) (pp e049243), 2026. Date of Publication: 01 Sep 2026. Author Zayat R.; Kolashov A.; Stoppe C.; Notz Q.; Shieba Y.; Moza A.; Catena D.; Mohsen G.; Beer J.; Duerr G.D.; Mohammed A.F.A. Institution (Zayat, Moza, Mohammed) Deparment of cardiac surgery, Medical Faculty University Hospital RWTH Aachen Aachen Germany, Germany (Kolashov) Department of Cardiothoracic Surgery, Heart Centre Trier Barmherzigen Brueder Hospital Trier Germany, Germany (Stoppe, Notz) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine University Hospital Wurzburg Germany, Germany (Stoppe, Catena, Mohsen) Department of Cardiac Anaesthesiology and Intensive Care Medicine Deutsches Herzzentrum der Charite Berlin Germany, Germany (Stoppe, Catena, Mohsen) Corporate Member of Freie Universitat Berlin Humboldt-Universitat zu Berlin Berlin Germany, Charite-Universitatsmedizin Berlin (Shieba, Mohammed) Department of Cardiothoracic Surgery, Faculty of Medicine Qena University Qena Egypt, Egypt (Beer, Duerr) Department of Cardiovascular Surgery University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany, Germany Abstract BACKGROUND: Sex-related differences after cardiac surgery remain controversial because women often present with higher baseline risk and complexity than men. We performed a post hoc propensity score-matched analysis of the SUSTAIN-CSX (Sodium Selenite Administration in Cardiac Surgery) trial to evaluate sex differences in mortality, postoperative complications, and recovery after high-risk cardiac surgery. METHOD(S): Of 1394 trial participants, 1386 had complete data. Women were matched 1:1 to men using nearest-neighbor propensity score matching based on age and European System for Cardiac Operative Risk Evaluation II (EuroSCORE II), with exact matching on surgical category, yielding 327 female-male pairs. Prespecified sensitivity analyses adjusted for frailty, baseline hemoglobin, renal disease, left ventricular ejection fraction, previous myocardial infarction, preoperative medications, and baseline creatinine. RESULT(S): In the primary matched analysis, 180-day survival did not differ between women and men (log-rank P=0.086; unadjusted hazard ratio, 1.80 [95% CI, 0.91-3.55]; P=0.091). In descriptive matched comparisons, women had numerically longer intensive care unit stay (median, 3 days [quartile 1, quartile 3 (Q1, Q3)=1, 6 days] versus 2 days [Q1, Q3=1, 5 days]) and hospital stay (median, 10 days [Q1, Q3=7, 18 days] versus 9 days [Q1, Q3=6, 16 days]; P=0.292), whereas major postoperative complications were similar. In adjusted sensitivity analyses accounting for the matched design and residual imbalance, female sex remained associated with longer intensive care unit stay (adjusted incidence rate ratio [IRR], 1.8 [95% CI, 1.2-2.9]; P=0.009) and hospital stay (adjusted IRR, 1.4 [95% CI, 1.0-1.9]; P=0.031). Mortality sensitivity analyses were model-dependent. CONCLUSION(S): In this propensity score-matched cohort of high-risk cardiac surgery patients, women showed a longer postoperative recovery trajectory in adjusted analyses, whereas mortality findings were sensitive to model specification and should be interpreted cautiously. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02002247. <28> Accession Number 2047007220 Title The endocarditis team: a review. Source Expert Review of Anti-Infective Therapy. 24(9) (pp 801-812), 2026. Date of Publication: 2026. Author Maher A.; Baddour L.M.; El Dalati S.; Miro J.M.; DeSimone D.C.; Marti-Carvajal A.J.; Thornhill M.H.; Dayer M.J. Institution (Maher, Dayer) Department of Cardiology, Mater Private Hospital, Dublin, Ireland (Maher) Department of Cardiology, Beaumont Hospital, Dublin, Ireland (Maher, Dayer) Royal College of Surgeons, Dublin, Ireland (Baddour) Division of Public Health, Infectious Diseases, and Occupational Medicine, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, United States (El Dalati) Division of Infectious Diseases, University of Kentucky Medical Center, Lexington, KY, United States (Miro) Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Miro) Reial Academia de Medicina de Catalunya (RAMC), Barcelona, Spain (DeSimone) Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, United States (Marti-Carvajal) Catedra Rectoral de Medicina Basada en la Evidencia, Universidad de Carabobo, Naguanagua, Venezuela (Marti-Carvajal) Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain (Thornhill) Unit of Oral and Maxillofacial Medicine, Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom Publisher Taylor and Francis Ltd. Abstract Introduction: Infective endocarditis (IE) is a complex infection of the endocardium, associated with significant morbidity and mortality. Diagnosing IE can be challenging, as shown by the evolution of original diagnostic criteria. Managing IE is difficult, involving decisions about diagnosis, antibiotic therapy, and surgery. Given these challenges, the 2015 European Society of Cardiology (ESC) IE Guidelines recommended establishing an endocarditis team (ET) in centers managing IE. This review evaluates the evidence supporting ETs. Areas covered: We identified 19 before-and-after studies including 5,327 patients (3,069 before and 2,258 after ET introduction) that examined the impact of implementing an ET on the quality of care for patients with IE. No RCTs were found. The studies were reviewed and revealed a significant reduction in in-hospital mortality (20.9-16.3% [RR 0.71, CI 0.54 to 0.93], p = 0.0154)) and the proportion of endocarditis cases in which an organism was not identified (23.8-9.8%; [RR 0.50, 0.39 to 0.64, p < 0.0001]) following ET introduction. Expert opinion: This review provides consistent observational evidence that ETs are effective in saving lives. Despite limitations, the consistency of effect across multiple studies, biological plausibility, and alignment with successful multidisciplinary models in other diseases support the widespread implementation of ETs. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <29> Accession Number 2048849379 Title SURGELLA: A Scoping Review of Impella-Assisted Hemodynamic Support in High-Risk Non-Cardiac Surgery. Source Artificial Organs. (no pagination), 2026. Date of Publication: 2026. Author Elghazaly H.; Allaf M.; Mian A.; Ahmed H.; Gordon-Weeks A.; Tindale A.; Panoulas V. Institution (Elghazaly) Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (Elghazaly) William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Allaf, Tindale, Panoulas) Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Mian, Gordon-Weeks) Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (Mian, Gordon-Weeks) Department of Hepato-Pancreato-Biliary Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Ahmed) Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (Ahmed) Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Panoulas) National Heart and Lung Institute, Imperial College London, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: Patients with advanced heart failure or severe ventricular dysfunction are often considered prohibitively high risk for non-cardiac surgery. Impella may provide temporary perioperative hemodynamic support by augmenting cardiac output and unloading the left ventricle, but evidence for this strategy remains limited and largely case based. Method(s): We conducted a scoping review of Impella use for adult high-risk non-cardiac surgery. MEDLINE and Embase were searched from inception to April 2026, with supplementary hand-searching and citation tracking. Eligible reports were synthesized descriptively, with particular attention to implantation timing, operative context, device strategy, outcomes, and complications. Result(s): Twenty-three publications comprising 36 unique patients were identified. Evidence consisted mainly of case reports and small series. Impella was used across bariatric, abdominal, oncological, endocrine, transplant-related, vascular, orthopedic, and neurosurgical procedures. Clinical strategies included planned pre-emptive support, surgery during established Impella or ECMELLA support, rescue implantation after perioperative deterioration, and combined support strategies. Operative completion was usually reported and 34 of 36 unique published patients survived to hospital discharge; however, this reflects selected published experience rather than a reliable estimate of effectiveness or safety. Conclusion(s): Impella-supported non-cardiac surgery appears technically feasible in highly selected patients treated in specialist centers. Current evidence supports feasibility, not comparative benefit or generalizable safety. Prospective multicenter data with standardized reporting are required before wider adoption can be justified. Copyright © 2026 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. <30> Accession Number 652004684 Title Prophylactic Surgical Left Atrial Appendage Closure in Bioprosthetic Aortic Valve Replacement: Short-Term Outcomes of Randomized Controlled LAA-CLOSURE Trial. Source Journal of the American Heart Association. 15(17) (pp e046654), 2026. Date of Publication: 01 Sep 2026. Author Kiviniemi T.; Halfwerk F.; Bustamante Munguira J.; Zindovic I.; Malmberg M.; Olsson C.; Perrotta S.; van Schaagen F.; Suwalski P.; Hartikainen J.; Hanke T.; Reyes Copa G.; Speekenbrink R.G.H.; Bustamante E.; Erixon C.; Gunn J.; Bjurbom M.; Jeppsson A.; Oei F.; Wietsma N.E.; Dahlberg S.; Lip G.; Lehto J.; Vasankari T.; Airaksinen J.; van Putte B. Institution (Kiviniemi, Malmberg, Gunn, Lehto, Vasankari, Airaksinen) Turku University Hospital and University of Turku Finland, Finland (Halfwerk, Speekenbrink, Wietsma) Medisch Spectrum Twente, Netherlands (Halfwerk, Speekenbrink, Wietsma) University of Twente, TechMed Centre Enschede The Netherlands, Netherlands (Bustamante Munguira, Bustamante) Hospital Clinico Universitario de Valladolid Valladolid Spain, Spain (Zindovic, Erixon, Dahlberg) Department of Clinical Sciences, Department of Cardiothoracic Surgery, Skane University Hospital Lund University Lund Sweden, Lund, Norway (Olsson, Bjurbom) Karolinska University Hospital and the Karolinska Institutet Stockholm Sweden, Sweden (Perrotta, Jeppsson) Department of Cardiothoracic Surgery Sahlgrenska University Hospital Gothenburg Sweden, Sweden (Perrotta, Jeppsson) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden, Sweden (van Schaagen, Oei) University Medical Center Rotterdam Rotterdam the Netherlands, Netherlands (Suwalski) National Medical Institute of the Ministry of Interior and Administration Center of Postgraduate Medical Education Warsaw Poland, Poland (Hartikainen) Kuopio University Hospital, University of Eastern Finland Kuopio Finland, Finland (Hanke) Asklepios Klinik Harburg Hamburg Germany, Germany (Reyes Copa) Hospital Universitario La Princesa Madrid Spain, Spain (Lip) Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK (van Putte) St. Antonius ziekenhuis Nieuwegein the Netherlands, Netherlands Abstract BACKGROUND: Surgical closure of the left atrial appendage (LAA) reduces stroke risk in patients with atrial fibrillation (AF) undergoing cardiac surgery. We evaluated the safety and efficacy of prophylactic LAA closure during bioprosthetic surgical aortic valve replacement in patients without prior AF. METHOD(S): In this investigator-initiated, academic, randomized, open-label, multicenter LAA-CLOSURE (Left Atrial Appendage CLOSURE for the Prevention of Thromboembolisms in Patients Undergoing Aortic Bioprosthesis Surgery) trial, 921 patients without prior AF undergoing bioprosthetic surgical aortic valve replacement with or without concomitant surgery were randomized and 904 patients included in the modified intention-to-treat analysis (prophylactic LAA closure, n=445; or usual care, n=459). Median age was 73 years (interquartile range, 69-76), 34.8% were women, and 49% had concomitant coronary artery disease. The primary end point was a composite of cardiovascular death, stroke, or systemic embolism at 30 days. RESULT(S): The primary end point occurred in 10 of 434 (2.2%) patients in the LAA closure group and 14 of 452 (3.1%) patients in the control group; however, the treatment effect changed direction at =7 days. In the time-split Cox regression model, hazard ratios were 2.4 (95% CI, 0.62-9.4; P=0.20) between 0 and 7 days and 0.29 (95% CI, 0.080-1.0; P=0.056) between 7 and 30 days. No closure-related serious complications or differences in bleeding were observed. Postoperative AF occurred in 205 of 445 (46.1%) versus 184 of 459 (40.1%) patients (relative risk, 1.1 [95% CI, 0.99-1.3]; P=0.07), and AF at discharge in 40 of 445 (9.2%) versus 34 of 459 (7.7%) patients (relative risk, 1.2 [95% CI, 0.77-1.8]; P=0.44), in the closure and control groups, respectively. CONCLUSION(S): Prophylactic LAA closure during bioprosthetic surgical aortic valve replacement was safe and did not increase bleeding. REGISTRATION: URL: clinicaltrials.gov; Unique Identifier: NCT02321137. <31> Accession Number 2048862594 Title Thoracoscopic internal fixation, open surgical internal fixation, and conservative treatment of rib fractures: differences in postoperative rehabilitation and chest volume (a randomized controlled trial). Source European Journal of Trauma and Emergency Surgery. 52(1) (no pagination), 2026. Article Number: 274. Date of Publication: 01 Dec 2026. Author Li T.; Zhao P.; Li W.; Liu B. Institution (Li, Li, Liu) Department of Thoracic Surgery, Weifang People's Hospital, 151 Guangwen Road, Shandong Province, Weifang, China (Zhao) Shandong Second Medical University, Shandong Province, Weifang, China Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Currently, the standard treatment for multiple rib fractures is still under debate. This study explores the efficacy of three treatments (thoracoscopic internal fixation, open surgical internal fixation and conservative treatment) for multiple rib fractures and their influence on thoracic cavity volume and postoperative rehabilitation. Method(s): Patients with multiple rib fractures admitted to Weifang People's Hospital of Shandong Province from March 2019 to March 2021 were enrolled in this study. The thoracic volume changes before and after treatment were measured by three-dimensional computed tomography (CT) reconstruction. Twenty-seven patients in the open operation group underwent internal fixation with the rib cage, and 24 patients in the non-internal fixation group underwent external fixation with the chest band. The recovery of multiple rib fractures was evaluated by comparing the difference in thoracic volume before and after treatment, the incidence of related complications and the Comprehensive Assessment of Generic Quality of Life Inventory-74 (GQOLI-74) score one month after the operation. Result(s): After 12 months of follow-up, thoracic volume was significantly different between the thoracoscopic and open fixation groups (P < 0.001). One month after the thoracoscopic internal fixation of rib fractures, the scores of physical function, psychological function and social function were better than those in the open operation internal fixation group and the chest band external fixation group and the differences were statistically significant (P < 0.001). Conclusion(s): Compared with conservative treatment, both surgeries restore thoracic volume and improve early quality of life. Thoracoscopic fixation causes less trauma and better short-term rehabilitation than open surgery, with equivalent thoracic recovery and complication rates. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2026. <32> Accession Number 2048846781 Title Ischaemic Optic Neuropathy After Cardiac Surgery: A Systematic Review and Meta-Analysis of Incidence and Risk Factors. Source ANZ Journal of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Mutahar D.; Zaka A.; Sidhu A.S.; Goswami S.; Singh A.; Ng J.; Stretton B.; Kovoor J.G.; Gupta A.K.; Bacchi S.; Chan W.O.; Chen C. Institution (Mutahar, Zaka) Department of Cardiology, Gold Coast University Hospital, Southport, QLD, Australia (Mutahar, Goswami, Singh, Ng) Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia (Sidhu) Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, NSW, Australia (Stretton, Chan) Royal Adelaide Hospital, Adelaide, SA, Australia (Kovoor, Gupta) Adelaide University, Adelaide, SA, Australia (Bacchi) Massachusetts General Hospital, Boston, MA, United States (Chen) Department of Ophthalmology, Flinders University, Adelaide, SA, Australia Publisher John Wiley and Sons Inc Abstract Background: Ischaemic optic neuropathy (ION) is the most common cause of perioperative visual loss, with the highest incidence reported after cardiac surgery involving cardiopulmonary bypass (CPB). Despite devastating complications, the overall incidence and risk factors for patients with ION in the setting of cardiac surgery remain contentious. We performed a systematic review and meta-analysis to evaluate the pooled incidence and risk factors for ION after cardiac surgery. Method(s): This review conformed to PRISMA guidelines. PubMed, MEDLINE, Web of Science and Cochrane were searched up to 24 March 2024 for multivariable-adjusted and propensity-matched observational studies assessing the incidence of ION exclusively in patients undergoing cardiac surgery. Odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor were pooled from the selected studies using a random-effects model. Result(s): Eleven studies totalling 6 471 577 patients were included. The pooled incidence of ION was approximately 1.50 per 10 000 cardiac surgeries. Significant risk factors for developing ION included coronary artery disease (OR 1.81, 95% CI 1.17-2.79), peripheral vascular disease (OR 1.67, 95% CI 1.10-2.54) and anaemia (OR 1.06, 95% CI 1.00-1.13). Notably, the incidence varied widely between studies, reflecting differences in diagnostic criteria and reporting standards. Newcastle-Ottawa risk of bias assessment found the studies to be of overall moderate methodological quality, with a high risk of bias. Conclusion(s): This study demonstrates a relatively low overall pooled incidence of ION following cardiac surgery, with identifiable risk factors such as pre-existing coronary artery disease, peripheral vascular disease and perioperative anaemia. Copyright © 2026 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. <33> Accession Number 2045712229 Title CytoSorb haemoadsorption in high-risk cardiac surgery: A focused review with proposed tiered patient selection. Source Perfusion (United Kingdom). 41(6) (pp 829-836), 2026. Date of Publication: 01 Sep 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 <34> Accession Number 2048666692 Title Effect of salbutamol during one-lung ventilation in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Source Canadian Journal of Anesthesia. 73(7) (pp 671-680), 2026. Date of Publication: 01 Jul 2026. Author Oh Y.J.; Kim N.; Choo H.; Lee K. Institution (Oh, Kim, Choo, Lee) Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea (Oh, Kim, Choo, Lee) Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea Publisher Springer Abstract Purpose: Ventilation-perfusion mismatch during one-lung ventilation (OLV) for thoracic surgery increases the risk of hypoxemia. Salbutamol may selectively dilate pulmonary vessels and enhance perfusion of the ventilated lung. We sought to investigate whether selective salbutamol nebulization to the ventilated lung during OLV improves gas exchange and respiratory mechanics in patients with chronic obstructive pulmonary disease (COPD). Method(s): In this prospective randomized controlled trial, we randomly allocated 90 patients scheduled for lung resection to receive salbutamol or placebo nebulization 30 min after OLV initiation and analyzed 82 patients (41 per group). The primary endpoint was the change in the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf>) after nebulization. Secondary outcomes included other gas exchange and respiratory mechanics indices, hemodynamic variables, and perioperative complications. Result(s): Compared with placebo, salbutamol increased PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> (mean difference, 26; 95% confidence interval [CI], 0 to 53; P = 0.03) and decreased alveolar dead space (mean difference, -1.7; 95% CI, -4.3 to -0.1; P = 0.04) as well as serum potassium (mean difference, -0.2; 95% CI, -0.4 to 0.0; P = 0.01). Heart rate rose transiently without arrhythmia. In a subgroup of patients who had received preoperative inhaler therapy, no between-group differences were observed. Conclusion(s): Selective salbutamol nebulization during OLV improved oxygenation and respiratory mechanics without serious adverse events, and it may be considered as an adjunctive option for the management of intraoperative hypoxemia in patients with COPD. The lack of benefit among patients who received preoperative inhaler therapy suggests that intraoperative selective one-lung nebulization may be more advantageous than preoperative two-lung nebulization. Study registration: ClinicalTrials.gov (NCT05914285); first submitted 13 June 2023. Copyright © Canadian Anesthesiologists' Society 2026. <35> Accession Number 2048847085 Title "Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Source Journal of Cardiovascular Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Al-Janabi A.A.H.; Al-Shammari A.S.; Hageen A.W.; Al-Tuaama A.Z.H.; Al-Ibraheem A.M.T.; Shahzaib M.; Rathi D.; Hamzah K.A.; shweliya M.A.; Kurmasha Y.H.; Wagdy M.; Refaat M.M. Institution (Al-Janabi, Al-Ibraheem, Hamzah) Department of Internal Medicine, ALkindy college of medicine/University of Baghdad, Baghdad, Iraq (Al-Shammari, shweliya) Department of Internal Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq (Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt (Al-Tuaama) Department of Internal Medicine, Privolzhsky Research Medical University, Novgorod, Nizhny, Russian Federation (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Rathi) Dow University of Health Sciences, Karachi, Pakistan (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Wagdy) Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt (Refaat) Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Publisher John Wiley and Sons Inc Abstract We aim to compare the impact of left atrial appendage closure vs. medical therapy on clinical outcomes in patients with atrial fibrillation, focusing on key clinical outcomes relevant to thromboembolic prevention. We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing LAAC with medical therapy in AF adults. PubMed, Embase, Scopus, ClinicalTrial. gov, and Cochrane Library were searched from inception to March 2026. Outcomes included all-cause mortality, any stroke, ischemic stroke, hemorrhagic stroke, major bleeding, systemic embolism and cardiac death. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Reconstructed individual patient-level survival data from published Kaplan-Meier curves were used for time-to-event analyses. Trial sequential analysis (TSA) assessed the conclusiveness of cumulative evidence. Six randomized controlled trials involving 7004 patients were included. LAAC demonstrated comparable outcomes to medical therapy for all-cause mortality, any stroke, major bleeding, systemic embolism, and cardiac death. There was a non-significant trend toward increased ischemic stroke and reduced hemorrhagic stroke with LAAC. Reconstructed time-to-event analyses showed similar cumulative incidence of stroke and bleeding outcomes over follow-up. TSA demonstrated that the required information size was not reached for any major endpoint, indicating that current evidence remains underpowered and additional randomized trials are needed. LAAC provides similar overall efficacy and safety compared with medical therapy for stroke prevention in AF but should currently remain reserved for selected patients rather than replacing oral anticoagulation broadly. Further adequately powered trials with longer follow-up are required. Copyright © 2026 Wiley Periodicals LLC. <36> Accession Number 652005461 Title Redo-Transcatheter Aortic Valve Implantation Versus Surgical Explantation in Patients With Previous Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(17) (pp e048885), 2026. Date of Publication: 01 Sep 2026. Author Ktenopoulos N.; Apostolos A.; Terentes-Printzios D.; Drakopoulou M.; Synetos A.; Latsios G.; Xaplanteris P.; Panoulas V.; Baumbach A.; Tsioufis K.; Toutouzas K. Institution (Ktenopoulos, Apostolos, Terentes-Printzios, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) First Department of Cardiology, Hippokration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece, Greece (Ktenopoulos, Apostolos, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece, Greece (Apostolos, Panoulas) Royal Brompton and Harefield Hospitals Guy's and St Thomas' NHS Foundation Trust London United Kingdom, United Kingdom (Apostolos) Faculty of Medicine, Imperial College London London United Kingdom, United Kingdom (Xaplanteris) Department of Cardiology, Centre Hospitalier Universitaire Saint-Pierre Universite Libre de Bruxelles Brussels Belgium, Belgium (Panoulas) National Heart and Lung Institute Imperial College London London United Kingdom, United Kingdom (Baumbach) Center for Cardiovascular Medicine and Devices, William Harvey Research Institute Queen Mary University of London and Barts Heart Center London United Kingdom, United Kingdom (Baumbach) Cleveland Clinic London United Kingdom, United Kingdom Abstract BACKGROUND: As transcatheter aortic valve implantation (TAVI) expands to younger and lower-risk populations, failed transcatheter heart valves are increasingly encountered, yet the optimal reintervention strategy remains uncertain. This meta-analysis aimed to compare the outcomes of redo-TAVI (TAVI-in-TAVI) versus surgical transcatheter heart valve explantation with surgical aortic valve replacement (TAVI-explantation) after transcatheter heart valve failure. METHOD(S): PubMed/Medline, Scopus and Cochrane Central Register of Controlled Trials were systematically searched from inception to September 10, 2025 for comparative studies. The primary outcome was all-cause mortality (in-hospital, 30-day, and 1-year). Secondary outcomes included cerebrovascular events, major adverse cardiac events, permanent pacemaker implantation, greater-than-mild paravalvular leak, major bleeding, length of stay, and 30-day readmission. As the primary analysis, reconstructed individual patient-level data were analyzed using Firth penalized logistic regression adjusting for study, and complementary random-effects meta-analyses were also used. RESULT(S): Eight observational studies including 6166 patients (3743 redo-TAVI; 2425 TAVI-explantation) were analyzed. Compared with TAVI-explantation, redo-TAVI was associated with lower in-hospital mortality (odds ratio [OR], 0.20 [95% CI, 0.11-0.35]; P<0.0001), 30-day mortality (OR, 0.28 [95% CI, 0.23-0.34]; P<0.0001), and 1-year mortality (OR, 0.70 [95% CI, 0.62-0.80]; P<0.0001). No significant differences were observed in cerebrovascular events or permanent pacemaker implantation rates. Redo-TAVI was associated with lower major bleeding (OR, 0.35 [95% CI, 0.24-0.50]; P<0.0001), fewer 30-day readmissions (OR, 0.53 [95% CI, 0.30-0.92]; P=0.023), and shorter hospitalization (Mean Difference -6.29 days [95% CI, -8.66 to -3.93), but a higher risk of greater-than-mild paravalvular leak (OR, 80.12 [95% CI, 11.30-10 153]; P<0.0001). CONCLUSION(S): Redo-TAVI was associated with lower early and 1-year mortality, reduced bleeding, and shorter hospitalization compared with TAVI-explantation, with similar cerebrovascular event and permanent pacemaker implantation rates but higher paravalvular leak risk. These findings support redo-TAVI as the preferred reintervention strategy in anatomically suitable patients, whereas randomized trials and longer-term follow-up are needed to refine lifetime management strategies after transcatheter heart valve failure. <37> Accession Number 2045727144 Title Determinants of Healthcare Costs in Individuals With Down Syndrome: A Systematic Review. Source Health Science Reports. 9(6) (no pagination), 2026. Article Number: e72297. Date of Publication: 01 Jun 2026. Author Rakhshan S.T.; Byford S.; Razimoghadam M.; Moradi F.; Soltani S. Institution (Rakhshan, Razimoghadam) Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Byford) King's Health Economics, King's College London, London, United Kingdom (Razimoghadam) National Center for Health Insurance Research, Tehran, Iran, Islamic Republic of (Moradi) Medical Education Department Center (EDC), Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic of (Soltani) Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Individuals with Down syndrome (DS) require specialized medical follow-up and services more frequently than the general population, resulting in substantial healthcare costs for families and health systems. This systematic review aimed to synthesize evidence on the magnitude and determinants of direct healthcare and indirect costs associated with DS. Method(s): We searched Web of Science, PubMed, and Scopus for observational and experimental studies published in English between January 1, 2000, and December 31, 2022 (updated June 15, 2024), that reported healthcare costs or cost determinants for individuals with DS. Reference lists were also screened. We excluded non-English papers, qualitative studies, reviews, protocols, editorials, and gray literature. Result(s): The search identified 625 unique citations, of which 14 matched the inclusion criteria. Half were conducted in the USA. Inpatient services constituted the largest share of direct healthcare costs in 58% of studies. Indirect costs, mainly productivity losses among families, were reported in 25% of studies. Healthcare costs were highest during infancy (driven primarily by congenital heart defects and early hospitalizations), decreased throughout childhood and adolescence, and increased again in adulthood, particularly after age 40, due to age-related comorbidities such as dementia and multimorbidity. Associated morbidities, greater functional limitations, and lower socioeconomic status were consistently associated with higher costs. Conclusion(s): Age, comorbidities, functional ability, and socioeconomic factors are key drivers of healthcare costs in DS. Long-term, comprehensive policies integrating medical, social, and educational support are needed. Priority should be given to early cardiac surgery coverage, multidisciplinary adult transition clinics, subsidized respite care, and financial assistance schemes to reduce both inpatient utilization and family productivity losses. Copyright © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC. <38> Accession Number 2048482493 Title Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation. Source JACC: Asia. 6(9) (pp 1959-1968), 2026. Date of Publication: 01 Sep 2026. Author Ren K.; Tan B.; Lin X.; Pu Z.; Wang L.; Hu P.; Jiang J.; Zhu Q.; Fan J.; He Y.; Guo Y.; Liu Q.; Liang J.; Li H.; Yan H.; Hu H.; Liu X.; Wang J. Institution (Ren, Tan, Lin, Pu, Wang, Hu, Jiang, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Hu, Liu, Wang) Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China (Ren, Tan, Lin, Pu, Wang, Hu, Jiang, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Hu, Liu, Wang) State Key Laboratory of Transvascular Implantation Devices, Zhejiang, Hangzhou, China (Ren, Tan, Lin, Pu, Wang, Hu, Jiang, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Hu, Liu, Wang) Heart Regeneration and Repair Key Laboratory of Zhejiang province, Zhejiang, Hangzhou, China (Liu, Wang) Transvascular Implant Instrument Research Institute, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang, Hangzhou, China (Liu, Wang) Binjiang Institute of Zhejiang University, Hangzhou, China Publisher Elsevier Inc. Abstract Background Tricuspid regurgitation (TR) is common, and severe TR independently predicts mortality and heart failure hospitalization, leading to functional impairment and poor quality of life. Optimal medical therapy (OMT), mainly using diuretic agents, provides symptomatic relief but does not correct valvular dysfunction and is often limited by the resistance of diuretic agents. Isolated tricuspid valve surgery remains high risk. Transcatheter options have therefore emerged, with transcatheter edge-to-edge repair (TEER) widely adopted. Objectives The Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation in China (TEER-CHINA) study is designed to evaluate the safety and efficacy of the DragonFly-T System compared with OMT in patients with severe TR. Methods The TEER-CHINA trial is a prospective, multicenter, randomized controlled trial ( NCT05556460 ) in which a total of 236 participants will be enrolled across 35 centers in China and randomized 1:1 to the device group or OMT alone. Key inclusion criteria include patients with severe or greater TR (>=3+) who remain clinically symptomatic despite OMT for at least 30 days, are at intermediate or higher surgical risk for tricuspid valve surgery by the local Heart Team, and are anatomically suitable for use of the investigational device. Participants will be followed up at 30 days, 6 months, 12 months, and annually thereafter for up to 5 years. Results The primary endpoint is a hierarchical composite assessed at 12 months, including all-cause mortality or tricuspid valve intervention, annualized heart failure hospitalization rates, and improvement in health status measured by the Kansas City Cardiomyopathy Questionnaire. Conclusions The TEER-CHINA trial is designed to assess the efficacy and safety of the DragonFly-T System and to inform future treatment strategies for severe TR. Copyright © 2026 The Authors. <39> Accession Number 2048376817 Title Effect of driving pressure-guided individualized PEEP in children undergoing right lateral thoracotomy cardiac surgery with cardiopulmonary bypass on postoperative atelectasis and oxygenation: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 496. Date of Publication: 01 Dec 2026. Author Chen X.; Song H.; Zang M.; Zhou J.; Liu Y.; Ren Y. Institution (Chen, Zang) Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China (Song, Zhou, Liu, Ren) Department of Anesthesiology, The Affiliated Women and Children's Hospital of Qingdao University, Qingdao, China Publisher BioMed Central Ltd Abstract Background: Right lateral thoracotomy cardiac surgery induces postoperative atelectasis due to cardiopulmonary bypass (CPB), patient positioning, and mechanical ventilation. Fixed positive end-expiratory pressure (PEEP) may fail to meet pediatric ventilation requirements. This study aims to investigate the effects of driving pressure-guided individualised PEEP on postoperative atelectasis and oxygenation. Method(s): Children aged 6 months to 5 years undergoing right lateral thoracotomy cardiac surgery with CPB were randomly assigned to two groups. Group C received conventional protective ventilation with fixed PEEP of 5 cmH<inf>2</inf>O in the lateral decubitus position until the end of ventilation. Group D had driving pressure-guided individualized PEEP titration following both the lateral decubitus position and the CPB, with ventilation maintained at the titrated PEEP. Both groups received lung recruitment maneuvers. Observations were conducted at the following time points: after intubation (T<inf>0</inf>), after lateral positioning (T<inf>1</inf>), before CPB (T<inf>2</inf>), after CPB (T<inf>3</inf>), at the end of surgery (T<inf>4</inf>), before leaving the operating room (T<inf>5</inf>), after admission to the ICU (T<inf>6</inf>), and 1 h after extubation (T<inf>7</inf>). Lung ultrasonography was performed for each patient at T<inf>0</inf> and T<inf>5</inf>. The primary outcomes were the incidence of postoperative atelectasis and lung ultrasound scores (LUS). Secondary outcomes included PaO<inf>2</inf>/FiO<inf>2</inf> ratio (P: F ratio), incidence of post-CPB hypoxemia and postoperative pulmonary complications (PPCs) within 3 days, peak airway pressure (P<inf>peak</inf>), dynamic pulmonary compliance (Cdyn), PEEP, driving pressure, extubation time, length of ICU stay, length of hospital stay, heart rate and mean arterial pressure. Result(s): At T<inf>5</inf>, the incidence of atelectasis and LUS were lower in Group D than in Group C (P < 0.05). P: F ratio in Group D was higher than in Group C at T<inf>2</inf>, T<inf>4</inf>, and T<inf>6</inf> (P < 0.05). The incidence of post-CPB hypoxemia and extubation time were lower in Group D (P < 0.05). Group D showed superior intraoperative respiratory mechanics parameters. However, there were no significant differences in the incidence of PPCs within 3 days, intraoperative hemodynamics, ICU length of stay, or hospital length of stay between the two groups (P > 0.05). Conclusion(s): Driving pressure-guided individualized PEEP ventilation reduces the incidence of postoperative atelectasis in children undergoing right lateral thoracotomy cardiac surgery with CPB. It also improves oxygenation and intraoperative respiratory mechanics. However, there was no significant difference in the incidence of PPCs within 3 days. Trial registration: ChiCTR, ChiCTR2500098036. Registered on February 28, 2025, www.chictr.org.cn. Copyright © The Author(s) 2026. <40> Accession Number 2048575129 Title In patients with CAD, clopidogrel vs. aspirin monotherapy reduces MACCE without increasing major bleeding. Source Annals of Internal Medicine. 179(2) (pp JC16), 2026. Date of Publication: 01 Feb 2026. Author Kelsey M.D. Institution (Kelsey) Duke University, Durham, NC, United States Publisher American College of Physicians <41> Accession Number 2048404777 Title Perioperative continuous vs. interrupted oral anticoagulation in TAVR: a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 711. Date of Publication: 01 Dec 2026. Author Gan X.; Lang Z.; Meng X.; Su Y.; Zhu Y.; Zhao J.; Bai M. Institution (Gan) Office of Graduate Education, The First Hospital of Lanzhou University, Gansu, Lanzhou, China (Lang, Meng, Su, Zhu, Zhao, Bai) The First School of Clinical Medicine of Lanzhou University, Gansu, Lanzhou, China (Lang, Meng, Su, Zhu, Zhao, Bai) Department of Cardiology, The First Hospital of Lanzhou University, Gansu, Lanzhou, China (Lang, Meng, Su, Zhu, Zhao, Bai) Gansu Province Clinical Research Center for Cardiovascular Diseases, Gansu, Lanzhou, China Publisher BioMed Central Ltd Abstract Objectives: To evaluate the clinical outcomes associated with continuous versus interrupted oral anticoagulation strategies during the perioperative period of transcatheter aortic valve replacement, with a focus on balancing thromboembolic and bleeding risks. Method(s): We searched PubMed, Web of Science, Cochrane Library, Scopus, Ovid and Embase up to February 2026. All studies compared continuous oral anticoagulation versus interruption of oral anticoagulation for TAVI. The primary outcomes were major bleeding, major vascular complications, and stroke. Data synthesis was performed by calculating risk ratios (RRs) or standardized mean differences (SMDs), each accompanied by 95% confidence intervals (CIs). The study was prospectively registered with PROSPERO (CRD420251070176). Result(s): A total of five studies comprising 3,316 patients were included. Compared with interrupted anticoagulation, continued OAC was not associated with a statistically significant increase in major bleeding or major vascular complications. Continued OAC showed a borderline association with a lower risk of stroke, together with lower red blood cell transfusion and higher device success rates. However, given the limited number of studies, the predominance of retrospective evidence, and the trial sequential analysis findings, these results should be interpreted cautiously. Conclusion(s): Continuation of OAC during TAVR appears feasible and was not associated with an increased risk of major bleeding or major vascular complications in the currently available evidence. Although continued OAC showed a possible association with lower stroke and transfusion risks, the evidence remains limited and statistically fragile. Larger randomized trials are needed before definitive clinical recommendations can be made. Copyright © The Author(s) 2026. <42> Accession Number 2038519271 Title Effect of Intracoronary Recombinant Human Prourokinase on Myocardial Perfusion and Clinical Outcomes in STEMI Patients Undergoing Primary PCI: A Randomized Controlled Trial. Source Reviews in Cardiovascular Medicine. 27(8) (no pagination), 2026. Article Number: 39580. Date of Publication: 01 Aug 2026. Author Gu C.; Hu X.; Liu H.; Qiao R.; Xiang X.; Chen H.; Zhao X. Institution (Gu, Zhao) Department of Cardiovascular, The Second Hospital of Dalian Medical University, Liaoning, Dalian, China (Gu, Hu, Liu, Qiao, Xiang, Chen) Department of Cardiovascular, Anqing Municipal Hospital, Anhui, Anqing, China Publisher IMR Press Limited Abstract Background: This study aimed to investigate whether intracoronary administration of recombinant human prourokinase (rhPro-UK) improves coronary blood flow, attenuates post-reperfusion inflammatory responses, and enhances clinical outcomes in patients with acute myocardial infarction. Method(s): In this prospective, single-blind, randomized, controlled clinical trial, 136 ST-segment elevation myocardial infarction (STEMI) patients undergoing emergency percutaneous coronary intervention (PCI) at Anqing Municipal Hospital (August 2021-June 2023) were randomized 1:1:1 to intracoronary rhPro-UK (n = 44), tirofiban (n = 44), or saline groups (n = 48). Perioperative serum levels of creatine kinase-MB (CK-MB), high-sensitivity cardiac troponin T (hs-cTnT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha), and soluble suppression of tumorigenicity-2 (sST2) were measured. Serum sST2 was re-evaluated at 1 month (28 +/- 7 days) post-PCI. Major adverse cardiovascular events (MACE) were assessed via clinic visits or telephone follow-up at 12 months. Result(s): The cohort had a mean age of 60.6 +/- 11.5 years and was predominantly male (89.0%). At 12 months, the rhPro-UK group had the lowest MACE incidence (log-rank p = 0.039). Multivariable Cox regression confirmed reduced MACE risk in the rhPro-UK group (hazard ratio [HR] 0.22, 95% confidence interval [CI]: 0.05-0.99, p = 0.049). The final intra-and postoperative corrected TIMI frame count (cTFC) results demonstrated that both the tirofiban group and the rhPro-UK group exhibited superior efficacy in alleviating the slow/no-reflow phenomenon compared with the saline control group. At 48 hours post-PCI, rhPro-UK significantly reduced CK-MB and hs-cTnT levels compared to saline (p < 0.05). Both rhPro-UK and tirofiban groups exhibited lower IL-6, IL-8, and TNF-alpha levels at 24, 48, and 72 hours (p < 0.05). At 1-month follow-up, sST2 levels were markedly reduced in the rhPro-UK group (12.9 +/- 3.3 pg/mL) versus tirofiban (18.7 +/- 4.9 pg/mL) and saline (24.4 +/- 15.7 pg/mL) (p = 0.001). Conclusion(s): Intracoronary rhPro-UK administration during emergency PCI in STEMI patients reduces post-reperfusion inflammation and fibrosis, limits infarct size, and improves clinical outcomes. Trial Registration: Chinese Clinical Trial Registry (ChiCTR http://www.chictr.org.cn Identifier: ChiCTR2100047095). Copyright © 2026 The Author(s). <43> Accession Number 2046702458 Title CT Perfusion vs FFR for Ischemia-Guided Revascularization: A Randomized Trial. Source JACC: Cardiovascular Imaging. 19(9) (pp 1150-1152), 2026. Date of Publication: 01 Sep 2026. Author Kim J.H.; Kang D.-Y.; Ahn J.-M.; Lee S.-W.; Kim H.-S.; Lee B.-K.; Lee S.H.; Choi B.W.; Yang D.H.; Kim Y.-H. Publisher Elsevier Inc. <44> Accession Number 2048827971 Title Optimizing Heparin and Protamine Dosing During Cardiopulmonary Bypass Using Activated Clotting Time-Guided Protocols: A Single-Centre Prospective Randomized Controlled Trial. Source Interdisciplinary Cardiovascular and Thoracic Surgery. 41(8) (no pagination), 2026. Article Number: ivag197. Date of Publication: 01 Aug 2026. Author El Dsouki Y.; Condello I.; Gunertem O.E.; Yildirim A.; Gunaydin S.; Lorusso R. Institution (El Dsouki, Lorusso) Maastricht University Medical Centre MUMC, Maastricht, Netherlands (El Dsouki, Lorusso) Cardiovascular Research Centre Maastricht CARIM, Maastricht, Netherlands (Condello) School of Medicine and Surgery, University of Insubria, Varese, Italy (Gunertem, Yildirim, Gunaydin) Department of Cardiovascular Surgery, Medical Park Hospital, YIH University, Ankara, Turkey Publisher Oxford University Press Abstract Objectives: To evaluate whether an activated clotting time (ACT)-guided, formula-based anticoagulation strategy supported by viscoelastic coagulation monitoring (ROTEM) improves perioperative coagulation management and reduces bleeding compared with standard weight-based heparin dosing in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Method(s): In this single-centre prospective, randomized controlled trial, 100 adults undergoing isolated CABG with CPB were allocated to ACT-guided management (n = 50) or standard care (n = 50). The ACT-guided group received individualized heparin and protamine dosing calculated using predefined ACT-based formulas targeting ACT >=400 seconds. The control group received a fixed heparin bolus (300 IU/kg) with empirical protamine reversal. ROTEM was performed preoperatively, intraoperatively, and postoperatively. The primary end-point was total chest drain output at 24 hours. Secondary end-points included transfusion requirements, thrombotic events, platelet count variation, oxygenator performance, additional heparin or protamine use, ROTEM-derived parameters, and perioperative clinical outcomes. Result(s): The ACT-guided group had lower 24-hour chest drain bleeding and reduced total exposure to heparin and protamine. Intraoperative ACT values were more consistently within target range, with fewer supplemental heparin doses required. ROTEM demonstrated shorter clotting times and improved clot firmness, indicating reduced postoperative hypocoagulability. Platelet decline during CPB was attenuated. Transfusion rates (28% vs 52%, P = .01) and total allogeneic units transfused (0.6 +/- 1.0 vs 1.4 +/- 1.6, P = .003) were significantly lower, with no observed increase in thrombotic events. Conclusion(s): Activated clotting time-guided, formula-based anticoagulation supported by ROTEM was associated with more favourable coagulation parameters and reduced bleeding without evidence of increased thrombotic complications within the limitations of the study sample size. Larger prospective studies are warranted to confirm these findings. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. <45> Accession Number 2038440130 Title Left atrial appendage closure with the AnchorMan or Watchman devices: 12-month results of the SAFE-PROTECT randomised trial. Source EuroIntervention. 22(13) (pp e720-e729), 2026. Date of Publication: 06 Jul 2026. Author Wang B.; Cai H.; Wu Y.; Chen M.; Wang C.; Jiang X.; Tao S.; Zhong Z.; Zeng J.; Wang F.; Ning Z.; Yuan Z.; He J.; Francese D.P.; Lansky A.J.; He B.; Chu H. Institution (Wang, Chu) Arrhythmia Center, First Affiliated Hospital of Ningbo University, Ningbo, China (Cai) Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China (Wu) Department of Cardiology, Second Affiliated Hospital of Nanchang, Nanchang, China (Chen) Department of Cardiology, Central Hospital of Wuhan, Wuhan, China (Wang) Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Jiang) Department of Cardiology, Zhuhai People's Hospital, Zhuhai, China (Tao) Department of Cardiology, Second People's Hospital of Yunnan Province, Kunming, China (Zhong) Department of Cardiology, Meizhou People's Hospital, Meizhou, China (Zeng) Department of Cardiology, Sichuan Provincial People's Hospital, Chengdu, China (Wang) Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, China (Ning) Department of Cardiology, Shanghai Pudong New District Zhoupu Hospital, Shanghai, China (Yuan) Department of Cardiology, First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China (He) Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Francese, Lansky) Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States (He) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China Publisher Europa Group Abstract BACKGROUND: Percutaneous closure of the left atrial appendage (LAA) is an alternative to chronic oral anticoagulation to reduce stroke risk in patients with non-valvular atrial fibrillation (AF). AIMS: The SAFE-PROTECT trial was designed to evaluate the safety and efficacy of the AnchorMan, a novel LAA closure device, compared with the Watchman 2.5 device for patients with AF at high risk of ischaemic stroke. METHOD(S): SAFE-PROTECT was a multicentre, open-label, non-inferiority trial of patients with non-valvular AF at high risk of ischaemic stroke, randomised 1:1 to LAA closure with the AnchorMan or the Watchman device. The 12-month primary endpoint was clinical success (freedom from ischaemic/haemorrhagic stroke, systemic embolism, cardiovascular or unexplained death); the secondary efficacy endpoint was echocardiography-defined LAA occlusion (peridevice leak 0.99; difference -0.3; 95% confidence interval [CI]: -3.9 to 3.5; pnon-inferiority=0.0004) and the powered secondary efficacy endpoint of LAA closure (100% vs 100%; difference 0%; 95% CI: -3.60 to 3.50; pnon-inferiority=not applicable). The rates of all-cause death, stroke, major bleeding, and device-related complications were low and similar between groups. CONCLUSION(S): Among patients with non-valvular AF at high risk of ischaemic stroke, the AnchorMan device met its prespecified non-inferiority primary clinical success and secondary LAA occlusion endpoints compared with the Watchman 2.5 device. ClinicalTrials.gov: NCT04479722. Copyright © Europa Group 2026. All rights reserved. <46> Accession Number 2038507299 Title EFFECT OF SCAR MOBILISATION TECHNIQUE ON CHEST EXPANSION AND BREATHING PATTERN IN CHILDREN FOLLOWING CHEST WALL SURGERY. Source Bioscan. 21(Special Issue 1) (pp 1330-1342), 2026. Date of Publication: 20 Jan 2026. Author Khan D.; Jhanwar P.; Yadav D.; Khan J.; Ramawat P.K.; Balala D.; Menaria S.; Sharma P.; Soni S.; Sheikh H. Institution (Khan, Yadav, Khan, Ramawat, Balala, Menaria, Sharma, Soni, Sheikh) Pacific college of Physiotherapy, Pacific medical university, Rajasthan, Udaipur, India (Jhanwar) Department of Pediatrics Surgery, Pacific Medical College & Udaipur, Pacific medical university, Rajasthan, Udaipur, India Publisher National Environmentalists Association Abstract Background Children undergoing chest wall surgery frequently develop postoperative scar adhesions that may restrict thoracic mobility and alter normal breathing mechanics. Reduced chest expansion and dysfunctional breathing patterns can negatively affect respiratory efficiency, physical activity, and overall recovery. Aim To evaluate the effectiveness of scar mobilisation techniques in improving chest expansion and restoring normal breathing patterns in children following chest wall surgery. Methodology A randomized experimental pretest-posttest study was conducted on 60 children aged 5-15 years who had undergone chest wall surgery. Participants were randomly allocated into a control group and a scar mobilisation group. Both groups received conventional postoperative physiotherapy, while the experimental group additionally received scar mobilisation techniques along with breathing retraining exercises for six weeks. Results Axillary chest expansion improved from 5.4 +/- 1.3 cm to 6.8 +/- 1.4 cm, nipple line expansion improved from 5.8 +/- 1.4 cm to 7.2 +/- 1.5 cm, and xiphisternal expansion improved from 6.3 +/- 1.4 cm to 7.7 +/- 1.5 cm. MARM scores improved from 4.1 +/- 0.7 to 7.1 +/- 0.7. All results were statistically significant (p < 0.01). Conclusion Scar mobilisation techniques combined with breathing retraining exercises were effective in improving chest expansion and restoring normal breathing patterns in children following chest wall surgery. Copyright © 2026, National Environmentalists Association. All rights reserved. <47> Accession Number 2048795270 Title Sex-Specific Differences in Clinical Outcomes After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Reconstructed Individual Patient Survival Data. Source Structural Heart. 10(9) (no pagination), 2026. Article Number: 101100. Date of Publication: 01 Sep 2026. Author Abdelaziz A.M.; Nounou M.V.; Al Othman A.; Alasnag M.; Chieffo A.; Abbott J.D.; Al-Allawee A.; Zreigh S.; Benhammou M.; Dervis M.; Guerguer W.; Haidarah A.; Elmezayen R.; Alzu'bi M.; Almzainy S.; Khalid S.; Shawesh Q.; Abuajamieh M.; Elhadi M.; Bagur R.; Mamas M.A. Institution (Abdelaziz) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Nounou) Faculty of Medicine, University of Nouakchott Al Aasrya, Nouakchott, Mauritania (Al Othman) Department of Medicine, Faculty of Medicine, Near East University, Nicosia, Cyprus (Alasnag) Cardiac Center, King Fahd Armed Forces Center, Jeddah, Saudi Arabia (Chieffo) Cardiology Department, Vita Salute San Raffaele University, Milan, Italy (Chieffo) San Raffaele Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (Abbott) Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, United States (Al-Allawee) College of Medicine, University of Fallujah, Fallujah, Iraq (Zreigh, Dervis) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey (Benhammou) Faculty of Medicine, University of Oran 1, Oran, Algeria (Guerguer) Faculty of Medicine, University of Health Sciences, Algiers, Algeria (Haidarah) West China Hospital, Sichuan University, Sichuan, Chengdu, China (Elmezayen) Faculty of Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt (Alzu'bi) Faculty of Medicine, The Hashemite University, Zarqa, Jordan (Almzainy, Elhadi) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab Jamahiriya (Khalid) Faculty of Medicine, University of Benghazi, Benghazi, Libyan Arab Jamahiriya (Shawesh) Department of Internal Medicine, HCA Mountain View Hospital, Las Vegas, NV, United States (Abuajamieh) Faculty of Medicine, Cairo University, Cairo, Egypt (Elhadi) College of Medicine, Korea University, Seoul, South Korea (Bagur) Department of Medicine, London Health Sciences Centre, Western University, London, ON, Canada (Mamas) Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom (Mamas) National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, United Kingdom Publisher Cardiovascular Research Foundation Abstract Background Females with severe aortic stenosis present with distinct anatomical and clinical characteristics compared to males, which may influence outcomes following transcatheter aortic valve replacement (TAVR). We sought to investigate the prognostic impact of sex-specific differences on short- and long-term outcomes following TAVR. Methods PubMed, Embase, Scopus, and Web of Science were searched through August 2025 for randomized and observational studies reporting sex-specific outcomes after TAVR. Reconstructed individual patient data from published Kaplan-Meier (KM) curves were used to estimate long-term survival outcomes. Results Overall, 71 studies involving 481,353 patients were included. Compared with males, females demonstrated a higher short-term risk of adverse outcomes, including 30-day all-cause mortality (hazard ratio [HR]: 1.064, 95% CI: 1.005-1.127; p = 0.033) and stroke/transient ischemic attack (HR: 1.511, 95% CI: 1.317-1.734; p < 0.001). Females were also more likely to experience life-threatening bleeding (risk ratio [RR]: 1.29, 95% CI: 1.03-1.62; p = 0.028), major bleeding (RR: 1.26, 95% CI: 1.13-1.41; p < 0.001), and major vascular complications (RR: 1.66, 95% CI: 1.53-1.81; p < 0.001). Despite these higher periprocedural risks, females demonstrated superior long-term outcomes, with lower all-cause mortality (HR: 0.812, 95% CI: 0.794-0.831; p < 0.001) and cardiovascular mortality (HR: 0.837, 95% CI: 0.784-0.893; p < 0.001) during follow-up extending to 10 years, whereas risks of stroke/transient ischemic attack and myocardial infarction were comparable between sexes. Conclusions Females undergoing TAVR experience higher early risks of mortality, stroke, bleeding, and vascular complications, but exhibit a sustained long-term survival advantage compared with males, highlighting the need for sex-centered periprocedural management strategies. Copyright © 2026 The Author(s). <48> [Use Link to view the full text] Accession Number 2044294951 Title Stroke Risk After Bioprosthetic Aortic Valve Replacement in Aortic Stenosis: Systematic Review and Meta-Analysis. Source Stroke. 57(6) (pp 1643-1657), 2026. Date of Publication: 20 Mar 2026. Author Bou Dargham T.; Hassani S.; Mac Grory B.; Daubert M.A.; Ryan D.; Truong T.; Moumneh M.B.; Kaplan S.J.; Feng W.; El Husseini N. Institution (Bou Dargham) Department of Neurosurgery (T.B.D.), Duke University School of Medicine, Durham, NC, United States (Mac Grory, Ryan, Feng, El Husseini) Department of Neurology, Duke University School of Medicine, Durham, NC, United States (Daubert) Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, United States (Truong) Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, United States (Kaplan) Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, United States (Hassani) Department of Neurology, Feinberg School of Medicine Northwestern University, Chicago, IL, United States (Moumneh) Inova Center of Outcomes Research, Inova Heart and Vascular, Fairfax, VA, United States Publisher Wolters Kluwer Health Abstract BACKGROUND: - Stroke is a possible complication after bioprosthetic aortic valve replacement (AVR) for severe aortic stenosis (AS), impacting morbidity and mortality. Accurate estimates of the proportion of individuals who experience stroke within and beyond the periprocedural period after transcatheter AVR (TAVR), surgical AVR, and valve-in-valve (ViV) replacement are essential for management and prognostication. The objective was to determine the proportion of adults aged >18 who experienced an ischemic stroke after bioprosthetic AVR for AS. METHOD(S): - A systematic search of MEDLINE, Embase, and Web of Science was conducted from database inception through March 2024. Studies reporting on stroke rates at least 90 days after bioprosthetic AVR for severe AS, including ViV procedures, and meeting predefined eligibility criteria were included. The pooled proportion of individuals experiencing a stroke was estimated for TAVR and ViV procedures, whereas comparative analyses between TAVR and surgical AVR were performed using mixed-effects models in studies directly comparing both procedures. RESULT(S): - Twenty-seven studies were included in the native AS treatment cohort, and 5 in the ViV subanalysis. In native AS, the pooled 30-day proportion of individuals who had a stroke after TAVR was 3.0% (95% CI, 2.5-3.9), with different studies reporting major and minor stroke proportions of 1.7% each. At 1 year, all stroke proportion was 5.0% (95% CI, 4.0-6.0), major stroke was 3.0%, and minor stroke was 2.0%. Comparative analysis demonstrated that TAVR was associated with significantly lower odds of all stroke at 30 days compared with surgical AVR (odds ratio, 0.73 [95% CI, 0.57-0.93]). No significant difference in the proportions of individuals who had a stroke was observed in TAVR versus surgical AVR at 1, 2, or 5 years. In the ViV cohort, the pooled 30-day and 1-year all stroke proportion after ViV was 2.0% (95% CI, 1.0-3.0) and 3.0% (95% CI, 2.0-6.0), respectively. CONCLUSION(S): - This meta-analysis provides updated estimates of stroke after bioprosthetic AVR for AS, capturing risk beyond the early periprocedural period. Future studies should investigate the causes of long-term stroke post-AVR, the effects of different antithrombotic therapies on the risk of stroke, as well as the potential impact of these procedures on short and long-term cognitive function. Copyright © 2026 American Heart Association, Inc. <49> Accession Number 2047691138 Title Comparison of Paravertebral Block and Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia After Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3323-3329), 2026. Date of Publication: 01 Oct 2026. Author Manici M.; Sincer Y.; Yaylak D.; Sogut M.S.; Darcin K.; Kalyoncu I.; Ozer K.B.; Tanju S.; Gurkan Y. Institution (Manici, Sincer, Yaylak, Sogut, Darcin, Kalyoncu, Gurkan) Department of Anaesthesiology and Reanimation, Koc University Hospital, Istanbul, Turkey (Ozer, Tanju) Department of Thoracic Surgery, Koc University Hospital, Istanbul, Turkey Publisher W.B. Saunders Abstract Objectives: To compare the analgesic efficacy of serratus posterior superior intercostal plane block (SPSIPB) versus thoracic paravertebral block (TPVB) in patients undergoing video-assisted thoracoscopic surgery (VATS), with a focus on postoperative opioid consumption and pain scores. Design(s): A prospective, randomized, controlled, single-center clinical trial. Setting(s): A tertiary university hospital. Participant(s): Sixty adult patients aged 18 to 80 years scheduled for elective VATS. Participants were randomized in a 1:1 ratio to receive either SPSIPB (n = 30) or TPVB (n = 30). Baseline characteristics were comparable between groups. Intervention(s): Prior to induction of general anesthesia, patients received either ultrasound-guided SPSIPB or TPVB using 30 mL of 0.25% bupivacaine. Measurements and Main Results: The primary outcome was cumulative 24-hour postoperative opioid consumption, expressed as oral morphine equivalents. Secondary outcomes included numeric rating scale (NRS, 0-10) for pain scores and the incidence of opioid-related adverse effects at 1, 3, 6, 12, and 24 hours after surgery. Twenty-four-hour opioid use was not significantly different between SPSIPB and TPVB (66.8 +/- 29.4 mg v 77.2 +/- 40.0 mg; mean difference -10.4 mg; 95% CI, -36.1 to 15.3; p = 0.439). No significant differences were seen in pain scores or opioid-related side effects at any assessed time point (p > 0.05). Conclusion(s): SPSIPB and TPVB were associated with similar postoperative opioid consumption, pain scores, and the incidence of adverse effects following VATS. Given its potentially simpler application, SPSIPB may serve as an effective alternative regional analgesic technique in thoracic surgery. Copyright © 2026 Elsevier Inc. <50> Accession Number 2046519188 Title Management of anticoagulation in patients with heparin-induced thrombocytopenia requiring cardiac surgery with cardiopulmonary bypass: guidance from the ISTH SSC on Perioperative and Critical Care Haemostasis and Thrombosis. Source Journal of Thrombosis and Haemostasis. 24(9) (pp 3369-3391), 2026. Date of Publication: 01 Sep 2026. Author Pishko A.M.; Frere C.; Maier C.L.; Levy J.H.; Connors J.M. Institution (Pishko) Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Frere) Department of Hematology, Pitie-Salpetriere Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, INSERM UMR_S 1166, Paris, France (Maier) Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, United States (Levy) Department of Anesthesiology, Critical Care and Surgery, Duke University School of Medicine, Durham, NC, United States (Connors) Hematology Division, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States Publisher Elsevier B.V. Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction characterized by thrombocytopenia and a high risk of thrombosis. Patients with HIT and a need for cardiac surgery with cardiopulmonary bypass represent a challenging group, as anticoagulation with unfractionated heparin (UFH) is the primary treatment choice. We conducted a systematic review evaluating intraoperative anticoagulation strategies for patients with a history of HIT who required cardiac surgery with cardiopulmonary bypass. Guidance statements were generated through consensus of the writing group. Of 1732 screened articles, 30 studies were included. Strategies evaluated were (1) direct thrombin inhibitors; (2) UFH after preoperative or intraoperative therapeutic plasma exchange (TPE); (3) UFH in combination with a potent antiplatelet agent; and (4) heparin reexposure in patients with negative functional assays. Of these, bivalirudin has the strongest supporting data and appears effective; still, its association with increased bleeding and practical limitations, including a lack of a reversal agent, limit its use. TPE with or without intravenous immunoglobulin reduces antiplatelet factor 4/heparin antibody titers and allows for intraoperative UFH use, although protocols are heterogeneous. Use of potent antiplatelet agents with UFH reexposure show promise but carry risks of bleeding and hypotension. Thus, alternative strategies of using UFH in combination with TPE or potent antiplatelet agents may be considered on a case-by-case basis. For patients with negative functional assays, evidence suggests that limited intraoperative UFH reexposure carries a low risk of HIT recurrence, provided postoperative monitoring is performed. These guidance statements provide a framework for multidisciplinary decision making in a complex clinical scenario. Copyright © 2026. Published by Elsevier Inc. <51> Accession Number 2041126758 Title Robotic-assisted versus video-assisted thoracoscopic surgery for non-small-cell lung cancer: A systematic review and meta-analysis of prospective studies. Source Surgical Practice. 30(3) (pp 182-193), 2026. Date of Publication: 01 Aug 2026. Author Ausath Z.F.; Tjiaman M.P.; Zaidan M.Z.; Furqon M.A.; Faisal H.K.P. Institution (Ausath, Tjiaman, Zaidan) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia (Furqon) Department of Cardiothoracic and Vascular Surgery, Persahabatan Hospital, Jakarta, Indonesia (Faisal) Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital, Jakarta, Indonesia Publisher John Wiley and Sons Inc Abstract Introduction: Lung cancer is one of the most commonly encountered cancers, with about 85% of cases classified as non-small cell lung cancer (NSCLC). Video-assisted thoracoscopic surgery (VATS) has certain limitations such as rigid instrument movement and poor hand-eye coordination. On the other hand, robotic-assisted thoracic surgery (RATS) has emerged, offering potential advantages such as a wider range of instrument manoeuvrability. However, the comparative outcomes between the two remain debated. This review aims to evaluate the outcomes of RATS compared with VATS in patients with NSCLC. Method(s): This systematic review and meta-analysis was conducted following the Cochrane Handbook for Systematic Reviews of Interventions 6.2 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The search was performed on PubMed, Cochrane, Science Direct and Scopus starting from 22 September 2024. Result(s): A total of eight studies involving 1580 NSCLC patients were included in this research. RATS demonstrated a higher number of dissected lymph node stations (mean difference [MD] 1. 34, CI 0.87-1.82, p <.00001, I2 = 87%) and better 3-year disease-free survival compared with VATS (MD 2.19, CI 1.21-3.95, p =.009, I2 = 47%). Subgroup analyses, including only randomized controlled trials (RCTs) or studies focusing exclusively on lobectomy, showed that RATS outperformed VATS in the number of dissected lymph node stations (p <.05). Conclusion(s): RATS is non-inferior to VATS and demonstrates superiority in the number of dissected lymph node stations in all analyses. Copyright © 2025 College of Surgeons of Hong Kong. <52> Accession Number 2046311735 Title Comparison of Paravertebral Block and Erector Spinae Plane Block in Thoracotomy Using Nociception Level Index Monitoring: A Prospective Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3315-3322), 2026. Date of Publication: 01 Oct 2026. Author Yorukoglu H.U.; Cesur S.; Alparslan V.; Bulut M.; Aksu C.; Kus A. Institution (Yorukoglu, Cesur, Alparslan, Bulut, Aksu, Kus) Department of Anesthesiology and Reanimation, Kocaeli University, School of Medicine, Kocaeli, Turkey Publisher W.B. Saunders Abstract Objective: Paravertebral block (PVB) is considered the gold-standard regional technique for thoracotomy analgesia, whereas the erector spinae plane block (ESPB) has gained popularity. However, evidence comparing these 2 techniques in open thoracotomy remains inconsistent. The nociception level (NOL) index provides a more objective assessment of intraoperative nociception. This study aimed to compare the analgesic efficacy of preoperative PVB and ESPB during thoracotomy using NOL-guided opioid administration. Design(s): Prospective randomized clinical trial. Setting(s): Single tertiary-care university hospital. Participant(s): Fifty-seven patients who underwent elective thoracotomy surgeries were included in this study. Intervention(s): Patients were randomized to receive preoperative ultrasound-guided PVB or ESPB at the T5 level using 20 mL of 0.25% bupivacaine. Measurements and Main Results: Intraoperative opioid infusion rate was titrated with the NOL index. Intraoperative remifentanil and postoperative morphine consumptions, pain scores at rest and during coughing, rescue analgesic need, and adverse events were recorded. Intraoperative remifentanil consumption was significantly lower in the PVB group than in the ESPB group (431.4 +/- 287.7 mcg vs 863.6 +/- 385.5 mcg, p < 0.001). Total 24-hour postoperative morphine use was also lower in the PVB group (15.2 +/- 6.6 mg vs 20.1 +/- 6.6 mg, p = 0.002). Numeric rating scale (NRS) scores at rest were significantly lower in the PVB group at 9 and 12 hours, while NRS scores during coughing were significantly lower at all postoperative time points. Conclusion(s): In patients undergoing thoracotomy, PVB provided superior intraoperative and postoperative analgesia compared with ESPB, with significantly reduced opioid requirements and lower pain scores. Objective nociception monitoring with the NOL index demonstrated that ESPB may be insufficient for major thoracic surgery. Copyright © 2026 Elsevier Inc. <53> Accession Number 2047692590 Title The Pediatric Cardiac Extubation Readiness Framework: An Evidence-Derived Translational Framework for Structured Extubation Assessment Following Pediatric Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3085-3100), 2026. Date of Publication: 01 Oct 2026. Author Alkhatip A.A.A.M.M.; Mills K.E.; Akram A.; Farag E.; Hamza M.K.; Abdelkader M.; Bahr M.; ELEmady M.F.M.; Hosny H.; Sallam A.; Farag A.M.G.; Wagih M.; Naguib A. Institution (Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom (Alkhatip, Farag, Abdelkader, Bahr) Department of Anesthesia, Pain Management and Surgical Intensive Care, Beni-Suef University Hospital and Faculty of Medicine, Beni Suef University, Beni Suef, Egypt (Mills) Department of Science and Technology, University of Canberra, Canberra, Australia (Akram) Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan (Hamza, ELEmady, Hosny, Wagih, Naguib) Department of Anesthesia, Kasr Al Ainy Faculty of Medicine and Cairo University Hospitals, Cairo University, Cairo, Egypt (Hosny) Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Freeman Hospital, Newcastle upon Tyne Foundation Trust, Newcastle upon Tyne, United Kingdom (Sallam) Department of Anaesthesia, St. Vincent's University Hospital, Dublin, Ireland (Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City, Makkah al-Mukarramah, Saudi Arabia Publisher W.B. Saunders Abstract This Special Article aimed to develop an evidence-derived translational framework for structured assessment of readiness for early extubation following pediatric cardiac surgery, informed by a previously published systematic review and meta-analysis. Framework development was based on secondary synthesis of aggregated study-level data from pediatric cardiac surgical populations across multiple institutions; no clinical intervention was performed. Extracted study-level data, subgroup findings, sensitivity analyses, and predefined clinical interpretability criteria were used. Candidate variables associated with extubation timing and postoperative outcomes were mapped into clinically coherent domains according to recurrent representation within the evidence base, biological plausibility, and applicability to routine multidisciplinary assessment. The Pediatric Cardiac Extubation Readiness Framework (PCERF) was revised into a 2-layer translational framework. Layer 1 comprises age, weight, procedural complexity, cardiopulmonary stability, and peri-extubation pathway factors. Layer 2 comprises mandatory non-scored clinical safety modifiers intended to identify physiological states that may independently preclude consideration of early extubation. The numerical score structure, weight categories, equal weighting, and readiness bands are illustrative prototype framework components rather than statistically optimized or outcome-derived thresholds. PCERF is a hypothesis-generating translational framework intended to support structured multidisciplinary assessment of extubation readiness following pediatric cardiac surgery. It is not a validated prediction model and requires prospective multicenter evaluation before clinical implementation. Copyright © 2026 Elsevier Inc. <54> Accession Number 2047692640 Title Heparin Dose-Response Curve for Heparin Dose Determination During Cardiopulmonary Bypass for Pediatric Cardiac Surgery: A Prospective Randomized Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(10) (pp 3287-3294), 2026. Date of Publication: 01 Oct 2026. Author Gokhale P.; Hasija S.; Choudhury A.; B S.G.; Yadav M.; Chauhan S. Institution (Gokhale, Hasija, Choudhury, Chauhan) Department of Cardiac Anaesthesia and Critical Care, AIIMS, New Delhi, India (B, Yadav) Department of Cardiothoracic and Vascular Surgery, AIIMS, New Delhi, India Publisher W.B. Saunders Abstract Objectives: To determine whether individualized heparin dosing guided by a heparin dose-response (HDR) curve is noninferior to conventional weight-based dosing in achieving target activated clotting time (ACT) of >=480 seconds before cardiopulmonary bypass (CPB) and to compare total heparin and protamine requirements, postoperative blood loss, and transfusion needs in children younger than 14 years undergoing cardiac surgery with cardiopulmonary bypass support. Design(s): Single-center, prospective, double-blinded, randomized controlled trial. Setting(s): Cardiothoracic operating theaters and intensive care unit of a tertiary care hospital in India. Participant(s): Pediatric (<14 years) patients undergoing elective cardiac surgery with CPB support. Intervention(s): The HDR group received an initial test dose of 100 IU/kg of heparin, and an individualized ACT dose-response curve was constructed to determine the dose required to target an ACT of 480 seconds. Controls received standard 400 IU/kg of heparin. Protamine was given post-CPB per protocol in both groups. Measurements and Main Results: In this noninferiority trial, HDR-guided anticoagulation was assessed against conventional weight-based dosing for first-pass attainment of ACT >=480 seconds before CPB. Target ACT was achieved in 72.2% (26/36) of HDR patients versus 83.3% (30/36) of controls (p = 0.396). Although HDR was associated with lower heparin exposure (260 v 420 IU/kg; p < 0.001) and protamine use (4.1 v 4.8 mg/kg; p = 0.002), as well as reduced 24-hour blood loss (5.2 v 6.5 mL/kg; p = 0.03) and packed red blood cell transfusion (6.8 v 8.2 mL/kg; p = 0.04), it did not demonstrate superior first-attempt ACT attainment. Conclusion(s): HDR-guided heparinization reduced heparin and protamine exposure and was associated with less bleeding and transfusion, but it did not improve first-pass ACT attainment. Because ACT is an imperfect surrogate for anticoagulant adequacy in children on CPB, these findings should be interpreted as ACT-guided dosing data rather than proof of equivalent anticoagulation. Larger multicenter studies with mechanistic and clinical endpoints are needed to confirm these results. Copyright © 2026 Elsevier Inc. <55> Accession Number 2038551112 Title Integrated and Device-Based Endotracheal Tube Stabilisation During General Anaesthesia: A Systematic Review and Meta-analysis. Source Bioscan. 21(Special Issue 3) (pp 1145-1171), 2026. Date of Publication: 01 Jul 2026. Author Sharma N.; Bharathi B.; Narayan L. Institution (Sharma) Department of Anaesthesiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Tamil Nadu, Chennai, India (Bharathi, Narayan) Department of Anaesthesiology, Saveetha Medical College and Hospital, SIMATS, Tamil Nadu, Chennai, India Publisher National Environmentalists Association Abstract Background. Adhesive tape is still the usual way of holding an orotracheal tube in place during general anaesthesia. Tube migration, accidental extubation, endobronchial intubation and pressure injury to the face and lips nevertheless remain familiar hazards, and they are most likely when the patient is prone or lateral or when the head is shared with the surgical team. Commercial tube holders have been available for some years, and integrated devices that combine securement with a bite block, an eye shield or a suction port have appeared more recently. The reviews published so far deal with the intensive care unit; no one has yet synthesised the intraoperative question. Methods. We followed PRISMA 2020. PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science and CINAHL were searched from inception with no language limit, together with trial registries and the reference lists of included papers. We accepted randomised and non-randomised comparative studies of patients receiving general anaesthesia through an orotracheal tube, provided a device-based or integrated system was compared with adhesive tape or with another device. Clinically relevant intraoperative displacement was the primary outcome. We appraised randomised trials with RoB 2 and the non-randomised study with ROBINS-I, and pooled dichotomous data as odds ratios and risk ratios using DerSimonian-Laird random-effects models with the Hartung-Knapp-Sidik-Jonkman adjustment. Certainty was graded with GRADE. Results. Six comparative operating-theatre studies were eligible. Only two, together enrolling 104 patients, reported dichotomous displacement counts that could be combined, and both favoured the device. The random-effects odds ratio was 0.05 (95% CI 0.001 to 1.49; p = 0.083) with substantial heterogeneity (I2 = 79.4%), and the risk ratio was 0.14 (95% CI 0.01 to 2.57). Fixed-effect estimates reached significance (OR 0.12, 95% CI 0.04 to 0.39; RR 0.39, 95% CI 0.20 to 0.76), the difference reflecting a two-study model that contains a zero cell. A single trial measuring displacement continuously reported a mean difference of -3.00 mm (95% CI -5.98 to -0.02). Accidental extubation and endobronchial intubation were rare and reported inconsistently. In absolute terms 708 per 1000 with tape corresponds to 102 per 1000 with a device (95% CI 4 to 783), and the larger contributing trial had a post hoc fragility index of 1. Certainty was very low for every outcome. Conclusions. Every study that measured tube movement found less of it with a device than with tape, but the operating-theatre evidence is thin, inconsistently defined and at moderate to high risk of bias, and the pooled estimate is correspondingly imprecise. Trials of adequate size, using an agreed definition of displacement and a blinded assessor, are needed before mechanical securement can be recommended for routine use. Registration. PROSPERO [number to be inserted]. Copyright © 2026, National Environmentalists Association. All rights reserved. <56> Accession Number 2047705256 Title Optimizing hemostasis to prevent bleeding and reduce transfusion requirements in neonatal and infant cardiac surgery with cardiopulmonary bypass: a systematic review and network meta-analysis. Source Frontiers in Pediatrics. 14 (no pagination), 2026. Article Number: 1823450. Date of Publication: 10 Jun 2026. Author Lu X.; Zhang J.; Pan J. Institution (Lu) Department of Critical Care Medicine, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China (Zhang, Pan) Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China Publisher Frontiers Media SA Abstract Background - Effective hemostatic management remained a critical challenge in neonatal and infant cardiac surgery with cardiopulmonary bypass (CPB), and a systematic review and network meta-analysis (NMA) had not been conducted to evaluate optimal strategy selection for this vulnerable population. Methods - We systematically searched PubMed, Web of Science, Cochrane Library, and Embase from inception to December 3, 2025. We use bivariate analysis and NMA with random effects. We use the surface beneath the cumulative ranking curve (SUCRA) to display the order of interventions. Results - Of the 8, 280 records screened, 27 studies involving 4, 556 patients were included. Aprotinin (APR) was identified as the optimal hemostatic strategy for reducing 24-hour blood loss (SUCRA=99.15%), platelet (PLT) (SUCRA=82.19%) and fresh frozen plasma (FFP) (SUCRA=84.82%) transfusion requirements, re-sternotomy for hemostasis (SUCRA=72.85%), and risks of thrombosis (SUCRA=79.13%) and renal dysfunction (SUCRA=72.61%). epsilon-aminocaproic acid (EACA) was found to be the most effective strategy for reducing red blood cell (RBC) transfusion needs (SUCRA=69.04%). Tranexamic acid (TXA) emerged as the optimal intervention for reducing mortality (SUCRA=84.77%). Conclusion - Antifibrinolytic agents may demonstrated significant hemostatic efficacy and a generally acceptable safety profile in neonatal and infant cardiac surgery with CPB. Among these agents, while APR showed the highest efficacy, its use is constrained by regulatory restrictions and evidence limitations; therefore, it should be used with caution. TXA remains a practical first-line alternative. In the available network, blood component therapies did not emerge as consistently superior strategies compared with other hemostatic interventions. For 24-hour blood loss, APR was associated with lower blood loss than FFP, FC, and PCC. However, because the relevant comparisons were largely against active comparators rather than placebo or no hemostatic intervention, the efficacy of blood component therapies relative to no blood component therapy remains uncertain. Future large-scale RCTs are needed to further validate these findings. Copyright © 2026 Lu, Zhang and Pan. <57> Accession Number 2048658947 Title Remotely Delivered Nutrition Interventions with or Without Physical Activity Interventions in Adults with Cardiovascular Diseases: A Systematic Review of Randomized Controlled Trials. Source Healthcare (Switzerland). 14(16) (no pagination), 2026. Article Number: 2523. Date of Publication: 01 Aug 2026. Author Dimopoulou M.; Isakoglou M.; Hoes J.; Androutsos O. Institution (Dimopoulou, Hoes, Androutsos) Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece (Isakoglou) Clinical Exercise Physiology and Rehabilitation Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Lamia, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Objective: The long-term management of cardiovascular diseases (CVDs) requires comprehensive rehabilitation strategies aimed at optimizing functional recovery and promoting behavioral changes. These interventions may include digital technologies that emerged as promising approaches to facilitate lifestyle changes, such as dietary behavior and physical activity (PA). Aim(s): This review aimed to synthesize the current evidence for the potential impact of remotely delivered nutrition interventions with or without a combination of PA interventions on biochemical biomarkers, cardiovascular indexes, anthropometric parameters, levels of PA, exercise and functional capacity, adherence to the Mediterranean Diet (MD), diet quality and quality of life, rehospitalization, urgent visits, death and acute events in adults (>=18 years) with CVDs. Secondary outcomes were accessibility, safety, usability, and adherence. Method(s): The PubMed, Web of Science, and Scopus databases were comprehensively searched up to 2026 for Randomized Controlled Trials (RCTs) published in English, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The methodological quality was assessed using the revised Cochrane Risk of bias tool for RCTs (RoB2). Result(s): 11 RCTs met the inclusion criteria. Sample sizes ranged from 66 to 879 participants. The duration of the interventions varied from 4 weeks to 12 months. The interventions were delivered remotely using a range of digital health technologies, including web-based programs, mobile phones, wearable devices, smartphone applications, and mini-apps. Favorable changes were observed in diet quality and in adherence to MD and PA levels, with no intervention-related adverse events reported. The RoB2 assessment indicated that the majority of included studies (6 out of 11) were classified as having some concerns regarding risk of bias. Conclusion(s): Remotely combined nutrition and PA interventions are a feasible and effective approach for improving mainly patient-reported outcomes in adults with CVDs. These findings support integrating remote multimodal rehabilitation into routine cardiovascular care and highlight the potential of telehealth-based models to enhance patients' access to rehabilitation services. Copyright © 2026 by the authors. <58> Accession Number 2048643936 Title Effects of Permissive Hypercapnia During Lung Surgery on Inflammatory Biomarkers in Serum and Bronchoalveolar Lavage Fluid: A Randomized Controlled Trial. Source Metabolites. 16(8) (no pagination), 2026. Article Number: 550. Date of Publication: 01 Aug 2026. Author Stojanovic M.; Vasilijic M.; Zivadinovic J.; Randjelovic M.; Nikolic A.; Jevtovic Stoimenov T.; Jankovic R. Institution (Stojanovic, Vasilijic, Zivadinovic, Randjelovic, Nikolic, Jankovic) Clinic for Anaesthesia and Intensive Therapy, University Clinical Center Nis, Nis, Serbia (Zivadinovic, Nikolic, Jevtovic Stoimenov, Jankovic) School of Medicine, University of Nis, Nis, Serbia (Jevtovic Stoimenov) Department for Biochemistry, School of Medicine, University of Nis, Nis, Serbia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Introduction: Permissive hypercapnia has become an integral component of lung-protective ventilation strategies during one-lung ventilation (OLV), particularly in thoracic surgery. Its potential immunomodulatory effects have attracted increasing interest; however, clinical evidence remains limited and inconsistent. The Aim: The primary objective was to evaluate the effects of permissive hypercapnia on inflammatory biomarkers in bronchoalveolar lavage fluid and serum during one-lung ventilation. The secondary objective was to assess the influence of different ventilation modes on these inflammatory responses. Method(s): Forty patients undergoing elective lung surgery requiring OLV were prospectively enrolled and allocated to either a normocapnic (n = 20) or hypercapnic group (n = 20). BAL concentrations of TNF-alpha, IL-1beta, IL-6, and IL-8 were measured before and after intervention. Serum IL-6, C-reactive protein (CRP), and leukocyte counts were also assessed. Outcome Measures: Primary outcome: Change in bronchoalveolar lavage (BAL) levels of preselected biomarkers for inflammation (TNF-alpha, IL-1beta, IL-6, and IL-8) and in serum (IL-6, CRP, and WBC) between the normocapnic and hypercapnic groups during one-lung ventilation. Secondary outcome: Whether the inflammatory response differed according to the ventilation mode (pressure-controlled versus volume-controlled ventilation). Result(s): Baseline and post-intervention BAL concentrations of TNF-alpha, IL-1beta, IL-6, and IL-8 were generally comparable between the hypercapnic and normocapnic groups. No significant differences were observed in post-intervention BAL concentrations of TNF-alpha, IL-1beta, or IL-6 among the ventilated subgroups. However, post hoc analysis demonstrated significantly lower IL-8 concentrations in the hypercapnic-PC subgroup compared with the normocapnic-PC subgroup (p = 0.034). Within the normocapnic cohort, BAL IL-8 concentrations were significantly higher in the PC subgroup than in the VC subgroup (p = 0.012). In serum, postoperative IL-6 concentrations were significantly higher in the hypercapnic than in the normocapnic group (p = 0.003). Conclusion(s): Permissive hypercapnia was not associated with a reduction in BAL concentration of the pro-inflammatory cytokines TNF-alpha, IL-1beta, IL-6, and IL-8. However, postoperative serum IL-6 concentrations were significantly higher in patients exposed to hypercapnia. As the duration of surgery, one-lung ventilation, and mechanical ventilation was longer in the hypercapnic group, the observed increase in serum IL-6 cannot be attributed solely to hypercapnia. Further large-scale randomized studies are required to clarify the immunological effects of permissive hypercapnia during thoracic surgery. Copyright © 2026 by the authors. <59> Accession Number 2048655596 Title NOTIFY-HF. Source JACC: Heart Failure. 14(9) (no pagination), 2026. Article Number: 103184. Date of Publication: 01 Sep 2026. Author Assad J.; Briggs N.E.; Lo S.; Rajaratnam R.; Femia G.; Leung D.; Dimitri H. Institution (Assad, Lo, Rajaratnam, Leung, Dimitri) Department of Cardiology, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia (Assad, Leung, Dimitri) South West Clinical School, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia (Assad, Dimitri) Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia (Briggs) Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia (Rajaratnam) Western Sydney University, School of Medicine, Sydney, NSW, Australia (Femia) The University of Sydney, School of Medicine, Camperdown, NSW, Australia Publisher Elsevier Inc. Abstract Background Worsening heart failure is often preceded by days-to-weeks of physiological deterioration; yet, remote-monitoring alerts are clinician-facing and may not translate into timely action. The authors evaluated a patient-facing HeartLogic-guided Mobile Health (mHealth) pathway designed to augment usual care. Objectives The purpose of this study was to assess feasibility, acceptability, and exploratory clinical associations of a patient-facing HeartLogic-triggered early-warning pathway. Methods This single-center, pragmatic, randomized pilot trial recruited adults with heart failure and a HeartLogic-capable implantable cardioverter-defibrillator, randomized 1:1 to usual care or usual care plus weekly patient-facing HeartLogic-triggered notifications via an mHealth platform with symptom screening and self-care guidance. Coprimary outcomes were feasibility/acceptability and HeartLogic recovery metrics. Follow-up ranged from 12 to 24 months. Results A total of 160 participants were randomized (81 intervention, 79 control); median follow-up was 1.82 years. Recruitment reached 160 of 200 participants (80% of target), retention was high, and mean Mobile App Usability Questionnaire scores demonstrated acceptability throughout follow-up. Engagement was high with 80% symptom-screen completion during alerts. Compared with usual care, the intervention was associated with lower HeartLogic alert incidence (IRR: 0.78 [95% CI: 0.62-0.99]) and 13% more monitored days outside alert state (RR: 1.13 [95% CI: 1.02-1.25]), whereas time to alert normalization was similar. The traffic-light pathway supported risk-tiered patient response, with greater self-reported health care contact following red than amber alerts. Exploratory clinical outcomes were directionally favorable, but the study was not powered for these endpoints. Conclusions In this randomized pilot trial, a patient-facing HeartLogic-guided mHealth pathway was feasible, acceptable, and associated with lower alert burden, supporting evaluation in a larger multicenter trial. Copyright © 2026 The Authors. <60> Accession Number 2048582130 Title Post-Intubation Hypotension After Titrated Induction with Ciprofol versus Propofol in Older Adults Undergoing Non-Cardiac Surgery: A Randomized Controlled Trial. Source Clinical Interventions in Aging. 21 (no pagination), 2026. Article Number: 609412. Date of Publication: 2026. Author Bai H.; Guo J.; Li Y.; Zhang S.; Chen S.; Wang Z.; Lu K.; Zhang L.; Zhong F.; Gong R.; Li J.; Han J.; Song X.; Jin S. Institution (Bai, Guo, Li, Zhang, Chen, Wang, Lu, Zhang, Zhong, Gong, Li, Han, Song, Jin) Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, No. 2, Guangzhou, China (Bai, Guo, Li, Zhang, Jin) Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Purpose: To compare ciprofol with propofol for titrated induction of anesthesia in older adults undergoing non-cardiac surgery, with a focus on post-intubation hypotension and related hemodynamic burden. Method(s): In this prospective, randomized, double-blind trial, adults aged 65-89 years undergoing elective non-cardiac surgery were randomly assigned in a 1:1 ratio to receive either ciprofol or propofol, following an identical titration-to-effect induction protocol. The primary outcome was post-intubation hypotension, defined as any mean arterial pressure (MAP) <= 65 mmHg during the 15-minute period after successful tracheal intubation and before surgical incision. Secondary outcomes included hypotension burden expressed as area under the curve (AUC), norepinephrine requirement, cardiac output trajectories, time to loss of consciousness, and early postoperative recovery outcomes. Result(s): 160 patients were randomized. Post-intubation hypotension occurred less frequently in the ciprofol group than in the propofol group (28/77 [36.3%] vs 53/79 [67.0%]; adjusted odds ratio 0.28, 95% confidence interval [CI] 0.15-0.54; P < 0.001), consistent across BIS-adjusted sensitivity analyses. Ciprofol was also associated with a lower AUC for MAP <= 65 mmHg (0.0 [0.0-3.2] vs 2.5 [0.0-14.8] mmHg min; P = 0.047), reduced norepinephrine requirement (0.0 [0.0-10.0] microg vs 10.0 [0.0-20.0] microg; P < 0.001), and milder early cardiac output decline (group-by-time interaction beta = -0.008, 95% CI -0.010 to -0.005; P < 0.001). No significant between-group differences were observed in early postoperative adverse outcomes. Conclusion(s): In this single-center trial of older adults undergoing non-cardiac surgery, ciprofol-based titrated induction was associated with less post-intubation hypotension, lower rescue vasopressor requirement, and less cumulative hypotensive exposure than propofol, without an apparent increase in early adverse recovery outcomes. These findings suggest a favorable hemodynamic profile of ciprofol, which requires confirmation in larger multicenter studies. Copyright © 2026 Bai et al. <61> Accession Number 2048338216 Title Perception and satisfaction with a Tai Chi-based community cardiac rehabilitation program: a qualitative sub-study of a pilot randomised controlled trial. Source European Journal of Integrative Medicine. 87 (no pagination), 2026. Article Number: 102717. Date of Publication: 01 Oct 2026. Author Jung J.; Chow C.; Ee C.; Liao A.; Chang D.; Kiat H.; Yang G. Institution (Jung) School of Medicine, Western Sydney University, Penrith, NSW, Australia (Chow) Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, NSW, Australia (Ee, Liao, Chang, Kiat, Yang) NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia (Ee) Caring Futures Institute, College of Health and Enablement, Flinders University, Bedford Park, SA, Australia (Kiat, Yang) Faculty of Medicine and Health, The University of Sydney, NSW, Australia (Kiat) Faculty of Medicine, Human and Health Sciences, Macquarie University, NSW, Australia (Kiat) College of Health and Medicine, Australian National University, ACT, Australia (Kiat) Cardiac Health Institute, Sydney, Australia Publisher Elsevier GmbH Abstract Introduction: Cardiac rehabilitation (CR) programs are increasingly incorporating innovative delivery models and interventions to improve implementation and enhance recovery following acute coronary events. This qualitative study aims to explore the perceptions and satisfaction of a novel CR program for Chinese migrants in Australia. Method(s): This is a qualitative sub-study embedded in a 24-week pilot randomised controlled trial evaluating a community-based CR program among participants who were of Chinese migrant background and had undergone a recent stent placement or coronary bypass graft surgery. This program consists of a virtual shared medical appointment, virtual Tai Chi classes, and semi-personalised health education messages delivered via text messages. Upon completion of the program, participants were invited to participate in a semi-structured interview conducted in Chinese. Interviews were conducted online via Zoom meetings, transcribed verbatim, translated in English, and analysed using NVivo software (version 20). Result(s): Interviews with eleven participants (mean age 69 years, 82% male) found that the CR program integrating Tai Chi was well-received, with physical improvements cited as the most common benefit. Half of the participants reported notable psychological benefits from Tai Chi including reduced depressive symptoms, heightened body awareness, and improved mood. The program also fostered strong social connectedness between Chinese participants, with participants valuing the shared experience and mutual encouragement among peers with similar health conditions. Remote delivery of Tai Chi was widely accepted, noting its convenience and cultural relevance. However, the health education text messaging component received mixed feedback due to the generic messages and/or accessibility issues. Overall satisfaction with the program was high, driven by supportive interactions with the rehabilitation and research team, perceived benefits, and the sustainability of Tai Chi as a long-term exercise modality. Suggested areas for improvement included expansion of services and more frequent engagement with healthcare professionals to support their recovery. Conclusion(s): Participants described generally high satisfaction and positive experiences with the telehealth-delivered, Tai Chi-based CR program. Culturally tailored exercise components appeared to support social connection, and flexible delivery models were viewed as helpful for program participation and engagement. Findings of this study may inform future CR program designs for diverse populations in Australia. Copyright © 2026 The Authors <62> Accession Number 2048351858 Title Differential association of hypothyroidism with cardiovascular events and cardiovascular mortality: a systematic review and meta-analysis. Source Endocrine. 91(1) (no pagination), 2026. Article Number: 277. Date of Publication: 01 Dec 2026. Author Gatta E.; Delbarba A.; Vizzardi E.; Rotondi M.; Cappelli C. Institution (Gatta, Delbarba, Cappelli) Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, Brescia, Italy (Gatta, Cappelli) Centro per la Diagnosi e Cura delle Neoplasie Endocrine e delle Malattie della Tiroide, University of Brescia, Brescia, Italy (Vizzardi) Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy (Rotondi) Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy (Rotondi) Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Pavia, Italy Publisher Springer Abstract Purpose: The cardiovascular impact of hypothyroidism remains controversial, particularly regarding the distinction between cardiovascular disease occurrence and cardiovascular prognosis. We performed a systematic review and meta-analysis to separately evaluate the association between hypothyroidism and incident cardiovascular events and cardiovascular mortality. Method(s): PubMed/MEDLINE, Scopus, and Web of Science were systematically searched for studies published between January 2014 and April 2026 evaluating cardiovascular outcomes in adult patients with overt or subclinical hypothyroidism compared with euthyroid controls. Separate random-effects meta-analyses were performed for cardiovascular events and cardiovascular mortality using pooled odds ratios (ORs) with 95% confidence intervals (CIs). Study quality was assessed using the QUIPS tool. Result(s): Nine studies involving 9,662 patients were included. Six studies evaluating cardiovascular events (5,795 participants) showed no significant association between hypothyroidism and incident cardiovascular events (OR 0.92, 95% CI 0.78-1.09; p = 0.35), with low-to-moderate heterogeneity (I2 = 24.6%). By contrast, eight studies evaluating cardiovascular mortality (7,526 participants) demonstrated a significantly increased mortality risk among hypothyroid patients (OR 2.73, 95% CI 2.16-3.43; p < 0.0001), with low heterogeneity (I2 = 9.7%). Leave-one-out sensitivity analyses confirmed the robustness and stability of the mortality findings. Qualitative synthesis consistently showed worse outcomes in acute and high-risk cardiovascular settings, including acute coronary syndromes, acute heart failure, spontaneous coronary artery dissection, and coronary artery bypass grafting. Conclusion(s): Hypothyroidism was more consistently associated with cardiovascular mortality than with incident cardiovascular events. However, the lack of a statistically significant association with cardiovascular events should not be interpreted as evidence of absence of effect. These findings are consistent with the hypothesis that thyroid dysfunction may be more closely associated with adverse cardiovascular outcomes after disease onset than with incident cardiovascular events. Copyright © The Author(s) 2026. <63> Accession Number 2048569985 Title Effect of Wearable Devices and 5G-Powered Remote Precision Rehabilitation on Vascular Function in Post-PCI Patients: An Analysis of the Associations Between FMS, Cardiorespiratory Fitness, and Arterial Stiffness. Source FASEB Journal. 40(16) (no pagination), 2026. Article Number: e72181. Date of Publication: 31 Aug 2026. Author Long Y.; Xu T.; Xiong Z.; Fu X.; Nie Z.; Zou C.; Yu H. Institution (Long, Fu, Nie) School of Basic Medical Sciences, Guizhou University of Traditional Chinese Medicine, Guizhou, Guiyang, China (Xu, Xiong, Zou) The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou, Guiyang, China (Yu) School of Information Engineering, Guizhou University of Traditional Chinese Medicine, Guizhou, Guiyang, China Publisher John Wiley and Sons Inc Abstract To explore the effects of personalized exercise prescriptions and 5G-supported remote rehabilitation on adherence, lipid levels, cardiorespiratory fitness, and vascular function in patients after percutaneous coronary intervention (PCI), as well as to conduct a correlation analysis. This study employed a randomized, prospective clinical trial design, enrolling 155 patients at the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from September 2024 to September 2025. Patients were divided into a conventional group (n = 81) and a 5G remote monitoring group (n = 74), with the intervention lasting for 12 months. The 5G group utilized wearable devices for real-time monitoring. There were no statistically significant differences in baseline characteristics between the two groups (p > 0.05), indicating comparability. Correlation analysis revealed strong positive correlations among peak oxygen uptake (peak VO<inf>2</inf>), peak work rate (Peak WR), oxygen uptake at anaerobic threshold (VO<inf>2</inf> at AT), and peak metabolic equivalents (peak METs) in the overall observed parameters (r > 0.8); peak VO<inf>2</inf> was positively correlated with left ventricular ejection fraction (LVEF) (r > 0.4). Vascular function showed positive correlations between Flow-Mediated Slowing of pulse wave velocity (FMS) and left atrial diameter (LA), the ratio of early mitral inflow velocity to mitral annulus velocity (E/e'), and left ventricular end-diastolic diameter (LVEDD), while carotid-femoral pulse wave velocity (cf-PWV) was negatively correlated with CPET parameters, and there was a strong positive correlation between bilateral ankle-brachial index (ABI). The Gini index ranking indicated that cf-PWV, LVEF, age, peak VO<inf>2</inf>, and Peak WR had the most significant impact on FMS. After a 12-month follow-up, the improvements in LDL-C in the traditional group were superior to those in the 5G remote monitoring group (p < 0.05). However, the 5G remote monitoring group showed significant improvements in LVEF, E/e', LA, LVEDD, FMS, and cf-PWV compared to the traditional group (all p < 0.05). Factor analysis indicated that in the 5G remote monitoring group, VO<inf>2</inf> at AT and Peak WR were the main positively correlated influencing factors for FMS (p < 0.05), while Peak WR was a key factor affecting cf-PWV in relation to LDL-C (p < 0.05). The integrated remote comprehensive rehabilitation program established through 5G wearable real-time monitoring significantly enhanced the rehabilitation compliance and exercise endurance of PCI patients. FMS and cf-PWV can intuitively reflect the vascular improvement effects brought about by multidimensional interventions and serve as core indicators for assessing the recovery of vascular injury after PCI. Although literature supports that 5G may confer benefits through the shear stress-eNOS-NO and ox-LDL-MMP pathways, this study did not measure the relevant biomarkers; thus, this mechanism remains hypothetical and requires validation in future research. Copyright © 2026 Federation of American Societies for Experimental Biology. <64> Accession Number 2048701181 Title Comparative Evaluation of Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Thoracic Surgery: A Randomised Controlled Trial. Source International Journal of Life Sciences Biotechnology and Pharma Research. 15(5) (pp 1739-1746), 2026. Date of Publication: 01 May 2026. Author Patil V.S.; Vadigeri P.; Sulepetkar S. Institution (Patil) Department of Anesthesiology, Pain Medicine and Critical Care, Mahadevappa Rampure Medical College, Karnataka, Kalaburagi, India (Vadigeri) Department of Anaesthesiology and Critical Care, Navodaya Medical College Hospital and Research Centre, Karnataka, Raichur, India (Sulepetkar) Department of Orthopedics, Gulbarga Institute of Medical Science, Karnataka, Kalaburagi, India Publisher International Journal of Life Sciences Biotechnology and Pharma Research Abstract Background: Erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) are increasingly used for postoperative analgesia following thoracic surgery. This study compared their analgesic efficacy and safety. Method(s): This randomized controlled trial included 120 patients undergoing thoracic surgery, allocated equally to ESPB and SAPB groups (n=60 each). Postoperative Numerical Rating Scale (NRS) scores, time to first rescue analgesia, analgesic requirements, opioid consumption, and adverse events were assessed during the first 24 hours. Result(s): ESPB was associated with significantly lower resting and dynamic NRS scores during the first 12 postoperative hours. Time to first rescue analgesia was longer with ESPB (9.84+/-3.16 vs. 7.12+/-2.74 hours; p<0.001), and fewer patients required rescue analgesia (41.7% vs. 65.0%; p=0.010). Twenty-four-hour opioid consumption was significantly lower with ESPB (7.82+/-4.26 vs. 11.64+/-5.18 mg morphine equivalent; p<0.001). Both techniques had favourable safety profiles without major block-related complications. Conclusion(s): ESPB provided better early postoperative analgesia, prolonged analgesic duration, and reduced opioid requirements compared with SAPB, suggesting that ESPB may be an effective opioid-sparing technique for thoracic surgery. Copyright ©2026 Int. J. Life Sci. Biotechnol. Pharma. Res. <65> Accession Number 2048655600 Title Beyond the Bioptome. Source JACC: Heart Failure. 14(9) (no pagination), 2026. Article Number: 103240. Date of Publication: 01 Sep 2026. Author Wong Y.W. Institution (Wong) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Publisher Elsevier Inc. Abstract Corresponding Author Copyright © 2026. Published by Elsevier Inc. <66> [Use Link to view the full text] Accession Number 2043620841 Title Will prothrombin complex concentrate replace plasma in cardiac surgical bleeding in North America?. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (pp 1-9), 2026. Article Number: 46031. Date of Publication: 04 Dec 2025. Author Bartoszko J.; Gabarin N.; Tanaka K.; Callum J. Institution (Bartoszko) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Canada (Bartoszko) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Canada (Bartoszko) Departments of Anesthesiology and Pain Medicine, Canada (Gabarin) Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Tanaka) Department of Anesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher Lippincott Williams and Wilkins Abstract Purpose of review - There is increasing interest in four-factor prothrombin complex concentrate (4F-PCC) for treatment of acquired coagulopathic bleeding in cardiac surgery. Plasma, traditionally the treatment of choice, has a different composition compared with 4F-PCC. This review summarizes the current evidence. Recent findings - Because of its rapid reconstitution at the bedside and small administration volume, the use of 4F-PCC over plasma is rising - particularly with new clinical trial evidence suggesting 4F-PCC has efficacy and safety advantages. This is reinforced by mechanistic evidence supporting the role of 4F-PCC in normalizing or improving thrombin generation, an important aspect of secondary hemostasis often impacted in cardiac surgery. Four randomized controlled trials contribute to the human evidence base for the use of 4F-PCC in cardiac surgery. FARES-II, the largest study to date, demonstrated that 4F-PCC has improved hemostatic efficacy and a superior safety profile compared with plasma. Three additional studies are underway to confirm these findings. Summary - The use of 4F-PCC for the treatment of coagulopathic bleeding in cardiac surgery is supported by high-quality clinical evidence. Several unanswered questions remain regarding sex- and race-specific efficacy, the mechanism through which 4F-PCC may reduce serious adverse events, and its use in procedures that were under-represented in existing clinical trials. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <67> Accession Number 2047189892 Title A Randomized Controlled Trial Comparing the TruSteer and FXD Double Curve Delivery Systems for Left Atrial Appendage Occlusion With the Watchman FLX Pro Device-The GUIDE-LAAO Study. Source Catheterization and Cardiovascular Interventions. 108(3) (pp 899-907), 2026. Date of Publication: 01 Sep 2026. Author Taieb P.; Frazzetto M.; Teixeira P.S.; Filby S.J. Institution (Taieb, Frazzetto, Teixeira, Filby) Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Taieb) Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel Publisher John Wiley and Sons Inc Abstract Background: Deflectable delivery systems have been introduced to enhance coaxial alignment and procedural efficacy during left atrial appendage occlusion (LAAO), yet randomized comparisons with conventional fixed-curve systems are lacking. Aim(s): The GUIDE-LAAO trial evaluated whether the TruSteer deflectable delivery system is non-inferior to the FXD Double Curve (FXD DC) delivery system for procedural success in patients undergoing LAAO with the Watchman FLX Pro device. Method(s): In this prospective, randomized, all-comers trial, 50 patients with non-valvular atrial fibrillation undergoing LAAO were assigned 1:1 to TruSteer (n = 25) or FXD DC (n = 25). The primary endpoint was procedural success, defined as successful device implantation without major procedural or periprocedural complications. Secondary endpoints included technical success, device success, procedural efficiency, and safety outcomes. Result(s): Procedural success occurred in 100% of TruSteer-treated patients and 84% of FXD DC-treated patients (risk difference 16%; 95% confidence interval -6.9% to 34.7%), meeting criteria for non-inferiority; superiority was not demonstrated (p = 0.11). Technical and device success were 100% with TruSteer and 92% with FXD DC. Procedural time (34.6 +/- 7.1 vs. 36.5 +/- 13.0 min), fluoroscopy time (22.3 +/- 4.4 vs. 22.1 +/- 7.2 min), and contrast volume (34.5 +/- 12.1 vs. 36.8 +/- 13.5 mL) were similar. Periprocedural complications occurred in 4% and 16%, respectively, with no deaths or strokes. Conclusion(s): In this first randomized comparison of LAAO delivery systems, TruSteer was non-inferior to a standard fixed-curve system, with comparable efficiency and safety in an unselected population. These findings provide randomized evidence supporting deflectable delivery technology in contemporary LAAO practice and inform future studies in anatomically complex subsets. Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. <68> Accession Number 2045249305 Title Beta-Blockers in Patients with Myocardial Infarction and No Heart Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Canadian Journal of Cardiology. 42(9) (pp 2248-2259), 2026. Date of Publication: 01 Sep 2026. Author Kawtharany H.; Rayyan A.; Mestarihi A.; Hamarsha Q.; Choaib A.; Azzam M.; Arora S. Institution (Kawtharany) Department of Internal Medicine, St Louis University School of Medicine, St Louis, MO, United States (Rayyan, Mestarihi) Department of Internal Medicine, College of Medicine, University of Central Florida / HCA North Florida, Gainesville, FL, United States (Hamarsha, Choaib, Azzam) Evidence-Based Practice and Impact Center, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States (Arora) Division of Cardiology, St Louis University Hospital/SSM Health, St Louis, MO, United States Publisher Elsevier Inc. Abstract Background beta-Blockers have an established role in patients with myocardial infarction (MI) and left ventricular ejection fraction (LVEF) <40%. In those with LVEF >40%, emerging new trials have inconsistent results. We conducted a meta-analysis to evaluate the outcomes of beta-blocker therapy compared with no beta-blocker therapy in patients with MI and LVEF >40%. Methods We searched PubMed, Embase, and CENTRAL for randomized controlled trials (RCTs) published after 2000. Meta-analyses estimated hazard ratio (HR) or risk ratio (RR) with 95% confidence intervals (CIs) using RevMan web. Results Five RCTs (N = 19,826) met the inclusion criteria, with 9892 patients (49.8%) randomized to beta-blockers and 9934 (50.2%) to no beta-blockers. All trials enrolled patients with MI and LVEF >40%. Meta-analysis demonstrated that beta-blockers were not associated with significant reduction in all-cause mortality (HR 0.98, 95% CI 0.85-1.13), cardiac mortality (HR 1.16, 95% CI 0.89-1.51), unplanned coronary revascularization (HR 1.01, 95% CI 0.87-1.17), or malignant ventricular arrhythmia (RR 0.87, 95% CI 0.51-1.48). beta-Blockers were associated with a trend toward lower MI (HR 0.88, 95% CI 0.77-1.00) and new-onset heart failure (HF) (HR 0.82, 95% CI 0.63-1.07). beta-Blockers were not associated with an increase in symptomatic atrioventricular block (HR 1.06, 95% CI 0.83-1.34) or stroke (RR 1.16, 95% CI 0.9-1.48). Conclusion In patients with MI with LVEF >40%, beta-blockers were not associated with a significant effect on any outcome; beta-blockers were associated with a trend toward lower MI and HF. Registration PROSPERO CRD420251139242. Copyright © 2026 Canadian Cardiovascular Society. <69> Accession Number 2048456366 Title Early predictive value of prediction models for mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Date of Publication: 15 Jul 2026. Author Wang R.; He M.; Yuan Z.; Zhou J.; Han L.; Cheng X.; Chen Y.; Wang F. Institution (Wang, Yuan) School of Nursing, Bengbu Medical University, Anhui, Bengbu, China (He, Wang) Department of Cardiology, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Zhou) Nursing Department, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Han) Department of Hematology, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Cheng, Chen) Department of Internal Medicine, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China Publisher Frontiers Media SA Abstract Background - Transcatheter aortic valve replacement (TAVR) is increasingly used due to the rising incidence of aortic stenosis (AS). Early identification of mortality risk after TAVR is challenging. Although various prediction models have been developed, no systematic review has evaluated their effectiveness in predicting mortality risk. Therefore, this study aimed to systematically evaluate the performance of models for early prediction of mortality risk after TAVR, so as to provide evidence-based support for the future development or updating of risk assessment tools. Methods - Databases (PubMed, Web of Science, Embase, and Cochrane Library) were systematically searched for studies on tools for predicting the risk of mortality after TAVR, up to June 2024. PROBAST was used to assess the risk of bias in the included studies. A subgroup analysis was conducted based on different time points. Results - This systematic review included 36 studies with 272, 390 patients receiving TAVR and 6 major scoring tools encompassing 23 new machine learning models. The meta-analysis showed that the concordance index (C-index) was 0.610 (95% CI: 0.588-0.632) for European System for Cardiac Operative Risk Evaluation I (EuroSCORE I), 0.615 (95% CI: 0.588-0.643) for EuroSCORE II, 0.578 (95% CI: 0.531-0.625) for French Aortic National CoreValve and Edwards II (France II), 0.594 (95% CI: 0.554-0.633) for the OBSERVANT score, 0.648 (95% CI: 0.622-0.674) for the Society of Thoracic Surgeons (STS) risk model, 0.632 (95% CI: 0.616-0.648) for the American College of Cardiology Transcatheter Valve Therapy (ACC TVT) risk model, and 0.705 (95% CI: 0.677-0.733) for summarized machine learning models. Conclusion - Determining the predictive performance of current established risk assessment tools for predicting the risk of modality after TAVR is challenging. Machine learning models seem to be more effective. Therefore, future research should include more subjects to develop more accurate models. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023485237. Copyright © 2026 Wang, He, Yuan, Zhou, Han, Cheng, Chen and Wang. <70> Accession Number 2048616215 Title Impact of Frailty on Activities of Daily Living in Hospitalized Older Adults: A Systematic Review and Meta-Analysis. Source Geriatrics and Gerontology International. 26(9) (no pagination), 2026. Article Number: e70811. Date of Publication: 01 Sep 2026. Author Kamo T.; Asahi R.; Inaba Y.; Uno I.; Kamide N.; Azami M.; Ogihara H.; Hayashi S.; Kera T. Institution (Kamo, Hayashi) Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, Takasaki, Japan (Asahi) Department of Physical Therapy, School of Health Sciences, Tokyo International University, Saitama, Japan (Inaba) Department of Physical Therapy, School of Nursing and Rehabilitation Sciences, Showa Medical University, Tokyo, Japan (Uno) School of Allied Health Sciences, Kitasato University, Tokyo, Japan (Kamide) Rehabilitation Medicine, Sakura Juji Fukuoka Hospital, Fukuoka, Japan (Azami) Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Saitama, Japan (Ogihara) Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan (Kera) Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Japan Publisher John Wiley and Sons Inc Abstract Aim: To determine whether frailty is associated with activities of daily living (ADL) and other clinical outcomes in hospitalized older adults. Method(s): MEDLINE, Embase and CENTRAL were searched for English-language cohort studies published from 1 January 2001 to 23 October 2025. Eligible studies included hospitalized adults aged >= 65 years (or samples with >= 80% aged >= 65 years), used a defined frailty measure and compared frail with non-frail participants. Two reviewers independently selected studies, extracted data and assessed risk of bias using the Quality In Prognosis Studies tool. Random-effects meta-analyses generated standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Result(s): Fifty-seven cohort studies were included. Frailty was associated with worse ADL status (SMD -1.04, 95% CI -1.89 to -0.20), higher mortality (RR 2.26, 95% CI 1.86-2.76), lower likelihood of discharge home (RR 0.79, 95% CI 0.73-0.86), and higher 30-day (RR 1.47, 95% CI 1.13-1.90) and 90-day readmission risks (RR 1.75, 95% CI 1.07-2.86). Pneumonia risk was not statistically significant. Heterogeneity was substantial to considerable for all pooled outcomes. Conclusion(s): Frailty identifies hospitalized older adults at increased risk of functional dependence, mortality, non-home discharge, and readmission. Substantial heterogeneity and residual confounding warrant cautious interpretation and support standardized frailty and functional-outcome assessment. Copyright © 2026 Japan Geriatrics Society. <71> Accession Number 2048222845 Title Effect of general anesthesia on postoperative outcomes of transcatheter aortic valve implantation in patients: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1714689. Date of Publication: 16 Jul 2026. Author Li G.; He J.; Yang Y.; Deng J.; Zeng C.; Zhao G.; Zhong M. Institution (Li, He, Yang, Deng, Zeng, Zhao, Zhong) Department of Anesthesiology, Guangdong Hospital of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China Publisher Frontiers Media SA Abstract Objective - The optimal mode of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgery has been controversial recently, especially with the popularization of TAVI in young and low-risk patients and reduced dependence on transesophageal echocardiography (TEE). Beyond general anesthesia (GA), there are more than one type of anesthetic methods such as regional anesthesia (RA), local anesthesia (LA), monitored anesthesia care (MAC), deep sedation (DS), conscious sedation (CS) et al. used on TAVI. The aim of this systematic review and meta-analysis was to evaluate the effects of general anesthesia on the prognosis of patients undergoing TAVI. Methods - The Cochrane Library, PubMed, Embase, and Medline databases were searched from their inception to May 2025. Literature was selected according to the inclusion and exclusion criteria, and the meta-analysis was completed using RevMan 5.3. Results - A total of eligible 38 literatures were enrolled, including 23, 848 patients. The results of the meta-analysis showed that compared with the non-GA groups, the in-hospital mortality (RR = 1.99, 95%CI, 1.19-3.30, P = 0.008), incidence of postoperative pneumonia (RR = 2.39, 95%CI, 1.43-4.00, P = 0.0009), procedure time (MD = 20.22, 95%CI, 15.37-25.07, P < 0.00001), length of hospital stay (MD = 1.43, 95%CI, 1.10-1.76, P < 0.00001), and ICU stay (SMD = 1.91, 95%CI, 1.40-2.42, P < 0.00001) were all increased in the GA group. There were no significant differences between the groups in 30-day mortality (RR = 1.19, 95%CI, 0.97-1.47, P = 0.09), postoperative acute kidney injury (RR = 1.16, 95%CI, 0.90-1.50, P = 0.26), postoperative stroke (RR = 0.99, 95%CI, 0.80-1.22, P = 0.90), postoperative vascular complication (RR = 1.10, 95%CI, 0.92-1.33, P = 0.30), and postoperative myocardial infarction (RR = 1.12, 95%CI, 0.72-1.73, P = 0.61). Conclusion - GA not only increases in-hospital mortality and the incidence of postoperative pulmonary infections in patients undergoing TAVI but also prolongs the length of hospitalization and ICU stay. However, GA did not increase the incidence of postoperative acute kidney injury, stroke, myocardial infarction, or vascular complications, nor did it increase the 30-day postoperative mortality rate and long-term quality of life in patients. The choice of anesthesia for TAVI should be evaluated according to the patient's condition and surgical approaches to minimize adverse complications and mortality. Further RCTs are required to verify the most likely anesthetic choices for TAVI. Copyright © 2026 Li, He, Yang, Deng, Zeng, Zhao and Zhong. <72> Accession Number 2038497921 Title INCIDENCE OF DELIRIUM WITH DEXMEDETOMIDINE COMPARED WITH FENTANYL BASED THERAPY IN POSTOPERATIVE CARDIAC SURGICAL PATIENTS: A RANDOMIZED CONTROLLED SINGLE BLINDED STUDY. Source Genetics and Molecular Research. 25(13s) (no pagination), 2026. Date of Publication: 05 Aug 2026. Author Mishra R.D.; Paidi P.; Acharya R.; Apurva G.; Bhoi S.K. Institution (Mishra, Paidi, Apurva) Department of Anesthesia and Critical Care Medicine, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India (Acharya) Department of Anesthesiology and Critical Care and Pain Medicine, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India (Bhoi) Department of Cardiac Anaesthesia, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India Publisher Fundacao de Pesquisas Cientificas de Ribeirao Preto Abstract Background: Postoperative Delirium represents complication in cardiac surgery, associated with increased morbidity and mortality. This study compared the efficacy of dexmedetomidine versus fentanyl-based therapy on clinical outcomes in postoperative cardiac surgical patients. Method(s): This study design was a single blinded Randomized Control Trial was conducted in tertiary hospitals in IMS and SUM between January 2023 to January 2025. Patients were randomized into two groups i.e., Dexmedetomidine (DEX) and fentanyl-based therapy in cardiac surgery patient. The primary endpoint was delirium incidence and severity, assessed 12-hourly for 7 days via CAM-ICU. Secondary outcomes included pain (CPOT/Wong-Baker), sedation (RASS), extubation time, and hemodynamic stability. Analysis was performed using SPSS v27, with significance set at p < 0.05. Result(s): One hundred fifty patients were randomized (n=75 per group) with no significant differences in age, weight, or gender. While delirium incidence was similar initially, Dexmedetomidine showed significantly lower mean delirium scores from day 5 to day 7 (p < 0.05) compared to Fentanyl. Additionally, Dexmedetomidine demonstrated significantly better sedation (RASS) and analgesia (CPOT) scores from 12 to 48 hours (p < 0.001). Furthermore, Dexmedetomidine group achieved significantly earlier extubation (17.54 +/- 2.59 vs. 18.4 +/- 3.16 hours; p = 0.03), lower incidences of tachyarrhythmias, and reduced rescue analgesia requirements. Hemodynamic parameters remained stable across both cohorts. Conclusion(s): Postoperative dexmedetomidine significantly reduced delirium severity, improves sedation quality, and provided superior analgesia compared to fentanyl. Dexmedetomidine is a more effective postoperative sedative-analgesic than fentanyl, supports modern cardiac surgical protocols to improve clinical outcomes in high-risk populations. Copyright © 2026, Fundacao de Pesquisas Cientificas de Ribeirao Preto. All rights reserved. <73> [Use Link to view the full text] Accession Number 2048170176 Title Sirolimus-Eluting Balloon With Provisional Stenting Versus Systematic Drug-Eluting Stent Implantation to Treat De Novo Coronary Lesions: A Randomized, Open-Label, Noninferiority Trial. Source Circulation. 154(3) (pp 185-197), 2026. Date of Publication: 15 Jun 2026. Author Spaulding C.; Krackhardt F.; Bogaerts K.; Abdelaal E.; Alfonso F.; Briguori C.; Bruch L.; Den Hartog A.W.; Garot P.; Godin M.; Hildick-Smith D.; Johnson T.; Ladwiniec A.; Linke A.; Maart C.A.; Mashayekhi K.; Meier P.; Meunier L.; Morgan K.; O'Kane P.; Puymirat E.; Rissanen T.T.; Sabate M.; Schmitz T.; Toth G.G.; Trevelyan J.; Wanczura P.; Wiemer M.; Wykrzykowska J.J.; Urban P.; Eccleshall S.; Frick M.; Steinwender C.; Pleva L.; Poloczek M.; Cayla G.; Delarche N.; Poustis P.; Andrassy M.; Birkemeyer R.; Brunner F.; Edelmann F.; Halbach M.; Langer C.; Rahimi Nedjat F.D.; Schofer J.; Wein B.; Bongiovanni D.; d'Amico M.; Ugo F.; Dickinson M.; Cambero M.; Skoczynski K.; Jiang Ming F.; Jimenez Diaz V.A.; Arroyo D.; Haner J.; Fernando Iglesias J.; Leibundgut G.; Rigger J.; Stahli B.; Keshavarzi F.; Cruden N.; Curzen N.; Ratib K.; Ruparelia N.; Peter Vanezis A.; Watkins S.; Iglesias J.; Idu Jion M.B.; Lesiak M.; Gabrio Secco G.; Royer T.; Carlier S.; Cook S.; Hawranek M.; Mas J.-L.; Szachniewicz J.; Meier B.; Mauri F.; Petronio S. Institution (Spaulding, Puymirat) Department of Cardiology, European Hospital Georges Pompidou, Assistance Publique Hopitaux de Paris, Paris-Cite University, INSERM Centre d'investigation Clinique 1414, France (Krackhardt) Berlin Institute of Health at Charite Universitatsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Charite Campus Virchow-Klinikum, Germany (Bogaerts) Department of Public Health and Primary Care, I-BioStat, KU Leuven, Leuven and UHasselt, I-BioStat, Hasselt, Belgium (Abdelaal) Manchester Heart Institute, Manchester University NHS Foundation Trust, United Kingdom (Alfonso) Cardiology Department, Hospital Universitario de La Princesa/Universidad Autonoma de Madrid IIS-IP, CIBER-CV, Spain (Briguori) Mediterranea Cardiocentro, Naples, Italy (Bruch) BG Klinikum Unfallkrankenhaus Department of Internal Medicine/Cardiology, Berlin, Germany (Cruden) Royal Infirmary of Edinburgh, United Kingdom (Den Hartog) Department of Cardiology, Amsterdam University Medical Center, Netherlands (Garot) Institut Cardiovasculaire Paris Sud Hopital Jacques Cartier Ramsay-Sante, Massy, France (Godin) Clinique Saint Hillaire, Rouen, France (Hildick-Smith) Sussex Cardiac Centre University Hospitals Sussex, Brighton, United Kingdom (Johnson) Bristol Heart Institute, Translational Health Sciences, University of Bristol, Bristol Royal Infirmary University, United Kingdom (Ladwiniec) Department of Cardiovascular Sciences, University of Leicester, National Institute for Health and Care Research Leicester Biomedical Research Center, British Heart Foundation Centre of Research Excellence, Glenfield Hospital, United Kingdom (Linke) Department of Internal Medicine and Cardiology, Herat Center, University Clinic, University of Technology Dresden, United Kingdom (Maart, Eccleshall) Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich Medical School, University of East Anglia, United Kingdom (Mashayekhi) Department of Internal Medicine and Cardiology, Heart Center Lahr, Germany (Meier) Service de Cardiologie, Fribourg Hospitals HFR, Switzerland (Meunier) Cardiology Department, Centre Hospitalier La Rochelle, France (Morgan) Northern General Hospital, Sheffield, United Kingdom (O'Kane) Dorset Heart Centre, University Hospitals Dorset, Royal Bournemouth Hospital, United Kingdom (Rissanen) Heart Center, North Karelia Central Hospital, Siunsote, University of Eastern Finland, Kuopio, Finland (Sabate) Interventional Cardiology Department, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, CIBER-CV, Barcelona, Spain (Sabate) University of Barcelona, CIBER-CV, Spain (Schmitz) Department of Cardiology, Elisabeth Krankenhaus Essen, Germany (Toth) Division of Cardiology, University Heart Center Graz, Medical University Graz, Germany (Trevelyan) Worcestershire Acute Hospital NHS Trust, United Kingdom (Wanczura) Department of Cardiology, Collegium Medicum, University of Rzeszow, Poland (Wiemer) Johannes Wesling Universitatsklinik, Minden, Germany (Wykrzykowska) Department of Cardiology, University Medical Center Groningen, Netherlands (Urban) Cardiovascular Department, Hopital de la Tour, Geneva, Switzerland Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Implantation of drug eluting stents (DESs) is currently the default approach for percutaneous coronary interventions, but long-term adverse events still exist. An approach with minimal stenting deserves to be assessed in a randomized trial. We studied a novel sirolimus-eluting balloon (SEB) that elutes sirolimus over a 90-day period using a biodegradable polymer microreservoir technology. METHOD(S): - In a multicenter, open-label, randomized trial, we compared an SEB-based strategy with provisional DES with one of systematic DES for de novo lesions in coronary arteries between 2 and 5 mm in diameter. Subjects were randomized 1:1 before percutaneous coronary intervention. The primary end point was target vessel failure, a composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization. It was tested for noninferiority at 1 year with the use of an absolute margin equal to 50% of the combined event rate at a significance level of 0.025. The primary analysis population included all randomized subjects with completed or attempted percutaneous revascularization, analyzed according to the intention-to-treat principle. A sensitivity analysis was performed on the per-protocol population. RESULT(S): - Between August 27, 2021, and July 29, 2024, 3323 participants were randomized and treated in 62 sites. Among 1661 participants in the SEB strategy group, bailout stenting was performed in 343 (20.7%). Target vessel failure occurred over 365 days in 88 (5.3%) and 73 (4.4%) participants in the SEB and the systematic DES strategy groups, respectively (risk difference, 0.91% [95% CI -0.55% to 2.38%]; 1-sided P=0.02 for noninferiority with a 2.44% noninferiority margin). Clinically driven target vessel revascularization occurred more frequently in the SEB strategy group (3.3% versus 2.1%; risk difference, 1.22% [95% CI, 0.11%-2.33%). Safety events, including lesion thrombosis, were low and similar in both groups. Although the results of the per-protocol population (3194 participants, 96%) did not confirm noninferiority (upper boundary of the 95% CI, 2.63; P=0.04), they were similar to the intention-to-treat results in both magnitude and direction. CONCLUSION(S): - At 1 year, in the primary intention-to-treat analysis population, a strategy of percutaneous coronary intervention with SEB and provisional DES was noninferior to the systematic use of DES for the primary end point of target vessel failure. The per-protocol population sensitivity analysis did not confirm noninferiority. Clinically driven target vessel revascularization occurred more frequently in the SEB strategy group. At 5 years, target vessel failure will be tested again for noninferiority and for superiority if noninferiority is achieved. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT04859985. Copyright © 2026 The Authors. <74> Accession Number 2048248805 Title Machine learning models for predicting postoperative acute kidney injury in pediatric cardiac surgery: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Date of Publication: 18 Jun 2026. Author Sihombing N.M.I.; Raz H.F.; Siahaan S.R.U.; Sihombing S.Y.R.; Rifa'i A.D.; Duha M.H. Institution (Sihombing, Siahaan, Sihombing, Rifa'i, Duha) Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia (Raz) Division of Thoracic, Cardiac, and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia Publisher Frontiers Media SA Abstract Background - Acute kidney injury (AKI) occurs in up to 42% of pediatric cardiac surgeries and is associated with prolonged intensive care, increased morbidity and in-hospital mortality. Machine learning (ML) has emerged as a promising approach for early AKI risk stratification by modeling complex, high-dimensional clinical data. Objectives - To systematically review and meta-analyze the diagnostic accuracy of ML models for predicting pediatric cardiac surgery associated AKI (CSA-AKI). Methods - We performed a systematic search of PubMed, ScienceDirect, Springer, and DOAJ. The review protocol was prospectively registered in PROSPERO (CRD420251145645). Study quality was assessed using QUADAS-2 tool and PROBAST + AI. A bivariate random-effects diagnostic meta-analysis was performed using Stata 17.0 to estimate the pooled area under the summary receiver operating characteristic curve (SROC AUC), sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR). Results - A meta-analysis of seven studies yielded a pooled SROC AUC of 0.91 (95% CI 0.88-0.93), driven predominantly by internally validated models (AUC 0.93, Sensitivity of 0.84, Specificity of 0.95). Externally validated models showed substantially lower performance (Sensitivity 0.70, Specificity 0.80), representing the more clinically relevant benchmark. A sensitivity analysis using median-performing models confirmed directional consistency (AUC 0.85, Sensitivity 0.75, Specificity 0.91). Substantial heterogeneity was observed (I2 = 81.48%). Conclusion - ML models show promising accuracy for predicting pediatric CSA-AKI. Substantial heterogeneity and limited external validation warrant cautious interpretation and further multicenter validation before clinical use. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251145645. Copyright © 2026 Sihombing, Raz, Siahaan, Sihombing, Rifa'i and Duha. <75> Accession Number 2046400924 Title Ventricular Tachycardia Recurrence After Catheter Ablation in Nonischemic Cardiomyopathy with Mildly to Moderately Reduced Ejection Fraction. Source CJC Open. 8(8) (pp 958-967), 2026. Date of Publication: 01 Aug 2026. Author Kovacs B.; Dinshaw L.; Marco del Castillo A.; Jungen C.; Kurath-Koller S.; Stojkovic S.; Santoro F.; Mugnai G.; Perrotta L.; ter Bekke R.M.A.; Vernooy K.; Volders P.G.A.; Vandenberk B. Institution (Kovacs) Department of Cardiology, Inselspital Bern, University Bern, Berne, Switzerland (Dinshaw) Department of Cardiology, Sana Hanse Hospital Wismar, Wismar, Germany (Marco del Castillo) Hospital Universitario 12 de Octubre, Madrid, Spain (Jungen) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany (Kurath-Koller) Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria (Stojkovic) University Clinic for Internal Medicine II, Divison of Cardiology, Medical University of Vienna, Vienna, Austria (Santoro) Cardiology Unit, Department of Medical and Surgery Sciences, University of Foggia, Foggia, Italy (Mugnai) Division of Cardiology, Cardio-Thoracic Department, University Hospital of Verona, Verona, Italy (Perrotta) Arrhythmia Unit, Cardio-thoracic Department, Careggi University Hospital, Florence, Italy (ter Bekke, Vernooy, Volders) Department of Cardiology, Maastricht University Medical Center +, Cardiovascular Research Institute, Maastricht, Netherlands (Vandenberk) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium Publisher Elsevier Inc. Abstract Background: Patients with nonischemic cardiomyopathy (NICM) are at risk for sustained ventricular tachycardia (VT). Implantable cardioverter-defibrillators (ICDs) are guideline-recommended for secondary prevention, but the necessity of routine ICD implantation after successful catheter ablation (CA) in patients with preserved or mildly reduced left ventricular ejection fraction (LVEF > 35%) remains uncertain. This review summarizes the current evidence. Method(s): A PROSPERO-registered systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane were searched through June 2025. Studies including adults with NICM and LVEF > 35% undergoing CA for sustained monomorphic VT were eligible. Data on patient characteristics, ablation outcomes, VT recurrence, mortality, and ICD therapies were extracted. Results were descriptively synthesized, and weighted means were calculated when feasible. Result(s): Eleven studies (1995-2024), including 1430 patients, were identified; 936 (66%) were analyzable. The weighted mean LVEF was 38% +/- 14%; mean age was 59 +/- 14 years. Sustained VT recurrence ranged from 14%-67% during a weighted mean follow-up period of 608 +/- 745 days. Procedural noninducibility consistently predicted lower recurrence rates (18%-32%), than those in inducible patients (up to 75%). Two studies using cardiac magnetic resonance imaging found non-circumferential mid-myocardial late gadolinium enhancement with septal involvement associated with higher recurrence risk. Risk of bias was moderate to serious. Conclusion(s): In NICM patients with LVEF > 35%, noninducibility after CA predicts favourable arrhythmic outcomes. Non-circumferential mid-myocardial late gadolinium enhancement with septal involvement, and inducibility after VT ablation, identify higher-risk patients. Registration: PROSPERO CRD420251075109. Copyright © 2026 The Authors <76> Accession Number 2046641768 Title Hypotension prediction index in surgical patients: A systematic review and meta-analysis of randomized controlled trials. Source Medicine (United States). 105(24) (pp e49257), 2026. Date of Publication: 12 Jun 2026. Author Xie C.-m.; Shen M.-q.; Yao Y.-t.; Yang K.; He L.-x.; Dai Z. Institution (Xie, Shen, Yang, He, Dai) Department of Anesthesiology, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China (Yao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Yao) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China Publisher Lippincott Williams and Wilkins Abstract Background: - The Hypotension Prediction Index (HPI) is a machine-learning-derived early-warning algorithm that uses real-time arterial pressure waveform features to prospectively identify episodes of intraoperative hypotension (IOH) - defined as mean arterial pressure < 65 mm Hg sustained for >= 1 minute. IOH is a common hemodynamic complication in surgical patients and is associated with impaired end-organ perfusion and an increased risk of postoperative morbidity. To rigorously evaluate the predictive performance of HPI and its impact on IOH, we conducted a systematic review and meta-analysis of randomized controlled trials, adhering strictly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Method(s): - A systematic literature search was conducted across multiple electronic databases from their inception to April 10, 2026. The search strategy employed a combination of keyword terms, including "hypotension, " "prediction, " "index, " "surgery, " and "randomized controlled trial." Primary outcomes were the time-weighted average, area under the threshold, incidence, and duration of IOH. Secondary outcomes included intraoperative fluid administration, estimated blood loss, urine output, use of vasopressors and inotropes, and postoperative acute kidney injury (AKI). Pooled effect estimates were calculated using odds ratios for dichotomous outcomes and weighted mean differences for continuous outcomes, with corresponding 95% confidence intervals. Result(s): - Eighteen randomized controlled trials (RCTs) involving 2279 noncardiac surgical patients and 1 RCT enrolling 130 cardiac surgical patients were included in the analysis. Following standardized data conversion, meta-analytic results demonstrated that HPI-guided hemodynamic management significantly reduced IOH across multiple complementary metrics: time-weighted average (WMD = -0.19, 95% CI: -0.25 to - 0.12), area under the threshold (WMD = -55.17, 95% CI: -73.62 to - 36.71), incidence (WMD = -2.42, 95% CI: -3.36 to - 1.49), cumulative duration (WMD = -10.61, 95% CI: -14.11 to - 7.11), all P < .00001. Similarly, the HPI-guided group reduced intraoperative fluid administration and phenylephrine utilization. In contrast, the incidence of AKI showed no statistically significant difference (OR = 0.83, 95% CI: 0.64 to 1.07, P = .16). Conclusion(s): - Current evidence shows that HPI-directed hemodynamic management effectively reduces IOH and decreases intraoperative fluid administration and phenylephrine utilization. However, these physiological improvements did not translate into clinical benefits for postoperative AKI. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <77> Accession Number 2048473610 Title Pre- and Immediate Postoperative Prediction Model for Organ Dysfunction or Death Early After Cardiac Surgery: A Post Hoc Analysis of a Multicenter Randomized Trial. Source Journal of the American Heart Association. 15(14) (no pagination), 2026. Article Number: e044394. Date of Publication: 2026. Author Dresen E.; Heyland D.K.; Lee Z.Y.; O'Brien B.; Elke G.; Radke D.I.; Meybohm P.; Schoenrath F.; Sundermann S.H.; von Dossow V.; McDonald B.; Christopher K.B.; Fremes S.E.; Mohammadi S.; Niemann B.; Boning A.; Mazer C.D.; Ke L.; Zarbock A.; Day A.G.; Stoppe C. Institution (Dresen, Lee, Meybohm, Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Heyland, Day) Clinical Evaluation Research Unit, Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada (Lee) Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (Lee, O'Brien, Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Lee, O'Brien, Schoenrath, Sundermann, Stoppe) Charite - Universitatsmedizin Berlin, Corporate Member, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany (O'Brien, Schoenrath, Sundermann, Stoppe) German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany (Elke) Department of Anaesthesiology, Intensive Care, Pain and Emergency Medicine, St. Bernward Hospital, Hildesheim, Germany (Radke) Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany (Schoenrath, Sundermann) Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany (von Dossow) Heart and Diabetes Centre North Rhine Westphalia, Institute of Anesthesiology and Pain Therapy, Ruhr-University Bochum, Bad Oeynhausen, Germany (McDonald) Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, ON, Canada (Christopher) Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, United States (Fremes) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, Schulich Heart Centre, University of Toronto, Toronto, ON, Canada (Mohammadi) Quebec Heart and Lung University Institute, Laval University, Quebec City, QC, Canada (Niemann) Department of Thoracic and Cardiovascular Surgery, University Medical Center Gottingen, Gottingen, Germany (Boning) Department of Adult and Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen, Germany (Mazer) Li Ka Shing Knowledge Institute of St. Michael's Hospital, Departments of Anesthesiology and Pain Medicine, Physiology, and Pharmacology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada (Ke) Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Jiangsu, Nanjing, China (Ke) National Institute of Healthcare Data Science, Nanjing University, Nanjing, China (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Zarbock) Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States (Zarbock, Stoppe) Center for Outcomes Research, Department of Anesthesiology, UTHealth, Houston, TX, United States (Day) Kingston Health Sciences Centre - Research Institute, Kingston, ON, Canada Publisher American Heart Association Inc. Abstract BACKGROUND: Development of organ dysfunction or death is still common in patients undergoing cardiac surgery. Yet, current risk stratification tools fail to adequately incorporate both preoperative vulnerability and immediate postoperative physiological derangements. This study aims to develop a predictive model integrating these critical timepoints to identify high-risk patients for presence of organ dysfunction or death 48hours after surgery. METHOD(S): This is a post hoc analysis of an international, multicenter, randomized, controlled trial in patients undergoing cardiac surgery (n=1394). Prespecified patient characteristics (age, Clinical Frailty Scale, at nutrition risk, combined procedures, urgent surgery, moderate-severe chronic kidney disease, left ventricular ejection fraction, European System for Cardiac Operative Risk Evaluation II, cardiopulmonary bypass duration, sex, Charlson Comorbidity Index, and Sequential Organ Failure Assessment score) were included in logistic regression models employing bootstrap validation. RESULT(S): A total of 434 (31.1%) patients had organ dysfunction or died 48hours after surgery. The preoperative model identified Clinical Frailty Scale, nutrition risk, urgent surgery and European System for Cardiac Operative Risk Evaluation II as significant predictors of organ dysfunction or death 48 hours after surgery (optimism-corrected area under the receiver operating characteristic curve, 0.644 [95% CI, 0.610-0.678]). Incorporation of postoperative variables (Sequential Organ Failure Assessment score at intensive care unit admission, and cardiopulmonary bypass duration) improved predictive performance (area under the receiver operating characteristic curve, 0.773 [95% CI, 0.745-0.801]). CONCLUSION(S): Incorporation of variables collected the day of surgery substantially improved the ability to predict organ dysfunction or death 48hours after surgery compared with using presurgical variables only. This pragmatic, clinically actionable model may enable targeted resource allocation and personalized interventions and may provide a stratification tool for future research. Copyright © 2026 The Author(s). <78> Accession Number 2045571558 Title Direct Oral Anticoagulants Compared to Warfarin Early After Cardiac Surgery: A Pilot Randomized Controlled Trial. Source CJC Open. 8(8) (pp 1109-1118), 2026. Date of Publication: 01 Aug 2026. Author Wang E.H.Z.; Turgeon R.; Chu E.; Sun T.; Bashir J.; Peng D.; Cook R.; Atherstone J.; Gwozd T.; Ye J. Institution (Wang, Turgeon) Pharmacy Department, St. Paul's Hospital, Vancouver, BC, Canada (Wang, Turgeon) Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada (Chu) Pharmacy Department, Vancouver General Hospital, Vancouver, BC, Canada (Sun) Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada (Bashir, Peng, Cook, Ye) Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (Peng) Centre for Cardiovascular Innovation, Vancouver, BC, Canada (Atherstone) Department of Anesthesiology, Vancouver General Hospital, Vancouver, BC, Canada (Gwozd) Vancouver General Hospital, Vancouver, BC, Canada Publisher Elsevier Inc. Abstract Background: The goal was to conduct a pilot randomized controlled trial (RCT) of direct oral anticoagulants (DOACs) early after cardiac surgery to determine the feasibility of a larger RCT. Method(s): We conducted an open-label, 2-site, pilot RCT of adults undergoing cardiac surgery with an indication for anticoagulation, excluding mechanical valves and bioprosthetic mitral valve replacements. We randomized patients 1:1 to receive a DOAC or warfarin started during the index hospitalization with a standardized time of postoperative initiation and bridging for high thrombosis risk. The coprimary feasibility outcome goals were recruitment of >= 70% eligible patients and adherence to the anticoagulation protocol in >= 80% patients. The primary clinical composite outcome included all-cause mortality, major bleeding, stroke, systemic embolism, or pericardial effusion requiring intervention within 3 months. Result(s): Between October 2022 and February 2024, a total of 547 patients were screened, 163 met inclusion criteria, 104 were randomized, and 100 were analyzed (50 in each group). The median age was 72 years; 22% were female; 54% had preexisting atrial fibrillation; 37% had postoperative atrial fibrillation, with a median Congestive Heart Failure, Hypertension, Age >= 75 Years, Diabetes Mellitus, Stroke, Vascular Disease, Age 65 to 74 Years, Sex Category (CHA<inf>2</inf>DS<inf>2</inf>-VASc) score of 3 and a Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (> 65 Years), Drugs/Alcohol Concomitantly (HAS-BLED) score of 2. We recruited 64% of eligible patients, and anticoagulation protocol adherence was 91%. The clinical composite outcome occurred in 8% with DOAC (2 major bleeding, 1 pericardial effusion, 1 death) vs 4% with warfarin (2 strokes); log-rank P = 0.42. Conclusion(s): Although the a priori recruitment goal was not met, this trial supports the need for and provides valuable insights into key challenges to mitigate, thereby guiding the design of a large, definitive multicentre RCT comparing DOACs vs warfarin in cardiac surgery patients. Clinical Trial Registration: NCT05006287. Copyright © 2026 The Authors <79> Accession Number 2048491970 Title Aspirin vs. Clopidogrel Monotherapy Beyond 1 Month After Percutaneous Coronary Intervention in Patients With Diabetes - Prespecified Subgroup Analysis of the STOPDAPT-3 Trial -. Source Circulation Journal. 90(8) (pp 1055-1065), 2026. Date of Publication: 2026. Author Kanenawa K.; Yamamoto K.; Domei T.; Natsuaki M.; Watanabe H.; Morimoto T.; Obayashi Y.; Nishikawa R.; Ando K.; Suwa S.; Isawa T.; Takenaka H.; Ishikawa T.; Yamada M.; Wakatsuki T.; Nozaki Y.; Kitahara H.; Kato R.; Kawai R.; Kobayashi Y.; Ishii M.; Goto Y.; Ono K.; Kimura T. Institution (Kanenawa, Yamamoto, Domei, Ando) Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (Natsuaki) Department of Cardiovascular Medicine, Saga University, Saga, Japan (Watanabe, Takenaka, Kimura) Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan (Morimoto, Kimura) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Kimura) Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan (Suwa) Department of Cardiology, Juntendo University Shizuoka Hospital, Shizuoka, Japan (Isawa) Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan (Ishikawa) Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan (Yamada) Division of Cardiology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan (Wakatsuki) Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan (Nozaki) Department of Cardiovascular Medicine, Hokko Memorial Hospital, Sapporo, Japan (Kitahara) Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan (Kato) Department of Cardiology, Higashiyamato Hospital, Tokyo, Japan (Kawai) Department of Cardiology, Tenri Hospital, Nara, Japan (Kobayashi) Department of Cardiovascular Center, Japanese Red Cross Osaka Hospital, Osaka, Japan (Ishii) Department of Cardiology, Kyoto Medical Center, Kyoto, Japan (Goto) Department of Cardiology, Fukuoka Wajiro Hospital, Fukuoka, Japan Publisher Japanese Circulation Society Abstract Background: No studies have compared aspirin to P2Y12 inhibitor monotherapy following short dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with diabetes. Methods and Results: We conducted a prespecified diabetes subgroup analysis of the 1-year STOPDAPT-3 trial; patients were randomized at the time of index PCI, and outcomes from 30 days to 1 year were assessed using a 30-day landmark analysis comparing 1-month DAPT followed by aspirin monotherapy (aspirin group) to 1-month prasugrel monotherapy followed by clopidogrel monotherapy (clopidogrel group). The effect of aspirin relative to clopidogrel was not significant for the coprimary cardiovascular endpoint (composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or stroke) regardless of diabetes (aspirin/clopidogrel 5.3/5.6 vs. 3.9/3.7 per 100 person-years for diabetes vs. non-diabetes, respectively; hazard ratios [HRs] 0.96 [95% confidence interval {CI} 0.67-1.37] and 1.06 [95% CI 0.72-1.55], respectively; Pinteraction=0.71), but there was a significant interaction between diabetes and the effect of aspirin relative to clopidogrel for the coprimary bleeding endpoint (Bleeding Academic Research Consortium 3 or 5; aspirin/clopidogrel 2.8/1.8 vs. 1.3/2.0 per 100 person-years diabetes vs. non-diabetes, respectively; HR 1.54 [95% CI 0.88-2.71] vs. 0.65 [95% CI 0.36-1.17], respectively; Pinteraction=0.04). Conclusion(s): From 30 days to 1 year after PCI, cardiovascular outcomes were similar between aspirin and clopidogrel regardless of diabetes. A nominal bleeding interaction was observed; given the exploratory and underpowered subgroup analyses, this finding should be interpreted cautiously. Copyright © (2026), (Japanese Circulation Society). All rights reserved. <80> Accession Number 2047867189 Title Deramiocel heart-derived cellular therapy in advanced Duchenne muscular dystrophy (HOPE-3): a phase 3, randomised, double-blind, placebo-controlled trial. Source The Lancet. 408(10556) (pp 721-733), 2026. Date of Publication: 22 Aug 2026. Author McDonald C.M.; Villa C.; Soslow J.H.; Maharry K.; Hogan N.; Binks M.; Berth K.C.; Elliott K.A.; Taylor M.; Hor K.N.; Signorovich J.; Henricson E.K.; Phan H.C.; Apkon S.; Ghosh P.S.; Tian C.; Veerapandiyan A.; Ramos-Platt L.; Gambetta K.; Bernes S.M.; Varadhachary A.S.; Iannaccone S.T.; Laverty C.G.; Perlman S.J.; Bass N.E.; Mosher K.; Butterfield R.J.; Mathews K.D.; Scharf R.J.; Smith E.C.; Emerson J.A.; Mercuri E.; Awadalla M.S.; Marban L.; Marban E.; Alton W.; Amalachandran M.; Anand P.; Arellano-Garcia M.; Batchelor S.; Batley K.; Billena R.J.; Bloom K.; Bochnak M.; Bonarrigo K.; Boudreau A.; Braun C.; Brown M.; Brown L.; Castillo Z.G.; Chatitanya S.K.; Chimienti J.; Chinander S.; Darras B.; Dayan J.; Decker A.; Dhillon K.; Dixon M.; Edmondson A.; Ellsworth E.; Farid R.; Ferrante C.; Folkes A.; Forrest D.; Getz J.; Ginsberg M.; Giompoletti S.; Goelz A.; Goldsbury C.; Goude E.; Grotski C.; Haigh K.; Haley W.; Haws C.C.; Hayes S.; Hayes L.; Henriquez A.; Hicks-Wittman M.; Hoffman K.; Hudspeth M.; Huett E.; Husain N.; Jesus A.; Johnson K.; Johnson H.; Johnson D.; Jorne R.; Joyce N.; Juel L.; Juhasz A.; Kaethler L.; Kashi B.; Kellogg A.; Kelly C.; Kelly K.; Keough T.M.; Kim R.; Kim Ma V.; Knight M.; Knoll E.; Kraemer M.; Kuntz N.; Laine R.; Laubscher K.; Lawrence H.; Lehman S.; Liber S.; Loftus M.; Lopez A.; Maczek E.; Marie A.; Masterson C.; McIntyre M.; Mehta R.; Menteer J.D.; Miller C.L.; Miner J.; Moldt S.; Moore L.; Moore-Burk M.F.; Most E.; Mueller A.; Murphy S.; Murray E.; Mwonga D.; Nakata K.; Nelson L.; Nguyen B.; Nicorici A.; O'Rourke D.; Omura J.; Oswald S.; Pare L.; Park E.; Pasternak A.; Patel A.; Patino S.; Peter K.; Phan H.; Pinkham M.; Platt K.; Plumb P.; Poelker S.; Pratt T.; Pyzik E.; R.H. S.; Ramm T.; Reebals L.; Rehborg R.; Reid L.; Renno M.; Rentfrow M.; Riddle K.; Robertson M.; Rocco C.; Romeo S.; Rossman I.; Rybalsky I.; Saade D.N.; Sanchez L.; Saneto R.; Schaefer C.; Schwieterman J.; Shayesteh P.; Shih R.; Silver A.; Skalsky A.; Slovensky L.; Stechschulte M.; Stefans V.; Surampudi P.; Tan J.; Tiongson E.; Torres R.; Valle M.; Vanderwerf L.; Vogel L.; Waymire L.; Williams L.; Wilson A.; Winston D.; Yang M.; Yank I.; Zimmerman D.N.; Zygmunt A. Institution (McDonald, Henricson) Davis Health System, University of California, Sacramento, CA, United States (Villa, Tian) Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States (Soslow) Vanderbilt University Medical Center, Nashville, TN, United States (Maharry, Hogan, Binks, Berth, Elliott, Awadalla, Marban) Capricor Therapeutics, San Diego, CA, United States (Taylor) Division of Cardiology, Children's National Hospital, Washington, DC, United States (Hor) Nationwide Children's Hospital, Columbus, OH, United States (Signorovich) Analysis Group, Boston, MA, United States (Phan) Rare Disease Research, Atlanta, GA, United States (Apkon) Children's Hospital Colorado, CU Anschutz, Aurora, CO, United States (Ghosh) Boston Children's Hospital, Boston, MA, United States (Veerapandiyan) Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, United States (Ramos-Platt) Children's Hospital Los Angeles, Los Angeles, CA, United States (Gambetta) Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States (Bernes) Phoenix Children's Hospital, Phoenix, AZ, United States (Varadhachary) Department of Neurology, Washington University, St Louis, MO, United States (Iannaccone) UT Southwestern, Dallas, TX, United States (Laverty) Rady Children's Hospital, University of California San Diego, San Diego, CA, United States (Perlman) Seattle Children's Hospital, University of Washington, Seattle, WA, United States (Bass) Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States (Mosher) Akron Children's Hospital, Akron, OH, United States (Butterfield) Departments of Pediatrics and Neurology, University of Utah, Salt Lake City, UT, United States (Mathews) Carver College of Medicine, University of Iowa, Iowa City, IA, United States (Scharf) University of Virginia Children's Hospital, Charlottesville, VA, United States (Smith) Rare Disease Research North Carolina, Hillsborough, NC, United States (Emerson) University of Missouri School of Medicine, Columbia, MO, United States (Mercuri) Child Neurology Unit e Centro Nemo, IRCCS Fondazione Policlinico Gemelli, Universita Cattolica del Sacro Cuore, Rome, Italy (Marban) Smidt Heart Institute, Cedars-Sinai Health Sciences University, Los Angeles, CA, United States Publisher Elsevier B.V. Abstract Background Duchenne muscular dystrophy (DMD) is an X-linked genetic disease of skeletal and cardiac muscle that leads to loss of ambulation and premature death due to progressive myopathy and cardiomyopathy. Deramiocel, a heart-derived cellular therapy consisting of human allogeneic cardiosphere-derived cells, improved cardiac and skeletal muscle function in phase 1-2 studies of DMD. Our aim was to assess the efficacy and safety of deramiocel in advanced DMD and support the findings of HOPE-2. Methods HOPE-3, a phase 3, multicentre, randomised (1:1), double-blind, placebo-controlled study, included participants aged 10 years or older with DMD. Investigational product was infused intravenously every 3 months in outpatient settings. Skeletal and cardiac function was evaluated at 12 months. The primary endpoint was total Performance of the Upper Limb 2.0 (PUL2.0) percentage change from baseline. The trial is registered with ClinicalTrials.gov ( NCT05126758 ). Findings Between June 22, 2022, and May 28, 2024, 139 participants were screened, of whom 106 were randomly assigned to deramiocel (n=54) or placebo (n=52), and included in the intention-to-treat population. The primary endpoint showed significant improvements in the deramiocel group versus placebo. For total PUL2.0, least-squares mean percentage change at 12 months favoured deramiocel by 4.55% (95% CI 0.47-8.63; p=0.029). The safety profile of deramiocel was similar to that of placebo. Interpretation Deramiocel safely slows disease progression in advanced DMD, preserving skeletal muscle function. Administered quarterly in a simple outpatient regimen, deramiocel is a promising treatment for DMD, agnostic to the precise underlying genetic lesion. Funding Capricor Therapeutics. Copyright © 2026 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. <81> Accession Number 2048787221 Title Perioperative mechanical ventilation strategies in adult cardiac surgery with cardiopulmonary bypass: a meta-analysis of randomised controlled trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mariotti C.; Guarnieri M.; Lazzari S.; Losiggio R.; Suriano P.; Pedrazzini G.; Stoppe C.; Ke L.; Wang Z.; Zangrillo A.; Landoni G.; Belletti A.; Pontillo D.; D'Amico F.; Labanca R.; Fresilli S.; Bonizzoni M.A.; D'Andria Ursoleo J.; Bugo S.; Redaelli M.B.; Borello M.; Zaraca L.; Mongardini E.; Bruno S. Institution (Mariotti, Lazzari, Losiggio, Zangrillo, Landoni, Belletti) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Guarnieri, Suriano, Pedrazzini) Department of Anesthesia and Intensive Care, IRCCS Centro Cardiologico Monzino, Milan, Italy (Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Stoppe) Department of Cardiac Anaesthesiology and Intensive Care Medicine, Charite, Berlin, Germany (Ke) Department of Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China (Ke) National Institute of Healthcare Data Science, Nanjing University, Jiangsu, Nanjing, China (Wang) Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China (Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Pontillo, D'Amico, Labanca, Fresilli, Bonizzoni, D'Andria Ursoleo, Bugo, Borello, Zaraca, Mongardini, Bruno) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Redaelli) General and Neurosurgical Intensive Care Units, ASST Sette Laghi, Ospedale Di Circolo, Varese, Italy Publisher Elsevier Ltd Abstract Background: Pulmonary complications occur frequently after cardiac surgery. Various intraoperative and perioperative mechanical ventilation strategies were investigated to reduce postoperative lung injury. Evidence of their benefits remains inconclusive. Method(s): We performed a systematic review and meta-analysis of RCTs investigating ventilation strategies applied during the preoperative, intraoperative, or postoperative period of cardiac surgery requiring cardiopulmonary bypass. The primary outcome was all-cause mortality. Secondary outcomes included the rate of infections, postoperative pulmonary complications, and the duration of mechanical ventilation. Result(s): We identified 105 RCTs. We conducted a meta-analysis of the 39 studies suitable for quantitative synthesis. Postoperative pulmonary complications were reduced when using ventilation during cardiopulmonary bypass (risk ratio [RR]=0.87; 95% confidence interval [CI]=0.79 to 0.96; P=0.005; I2=0%, with 15 studies included). Mortality was 17/414 (4.1%) in patients receiving postoperative noninvasive respiratory support vs 24/377 (6.4%) in control group patients (RR=0.60; 95% CI=0.34 to 1.08; P=0.09; I2=0%, with five studies included). Pressure-controlled vs volume-controlled ventilation during surgery and adaptive support ventilation vs conventional ventilation in the postoperative period were not associated with improvements in primary or secondary outcomes. Conclusion(s): Ventilation strategies in cardiac surgery remain highly heterogeneous regarding protocols and timing. Ventilation during cardiopulmonary bypass significantly reduced postoperative pulmonary complications. Postoperative noninvasive respiratory support showed a non-significant trend toward improved survival and remains hypothesis-generating. Additional evidence is required to validate these results. Registration: PROSPERO registration number CRD420251057156. 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. <82> Accession Number 2011486117 Title European Resuscitation Council Guidelines 2021: Executive summary. Source Resuscitation. 161 (pp 1-60), 2021. Date of Publication: 01 Apr 2021. Author Perkins G.D.; Graesner J.-T.; Semeraro F.; Olasveengen T.; Soar J.; Lott C.; Van de Voorde P.; Madar J.; Zideman D.; Mentzelopoulos S.; Bossaert L.; Greif R.; Monsieurs K.; Svavarsdottir H.; Nolan J.P. Institution (Perkins, Nolan) Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Perkins) University Hospitals Birmingham, Birmingham, United Kingdom (Graesner) University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany (Semeraro) Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy (Olasveengen) Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway (Soar) Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom (Lott) Department of Anesthesiology, University Medical Center, Johannes Gutenberg-University Mainz, Germany (Van de Voorde) Department of Emergency Medicine, Faculty of Medicine Ghent University, Ghent, Belgium (Van de Voorde) EMS Dispatch Center, East-West Flanders, Federal Department of Health, Belgium (Madar) Department of Neonatology, University Hospitals Plymouth, Plymouth, United Kingdom (Zideman) Thames Valley Air Ambulance, Stokenchurch, United Kingdom (Mentzelopoulos) National and Kapodistrian University of Athens Medical School, Athens, Greece (Bossaert) University of Antwerp, Antwerp, Belgium (Greif) Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland (Greif) School of Medicine, Sigmund Freud University Vienna, Vienna, Austria (Monsieurs) Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Belgium (Svavarsdottir) Akureyri Hospital, Akureyri, Iceland (Svavarsdottir) University of Akureyri, Akureyri, Iceland (Nolan) Royal United Hospital, Bath, United Kingdom Publisher Elsevier Ireland Ltd Abstract Informed by a series of systematic reviews, scoping reviews and evidence updates from the International Liaison Committee on Resuscitation, the 2021 European Resuscitation Council Guidelines present the most up to date evidence-based guidelines for the practice of resuscitation across Europe. The guidelines cover the epidemiology of cardiac arrest; the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, first aid, neonatal life support, paediatric life support, ethics and education. Copyright © 2021 <83> Accession Number 2048819950 Title The Effect of Slow Deep Breathing Relaxation Exercise on Pain and Anxiety Levels During and Post-Chest Tube Removal After CABG. Source Critical Care Nursing Quarterly. 49(4) (pp 392-409), 2026. Date of Publication: 01 Dec 2026. Author Abu Sabiha A.L.; Salameh B.; Alkubati S.A.; Salameh Y. Institution (Abu Sabiha) Men's Surgical Ward, Rafidia Hospital, Palestinian Ministry of Health, Nablus, Palestine (Salameh) Faculty of Nursing, Arab American University, Jenin, Palestine (Alkubati) Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia (Salameh) Faculty of Medicine, Medical Intern, Ain Shams University Hospitals, Ain Shams University, Cairo, Egypt Publisher Wolters Kluwer Health Abstract Chest tube removal after coronary artery bypass graft is frequently reported by patients as stressful and painful, highlighting the need for effective nonpharmacological interventions. Slow deep breathing relaxation exercises (SDBREs) may serve as a simple nursing strategy to reduce discomfort. In this study, we aimed to evaluate the effect of SDBRE on pain and anxiety during and after chest tube removal following coronary artery bypass grafting in Nablus hospitals. An experimental design was used with 80 patients recruited from 2 hospitals. Participants were randomly assigned to either an intervention group (n = 40) that practiced SDBRE or a control group (n = 40) that received standard care. Data were collected through a self-administered questionnaire, the Numeric Pain Scale, and the Visual Anxiety Scale. Data collection occurred from March to October 2024. The intervention group reported significantly lower pain scores during removal (M: 5.325 vs 7.125, P <.001) and after removal (P <.001). Anxiety scores were significantly lower both during and after removal (P <.001). Pain correlated with duration, with more complex operations and prolonged chest tube insertion linked to higher scores. SDBRE significantly reduced pain and anxiety during and after chest tube removal, supporting its integration into routine postoperative nursing care. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <84> Accession Number 2048766799 Title Intraoperative corticosteroid administration and postoperative pulmonary complications: a secondary analysis of the iPROVE clinical trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Zorrilla-Vaca A.; Zapata-Pena D.A.; Allen M.B.; Linares M.; Sanahuja P.; Librero J.; Ferrando C. Institution (Zorrilla-Vaca, Zapata-Pena, Allen) Department of Anesthesiology, Mass General Brigham, Brigham and Women's Hospital, Boston, MA, United States (Linares, Sanahuja, Ferrando) Red de Investigacion en Servicios de Salud, Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain (Librero) Department of Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona, Spain (Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain (Ferrando) CIBER de Enfermedades Respiratorias CIBERES, Instituto de Salud Carlos III, Madrid, Spain Publisher Elsevier Ltd Abstract Background: This study aimed to explore the effect of intraoperative corticosteroid administration at antiemetic doses on postoperative pulmonary complications in adult patients undergoing major surgery. Method(s): We designed a post hoc analysis of two clinical trials conducted across 30 hospitals that included adult patients undergoing major abdominal or thoracic surgeries. Patients who received intraoperative corticosteroids were identified and balanced with those who did not receive corticosteroids using inverse probability of treatment weighting based on preoperative confounders. The primary outcome was a composite of postoperative pulmonary complications within 30 days after surgery. Generalised mixed-effects models with random intercepts at each hospital were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Result(s): A total of 1963 patients were included. Before weighting for potential confounders, the incidence of severe postoperative pulmonary complications was lower in those who received corticosteroids than those who did not (9.3% [107/1142] vs 14.0% [113/821], P=0.002). After weighting, intraoperative corticosteroids were not associated with a significant reduction in the incidence of postoperative pulmonary complications (OR 0.86, 95% CI 0.62-1.18, P=0.347), but there was a modest improvement in partial pressure of oxygen in arterial blood-to-fraction of inspired oxygen ratios in the PACU in those who received intraoperative corticosteroids compared with those who did not (adjusted mean difference 19.9 mm Hg, 95% CI 0.64-39.1, corrected P=0.043). Conclusion(s): Corticosteroid administration at antiemetic doses in adult patients having major abdominal or thoracic surgery was not associated with a lower incidence of postoperative pulmonary complications. Postoperative pulmonary gas exchange marginally improved in patients receiving intraoperative corticosteroids. Clinical trial registration: NCT03182062 and NCT02798133. 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. <85> Accession Number 2049042316 Title Continuous wound infiltration with local anesthetics in adult patients undergoing cardiac surgery: a PRISMA-compliant systematic review and meta-analysis. Source Chinese Medical Sciences Journal. 41(2) (pp 89-99), 2026. Date of Publication: 01 Jun 2026. Author Yao Y.-T.; More A.; Chao M.; Huang S. Institution (Yao, Huang) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Yao, Huang) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Yao, More, Chao) Center of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Yao, More, Chao) Outcomes Research Consortium, Houston, TX, United States Publisher KeAi Communications Co. Abstract Background: Effective postoperative analgesia is critical to recovery after cardiac surgery. Continuous wound infiltration (CWI) with local anesthetics (LAs) has been proposed as an opioid-sparing adjunct, but its efficacy beyond pain control and its safety profile remain incompletely defined. Method(s): We conducted a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials (RCTs) comparing CWI with control in adult cardiac surgery. PubMed, Embase, and Cochrane CENTRAL were searched from inception to August 30, 2025, and updated on April 2, 2026. Primary outcomes were postoperative Visual Analogue Scale (VAS) pain scores and cumulative morphine consumption. Secondary outcomes included mechanical ventilation duration, length of stay, mortality, complications, patient satisfaction, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Result(s): Twelve RCTs involving 2,117 patients were included. CWI significantly reduced VAS during mobilization at 24 h (MD=-0.93, 95% confidence interval [CI]: -1.53--0.33, P = 0.002) and 48 h (MD=-0.80, 95% CI: -1.17--0.44, P < 0.001), and decreased 48-hour morphine consumption (MD=-8.10 mg, 95% CI: -13.41--2.79, P = 0.003). No significant effects were observed on VAS at rest, mechanical ventilation duration, ICU or hospital length of stay, mortality, or major cardiovascular, pulmonary, renal, gastrointestinal complications, or postoperative infections. Patient satisfaction was higher with CWI. Technical complications were uncommon, and no clinically significant LA toxicity was reported. Conclusion(s): In adult cardiac surgery, CWI with LAs modestly improves analgesia during mobilization and reduces opioid requirements without clear improvement in major clinical outcomes or length of stay. CWI appears safe and feasible and may serve as an adjunct in multimodal, opioid-sparing analgesia strategies. Further adequately powered trials are warranted to define its comparative effectiveness within contemporary enhanced recovery after surgery (ERAS) pathways. Copyright © 2026 The Authors. Publishing Services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/ <86> Accession Number 652128345 Title Safety and Glycemic Efficacy of Perioperative Liraglutide in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in review. (no pagination), 2026. Date of Publication: 04 Sep 2026. Author Gamal I.; Elkasaby M.H.; Ewidat O.; Riyad N.; Sadin Z.; Singh Gill A.; Nassar M.; Frishman W.H.; Aronow W.S. Institution (Gamal, Elkasaby) From the Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Ewidat, Riyad) Department of Medicine, An-Najah National University, Nablus, Palestine (Sadin) Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Singh Gill) Department of Medicine, Division of Endocrinology, Champlain Valley Physicians Hospital, Plattsburgh, NY, United States (Nassar) Department of Medicine, Division of Endocrinology and Diabetes, Larner College of Medicine, University of Vermont, Burlington, VT, United States (Frishman, Aronow) Departments of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Abstract Perioperative hyperglycemia in cardiac surgery is associated with wound infection, acute kidney injury, and death, yet the intravenous insulin used to treat it is itself coupled to hypoglycemia. Glucagon-like peptide-1 receptor agonists lower glucose only when glucose is elevated and might therefore separate glycemic control from hypoglycemic risk. We searched PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL through September 2025 for randomized controlled trials of perioperative subcutaneous liraglutide versus placebo or insulin-based usual care in adults undergoing cardiac surgery. Two reviewers screened, extracted data, and applied the Cochrane Risk of Bias 2 tool independently; certainty was graded using GRADE. Effects were pooled by inverse variance, fixed-effect when I2 was below 50%. Seven reports of 4 trials, enrolling 446 randomized patients, were eligible. Liraglutide did not alter 30-day mortality (1/161 vs 3/160; risk ratio [RR] 0.42, 95% confidence interval [CI], 0.06-2.81), the composite of any postoperative complication (68/129 vs 76/132; RR 0.92; 95% CI, 0.74-1.14), cardiac adverse events (RR 1.08; 95% CI, 0.83-1.40), hypoglycemia (8/165 vs 9/166; RR 0.85; 95% CI, 0.34-2.13), or postoperative nausea and vomiting (RR 3.01; 95% CI, 0.26-35.27). Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <87> Accession Number 2048984783 Title Timing Matters: Differential Effects of Preoperative Carbohydrate Loading on Perioperative Inflammatory and Metabolic Responses in CABG Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 37), 2026. Date of Publication: 01 Sep 2026. Author Savluk O.F.; Yilmaz A.A.; Corbacioglu S.; Tomrukcu F. Institution (Savluk, Yilmaz, Corbacioglu, Tomrukcu) Kartal Kosuyolu High Education And Training Hospital, Turkey Publisher W.B. Saunders Abstract Introduction: Preoperative carbohydrate (CHO) loading is a central component of Enhanced Recovery After Surgery (ERAS) pathways and is widely used to attenuate perioperative insulin resistance. However, whether the timing of CHO administration differentially modulates the inflammatory response in cardiac surgery remains unknown. In cardiopulmonary bypass-associated surgery, where perioperative inflammation is markedly amplified, the biologic impact of CHO timing may be clinically important. No prospective randomized study has directly compared multiple perioperative CHO timing strategies in elective CABG patients. We therefore evaluated whether distinct CHO timing regimens differentially influence perioperative inflammatory and metabolic biomarker kinetics. Method(s): In this prospective randomized study, 55 elective CABG patients were assigned to four perioperative fasting/CHO-loading strategies: * Group 1 (Sequential, n=15): 800 mL CHO at 8h + 400 mL at 2h preoperatively * Group 2 (Early, n=10): 800 mL CHO at 8h preoperatively * Group 3 (Late, n=20): 400 mL CHO at 2h preoperatively * Group 4 (Control, n=10): Standard overnight fasting Serum levels of IL-6, IL-8, TNF-alpha, and insulin were measured at baseline (T0), ICU arrival (T1), and 24 hours postoperatively (T2). Baseline demographic and clinical characteristics were comparable across groups (all p>0.05). Data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Friedman tests. Result(s): Perioperative inflammatory responses differed significantly according to CHO timing strategy. At ICU admission (T1), IL-6 levels demonstrated marked inter-group differences (H=13.96, p=0.003). Peak IL-6 concentrations were nearly twofold higher in the Sequential (121 [77-199] pg/mL) and Late-loading groups (110.5 [87-210] pg/mL) compared with Early loading (63.3 [51-83] pg/mL) and Control patients (60.2 [49-80] pg/mL). Post-hoc analysis confirmed significant pairwise differences between Groups 1 & 3 versus Groups 2 & 4 (p<0.01). Sequential loading generated the strongest pre-incision insulin response at T0 (23.3 [5.8-51.7] microIU/mL vs. 2.8-6.3 microIU/mL in other groups, p=0.007), indicating superior metabolic priming before surgical stress exposure. At 24 h postoperatively (T2), TNF-alpha levels were highest in the Early-loading group (12.0 [9.8-12.7] pg/mL, p=0.045), suggesting a delayed inflammatory shift despite favorable early IL-6 kinetics. IL-8 showed a parallel non-significant trend toward higher perioperative levels in late-loading groups (p=0.059). All biomarkers demonstrated significant within-group temporal changes (Friedman p<0.05). No aspiration, pulmonary, or metabolic complications occurred. Discussion(s): Preoperative carbohydrate loading exerts significant timing-dependent immunometabolic effects in elective CABG surgery. Early-only loading was associated with a more favorable immediate postoperative inflammatory profile, while sequential loading, despite superior metabolic priming, paradoxically amplified the early IL-6 surge. These findings challenge the uniform application of CHO loading in ERAS protocols for cardiac surgery and support the need for timing-optimized, individualized strategies. Copyright © 2026 <88> Accession Number 2048897728 Title Targeting inflammation to prevent conduction injuries following TAVI: A systematic review and meta-analysis of glucocorticoid therapy. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Suruagy-Motta R.F.O.; Calheiros C.D.O.S.; Silva J.A.; Borges M.C.M.; Freitas D.E.S.; Vieira L.L.P.; Aguiar-Barros A.B.P.; Firmino M.M.R.; de Moraes S.R.R.; Filho A.A.M.R.; Dall'Orto C.; Fernandes J.R.C.; Cervone A.C.; Filho E.M.; Stone G.W. Institution (Suruagy-Motta, Calheiros, Silva, Borges, Freitas, Vieira, Aguiar-Barros, Firmino, de Moraes) Cesmac University Center, AL, Maceio, Brazil (Filho, Cervone) Dante Pazzanese Institute of Cardiology, SP, Sao Paulo, Brazil (Dall'Orto) Advanced Hemodynamic Therapy Center, Brazilian Society of Health Support Hospital, Bahia, Teixeira de Freitas, Brazil (Fernandes) Heart Institute, University of Sao Paulo, SP, Sao Paulo, Brazil (Filho) Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Elsevier Inc. Abstract Introduction Cardiac conduction disturbances are common after transcatheter aortic valve implantation (TAVI) and frequently require permanent pacemaker implantation (PPI), associated with worse outcomes. Glucocorticoids have been proposed to reduce conduction injury by limiting inflammation and edema. Aims To assess whether peri-procedural glucocorticoid therapy reduces conduction complications compared to standard care in TAVI patients. Methods Systematic review and meta-analysis following Cochrane Handbook and PRISMA 2020 guidelines. PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library were searched through 2026. Randomized controlled trials and observational studies evaluating peri-procedural glucocorticoids in adults undergoing TAVI were included. Random-effects models estimated pooled risk ratios (RRs) with 95% confidence intervals (CIs). Results Nine studies (8841 patients) were analyzed. Glucocorticoid therapy did not reduce pacemaker implantation (RR 0.91, 95% CI 0.73-1.14), new-onset left bundle branch block (RR 0.94, 95% CI 0.71-1.24), or acute kidney injury (RR 1.10, 95% CI 0.69-1.74). Mortality did not differ between groups (RR 0.94, 95% CI 0.61-1.45). Conversely, glucocorticoids were associated with increased bleeding (RR 1.39, 95% CI 1.01-1.90) and vascular complications (RR 1.86, 95% CI 1.36-2.55). Conclusion Peri-procedural glucocorticoid therapy does not reduce conduction-related complications following TAVI and is associated with increased bleeding and vascular complications. These findings suggest caution regarding routine glucocorticoid use in contemporary TAVI practice. Copyright © 2026 Elsevier Inc. <89> Accession Number 2048228800 Title Cost-effectiveness analysis of total intravenous vs. inhalation anaesthesia among adults aged >= 50 y undergoing major non-cardiac surgery. Source Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Frempong S.; Kandiyali R.; Mason J.; Hiller L.; Dunn J.; Booth K.; Moonesinghe R.; Pearse R.; Shelley B.; Jhanji S.; Yeung J. Institution (Frempong, Kandiyali, Mason) Centre of Health Economics, University of Warwick, Coventry, United Kingdom (Hiller, Dunn, Booth, Yeung) Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Moonesinghe) Department of Targeted Intervention, University College London, London, United Kingdom (Pearse) Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom (Shelley) School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom (Jhanji) Department of Anaesthesia, Perioperative Medicine and Critical Care, Royal Marsden NHS Foundation Trust, London, United Kingdom (Jhanji) Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Introduction: Total intravenous and inhalational anaesthesia are used widely to maintain general anaesthesia for major non-cardiac surgery, yet their comparative cost-effectiveness remains uncertain. The VITAL trial evaluated clinical outcomes, showing no difference in days alive and at home at 30 days. We conducted an economic evaluation alongside VITAL to determine whether total intravenous anaesthesia offers an economic advantage within the UK NHS. Method(s): A within-trial economic evaluation was conducted from the NHS and personal social services perspective over a 6-month time horizon. Resource use was collected from trial records and questionnaires, and health-related quality of life was measured using EuroQol five-dimension five-level instrument at baseline, discharge, 30 days and 6 months. Costs were evaluated using national sources and quality-adjusted life years were calculated using the area under the curve approach. Incremental cost-effectiveness ratios were estimated using imputed datasets, with uncertainty explored through bootstrapping and the probability of cost-effectiveness illustrated using a cost-effectiveness acceptability curve across a range of willingness-to-pay thresholds. Result(s): A total of 2507 patients were allocated randomly: 1253 (50%) received total intravenous anaesthesia; and 1254 (50%) inhalational anaesthesia. Mean costs and quality-adjusted life years were similar across groups. Incremental cost was -145 (95%CI -1510-1220) and incremental quality-adjusted life years -0.001 (95%CI -0.008-0.005). Total intravenous anaesthesia showed a 56-57% probability of cost-effectiveness at standard willingness-to-pay thresholds. Sensitivity analyses, including complete-case and societal-perspective models, yielded consistent findings of equivalence. Discussion(s): Total intravenous and inhalational anaesthesia show comparable cost-effectiveness for adults aged >= 50 y undergoing major non-cardiac surgery. Given clinical equipoise and equivalent economic outcomes, anaesthetic choice should continue to be guided by patient factors, clinician expertise and organisational context. Further research may be justified given the large population undergoing major surgery. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <90> Accession Number 652131303 Title Early and Late TAVI Outcomes in Aortic Stenosis with Transthyretin Cardiac Amyloidosis: A Systematic Review. Source European journal of heart failure. (no pagination), 2026. Date of Publication: 03 Sep 2026. Author Giusti M.; Malvindi P.G.; Benedetti M.; Vagnarelli F.; Lofiego C.; Capodaglio I.; Patani F.; Marini M.; Sinagra G.; Nitsche C.; Porcari A.; Di Eusanio M. Institution (Giusti, Malvindi, Di Eusanio) Cardiac Surgery Unit, Azienda Ospedaliero Universitaria delle Marche, Universita Politecnica delle Marche, Ancona, Italy (Benedetti, Vagnarelli, Lofiego, Capodaglio, Patani, Marini) Cardiology Unit, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy (Sinagra, Porcari) Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy (Sinagra, Porcari) European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, Trieste, Italy (Nitsche) Department of Cardiology, Internal Medicine II, Medical University of Vienna, Vienna, Austria Abstract Concomitant transthyretin cardiac amyloidosis (ATTR-CA) is increasingly recognized among elderly patients with severe aortic stenosis (AS) referred to transcatheter aortic valve implantation (TAVI), yet its impact on early and late outcomes remains incompletely defined. We conducted a systematic review of studies comparing TAVI outcomes in patients with isolated AS and those with AS+ATTR-CA. Eleven observational studies were included, comprising 644,107 patients with isolated AS and 1,637 with AS+ATTR-CA. AS+ATTR-CA patients were older, more frequently male, and showed more atrial fibrillation, mildly reduced left ventricular ejection fraction, and markedly elevated cardiac biomarkers. Thirty-day mortality was low and similar between groups, with no consistent differences in stroke or major bleeding, whereas acute kidney injury and permanent pacemaker implantation were more frequent in AS+ATTR-CA. During follow-up, AS+ATTR-CA patients experienced higher heart failure readmissions and late all-cause mortality. ATTR-CA should not preclude TAVI but should inform risk stratification, peri-procedural management, and post-TAVI follow-up. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <91> Accession Number 2048881879 Title Hospital costs and procedural learning curves of robotic mitral valve surgery: a systematic review and meta-analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 933. Date of Publication: 01 Dec 2026. Author Nguyen D.; Le M.H.N.; Taha A.M.; Rutledge-Jukes H.; Thuan P.Q.; Tran T.; Le P.T.V.; Le T.T.B.; Dinh N.H.; Huynh P.K.; Sun L.Y.; Kpodonu J. Institution (Nguyen) Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States (Nguyen) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Le) Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States (Taha, Huynh) PASSIO Laboratory, North Carolina A & T State University, Greensboro, NC, United States (Rutledge-Jukes) Washington University School of Medicine, Saint Louis, MO, United States (Thuan, Dinh) Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam (Tran) John T. Milliken Department of Medicine, Washington University School of Medicine, Saint Louis, MO, United States (Le) Ascension Saint Joseph Hospital Chicago, Chicago, IL, United States (Le) Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States (Sun) Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, United States (Kpodonu) Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Publisher Springer Nature Abstract Robotic-assisted mitral valve surgery offers a less invasive alternative to traditional open sternotomy, with potential benefits including faster recovery and reduced morbidity. However, the higher upfront expenses have slowed its broader acceptance. This study aimed to synthesize existing evidence comparing robotic and conventional mitral valve procedures regarding overall hospital expenses, intraoperative and post-procedure costs, as well as learning trajectory parameters including aortic cross-clamp and cardiopulmonary bypass durations. A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted up to May 2026 to identify studies reporting cost or learning curve outcomes. A random-effects model with restricted maximum likelihood estimation was used in R software for all pooled analyses. Seventeen studies met inclusion criteria. Total hospital costs from five studies (91,541 participants) showed no significant difference between approaches (MD + 1,620 USD; p = 0.423) with high heterogeneity (I2 = 99.3%). Leave-one-out analysis excluding one large US database study demonstrated significantly lower total costs for robotic surgery (p < 0.001) with no heterogeneity. Robotic procedures had higher intraoperative costs (MD + 2,144 USD; p < 0.001) but lower postoperative costs (MD -556 USD; p < 0.001). The learning phase trended toward longer cross-clamp and bypass times versus proficiency, with no differences between proficiency and mastery phases. Robotic mitral surgery demonstrated no significant difference in total hospital costs compared with conventional approaches in the primary analysis, with higher intraoperative costs offset by lower postoperative expenses. However, substantial heterogeneity and limited learning curve evidence prevent definitive conclusions. Future studies should adopt standardized economic and learning curve methodologies. Copyright © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2026. <92> Accession Number 2048984668 Title Hypotension Early Warning Tool in Cardiac Surgical Patients - A Cohort Study. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 13-14), 2026. Date of Publication: 01 Sep 2026. Author Watson N.; Panda M.A.; Amna A.; Isted A.; Arora N.; Kunst P.G.; Milne B. Institution (Watson, Amna, Isted, Arora, Kunst, Milne) King's College Hospital NHS Foundation Trust, London, United Kingdom (Panda, Kunst) King's College London, London, United Kingdom Publisher W.B. Saunders Abstract Introduction: Intraoperative hypotension is associated with adverse postoperative outcomes, including end-organ injury, acute kidney injury, stroke, and increased mortality, with risk related to both the severity and duration of hypotension.1 The Hypotension Prediction Index (HPI) is a machine-learning algorithm that uses arterial waveform analysis to predict the likelihood of hypotension, defined as MAP <65 mmHg, within the following 15 minutes. However, a recent systematic review and meta-analysis identified substantial heterogeneity between studies and a lack of reliable data on clinical significance, supporting the need for further investigation.2 Methods: We assessed HPI as part of a quality improvement project in 90 all-comer patients undergoing cardiac surgery at a tertiary referral centre, from induction of general anaesthesia until the start of cardiopulmonary bypass (CPB). The first cohort received blinded HPI monitoring without an early warning system (control group, n=45), while the second cohort received unblinded HPI monitoring with an early warning system (HPI group, n=45). The primary outcome was the time-weighted average (TWA) of hypotension below MAP 65 mmHg, and secondary outcomes included TWA below MAP 55 mmHg, percentage of time with MAP <65 and <55 mmHg, and critical care and hospital length of stay. Result(s): Data from 82 patients was included: 43 in the control group and 39 in the HPI group. Mean age was 67.2 +/- 9.6 years in the control group and 64.7 +/- 11.4 years in the HPI group. The duration from induction to CPB was 100.0 +/- 27.8 minutes in the control group and 105.2 +/- 26.3 minutes in the HPI group (mean + SD). TWA MAP <65 mmHg was significantly lower in the HPI group than in the control group: 0.57 [0.16-1.61] vs 1.35 [0.74-2.95] mmHg, respectively; p=0.003. Time spent below MAP 65 mmHg was also significantly reduced: 10.3% [3.6 - 23.0] in the HPI group vs 24.8% [13.1-39.7] in the control group; p=0.001, (median, [IQR]). There was a trend towards lower TWA MAP <55 mmHg in the HPI group: 0.03 [0.00-0.21] vs 0.11 [0.02-0.43] mmHg; p=0.055. Time spent below MAP 55 mmHg was significantly reduced from 3.1% [0.0-10.3] in the control group to 0.0% [0.0-4.4] in the HPI group; p=0.027, (median, [IQR]). There were no significant differences in ICU or hospital length of stay. Conclusion(s): This prospective cohort study suggests that HPI-guided haemodynamic management may reduce intraoperative hypotension below MAP thresholds of 65 and 55 mmHg in all-comer patients undergoing cardiac surgery. Further studies are needed to determine whether this reduction translates into improved clinical outcomes. Copyright © 2026 <93> Accession Number 2049133685 Title Comparing coronary angiography, intravascular ultrasound, and optical coherence tomography for percutaneous coronary intervention: A network meta-analysis. Source Radiography. 32(7) (no pagination), 2026. Article Number: 103565. Date of Publication: 01 Oct 2026. Author Saeed S.; Ali M.A.; Osama M.; Khan A.; Waseem M.H.; Alam U.; Ali S.; Hudaib M.; Shoaib A.; Abideen Z.U.; Khan S.; Siddique M.; Rehman M.E.U. Institution (Saeed, Khan, Rehman) Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan (Ali, Alam) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Osama) Department of Medicine, Hayatabad Medical Complex, Peshawar, Pakistan (Waseem) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Ali) Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan (Hudaib) Department of Medicine, Fazaia Ruth Pfau Medical College, Karachi, Pakistan (Shoaib) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Abideen) Department of Medicine, King Edward Medical University, Lahore, Pakistan (Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan (Siddique) Department of Medicine, Saidu group of teaching Hospital, Swat, Pakistan Publisher W.B. Saunders Ltd Abstract Introduction: Percutaneous coronary intervention (PCI) is widely used for coronary revascularization, with invasive coronary angiography (ICA) remaining the conventional method for guiding stent implantation. However, ICA provides only a two-dimensional luminal assessment and may underestimate vessel size, lesion morphology, stent under expansion, malapposition, and edge complications. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) provide detailed intravascular assessment and may improve PCI optimization. Method(s): This systematic review and network meta-analysis of randomized controlled trials compared ICA-guided, IVUS-guided, and OCT-guided PCI. PubMed, Embase, and Cochrane Library were searched, with an updated search to April 10, 2026. Binary outcomes were analyzed using random-effects frequentist and Bayesian network meta-analysis. ICA-guided PCI was the reference treatment. Treatment ranking was assessed using SUCRA, and inconsistency was evaluated using node-splitting. Result(s): Thirty-three randomized trials including 25,315 participants were included. Compared with ICA-guided PCI, IVUS-guided PCI reduced target lesion revascularization, target vessel revascularization, major adverse cardiovascular events, and stent thrombosis. OCT-guided PCI reduced target lesion revascularization, all-cause death, cardiac death, target vessel myocardial infarction, and stent thrombosis compared with ICA. Myocardial infarction was directionally lower with both IVUS and OCT, although estimates were not statistically definitive. No clear difference was observed between IVUS and OCT for major clinical outcomes. Node-splitting analyses showed no significant inconsistency across treatment comparisons. Conclusion(s): Intravascular imaging-guided PCI was associated with improved outcomes compared with ICA-guided PCI. IVUS showed the most consistent benefit for repeat revascularization and major adverse cardiovascular events, whereas OCT ranked favorably for several safety outcomes. Current randomized evidence does not establish superiority of OCT over IVUS. Implications for practice: Intravascular imaging should be considered to optimize PCI, particularly in anatomically complex or high-risk coronary interventions. Copyright © 2026 The College of Radiographers <94> Accession Number 2048879258 Title Outcomes of single versus double Perclose suture device use after transfemoral transcatheter procedures using large-bore arterial access: A meta-analysis and systematic review. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Thakurathi P.; Lee J.; Nana M.G.; Thapa S.; Kshetri R.; Kim A.S.; McKay R.G.; Dahal K. Institution (Thakurathi, Thapa) Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States (Lee, Kim, Dahal) Division of Cardiology, University of Connecticut Health Center, Farmington, CT, United States (Nana) Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States (Kshetri) Division of Cardiology, MercyOne North Iowa Medical Center, Mason City, IA, United States (McKay) Division of Cardiology, Hartford Hospital, Hartford, CT, United States Publisher Elsevier Inc. Abstract Background In large-bore transfemoral procedures such as transcatheter aortic valve replacement and endovascular aneurysm repair, the comparative effectiveness of single (SP) versus the default double Perclose (DP) strategies for arterial closure remains uncertain. Methods We performed a systematic literature search in PubMed, Scopus, Web of Science, and the Cochrane Library from January 2014 to April 2026 to identify studies comparing SP and DP devices for large-bore transfemoral arterial access closure. Outcomes included device/technical success, need for unplanned surgical or catheter-based intervention, 30-day mortality, any vascular complication, major bleeding, arterial dissection, and arterial stenosis. Random-effects meta-analysis using inverse-variance weighting was performed, and heterogeneity was assessed using the I2 statistic. Results We identified 14 studies published or available between 2015 and 2026, comprising 6487 patients before matching or adjustment (SP 3518; DP 2969). Post-matching adjusted cohorts comprised 5077 patients (SP 2691; DP 2386). Comparing SP with DP, device/technical success was similar (RR 1.02, 95% CI 1.00-1.03; P = 0.07), as was the need for unplanned surgical/catheter intervention (RR 0.77, 95% CI 0.54-1.09; P = 0.14). There were no significant differences in overall vascular complications (RR 0.78, 95% CI 0.59-1.04; P = 0.09), major bleeding (RR 0.83, 95% CI 0.51-1.36; P = 0.46), arterial stenosis (RR 0.81, 95% CI 0.55-1.20; P = 0.30), or 30-day mortality (RR 0.99, 95% CI 0.65-1.50; P = 0.96). However, SP was associated with a lower risk of arterial dissection (RR 0.32, 95% CI 0.15-0.70; P = 0.004). Conclusion In large-bore transfemoral transcatheter procedures, a single Perclose strategy was associated with a lower risk of arterial dissection compared to double Perclose and no significant difference for other major outcomes and complications. Copyright © 2026 Elsevier Inc. <95> Accession Number 2048893255 Title Association of Prior Balloon Atrial Septostomy with Mortality and Perioperative Outcomes in Neonates with D-Transposition of the Great Arteries Undergoing Arterial Switch Operation: A Systematic Review and Meta-analysis. Source Pediatric Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Ahmed M.A.M.; Jonani B.; Bongomin F.; Mohamed A.A.; Hussein A.M.; Kassim M.M. Institution (Ahmed) Department of Pediatrics, Faculty of Medicine, Mogadishu University, P.O.Box. 004, Mogadishu, Somalia (Ahmed, Mohamed, Hussein, Kassim) Department of Pediatric and Congenital Cardiology, Mogadishu Heart Center, Mogadishu, Somalia (Jonani) Department of Clinical Laboratories, Sebbi Hospital, P.O. Box 101601, Wakiso District, Kampala, Uganda (Bongomin) Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda Publisher Springer Abstract The role of balloon atrial septostomy (BAS) in the contemporary management of neonates with dextra-transposition of the great arteries (d-TGA) undergoing arterial switch operation (ASO) remains controversial, with marked inter-institutional practice variation and conflicting outcome data. We evaluated the association between prior BAS and mortality, length of stay, pre-operative intubation rate, and neurological outcomes in neonates with d-TGA undergoing ASO, with pre-specified subgroup analyses stratified by TGA anatomical subtype. We conducted a systematic review and meta-analysis of studies reporting outcomes in neonates with d-TGA undergoing ASO with and without prior BAS. Databases were searched from inception to 2024. Risk of bias was assessed using ROBIN-I. Random-effects meta-analyses were performed for mortality, length of stay, and pre-operative intubation rate. Studies reporting only adjusted effect estimates without counts data were described narratively. The protocol was registered in PROSPERO (CRD420251041501). Twenty-eight studies (1983-2024) were included. Six contributed to mortality analysis (n=1151; 43 deaths). The pooled odds ratio (OR) for mortality was 0.73 (95% CI 0.40-1.34, I2 = 0%). In TGA-IVS (4 studies, n = 443), OR was 0.89 (95% CI 0.30-2.65; I2 = 0%). in mixed TGA (2 studies, n=708), OR was 0.66 (95% CI 0.27-1.62, I2 = 34%), with no significant subgroup difference. Sensitivity analysis showed similar results. Overall length of stay did not differ significantly, though TGA-IVS neonates showed moderately longer pre-operative stay. Pre-operative intubation was more frequent with BAS (OR 8.96, 95% CI 3.69-21.71). Prospective MRI studies showed no clear association with pre-operative brain injury. Prior BAS was not associated with reduced mortality in neonates with d-TGA undergoing ASO. Higher intubation rates likely reflect illness severity rather than harm. This evidence does not exclude benefit in selected high-risk neonates but remains insufficient to confirm it. Copyright © The Author(s) 2026. <96> Accession Number 652128271 Title Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data and GRADE Assessment. Source Cardiology in review. (no pagination), 2026. Date of Publication: 04 Sep 2026. Author Yassin M.N.; Elfeqi K.; Abdelmaksoud A.; Hanna F.; El-Helbawy A.; Elkasaby M.H.; Mohsen A.; Frishman W.H.; Aronow W.S. Institution (Yassin, Elfeqi, Hanna) From the Department of Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt (Abdelmaksoud) Department of Internal Medicine, University of California, Riverside, CA, United States (El-Helbawy) Department of Medicine, Faculty of Medicine, Capital University (formerly Helwan University), Cairo, Egypt (Elkasaby) Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Mohsen) Department of Medicine, Division of Cardiology, Loma Linda University, Loma Linda, CA, United States (Frishman, Aronow) Departments of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Abstract Coronary artery disease coexists in approximately 50% of transcatheter aortic valve implantation candidates, yet the role of percutaneous coronary intervention (PCI) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing PCI with conservative management or deferral in transcatheter aortic valve implantation candidates with coronary artery disease. We searched 4 databases from inception to June 19, 2026. Odds ratios (ORs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Individual patient data were reconstructed from published Kaplan-Meier curves. Risk of bias and certainty of evidence were assessed. Three randomized controlled trials (n = 1156 patients) were included. PCI showed no significant reductions in all-cause death (OR 0.88; 95% confidence interval [CI], 0.62-1.25; I2 = 0%), cardiovascular death (OR 0.72; 95% CI, 0.40-1.29; I2 = 0%), or myocardial infarction (OR 0.85; 95% CI, 0.17-4.18; I2 = 51.8%). Stroke was significantly reduced with PCI (OR 0.68; 95% CI, 0.48-0.95; I2 = 0%). PCI was associated with a trend toward increased any bleeding (OR 2.26; 95% CI, 0.81-6.29; I2 = 69.8%) and major bleeding (OR 1.70; 95% CI, 0.63-4.60; I2 = 35.9%). Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <97> Accession Number 2048984143 Title Inflammatory and immune-mediated mechanisms in Early Graft Dysfunction after heart transplantation: a systematic review of pathways and biomarkers. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 55-56), 2026. Date of Publication: 01 Sep 2026. Author Giorgi A.; Siragusa A.; Cognini C.; Aresta F.; Meani P.; Mondino M.G. Institution (Giorgi, Siragusa, Cognini, Aresta, Meani, Mondino) Grande Ospedale Metropolitano Niguarda, Milan, Italy Publisher W.B. Saunders Abstract Introduction: Early graft dysfunction (EGD), previously referred to as primary graft dysfunction, remains a major early complication after heart transplantation and is associated with adverse short- and long-term outcomes. Despite evolving definitions, substantial uncertainty remains regarding both the definition and biological mechanisms of EGD. This systematic review aimed to summarize the available evidence on inflammatory and immune-related mechanisms and candidate biomarkers associated with EGD after heart transplantation. Method(s): This systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Embase, and Web of Science were searched from November 2025 to March 2026 to identify studies evaluating inflammatory or immune-mediated mechanisms and biomarkers associated with EGD after heart transplantation. Study characteristics, demographic variables, and transplant-related data were systematically recorded. Data on inflammatory and immune-mediated pathways, together with candidate biomarkers, were extracted. Result(s): Overall, 360 records were identified, and 17 studies were included in the qualitative synthesis after duplicate removal and screening. The included studies were characterized by relatively small sample sizes, with only two studies enrolling more than 100 patients. Only some studies specifically reported the incidence of severe PGD, which ranged from 9.5% to 40.7%. Overall, the included studies suggested a significant association between dysregulated inflammatory responses and the development of PGD following heart transplantation: numerous donor-, recipient-, and procedure-related risk factors contribute to the development of graft dysfunction. The main driver of this phenomenon is ischaemia-reperfusion injury (IRI) and the subsequent activation of the inflammatory response by both the innate and adaptive immune system. The present review outlined specific key mechanisms with associated biomarkers that could be implemented into PGD diagnosis and treatment algorithms: kallikrein-kinin system (KKS), cytokine release, apoptosis pathways, hypoxia-inducible factor-1 (HIF-1), vascular endothelial growth factor A (VEGF-A), sarcoplasmic/endoplasmic reticulum calcium ATPase 2a (SERCA2a), growth differentiation factor-15 (GDF-15), C-type lectin domain family 4 member C (CLEC4C) and extracellular vesicles (EVs). Conclusion(s): This review highlights the central role of inflammatory pathways in PGD pathogenesis and underscores the urgent need for simple, rapid, and cost-effective biomarkers. The development of such tools may substantially enhance donor-recipient matching, enable earlier identification of high-risk patients, and ultimately improve both short- and long-term transplant outcomes. Ultimately, multicentre prospective studies are essential to standardise diagnostic criteria, validate emerging biomarkers, and translate mechanistic insights into clinically applicable strategies for personalised heart transplantation. Copyright © 2026 <98> Accession Number 2049041794 Title Mechanisms, outcomes, and management of heart failure-associated dysphagia: a scoping review - revised marked. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102930. Date of Publication: 01 Nov 2026. Author Velasco J.-L.P.; Cazares S.; Luo K.; Wung S.-F. Institution (Velasco) Alumna, The University of Arizona, College of Nursing, 1305 N. Martin Avenue, Tucson, AZ, United States (Velasco) Nurse Practitioner, Small Valley Healthcare Partners, 4743 N. 1st Avenue, Tucson, AZ, United States (Cazares) Nurse Navigator, Banner University Medical Center Tucson, 3838 N. Campbell Avenue, Tucson, AZ, United States (Luo) Alumna, University of Washington, College of Nutritional Sciences, 1901 Chelan Lane, Seattle, WA, United States (Wung) University of California Davis Betty Irene Moore School of Nursing, 2570 48th St., Sacramento, CA, United States Publisher Elsevier Inc. Abstract Background: More than 20% of patients with heart failure (HF) experience dysphagia, or difficulty swallowing. Although a previous review identified several risk factors and highlighted the bidirectional relationship between dysphagia and sarcopenia, it focused primarily on older hospitalized adults, leaving important knowledge gaps across the broader HF population. Method(s): A scoping review was conducted using four electronic databases: PubMed, CINAHL, Embase, and Google Scholar, to identify studies involving adult patients with HF and dysphagia. No restrictions were placed on publication date, study duration, or geographical region. Result(s): Thirty-six articles met the inclusion criteria. Key mechanisms of HF-associated dysphagia (HFAD) included cardiomegaly-induced esophageal compression, esophageal dysmotility, and stricture formation. HFAD was associated with adverse outcomes, including dehydration, malnutrition, aspiration, prolonged hospitalization, non-home discharge, and mortality. Reported risk factors included advanced age, systemic inflammation, poor nutritional status, reduced functional independence, female sex, polypharmacy, prolonged hospitalization, dementia, prior cardiac surgeries, and valvular heart disease. Clinical presentations ranged from sudden to gradual onset and included dysphagia, globus sensation, and hoarseness. Reported management strategies included nutritional support, swallowing rehabilitation, HF optimization, pharmacologic therapy, procedural interventions, and follow-up monitoring. Conclusion(s): HFAD appears to be a common yet underrecognized comorbidity among individuals with HF and is associated with substantial adverse outcomes. Although early recognition and multidisciplinary management may be beneficial, evidence regarding optimal screening and treatment approaches remain limited. Further research is needed to establish standardized definitions, diagnostic criteria, screening approaches, and management pathways. Copyright © 2026 Elsevier Inc. <99> Accession Number 2048881440 Title Robotic-assisted versus video-assisted thoracoscopic anatomical lung resection for early-stage non-small cell lung cancer: a systematic review and meta-analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 938. Date of Publication: 01 Dec 2026. Author Johow Reichert M.; Urnia N.; Jofre A.; Sanhueza L.; Ortega J.I.; Mordojovich G. Institution (Johow Reichert, Sanhueza) Department of Surgery, Hospital Padre Hurtado, Santiago, Chile (Urnia) Department of Surgery, Hospital Clinico San Borja Arriaran, Santiago, Chile (Urnia) Faculty of Medicine, Universidad de Chile, Santiago, Chile (Jofre) Hospital San Juan de Dios de Teno, Teno, Chile (Ortega, Mordojovich) Department of Surgery, Thoracic Surgery Unit, Clinica Alemana de Santiago, Santiago, Chile (Ortega) Faculty of Medicine, Clinica Alemana de Santiago-Universidad del Desarrollo, Santiago, Chile Publisher Springer Nature Abstract Non-small cell lung cancer (NSCLC) represents 80-85% of lung cancer cases. Anatomical resection remains the cornerstone treatment for early-stage disease. Video-assisted (VATS) and robotic-assisted (RATS) thoracic surgery are alternatives to thoracotomy, though RATS's advantages over VATS remain controversial. We conducted this systematic review and meta-analysis to compare their perioperative and oncologic outcomes for anatomical resection in early-stage NSCLC. We searched PubMed, Cochrane Library, CINAHL, Web of Science, ClinicalTrials.gov, LILACS, and Google Scholar from October 8, 2025, updated June 15, 2026, for studies comparing RATS and VATS in adults with early-stage (up to IIA) NSCLC undergoing anatomical resection. Non-anatomical resections, hybrid techniques, and neoadjuvant therapy were excluded. Risk of bias was assessed with the Newcastle-Ottawa Scale and Cochrane RoB 2.0. Pooled estimates (odds ratios [OR] or mean differences [MD], 95% CI) were generated in Review Manager; certainty was graded using GRADE. Registered with PROSPERO (CRD420251229273). Twenty-eight studies (3 randomized, 25 observational; 68,349 participants) were included. Survival endpoints could not be pooled due to heterogeneity. RATS showed fewer conversions to thoracotomy (OR 0.54; 95% CI 0.50-0.58), shorter hospital stay (MD -0.33 days; -0.61 to -0.06), and greater lymph node retrieval (MD 0.82; 95% CI 0.35-1.30), with no differences in perioperative outcomes. Heterogeneity was substantial and largely unexplained. Oncologic endpoints could not be quantitatively compared. Perioperative advantages favoring RATS were modest, heterogeneous, and of low-to-very-low certainty. Adequately powered randomized trials are needed. No external funding was received. Copyright © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2026. <100> Accession Number 652129823 Title Contemporary Management of Failed Tricuspid Valve Prosthesis. Source Current cardiology reviews. (no pagination), 2026. Date of Publication: 21 Aug 2026. Author Allaham H.; Chahal D.; Srivastava M.; Aalaei-Andabili S.H.; Gupta A.; Brown J. Institution (Allaham, Chahal, Srivastava, Aalaei-Andabili, Gupta) Division of Cardiovascular Medicine, Department of Medicine, University of Maryland Medical Center, Baltimore, MD, United States (Brown) Division of Cardiac Surgery, Department of General Surgery, University of Maryland Medical Center, Baltimore, MD, United States Abstract Failure of tricuspid valve prostheses is an increasingly encountered and complex clinical problem. Patients often present with advanced comorbidities, progressive right ventricular dysfunction, and prohibitive surgical risk. Despite growing burden, high-quality evidence and clear guideline-directed strategies remain limited. This narrative review summarizes contemporary approaches to the management of failed tricuspid valve prostheses, which include traditional redosurgical re-intervention, minimal invasive and beating-heart surgical techniques, and transcatheter valve-in-valve and valve-in-ring implantation, as well as emerging therapies for failed transcatheter tricuspid devices. Redo tricuspid valve surgery has historically carried substantial perioperative risk, although outcomes have improved at experienced centers, particularly with less invasive surgical approaches. Transcatheter valve-in-valve and valve-in-ring procedures demonstrate a high procedural success rate and favorable early outcomes in selected patient profiles with failed bioprosthetic valves or annuloplasty rings. However, durability beyond short to mid-term remains uncertain, especially in younger individuals. Given the heterogeneity of the prosthesis types and patients' profiles, the management should be individualized. A multidisciplinary Heart Team approach that integrates surgical risk, right ventricular function, prosthesis characteristics, and anatomic considerations is essential to optimize outcomes in this high-risk patient population. Given the limited and heterogeneous nature of currently available evidence, this review was designed as a clinically focused narrative review rather than a formal systematic review or meta-analysis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. <101> Accession Number 2048984756 Title Use of Superficial Parasternal Intercostal Plane Block as Part of Enhanced Recovery In Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 40), 2026. Date of Publication: 01 Sep 2026. Author George N.; Das A.; Mattam K.; Rethnamma R.K.; Joy A.; Ajithakumaran D.; Reddy H. Institution (George, Das, Rethnamma, Joy, Ajithakumaran, Reddy) Dr K M Cherian Hospital, India (Mattam) Sheffield Teaching Hospitals, Sheffield, United Kingdom Publisher W.B. Saunders Abstract Introduction: Enhanced Recovery After Cardiac Surgery requires a multimodal approach. Perioperative and post operative pain relief forms a major component in Enhanced Recovery After Cardiac Surgery. Method(s): Sixty patients for CABG at a Rural Cardiac Centre in India between November 2025 and March 2026 were enrolled as part of study after informed consent and institution ethic committee approval. Two groups A and B were formed. In Group A after Induction of General Anesthesia Bilateral Superficial Parasternal Intercostal Plane Block (S-PIP) with Levo bupivacaine 0.25% 40 mls. was administered under ultrasound guidance. Group B were not administered any Fascial plane block and was administered normal doses of opioids during induction. PRST Score and Entropy Score was used to assess response to pain from incision for both groups along with regular monitoring used for cardiac surgery. If PRST score was found to be more than 3 and entropy score was found to be more than 60,additional doses of opioid for analgesia was administered. Result(s): Group A patients consistently had a lower PRST Score during skin incision showing minimal response to surgical stimulation. as compared to patients in group B. All Group A patients required lesser doses of opioid analgesia and leading to faster extubation and reduced postoperative ventilation duration as compared to Group B patients Discussion: Adding Superficial Intercostal Plane Block as part of multimodal analgesia using Levo bupivacaine helped in significantly lower the doses of opioid requirement during cardiac surgery. Superficial plane block was used as concerns was raised about inadvertent injury to Left Internal Mammary artery during Deep Intercostal Plane block. Levo Bupivacaine was used for its cardiac safety profile and longer duration of action. All patients who received Superficial Parasternal Intercostal Plane Block had reduced pain response during surgery and experienced significant pain relief in the post operative period leading to reduced opioid requirement. This helped in early extubation and early mobilization of post cardiac surgery patients. Superficial Parasternal Intercostal Plane Block can be used during cardiac surgery safely as it reduces opioid requirement and postoperative ventilation .It aids in Early recovery after cardiac surgery. It can be added to Cardiac Enhanced Recovery Bundle of Care. Copyright © 2026 <102> Accession Number 652109314 Title Atrial fibrillation in coronary artery bypass patients: what should be offered. Source Current opinion in cardiology. (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Eqbal A.; Belley-Cote E.; Whitlock R. Institution (Eqbal, Whitlock) Division of Cardiac Surgery, Department of Surgery (Belley-Cote) Division of Cardiology, Department of Medicine, McMaster University (Belley-Cote, Whitlock) Population Health Research Institute, Hamilton, ON, Canada Abstract PURPOSE OF REVIEW: Of patients undergoing coronary artery bypass grafting (CABG), 10-20% have preexisting atrial fibrillation (AF), which remains undertreated at the time of surgery. With rapidly evolving data, interest and enthusiasm for concomitant surgical management of AF have grown concurrently. This review summarizes the contemporary evidence, techniques, and approaches for surgical management of AF in patients undergoing CABG and proposes tailored operative strategies for these patients at the time of surgery. RECENT FINDINGS: Concomitant surgical management of AF at the time of CABG is underutilized, with only 30-40% of eligible patients receiving concomitant AF treatment. Surgeons can offer a spectrum of options to concurrently treat AF, from left atrial appendage occlusion (LAAO) to a full biatrial Cox-maze iteration without significant additional perioperative risk. Contemporary large-scale observational analyses suggest concomitant surgical ablation improves rhythm outcomes and is associated with improved survival, and lower risk of stroke long-term. SUMMARY: Concomitant LAAO is essential. Ablation techniques can be tailored based on the patient's burden of AF, clinical complexity, and surgeon expertise. A robust randomized trial is needed to convince clinicians to expand adoption. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <103> Accession Number 2048830301 Title Association between frailty and postoperative delirium after transcatheter aortic valve replacement: a meta-analysis. Source Frontiers in Psychiatry. 17 (no pagination), 2026. Article Number: 1840158. Date of Publication: 21 May 2026. Author Liu Z.; Wu N.; Wu F.; Liu T.; Ren K. Institution (Liu, Wu, Wu, Liu) Department of Cardiovascular Surgery, Air Force 986 Hospital, Air Force Medical University, Xi'an, China (Ren) Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China Publisher Frontiers Media SA Abstract Background - Postoperative delirium (POD) is a common complication following transcatheter aortic valve replacement (TAVR) and is associated with adverse outcomes in older patients. Frailty, a multidimensional geriatric syndrome, has been increasingly recognized as a potential risk factor for POD. However, existing evidence remains inconsistent. This meta-analysis aimed to evaluate the association between frailty and POD after TAVR. Methods - A systematic search of PubMed, Embase, and Web of Science was conducted from inception to January 22, 2026. Cohort studies evaluating the association between preprocedural frailty and POD after TAVR were included. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for the influence of potential heterogeneity. Results - Ten cohort studies involving 7, 702 patients were included. Frailty was present in 2, 062 (26.8%) patients, and 786 (10.2%) developed POD. Pooled analysis showed that frailty was significantly associated with an increased risk of POD after TAVR (OR: 2.17, 95% CI: 1.60-2.95; I2 = 55%). The association was stronger in studies with sample size >= 500 compared with < 500 (OR: 2.74 vs. 1.38; p for subgroup difference < 0.001). The effect estimates were consistent across subgroups stratified by study design, age, sex, frailty assessment methods, follow-up duration, analytic models, and study quality (all p for subgroup difference > 0.05). Notably, studies using CAM-ICU to diagnose POD showed a stronger association than those using DSM criteria or other methods (OR: 3.60 vs. 1.56 and 2.53; p = 0.006). Meta-regression identified sample size as a significant source of heterogeneity (p = 0.02). Conclusions - Frailty is associated with an increased risk of POD after TAVR. These findings highlight the importance of frailty assessment for perioperative risk stratification and support targeted strategies to prevent delirium in high-risk patients undergoing TAVR. Systematic review registration - https://www.crd.york.ac.uk/prospero/, identifier CRD420261352173. Copyright © 2026 Liu, Wu, Wu, Liu and Ren. <104> Accession Number 652114579 Title Hospital costs and procedural learning curves of robotic mitral valve surgery: a systematic review and meta-analysis. Source Journal of robotic surgery. 20(1) (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Nguyen D.; Le M.H.N.; Taha A.M.; Rutledge-Jukes H.; Thuan P.Q.; Tran T.; Le P.T.V.; Le T.T.B.; Dinh N.H.; Huynh P.K.; Sun L.Y.; Kpodonu J. Institution (Nguyen) Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States (Nguyen) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Le) Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States (Taha, Huynh) PASSIO Laboratory, North Carolina A&T State University, Greensboro, NC, United States (Rutledge-Jukes) Washington University School of Medicine, Saint Louis, MO, USA (Thuan, Dinh) Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam (Tran) John T. Milliken Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA (Le) Ascension Saint Joseph Hospital Chicago, Chicago, IL, United States (Le) Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States (Sun) Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, United States (Kpodonu) Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Abstract Robotic-assisted mitral valve surgery offers a less invasive alternative to traditional open sternotomy, with potential benefits including faster recovery and reduced morbidity. However, the higher upfront expenses have slowed its broader acceptance. This study aimed to synthesize existing evidence comparing robotic and conventional mitral valve procedures regarding overall hospital expenses, intraoperative and post-procedure costs, as well as learning trajectory parameters including aortic cross-clamp and cardiopulmonary bypass durations. A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted up to May 2026 to identify studies reporting cost or learning curve outcomes. A random-effects model with restricted maximum likelihood estimation was used in R software for all pooled analyses. Seventeen studies met inclusion criteria. Total hospital costs from five studies (91,541 participants) showed no significant difference between approaches (MD + 1,620 USD; p = 0.423) with high heterogeneity (I2 = 99.3%). Leave-one-out analysis excluding one large US database study demonstrated significantly lower total costs for robotic surgery (p < 0.001) with no heterogeneity. Robotic procedures had higher intraoperative costs (MD + 2,144 USD; p < 0.001) but lower postoperative costs (MD -556 USD; p < 0.001). The learning phase trended toward longer cross-clamp and bypass times versus proficiency, with no differences between proficiency and mastery phases. Robotic mitral surgery demonstrated no significant difference in total hospital costs compared with conventional approaches in the primary analysis, with higher intraoperative costs offset by lower postoperative expenses. However, substantial heterogeneity and limited learning curve evidence prevent definitive conclusions. Future studies should adopt standardized economic and learning curve methodologies. Copyright © 2026. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature. <105> Accession Number 652112588 Title Effect of cerebral embolic protection devices on TAVI outcomes: a network meta-analysis of randomized controlled trials. Source Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese. (no pagination), 2026. Date of Publication: 01 Sep 2026. Author Theodoropoulou T.; Vythoulkas-Biotis N.; Apostolos A.; Ktenopoulos N.; Drakopoulou M.; Synetos A.; Tsalamandris S.; Latsios G.; Tsioufis K.; Toutouzas K. Institution (Theodoropoulou, Ktenopoulos, Drakopoulou, Synetos, Tsalamandris, Latsios, Tsioufis, Toutouzas) Unit of Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece (Vythoulkas-Biotis) Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece (Apostolos) Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Unit of Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece <106> Accession Number 2048844328 Title Left Atrial Appendage Closure Versus Oral Anticoagulation in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Circulation: Arrhythmia and Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Rao A.; Ravi V.; Murthi M.; Chikatimalla R.; Talla V.; Nagaraj N.; Dhar G.; Jolly N.; Vij A. Institution (Rao) Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, United States (Ravi) Division of Electrophysiology, Heart and Vascular Institute, Saint Francis Health System, Tulsa, OK, United States (Murthi, Vij) Division of Cardiology, Cook County Health, Chicago, IL, United States (Chikatimalla) Department of Cardiology, University of Miami Miller School of Medicine, FL, United States (Talla) Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India (Nagaraj) Jagadguru Jayadeva Murugarajendra Medical College, Davanagere, India (Dhar, Jolly, Vij) Division of Cardiology, Rush University Medical Center, Chicago, IL, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation, but randomized controlled trials have primarily focused on composite end points, potentially obscuring differences in individual clinical outcomes. We compared the efficacy and safety of LAAC versus OAC with an emphasis on individual clinical outcomes. METHOD(S): - A systematic review and meta-analysis of randomized controlled trials comparing LAAC with OAC in adults with atrial fibrillation was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases were searched from January 2000 to March 2026. The primary efficacy end point was any stroke, and the primary safety end point was major bleeding. Risk ratios (RRs) with 95% CIs were pooled using a random-effects model. RESULT(S): - Six randomized controlled trials comprising 7004 patients (3681 LAAC; 3323 OAC) were included. LAAC was associated with a higher risk of ischemic stroke (RR, 1.41 [95% CI, 1.04-1.91]; P=0.03; 3.2% versus 2.1%), without a significant difference in any stroke (RR, 1.08 [95% CI, 0.82-1.42]; P=0.60) or the composite of stroke, systemic embolism, or death (RR, 0.99 [95% CI, 0.77-1.29]; P=0.96). Cardiovascular mortality (RR, 0.88; P=0.40) and all-cause mortality (RR, 0.92; P=0.36) were similar between groups. Major bleeding, including procedural events, did not differ significantly (RR, 0.93; P=0.40), although LAAC was associated with a significantly lower risk of nonprocedural major bleeding (RR, 0.57 [95% CI, 0.43-0.77]; P<0.01; 6.2% versus 10.7%). CONCLUSION(S): - In patients with atrial fibrillation, LAAC is associated with a higher risk of ischemic stroke, but lower risk of nonprocedural major bleeding compared with OAC, with no significant differences in composite thromboembolic outcomes or mortality, underscoring the importance of individualized risk-benefit assessment in stroke prevention strategies. Copyright © 2026 American Heart Association, Inc. <107> Accession Number 652114258 Title Association of Prior Balloon Atrial Septostomy with Mortality and Perioperative Outcomes in Neonates with D-Transposition of the Great Arteries Undergoing Arterial Switch Operation: A Systematic Review and Meta-analysis. Source Pediatric cardiology. (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Ahmed M.A.M.; Jonani B.; Bongomin F.; Mohamed A.A.; Hussein A.M.; Kassim M.M. Institution (Ahmed) Department of Pediatrics, Faculty of Medicine, Mogadishu University, P.O.Box. 004, Mogadishu, Somalia (Ahmed, Mohamed, Hussein, Kassim) Department of Pediatric and Congenital Cardiology, Mogadishu Heart Center, Mogadishu, Somalia (Jonani) Department of Clinical Laboratories, Sebbi Hospital, P.O. Box 101601, Kampala, Uganda (Bongomin) Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda Abstract The role of balloon atrial septostomy (BAS) in the contemporary management of neonates with dextra-transposition of the great arteries (d-TGA) undergoing arterial switch operation (ASO) remains controversial, with marked inter-institutional practice variation and conflicting outcome data. We evaluated the association between prior BAS and mortality, length of stay, pre-operative intubation rate, and neurological outcomes in neonates with d-TGA undergoing ASO, with pre-specified subgroup analyses stratified by TGA anatomical subtype. We conducted a systematic review and meta-analysis of studies reporting outcomes in neonates with d-TGA undergoing ASO with and without prior BAS. Databases were searched from inception to 2024. Risk of bias was assessed using ROBIN-I. Random-effects meta-analyses were performed for mortality, length of stay, and pre-operative intubation rate. Studies reporting only adjusted effect estimates without counts data were described narratively. The protocol was registered in PROSPERO (CRD420251041501). Twenty-eight studies (1983-2024) were included. Six contributed to mortality analysis (n=1151; 43 deaths). The pooled odds ratio (OR) for mortality was 0.73 (95% CI 0.40-1.34, I2 = 0%). In TGA-IVS (4 studies, n = 443), OR was 0.89 (95% CI 0.30-2.65; I2 = 0%). in mixed TGA (2 studies, n=708), OR was 0.66 (95% CI 0.27-1.62, I2 = 34%), with no significant subgroup difference. Sensitivity analysis showed similar results. Overall length of stay did not differ significantly, though TGA-IVS neonates showed moderately longer pre-operative stay. Pre-operative intubation was more frequent with BAS (OR 8.96, 95% CI 3.69-21.71). Prospective MRI studies showed no clear association with pre-operative brain injury. Prior BAS was not associated with reduced mortality in neonates with d-TGA undergoing ASO. Higher intubation rates likely reflect illness severity rather than harm. This evidence does not exclude benefit in selected high-risk neonates but remains insufficient to confirm it. Copyright © 2026. The Author(s). <108> Accession Number 652111627 Title Real-time vs. pre-procedural ultrasound guidance for lower thoracic epidural puncture: a randomised controlled trial. Source Anaesthesia. (no pagination), 2026. Date of Publication: 01 Sep 2026. Author Jotaki S.; Maesako N.; Murotani K.; Uchimura M.; Hiraki T. Institution (Jotaki, Maesako, Uchimura) Department of Anesthesiology, Omuta City Hospital, Omuta, Fukuoka, Japan (Jotaki, Maesako, Uchimura, Hiraki) Department of Anesthesiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan (Murotani) Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan Abstract INTRODUCTION: Ultrasound-guided neuraxial anaesthesia has gained increasing attention because it may improve procedural success and safety. Lower thoracic epidural anaesthesia provides effective postoperative analgesia and is used widely in patients undergoing abdominal surgery. However, studies evaluating lower thoracic epidural puncture remain limited, and whether real-time or pre-procedural ultrasound guidance provides superior technical performance remains unclear. Therefore, we aimed to compare real-time and pre-procedural ultrasound-guided techniques in achieving first-pass success in lower thoracic epidural puncture. METHOD(S): We enrolled patients scheduled to undergo abdominal surgery requiring thoracic epidural anaesthesia. Patients were allocated randomly to real-time or pre-procedural ultrasound groups. In both groups, a preliminary scan was performed to identify and mark the target intervertebral level before needle insertion. In patients allocated to the real-time group, continuous in-plane ultrasound guidance was maintained throughout needle advancement. The primary outcome was first-pass success rate. Secondary outcomes included procedure time; number of passes; and number of punctures. RESULT(S): In total, 64 patients were included in the final analysis. Patients allocated to the pre-procedural ultrasound group had a significantly lower first-pass success rate compared with the real-time ultrasound group (15/32 (47%) vs. 26/32 (81%), p = 0.008). In addition, fewer passes and punctures were required in patients allocated to the real-time group. Procedure time did not differ significantly between groups. DISCUSSION(S): Real-time ultrasound guidance significantly improved first-pass success compared with pre-procedural ultrasound guidance. These findings support the use of real-time ultrasound guidance to improve procedural success and technical performance during lower thoracic epidural puncture. Copyright © 2026 Association of Anaesthetists. <109> Accession Number 652120523 Title Long-Term Outcomes Following Bilateral vs Single Internal Thoracic Artery Grafts: A Secondary Analysis of a Randomized Clinical Trial. Source JAMA cardiology. (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Taggart D.P.; Gaudino M.; Gerry S.; Jasinski M.; Lees B.; Gray A.M.; Zamvar V.; Deja M.; Seevanayagam S.; de Moraes Neto F.R.; Konstanty-Kalandyk J.; Pawlaczyk R.; Sajja L.R.; Actis Dato G.; Guazzelli A.; Cook J.; Wallis C.; Benedetto U.; Puskas J.D.; Flather M. Institution (Taggart, Lees, Wallis) Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, NY, United States (Gerry) Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, United Kingdom (Jasinski) Department of Cardiac Surgery, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland (Jasinski) Department of Pediatric Cardiothoracic Surgery, Children Memorial Health Institute, Warsaw, Poland (Gray) Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (Zamvar) Department of Cardiac Surgery, Royal Infirmary of Edinburgh and University of Edinburgh, Edinburgh, United Kingdom (Deja) Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland (Deja) Department of Cardiac Surgery, Medical University of Bialystok, Bialystok, Poland (Seevanayagam) Department of Cardiac Surgery, Austin and Repatriation Medical Centre, Melbourne, VIC, Australia (de Moraes Neto) Department of Cardiac Surgery, Federal University of Pernambuco, Recife, Brazil (Konstanty-Kalandyk) Department of Cardiovascular Surgery and Transplantation, Jagiellonian University Medical College, Krakow, Poland (Pawlaczyk) Department of Cardiac Surgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland (Sajja) Division of Cardiothoracic Surgery, STAR Hospitals, Hyderabad, India (Actis Dato) Department of Cardiac Surgery, Mauriziano Hospital, Turin, Italy (Guazzelli, Cook) Surgical Intervention Trials Unit (SITU), Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (Benedetto) Division of Cardiac Surgery, University G.d'Annunzio Chieti-Pescara and SS Annunziata Hospital, Chieti, Italy (Puskas) Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia (Flather) Norwich Medical School, University of East Anglia and Norfolk and Norwich University Hospital, Norwich, United Kingdom Abstract Importance: Bilateral internal thoracic artery grafting has been proposed to improve survival compared to standard single internal thoracic artery grafting during coronary artery bypass graft (CABG) surgery, but any survival benefit may emerge only with longer-term follow-up. Objective(s): To report 15-year extended follow-up of a randomized clinical trial of bilateral vs single internal thoracic artery grafting for CABG. Design, Setting, and Participant(s): This is a secondary analysis of an unblinded randomized clinical trial that took place at 28 cardiac surgery centers in 7 countries between June 2004 and December 2007, with 15-year follow-up reported after 2025. Patients scheduled for CABG on clinical grounds were eligible. Those requiring only single grafts or concomitant valve surgery, as well as those with a history of previous CABG, were excluded. All 3102 patients in the original trial provided data for this analysis, while 3042 completed the full 15-year follow-up. Data were analyzed from January to March 2026. Intervention(s): If patients fulfilled all the eligibility criteria and provided written informed consent, they were randomly assigned to bilateral or single internal thoracic artery grafts with vein or radial artery grafts used in both groups as clinically indicated. Main Outcomes and Measures: All-cause mortality at 15 years. The composite of all-cause mortality, myocardial infarction, or stroke was a secondary outcome. Result(s): A total of 1548 patients were randomized to bilateral internal thoracic artery grafts and 1554 to single internal thoracic artery grafts. The mean (SD) age was 64 (9) years and 446 (15%) were female. In the bilateral graft group, 215 (14%) received only a single arterial graft, while in the single graft group, 359 (23%) also received a radial artery graft. At 15 years, vital status was known for 3039 patients (98%). There were 585 deaths (37.8%) in the bilateral graft group and 584 (37.6%) in the single graft group (hazard ratio [HR], 1.00; 95% CI, 0.89-1.12; P = .97). Secondary outcome event rates were 43.9% and 45.8%, respectively (HR, 0.94; 95% CI, 0.85-1.05). Conclusions and Relevance: There was no difference in all-cause mortality at 15 years between patients undergoing CABG who were randomized to bilateral vs single internal thoracic artery grafts in an intention-to-treat analysis. Given the high rate of potential postrandomization confounders (eg, crossovers and use of radial arteries), the multiple arterial graft hypothesis still needs to be tested in randomized clinical trials. Trial Registration: isrctn.org Identifier: ISRCTN46552265. <110> Accession Number 2048830293 Title Concomitant surgical ablation for atrial fibrillation in mitral valve surgery: a systematic review of clinical outcomes and surgical strategies. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1857413. Date of Publication: 13 Aug 2026. Author Nurbay Z.; Tuleutayev R.; Zhakayev M.; Dzhumabekov A.; Musrepov N. Institution (Nurbay, Musrepov) Department of Cardiac Surgery, SCE "City Cardiology Center", Almaty, Kazakhstan (Tuleutayev, Zhakayev) Department of Cardiac Surgery, JSC "Research Institute of Cardiology and Internal Diseases", Almaty, Kazakhstan (Dzhumabekov) Department of Clinical Work, Kazakh Medical University "KSPH", Almaty, Kazakhstan Publisher Frontiers Media SA Abstract Background - Atrial fibrillation frequently coexists with mitral valve disease and is associated with adverse clinical outcomes. Concomitant surgical ablation has emerged as an effective strategy to restore sinus rhythm during mitral valve surgery. Methods - A systematic review was conducted according to PRISMA guidelines. Electronic databases were searched for studies published between January 1991 and January 2026. Eligible studies included adult patients undergoing mitral valve surgery with concomitant surgical ablation. Due to heterogeneity, a qualitative synthesis was performed. Results - A total of 25 studies were included. Early evidence established the Cox-Maze III procedure as an effective approach with high rates of sinus rhythm restoration. Contemporary data demonstrate that the Cox-Maze IV procedure provides comparable efficacy with reduced technical complexity. Long-term follow-up showed sustained sinus rhythm in a substantial proportion of patients, with possible reductions in thromboembolic events and possible survival benefit reported in some observational studies. However, interpretation of these findings is limited by clinical and methodological heterogeneity. However, an increased risk of permanent pacemaker implantation remains a consistent finding. Procedural success is influenced by lesion set configuration, completeness of ablation, and surgical approach. Conclusions - Concomitant surgical ablation during mitral valve surgery is consistently associated with better rhythm outcomes, while evidence for harder clinical endpoints, including stroke and survival, remains less certain. Individualized surgical approaches remain essential to balance rhythm efficacy, procedural complexity, and the risk of permanent pacemaker implantation. Copyright © 2026 Nurbay, Tuleutayev, Zhakayev, Dzhumabekov and Musrepov. <111> Accession Number 652115617 Title Outcomes of single versus double Perclose suture device use after transfemoral transcatheter procedures using large-bore arterial access: A meta-analysis and systematic review. Source Cardiovascular revascularization medicine : including molecular interventions. (no pagination), 2026. Date of Publication: 21 Aug 2026. Author Thakurathi P.; Lee J.; Nana M.G.; Thapa S.; Kshetri R.; Kim A.S.; McKay R.G.; Dahal K. Institution (Thakurathi, Thapa) Department of Medicine, Dartmouth Hitchcock Medical Center, NH, United States (Lee, Kim, Dahal) Division of Cardiology, University of Connecticut Health Center, Farmington, CT, United States (Nana) Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States (Kshetri) Division of Cardiology, MercyOne North Iowa Medical Center, Mason City, IA, United States (McKay) Division of Cardiology, Hartford Hospital, Hartford, CT, United States Abstract BACKGROUND: In large-bore transfemoral procedures such as transcatheter aortic valve replacement and endovascular aneurysm repair, the comparative effectiveness of single (SP) versus the default double Perclose (DP) strategies for arterial closure remains uncertain. METHOD(S): We performed a systematic literature search in PubMed, Scopus, Web of Science, and the Cochrane Library from January 2014 to April 2026 to identify studies comparing SP and DP devices for large-bore transfemoral arterial access closure. Outcomes included device/technical success, need for unplanned surgical or catheter-based intervention, 30-day mortality, any vascular complication, major bleeding, arterial dissection, and arterial stenosis. Random-effects meta-analysis using inverse-variance weighting was performed, and heterogeneity was assessed using the I2 statistic. RESULT(S): We identified 14 studies published or available between 2015 and 2026, comprising 6487 patients before matching or adjustment (SP 3518; DP 2969). Post-matching adjusted cohorts comprised 5077 patients (SP 2691; DP 2386). Comparing SP with DP, device/technical success was similar (RR 1.02, 95% CI 1.00-1.03; P = 0.07), as was the need for unplanned surgical/catheter intervention (RR 0.77, 95% CI 0.54-1.09; P = 0.14). There were no significant differences in overall vascular complications (RR 0.78, 95% CI 0.59-1.04; P = 0.09), major bleeding (RR 0.83, 95% CI 0.51-1.36; P = 0.46), arterial stenosis (RR 0.81, 95% CI 0.55-1.20; P = 0.30), or 30-day mortality (RR 0.99, 95% CI 0.65-1.50; P = 0.96). However, SP was associated with a lower risk of arterial dissection (RR 0.32, 95% CI 0.15-0.70; P = 0.004). CONCLUSION(S): In large-bore transfemoral transcatheter procedures, a single Perclose strategy was associated with a lower risk of arterial dissection compared to double Perclose and no significant difference for other major outcomes and complications. Copyright © 2026 Elsevier Inc. All rights reserved. <112> Accession Number 2048984648 Title Impact of Balanced Forced Diuresis on Urine Oxygen Tension during Cardiac Surgery - Interim Data from a Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 77), 2026. Date of Publication: 01 Sep 2026. Author Lundin E. Institution (Lundin) Sahlgrenska University hospital, Gothenburg, Sweden Publisher W.B. Saunders Abstract Introduction: Renal oxygenation is impaired during cardiac surgery and may contribute to postoperative acute kidney injury (AKI). Balanced forced diuresis with furosemide and 1:1 crystalloid replacement, i.e. RenalGuard Therapy (RG, CardioRenal Systems Inc., Milford, MA, USA) has been shown to reduce AKI. This study investigated the effect of RG on urine oxygen tension, a surrogate marker of renal medullary oxygenation. We hypothesized that RG would reduce renal oxygen consumption and improve medullary oxygenation. Method(s): In this investigator driven, single center, non-blinded randomized controlled pilot trial, adult patients undergoing elective cardiac surgery with normothermic cardiopulmonary bypass (CPB) were randomized to RG or standard care. Bladder urine oxygen tension was measured continuously using an optode inserted through the urinary catheter (Oxford Optronics, UK). After baseline recording, patients assigned to RG received 20 mg furosemide and were started on 1:1 urine output replacement with PlasmaLyte. Additional furosemide was administered if urine flow decreased below 200 mL/h. RG was discontinued 3 hours after CPB weaning; measurements ended 4 hours after CPB. Mean arterial pressure was maintained at 60-80 mmHg in both groups. Urine oxygen tension was averaged over 5-minute periods and change over time was assessed using a linear mixed model. Point group differences were evaluated with t-tests or chi2 tests. Result(s): This interim analysis included 20 of 30 planned patients (RG n=9, controls n=11). Surgical procedures included coronary bypass (5/20), aortic valve replacement (8/20), or combined surgery (7/20). Seven patients were women; mean age was 61+/-12 years; baseline creatinine was 71+/-11 micromol/L; CPB duration was 109+/-37 min. There were no significant baseline differences between groups. Urine oxygen tension decreased significantly during CPB compared with baseline (p<0.01) and gradually recovered after CPB. Mean urine oxygen tension was higher in the RG group at all time points except the final measurement (1 hour after RG cessation), though this difference was not statistically significant (time x group interaction p=0.177). See figure. Postoperative AKI occurred in 1/9 RG patients versus 4/11 controls (p=0.194). At 1 hour after CPB weaning, urine oxygen tension was lower in patients who later developed AKI (24+/-7 vs 36+/-11 mmHg, p=0.012). No device-related adverse events were observed. Conclusion(s): These preliminary data confirm that urine oxygen tension, reflecting renal medullary oxygenation, is reduced during cardiac surgery with CPB. Balanced forced diuresis may improve medullary oxygenation, but larger numbers are required to verify this effect. Urine oxygen tension measured 1 hour after CPB weaning may serve as an early indicator of postoperative AKI. Copyright © 2026 <113> Accession Number 2048930459 Title Pain management strategies following thoracic surgery: best practices and innovations. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 972. Date of Publication: 31 Aug 2026. Author Sylvester C.B.; Groth S.S. Institution (Sylvester, Groth) Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, Houston, TX, United States Publisher AME Publishing Company Abstract Pain after thoracic surgery can be among the most severe, complex, and difficult to manage of any procedure. Acute pain has somatic, visceral, and neuropathic components, and its severity is the strongest modifiable predictor of chronic post-surgical pain. Inadequate analgesia drives complications, delays recovery, and may progress to chronic post-surgical pain. This review synthesizes the pathophysiology of acute and chronic pain after thoracic surgery, examines the updated guideline recommendations for regional anesthesia, describes methods that can be used as part of a comprehensive pain control protocol after thoracic surgery, and points to promising future developments. Surgical approach is a powerful determinant of pain, and minimally invasive access reduces acute pain relative to open thoracotomy. Multimodal analgesia combining systemic agents with procedure-specific regional anesthesia remains the foundation of perioperative management, but guidelines strongly emphasize the use of regional anesthesia as an adjunct for pain control. Recent studies suggest that moving towards surgeon-administered blocks and implementation of developing technologies may improve the efficacy and decrease the resources needed for analgesia after thoracic surgery. Future priorities include trials with standardized outcomes, cost-effectiveness analyses, validation of newer therapies, and long-term follow-up. Overall, protocols for pain management after thoracic surgery should focus on an evidence-based, patient-centered framework for analgesia selection to optimize recovery and reduce the rate of complications. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <114> [Use Link to view the full text] Accession Number 2048791671 Title Effect of Remimazolam on Hemodynamic Stability in Patients Undergoing Cardiac Surgery: A Grade-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in Review. (no pagination), 2025. Date of Publication: 2025. Author Jamal A.; Khan S.; Qadri M.; Shah M.A.; Ahmed U.; Iftikhar H.; Uddin M.; Bacha Z.; Khalid A.A.; Khan A.; Afridi Z.; Fatima N.e.; Ullah A.; Javed J.; Khan H.; Mohmand M.S.; Khan F.Z.; Ulain Q. Institution (Jamal, Khan, Shah, Iftikhar, Uddin, Bacha, Afridi, Fatima, Ullah, Mohmand) From the Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Qadri, Ahmed, Javed) Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Khalid) Department of Medicine, Peshawar Medical College, Peshawar, Pakistan (Khan) Department of Medicine, Khyber Girls Medical College, Peshawar, Pakistan (Khan) Department of Medicine, Anwar Teaching Hospital Swat, Swat, Pakistan (Khan) Department of Medicine, Hayatabad Medical Complex, Peshawar, Pakistan (Ulain) Department of Medicine, Women Medical College, Abbottobad, Pakistan Publisher Lippincott Williams and Wilkins Abstract Hemodynamic instability during cardiac surgery, particularly procedures requiring cardiopulmonary bypass, increases the risk of mortality and adverse events. Conventional anesthetics such as propofol and etomidate have limitations in maintaining stability, prompting investigation of remimazolam, an ultra-short-acting benzodiazepine with a potentially favorable cardiovascular profile. This systematic review and meta-analysis evaluated the effects of remimazolam versus conventional anesthetics on hemodynamic stability, vasopressor use, extubation time, and recovery in cardiac surgery. Seven randomized controlled trials involving 557 patients were included following literature searches in PubMed, Scopus, and Cochrane Central Register of Controlled Trials. Data extraction and risk-of-bias assessment were conducted using the Cochrane RoB 2 tool, and certainty of evidence was graded with the Grading of Recommendations Assessment, Development, and Evaluation approach. Pooled analysis showed no significant differences in operative time (mean difference: 1.91 minutes, P = 0.53) or mean arterial pressure (mean difference: -0.90 mm Hg, P = 0.80). The risk of intraoperative hypotension was higher but not statistically significant with remimazolam (risk ratios: 1.25, P = 0.57); however, sensitivity analysis excluding one study demonstrated a significant 64% increase in hypotension risk (risk ratios: 1.64, P = 0.005), suggesting possible hemodynamic vulnerability. Remimazolam significantly shortened extubation time by 27.98 minutes (P = 0.04), while hospital stay, vasopressor use, and postoperative nausea and vomiting showed no significant differences. Overall, remimazolam did not significantly improve intraoperative hemodynamic stability compared with conventional anesthetics, but its main potential advantage may lie in enhancing recovery through faster extubation. The clinical importance of this finding remains uncertain, and remimazolam should not currently be regarded as superior for stability in cardiac anesthesia. Large, standardized randomized controlled trials are required to further define its safety and efficacy in cardiac surgery. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <115> Accession Number 652114728 Title Prehospital versus in-hospital unfractionated heparin in ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis. Source European journal of emergency medicine : official journal of the European Society for Emergency Medicine. (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Wu Y.-J.; Lin H.-J.; Lin Y.-H.; Hung C.-S. Institution (Wu) Department of Pharmacy (Lin, Lin, Hung) Division of Cardiology, Department of Internal Medicine and Cardiovascular Center (Hung) Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan (Republic of China) Abstract BACKGROUND AND IMPORTANCE: In patients with ST-segment elevation myocardial infarction (STEMI), myocardial loss continues until coronary reperfusion is achieved. OBJECTIVE(S): To evaluate whether prehospital administration of unfractionated heparin (UFH) improves preprocedural infarct-related artery patency and clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI). DESIGN: Systematic review and meta-analysis. Electronic databases (PubMed, EMBASE, CENTRAL, and Web of Science) and clinical trial registries were systematically searched through March 2026. SETTINGS AND PARTICIPANTS: Patients with STEMI scheduled for primary PCI across seven included studies (two randomized controlled trials and five observational studies), totaling 10 954 participants, with 78.1% male patients. INTERVENTION OR EXPOSURE: Prehospital UFH administration compared with PCI-capable hospital UFH administration. OUTCOME MEASURES AND ANALYSIS: Prespecified endpoints included pre- and postprocedural thrombolysis in myocardial infarction (TIMI) flow grade, 30-day mortality, a composite endpoint of 30-day or in-hospital mortality, and major bleeding events. MAIN RESULTS: Prehospital UFH was associated with a significantly higher rate of preprocedural TIMI 2-3 flow compared with control [odds ratio (OR): 1.49, 95% confidence interval (CI): 1.28-1.74; P < 0.001). Prehospital UFH was not associated with a significant reduction in 30-day all-cause mortality (OR: 0.70, 95% CI: 0.44-1.13; P = 0.141; I2 = 60.9%), although a significant reduction was observed for the composite endpoint of 30-day or in-hospital mortality across all seven studies (OR: 0.68, 95% CI: 0.49-0.95; P = 0.023). Prehospital UFH was not associated with a significantly increased risk of major bleeding (OR: 0.77, 95% CI: 0.57-1.05; P = 0.099; I2 = 0%). CONCLUSION(S): In patients with STEMI undergoing primary PCI, prehospital UFH was associated with improved preprocedural coronary patency without an apparent increase in major bleeding. However, no statistically significant reduction was observed in 30-day mortality. Large-scale randomized controlled trials adequately powered for clinical endpoints are needed to establish the role of prehospital UFH in contemporary STEMI care. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. <116> Accession Number 652114487 Title Robotic-assisted versus video-assisted thoracoscopic anatomical lung resection for early-stage non-small cell lung cancer: a systematic review and meta-analysis. Source Journal of robotic surgery. 20(1) (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Johow Reichert M.; Urnia N.; Jofre A.; Sanhueza L.; Ortega J.I.; Mordojovich G. Institution (Johow Reichert, Sanhueza) Department of Surgery, Hospital Padre Hurtado, Santiago, Chile (Urnia) Department of Surgery, Hospital Clinico San Borja Arriaran, Santiago, Chile (Urnia) Faculty of Medicine, Universidad de Chile, Santiago, Chile (Jofre) Hospital San Juan de Dios de Teno, Teno, Chile (Ortega, Mordojovich) Department of Surgery, Thoracic Surgery Unit, Clinica Alemana de Santiago, Santiago, Chile (Ortega) Faculty of Medicine, Clinica Alemana de Santiago-Universidad del Desarrollo, Santiago, Chile Abstract Non-small cell lung cancer (NSCLC) represents 80-85% of lung cancer cases. Anatomical resection remains the cornerstone treatment for early-stage disease. Video-assisted (VATS) and robotic-assisted (RATS) thoracic surgery are alternatives to thoracotomy, though RATS's advantages over VATS remain controversial. We conducted this systematic review and meta-analysis to compare their perioperative and oncologic outcomes for anatomical resection in early-stage NSCLC. We searched PubMed, Cochrane Library, CINAHL, Web of Science, ClinicalTrials.gov, LILACS, and Google Scholar from October 8, 2025, updated June 15, 2026, for studies comparing RATS and VATS in adults with early-stage (up to IIA) NSCLC undergoing anatomical resection. Non-anatomical resections, hybrid techniques, and neoadjuvant therapy were excluded. Risk of bias was assessed with the Newcastle-Ottawa Scale and Cochrane RoB 2.0. Pooled estimates (odds ratios [OR] or mean differences [MD], 95% CI) were generated in Review Manager; certainty was graded using GRADE. Registered with PROSPERO (CRD420251229273). Twenty-eight studies (3 randomized, 25 observational; 68,349 participants) were included. Survival endpoints could not be pooled due to heterogeneity. RATS showed fewer conversions to thoracotomy (OR 0.54; 95% CI 0.50-0.58), shorter hospital stay (MD -0.33 days; -0.61 to -0.06), and greater lymph node retrieval (MD 0.82; 95% CI 0.35-1.30), with no differences in perioperative outcomes. Heterogeneity was substantial and largely unexplained. Oncologic endpoints could not be quantitatively compared. Perioperative advantages favoring RATS were modest, heterogeneous, and of low-to-very-low certainty. Adequately powered randomized trials are needed. No external funding was received. Copyright © 2026. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature. <117> Accession Number 2048980694 Title Factor Concentrates for the Treatment of Acquired Coagulopathy in Patients With Left Ventricular Assist Devices: A Systematic Review. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Kojundzic I.; Lam A.; Holmes M.; Dvirnik N.; Janda A.; Petricevic M.; Englesakis M.; Karkouti K.; Bartoszko J. Institution (Kojundzic, Holmes, Karkouti, Bartoszko) Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada (Kojundzic, Lam) University of Ottawa, Ottawa, ON, Canada (Lam, Holmes, Karkouti, Bartoszko) University of Toronto, Toronto, ON, Canada (Holmes, Karkouti, Bartoszko) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Dvirnik) Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (Dvirnik) Division of Cardiothoracic Surgery, Department of Surgery, University Health Network, Toronto, ON, Canada (Janda) Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States (Petricevic) Department of Cardiac Surgery, University Hospital Center Split, Split, Croatia (Petricevic) University Department of Health Studies, University of Split, Split, Croatia (Englesakis) Library & Information Services, University Health Network, Toronto, ON, Canada Publisher W.B. Saunders Abstract Patients with left ventricular assist devices (LVADs) represent a high-risk population at risk of both bleeding and thrombotic complications. A review of the available literature on nonfibrinogen factor concentrate use in LVAD patients up to June 1, 2026, was conducted by searching MEDLINE, Embase, and clinical trial and review registries. A total of 2,355 studies were identified, and 14 retrospective studies were included. Seven studies used factors to treat bleeding during LVAD implant or exchange. In this context, 134 patients received prothrombin complex concentrate (PCC), 487 received usual management or frozen plasma, 82 received factor eight inhibitor bypassing activity (FEIBA), 78 received recombinant activated factor VII (rVIIa), and 5 received isolated factor IX complex/3F-PCC. Given the limited and heterogeneous evidence, this review provides a descriptive summary of eligible studies rather than a formal evidence synthesis. When used first-line and protocolized, PCC is likely safe and effective. rFVIIa appears effective, but higher doses are associated with thrombosis and mortality. Evidence for FEIBA is limited to one small nonrandomized study. Seven studies used factors for emergency anticoagulation reversal, with 139 individual PCC exposures, 47 frozen plasma exposures, and 3 rVIIa exposures. PCC was associated with more rapid International Normalized Ratio normalization, no excess harm, and, in one study, improved survival and progression to transplant. In this context, rFVIIa was associated with a dose-dependent risk of thrombosis. Overall, PCC-based hemostatic management in LVAD patients appears reasonable; however, it is not currently possible to judge the safety of low-dose rVIIa or FEIBA. Copyright © 2026 Elsevier Inc. <118> Accession Number 2048978607 Title Comparison of C-MAC Videolaryngoscope and Macintosh Laryngoscope for Ease of Double-Lumen Tube Insertion in Patients Undergoing Elective Thoracic Surgeries: A Prospective Randomized Controlled Study. Source International Journal of Pharmacy Research and Technology. 16(2) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Dhar S.; Uikey T.; Sawarkar J.; Dond S.; Jadhav S.U.; Mahatme S.; Tajne M. Institution (Dhar, Mahatme, Tajne) Department of Anaesthesia, Government Medical College, Maharashtra, Nagpur, India (Uikey, Sawarkar, Dond, Jadhav) Datta Meghe Institute of Higher Education and Research Centre, Maharashtra, Nagpur, India Publisher Advanced Scientific Research Abstract Background: Double-lumen tube placement is the gold standard for lung isolation during elective thoracic surgery but is technically more challenging than single-lumen intubation due to its larger size and rotational requirements. The C-MAC videolaryngoscope may improve glottic visualization and facilitate easier DLT (Double-Lumen Tube) insertion compared with the conventional Macintosh laryngoscope. Method(s): A prospective randomized controlled study was conducted among patients undergoing elective thoracic surgeries requiring DLT insertion. Participants were randomly allocated to either the C-MAC videolaryngoscope group or the Macintosh laryngoscope group. The primary outcomes included IDS (Intubation Difficulty Score), intubation time, first-pass success rate, and overall success rate. Secondary outcomes were hemodynamic responses (heart rate, systolic and diastolic blood pressure, and mean arterial pressure) and airway-related complications, including mucosal trauma, sore throat, and hoarseness. Result(s): The C-MAC videolaryngoscope demonstrated superior intubation performance compared with the Macintosh laryngoscope. First-pass success was significantly higher with C-MAC (93.8%) than with Macintosh (75.0%; p=0.039). Overall success was 100% with C-MAC compared with 93.8% with Macintosh. C-MAC was associated with lower intubation difficulty, shorter intubation time, improved glottic visualization, fewer intubation attempts, reduced need for optimization maneuvers, and fewer airway-related complications. Hemodynamic responses were also more favourable with C-MAC during DLT insertion. Conclusion(s): The C-MAC videolaryngoscope offers significant advantages over the conventional Macintosh laryngoscope for DLT insertion during elective thoracic surgery. Its higher first-pass success, reduced intubation difficulty, shorter intubation time, improved glottic visualization, and lower complication rates make it a reliable and effective device for thoracic airway management. Copyright (c) 2026 Authors This work is licensed under a Creative Commons Attribution 4.0 International License.https://creativecommons.org/licenses/by/4.0/. <119> Accession Number 2049048917 Title Association of Operative Timing with Clinical Outcomes and Safety in Thoracic Organ Transplantation: A Meta-Analytic Synthesis of Evidence. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102926. Date of Publication: 01 Nov 2026. Author Hussein A.M.; Hammadeh B.M.; Asassfeh A.; Yaghi G.; Alzoubi A.; Shabaneh A.; Al-Hayk A.; Rawashdeh B.; Rackauskas M.; Aladaileh M. Institution (Hussein, Hammadeh, Yaghi) Faculty of Medicine, Al- Balqa' Applied University, Salt, Jordan (Asassfeh, Rawashdeh) Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States (Alzoubi) Division of Thoracic Surgery, Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, AZ, United States (Shabaneh) Department of General Surgery, University of Missouri - Kansas City, Kansas City, MO, United States (Al-Hayk) Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States (Rackauskas, Aladaileh) Division of Thoracic Surgery, Department of Surgery, University of Florida, Gainesville, FL, United States Publisher Elsevier Inc. Abstract Background: Thoracic organ transplantation is often performed at night because of donor availability and the need to minimize cold ischemia time. Whether operative timing is independently associated with short- and long-term outcomes after heart and lung transplantation remains uncertain. Method(s): We conducted a PRISMA-guided systematic review and meta-analysis with PROSPERO registration. PubMed, Scopus, the Cochrane Library, and Web of Science were searched through November 2025 for studies comparing daytime versus nighttime heart or lung transplantation. Primary outcomes included short-term mortality (in-hospital, 30-day, and 90-day) and mid-to-long-term survival (1, 3, and 5 years). Secondary outcomes included major postoperative complications and resource utilization. Pooled risk ratios or mean differences were estimated, with prespecified subgroup and sensitivity analyses. Result(s): Eight studies were included. Definitions of daytime and nighttime varied considerably across cohorts. Daytime transplantation was associated with a lower incidence of in-hospital mortality (RR, 0.89; 95% CI, 0.82 to 0.97; P = 0.029). However, no statistically significant differences were observed in 30-day, 90-day, or 1-, 3-, and 5-year mortality. Secondary outcomes, including ECMO support, pacemaker implantation, major complications, ICU length of stay, and overall hospital length of stay (LOS), were largely comparable between groups. A subgroup analysis suggested shorter hospital LOS after daytime heart transplantation, although this finding was not observed for lung transplantation or overall hospital LOS. Sensitivity analyses showed that the observed association with in-hospital mortality was influenced by the largest contributing cohort. Conclusion(s): Daytime transplantation was associated with a lower incidence of in-hospital mortality, but this association was not observed across subsequent mortality time points. Safety outcomes and resource utilization were otherwise comparable, and the available evidence did not demonstrate consistently worse outcomes following nighttime transplantation within structured thoracic transplant systems. Copyright © 2026 Elsevier Inc. <120> Accession Number 652095007 Title Tricuspid-Valve Intervention in Heart Failure. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 30 Aug 2026. Author Hausleiter J.; Stocker T.J.; Geisler T.; Lurz P.; Rottbauer W.; Lubos E.; Schofer N.; Frerker C.; Frank J.; Thiele H.; Osteresch R.; Rudolph V.; Lauten A.; Xhepa E.; Rothe J.; Rassaf T.; Baldus S.; Nickenig G.; Leistner D.M.; Tigges E.; Kehl V.; Kessler M.; Kister T.; Ruf T.; Gercek M.; Gawaz M.; Frank D.; Eitel I.; von Bardeleben R.S.; Kalbacher D.; Soliman O.; Nabauer M.; Massberg S. Institution (Hausleiter, Stocker, Nabauer, Massberg) Department of Medicine I, LMU University Hospital, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Hausleiter, Stocker, Xhepa, Massberg) German Center for Cardiovascular Research (DZHK) Partner Site Munich Heart Alliance, Munich, Germany (Geisler, Gawaz) Department of Cardiology and Angiology, Eberhard Karls University Tubingen, Tubingen, Germany (Lurz, Ruf, von Bardeleben) Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (Lurz, Leistner, Ruf, von Bardeleben) DZHK Partner Site Rhine-Main, Germany (Rottbauer, Kessler) Department of Cardiology, University Heart Center, Ulm, Germany (Lubos) Department of Cardiology, Asklepios Klinik Barmbek, Hamburg, Germany (Schofer, Kalbacher) Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Schofer) Department of Cardiology, Electrophysiology, Pulmonology, General Internal Medicine, Germany (Schofer, Frerker, Frank, Thiele, Frank, Eitel, Kalbacher) DZHK Partner Site North, Germany (Frerker, Eitel) University of Luebeck, Heart Center, Germany (Frerker, Eitel) Department of Cardiology, Angiology, Intensive Care Medicine, University Hospital Schleswig-Holstein, Germany (Frank, Frank) Department of Cardiology and Internal Intensive Medicine, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany (Thiele, Kister) Department of Cardiology, Heart Center Leipzig, Leipzig University, Leipzig, Germany (Osteresch) Bremen Institute for Heart and Circulation Research, Klinikum Links der Weser, Bremen, Germany (Rudolph, Gercek) Heart and Diabetes Center North Rhine-Westphalia, Department of General and Interventional Cardiology/Angiology, Ruhr University Bochum, Bad Oeynhausen, Germany (Lauten) Department of General and Interventional Cardiology and Rhythmology, Helios Klinikum Erfurt, Health and Medical University Erfurt, Erfurt, Germany (Xhepa) Department of Cardiovascular Diseases, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Germany (Rothe) Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany (Rothe) Department of Medicine, Freiburg University, Freiburg im Breisgau, Germany (Rassaf) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany (Baldus) Department of Cardiology, University Hospital Cologne, Cologne, Germany (Nickenig) Heart Center University Hospital Bonn, Bonn, Germany (Leistner) Department of Cardiology and Angiology, Goethe University, Frankfurt am Main, Germany (Tigges) Department of Cardiology and Intensive Care Medicine, Asklepios Clinic St. Georg, Hamburg, Germany (Kehl) Munchner Studienzentrum, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany (Kehl) Biostatistics and Clinical Epidemiology, Institute for AI and Informatics in Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany (Soliman) Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, United States (Soliman) Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, United States (Soliman) Department of Cardiology, Mater Private Network, Dublin, United States Abstract BACKGROUND: The effect of transcatheter tricuspid-valve repair on clinical outcomes, including death and hospitalization for heart failure, in patients with severe tricuspid regurgitation remains uncertain. METHOD(S): We randomly assigned patients with symptomatic severe tricuspid regurgitation and an increased risk of future heart-failure events in a 2:1 ratio to tricuspid-valve repair plus medical therapy (tricuspid-repair group) or medical therapy alone (medical-therapy group). The first primary end point was a hierarchical composite of death from any cause, hospitalization for heart failure, and quality-of-life improvement at 1 year, assessed by win ratio. If the between-group difference was significant, a second primary end point would be tested: a composite of death from any cause or hospitalization for heart failure through 3 years. RESULT(S): A total of 360 patients underwent randomization (237 patients were assigned to the tricuspid-repair group and 123 to the medical-therapy group). The mean (+/-SD) age of the patients was 80.3+/-6.4 years, and 56.4% were women. The win ratio for the first primary end point was 2.42 (95% confidence interval [CI], 1.76 to 3.33; P<0.001), favoring tricuspid-valve repair. The Kaplan-Meier estimate for freedom from death from any cause or hospitalization for heart failure (second primary end point) through 3 years was 52.4% (95% CI, 43.2 to 63.6) in the tricuspid-repair group and 21.0% (95% CI, 12.7 to 34.6) in the medical-therapy group (hazard ratio for death from any cause or hospitalization for heart failure, 0.40; 95% CI, 0.29 to 0.55; P<0.001). Major adverse events within 30 days occurred in 14 patients (5.9%) in the tricuspid-repair group. CONCLUSION(S): Among patients with symptomatic severe tricuspid regurgitation, transcatheter tricuspid-valve repair plus medical therapy was superior to medical therapy alone with respect to a hierarchical composite of death from any cause, hospitalization for heart failure, and quality-of-life improvement at 1 year and was also associated with a lower risk of a composite of death from any cause or hospitalization for heart failure through 3 years. (Funded by the German Center for Cardiovascular Research and others; TRIC-I-HF ClinicalTrials.gov number, NCT04634266.). Copyright © 2026 Massachusetts Medical Society. <121> Accession Number 652093590 Title Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 29 Aug 2026. Author Zoungas S.; Wolfe R.; Moran C.; Nicholls S.J.; Cloud G.C.; Reid C.M.; Tauonkin A.M.; Beilin L.; Wierzbicki A.S.; Chong T.T.-J.; Broder J.C.; Curtis A.J.; Flanagan Z.; Hopper I.; Ryan J.; Spark S.; McNeil J.J.; Nelson M.R. Institution (Zoungas, Wolfe, Moran, Reid, Tonkin, Broder, Curtis, Flanagan, Hopper, Ryan, Spark, McNeil, Nelson) School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Wolfe, Broder, Flanagan, Spark) Monash University Clinical Trials Centre, Faculty of Medicine, Nursing, Health Sciences, Monash University, Melbourne, VIC, Australia (Moran) Health of Older People, Bayside Health, Alfred Care Group, Melbourne, VIC, Australia (Nicholls) Victorian Heart Institute, Monash University, Clayton, VIC, Australia (Cloud, Chong) Department of Neurology, Bayside Health, Alfred Care Group, Melbourne, VIC, Australia (Cloud) Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia (Reid) School of Population Health, Curtin University, Perth, WA, Australia (Beilin) School of Medicine, University of Western Australia, Perth, United Kingdom (Wierzbicki) Department of Metabolic Medicine and Chemical Pathology, Guy's and St. Thomas' Hospitals, London, United Kingdom (Chong) Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia (Hopper) Department of Cardiology, Bayside Health, Alfred Care Group, Melbourne, VIC, Australia (Hopper) General Medicine Unit, Bayside Health, Alfred Care Group, Melbourne, VIC, Australia (Nelson) Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Abstract BACKGROUND: The effectiveness and safety of statins for the primary prevention of cardiovascular events and the extension of disability-free survival among older adults remain uncertain. METHOD(S): We conducted a double-blind, randomized, placebo-controlled trial at general medical practices across Australia. Community-dwelling adults at least 70 years of age with no history of cardiovascular disease, diabetes, or dementia were randomly assigned in a 1:1 ratio to receive atorvastatin at a dose of 40 mg once daily or identical placebo. The two primary end points were a composite of death from cardiovascular causes, nonfatal myocardial infarction or stroke, or coronary revascularization (to assess effects on major cardiovascular events) and a composite of death from any cause, dementia, or persistent physical disability (to assess effects on disability-free survival). Analyses were performed according to a hierarchical testing plan. RESULT(S): A total of 9971 participants were enrolled: 4984 were assigned to receive atorvastatin and 4987 to receive placebo. The mean (+/-SD) age of the participants was 74.7+/-4.5 years, and 51.9% were women. After a median of 5.9 years, a primary cardiovascular event had occurred in 297 participants (10.9 events per 1000 person-years) in the atorvastatin group and in 412 participants (15.5 events per 1000 person-years) in the placebo group (hazard ratio, 0.70; 95% confidence interval [CI], 0.61 to 0.82; P<0.001). Death from any cause, dementia, or persistent physical disability occurred in 637 participants (21.6 events per 1000 person-years) in the atorvastatin group and in 676 participants (23.0 events per 1000 person-years) in the placebo group (hazard ratio, 0.94; 95% CI, 0.84 to 1.05; P = 0.25). Serious adverse events occurred in 131 participants (2.7%) in the atorvastatin group and in 129 (2.7%) in the placebo group, with musculoskeletal, hepatobiliary, and diabetes-related adverse events occurring more commonly in the atorvastatin group. CONCLUSION(S): Treatment with atorvastatin led to a lower risk of major cardiovascular events than placebo at a median of 5.9 years but did not result in longer disability-free survival among community-dwelling older adults without clinical cardiovascular disease. (Funded by the National Health and Medical Research Council and others; STAREE ClinicalTrials.gov number, NCT02099123.). Copyright © 2026 Massachusetts Medical Society. <122> Accession Number 652101498 Title Coronary Revascularization of Ischemic Territories Improves Myocardial Perfusion, Increases Submaximal Aerobic Capacity and Reduces Exercise-Induced Angina in Patients with Chronic Coronary Syndrome. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 31 Aug 2026. Author Mosen H.; Szekely A.; Steding-Ehrenborg K.; Akil Engblom S.; Hedeer F.; Arheden H.; Erlinge D.; Engblom H. Institution (Mosen, Szekely, Steding-Ehrenborg, Akil Engblom, Hedeer, Arheden, Engblom) Department of Clinical Physiology, Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden (Erlinge) Department of Cardiology, Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden Abstract Chronic coronary syndrome (CCS) is associated with reduced stress perfusion, a predictor of adverse cardiovascular outcome. To what extent myocardial perfusion is related to cardiorespiratory fitness is not completely known. The aim was to investigate if change in myocardial perfusion correlates to change in aerobic capacity after revascularization. Sixty-two patients with suspected or established CCS underwent cardiopulmonary exercise testing (CPET) and [13N]NH3 positron emission tomography (PET) before and after elective invasive coronary angiography. Thirty-six patients were revascularized and 26 were not. The angiographer was blinded to the results from CPET and PET. Myocardial perfusion was defined as decreased when below 2 ml/min/g and as myocardial perfusion reserve (MPR) < 2. Change in oxygen uptake at submaximal effort (VO2 at AT) correlated positively to change in MPR in revascularized patients (r=0.36, p=0.04), but not in conservatively treated patients (r=0.03, p=0.90). Change in VO2peak, however, did not correlate to change in myocardial perfusion in any of the groups. Myocardial perfusion at stress and MPR increased significantly after revascularization, when baseline perfusion was decreased (P=0.01 stress and P=0.001 MPR, respectively). Furthermore, the number of patients with exercise-induced angina decreased significantly for the revascularized patients (42% (14/33) at baseline vs 3% (1/33) at follow-up, p<0.001) whereas half of the conservatively treated patients still had exercise-induced angina at follow-up (42% (10/24) at baseline vs 21% (5/24) at follow-up, p=0.12). In conclusion, change in myocardial perfusion correlates with change in submaximal aerobic capacity after revascularization and revascularization reduces exercise-induced angina. Copyright © 2026. Published by Elsevier Inc. <123> Accession Number 652106595 Title Colchicine for cardiovascular secondary prevention: evidence from recent trials and meta-analyses. Source Current opinion in cardiology. (no pagination), 2026. Date of Publication: 02 Sep 2026. Author Muroke V.; Samuel M.; Pierre R.; Tardif J.-C. Institution (Muroke, Pierre, Tardif) Montreal Heart Institute (Muroke, Pierre, Tardif) Faculty of Medicine, Universite de Montreal, Montreal, QC, Canada (Samuel) Faculty of Medicine, Drexel University (Samuel) Mario Lemieux Center for Heart Rhythm Care, Allegheny Health Network, Pittsburgh, PA, United States (Samuel) Faculty of Medicine, Dalhousie University, Halifax, Canada Abstract PURPOSE OF REVIEW: Residual inflammatory risk remains an important driver of recurrent vascular events despite contemporary lipid-lowering and antithrombotic therapies. Low-dose colchicine is the first widely available anti-inflammatory therapy to be incorporated into contemporary guidelines for secondary prevention in coronary artery disease. This review summarizes contemporary evidence on the efficacy and safety of low-dose colchicine for secondary prevention. RECENT FINDINGS: Large randomized trials have demonstrated that colchicine reduces recurrent ischemic events in patients with chronic coronary disease and after myocardial infarction. Recent trials in acute myocardial infarction and stroke populations, however, have produced heterogeneous results. Nevertheless, contemporary meta-analyses consistently demonstrate reductions in major adverse cardiovascular events (MACE), driven mainly by fewer myocardial infarctions, strokes, and coronary revascularizations. Safety data are reassuring, with no consistent excess in serious infection, cancer, pneumonia, or noncardiovascular death, although gastrointestinal intolerance remains the most common adverse effect. SUMMARY: Low-dose colchicine has established residual inflammation as an actionable target in secondary prevention of vascular events in patients with chronic coronary disease or recent myocardial infarction. Ongoing trials will clarify colchicine's role across broader vascular indications. Future work should also focus on implementing the use of colchicine for prevention of clinical events in patients with coronary artery disease in clinical practice. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <124> Accession Number 652096331 Title State of the ART: practical evaluation and management of pleural infection. Source Current opinion in pulmonary medicine. (no pagination), 2026. Date of Publication: 31 Aug 2026. Author Yeboah-Kordieh Y.A.; Mihalache D.; Chaddha U. Institution (Yeboah-Kordieh) Department of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, NY, United States Abstract PURPOSE OF REVIEW: This review synthesizes recent evidence and provides a stepwise approach to management, emphasizing timely recognition of treatment failure, appropriate escalation of therapy, and individualized decision-making to optimize clinical outcomes. RECENT FINDINGS: The cornerstone of pleural infection management is appropriate antibiotic therapy and effective pleural drainage. Most infections are polymicrobial, with anaerobic organisms predominating. Image-guided chest tube drainage remains the standard initial intervention. Early recognition of inadequate drainage or persistent pleural infection-related sepsis through close clinical, biochemical, and radiographic assessment is essential to facilitate timely escalation of care. Intrapleural enzyme therapy (IET) reduces the need for surgery, and emerging evidence suggests that lower-dose tissue plasminogen activator (tPA) regimens may preserve efficacy. Current evidence supports a sequential management strategy in which IET precedes surgery, with early thoracic surgical consultation and prompt recognition of IET failure to avoid delays that may increase surgical morbidity. SUMMARY: Successful management of pleural infection depends on early source control, vigilant assessment of treatment response, and timely escalation of care. A structured, stepwise approach that integrates antibiotics and effective pleural drainage, early use of IET when indicated, and prompt surgical consultation for nonresponders offers the best opportunity to improve outcomes while minimizing morbidity. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <125> Accession Number 652100801 Title One-Year Outcomes of Myval Versus Contemporary Transcatheter Heart Valves in Severe Aortic Stenosis: A Systematic Review and Meta-Analysis. Source Cardiology in review. (no pagination), 2026. Date of Publication: 01 Sep 2026. Author Al-Harbi F.A.; Alanazi A.K.; Algoblan N.A.; Aldhafeeri S.S.; Alrashoodi L.B.; Alamer M.A.; Alquraishi O.F.; Alresaini A.A.; Almutiq N.M.; Aljibreen M.S.; Alwabili L.F.; Kolko N. Institution (Al-Harbi, Alanazi, Algoblan, Aldhafeeri, Alrashoodi, Alamer, Alresaini, Almutiq, Aljibreen, Alwabili) From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia (Alquraishi) Department of Medicine, College of Medicine, Qassim University, Saudi Arabia (Kolko) Department of Cardiology, Prince Sultan Cardiac Center, Saudi Arabia Abstract The Myval and Myval Octacor transcatheter heart valves (THVs) are newer-generation balloon-expandable devices for transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS), but comprehensive synthesis of 1-year outcomes incorporating recent randomized data remains limited. We searched PubMed/MEDLINE, Embase, and CENTRAL through June 2026 for randomized controlled trials and propensity-matched or adjusted observational studies comparing Myval/Myval Octacor with contemporary THVs in adults undergoing transfemoral TAVI for severe symptomatic AS. The primary outcome was 1-year all-cause mortality; secondary outcomes included cardiovascular death, stroke, new permanent pacemaker implantation (PPI), mean transvalvular gradient, effective orifice area, and moderate-to-severe aortic regurgitation. Random-effects meta-analyses generated pooled risk ratios (RRs) and mean differences with 95% confidence intervals. Five studies (2 randomized trials, 3 propensity-matched/adjusted cohorts; 2327 patients: 1107 Myval, 1220 contemporary THV recipients) were included. At 1 year, Myval showed comparable outcomes to contemporary THVs for all-cause mortality (RR 0.89, 0.66-1.21), cardiovascular death (RR 0.92, 0.55-1.55), and stroke (RR 1.41, 0.91-2.18), with similar new PPI rates (RR 0.82, 0.47-1.42). Among randomized trials, Myval had lower mean transvalvular gradients (MD -1.28 mm Hg, -1.73 to -0.82) and larger effective orifice area (mean difference +0.15 cm2, 0.09-0.20) than SAPIEN, with no significant difference in moderate-to-severe aortic regurgitation (RR 1.28, 0.19-8.71). Myval demonstrated comparable all-cause mortality, cardiovascular death, stroke, and PPI rates to contemporary THVs at 1 year, along with favorable hemodynamics versus SAPIEN, supporting Myval as an effective contemporary TAVI platform; longer-term studies are needed to confirm durability and clinical outcomes. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <126> Accession Number 2048864609 Title Transcatheter tricuspid valve replacement for severe tricuspid regurgitation: current and future perspectives. Source Expert Review of Medical Devices. (no pagination), 2026. Date of Publication: 2026. Author Calamita G.; Leone P.P.; Elsaid O.; Sturla M.; Rizvi S.; Lin J.; Sugiura T.; Scotti A.; Abelow A.; Assafin M.; Ho E.; Latib A. Institution (Calamita, Leone, Elsaid, Sturla, Rizvi, Lin, Sugiura, Scotti, Abelow, Assafin, Ho, Latib) Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States (Calamita) Department of Biomedical Sciences, Humanitas University, Milan, Italy (Calamita) IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (Leone, Scotti, Assafin, Ho, Latib) Department of Cardiology, White Plains Hospital, White Plains, NY, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Severe tricuspid regurgitation (TR) is common, undertreated, and associated with significant morbidity and mortality. Transcatheter tricuspid valve replacement (TTVR) has emerged as a promising option for patients unsuitable for surgical repair or transcatheter edge-to-edge repair. Areas covered: This review examines the innovation trajectory, current device landscape, patient selection, imaging guidance, procedure-specific challenges, and future perspectives of TTVR. A systematic literature search was performed using PubMed/MEDLINE, Embase, and ClinicalTrials.gov, covering publications from January 2015 to May 2025, using search terms including 'transcatheter tricuspid valve replacement,' 'TTVR,' 'tricuspid regurgitation,' and device-specific names. Expert opinion: TTVR offers near-complete regurgitation elimination but remains anatomy- and mechanism-dependent. Its role is best defined in patients with anatomy unfavorable for repair. Optimal timing, device selection, antithrombotic management, and long-term durability require prospective validation through dedicated trials and head-to-head comparisons with repair strategies. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <127> Accession Number 652100714 Title Complete Revascularization Guided by Functional Coronary Angiography in STEMI. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 29 Aug 2026. Author Biscaglia S.; Erriquez A.; Colaiori I.; Hakeem A.; Mantovani F.; Menozzi M.; Barbierato M.; Arioti M.; Bugani G.; Scarsini R.; D'Amario D.; Donazzan L.; Polimeni A.; Giordan M.; Benatti G.; Venturi G.; Ruozzi M.; Moretti F.; Monello A.; Moscarella E.; Versaci F.; Shah J.A.; Guiducci V.; Cavazza C.; Gallo F.; Rubboli A.; Borgi M.; Lakho A.A.; Capecchi A.; Lanzilotti V.; Ottani F.; Casella G.; Leone A.M.; Tebaldi M.; Pavasini R.; Piccolo R.; Farina J.; Martella D.; Campo G. Institution (Biscaglia, Erriquez, Pavasini, Farina, Campo) Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, Cona, Italy (Colaiori, Versaci, Borgi) Cardiology Intensive Care Unit, Emodinamica e Cardiologia, Ospedale Santa Maria Goretti, Latina, Italy (Hakeem, Shah, Lakho) National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan (Mantovani, Guiducci) Cardiology Unit, Azienda Unita Sanitaria Locale-IRCCS Reggio Emilia, S. Maria Nuova Hospital, Reggio Emilia, Italy (Menozzi, Cavazza, Ottani) Cardiovascular Department, Infermi Hospital, Rimini, Italy (Barbierato, Gallo) Unita Operativa Complessa Cardiologia, Ospedale dell'Angelo, Mestre, Italy (Arioti, Rubboli) Cardiology Department, S. Maria delle Croci Hospital, Ravenna, Italy (Bugani, Capecchi, Lanzilotti, Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy (Scarsini) Cardiology Unit, Integrated University Hospital, Verona, Italy (D'Amario) Azienda Ospedaliero-Universitaria Maggiore della Carita, Dipartimento Toraco-Cardio-Vascolare, Unita Operativa Complessa di Cardiologia, Novara, Italy (Donazzan) Department of Cardiology, Ospedale Regionale San Maurizio, Bolzano, Italy (Polimeni) Division of Cardiology, Azienda Ospedaliera di Cosenza, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy (Giordan) Unit of Interventional Cardiology, Ospedale Santa Maria della Misericordia, Rovigo, Italy (Benatti) Division of Cardiology, Parma University Hospital, Parma, Italy (Venturi) Mater Salutis Hospital, Legnago, Italy (Ruozzi) Cardiology Unit, Ospedale Civile di Baggiovara, Modena, Italy (Moretti) Cardiology Unit, Azienda Socio-Sanitaria Territoriale-Ospedale Papa Giovanni XXIII, Bergamo, Italy (Monello) Cardiology Unit, Ospedale San Guglielmo da Saliceto, Piacenza, Italy (Moscarella) Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli, Naples, Italy (Leone) Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina-Gemelli Isola, Rome, United States (Tebaldi) Cardiology Unit, Infermi Hospital, Faenza, Italy (Piccolo) Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy (Martella) We4 Clinical Research, Milan, United States Abstract BACKGROUND: Complete coronary-artery revascularization is recommended in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, but the preferred strategy for identifying nonculprit lesions that warrant treatment remains uncertain. METHOD(S): In this international, randomized trial, we assigned patients with STEMI and multivessel disease in whom the culprit lesion had been successfully treated to undergo complete coronary-artery revascularization guided by functional coronary angiography (physiology-guided group) or by conventional angiography (angiography-guided group). The primary outcome was a composite of death from any cause, myocardial infarction, cerebrovascular accident (stroke or transient ischemic attack), or ischemia-driven revascularization, assessed in a time-to-event analysis. The primary safety outcome was a composite of contrast-associated acute kidney injury or major bleeding. RESULT(S): A total of 1823 patients underwent randomization; 913 were assigned to the physiology-guided group and 910 assigned to the angiography-guided group. The median age of the patients was 66 years (interquartile range, 58 to 76), and 24% were women. At a median follow-up of 17.9 months, a primary-outcome event had occurred in 81 patients (8.9%) in the physiology-guided group and in 125 patients (13.7%) in the angiography-guided group (hazard ratio, 0.62; 95% confidence interval [CI], 0.47 to 0.83; P<0.001). A primary-safety-outcome event occurred in 42 patients (4.6%) in the physiology-guided group and in 65 patients (7.1%) in the angiography-guided group (hazard ratio, 0.63; 95% CI, 0.43 to 0.93; P = 0.02). CONCLUSION(S): In patients with STEMI and multivessel coronary artery disease, a strategy of complete coronary-artery revascularization guided by functional coronary angiography resulted in a lower risk of a primary-outcome event (death, myocardial infarction, cerebrovascular accident, or ischemia-driven revascularization) than a strategy guided by conventional angiography. (Funded by the Italian Health Ministry and others; AIR-STEMI ClinicalTrials.gov number, NCT05818475.). Copyright © 2026 Massachusetts Medical Society. <128> Accession Number 652092816 Title Half-dose rivaroxaban vs antiplatelet therapy for preventing silent cerebral embolism after left atrial appendage occlusion: the HALO-SCE trial. Source European heart journal. (no pagination), 2026. Date of Publication: 31 Aug 2026. Author Wang K.; Shi L.; Ruan Z.; Chen H.; Liu H.; Wang Z.; Jiang X.; Li M.; Chen M.; Ju W. Institution (Wang, Chen, Liu, Wang, Jiang, Li, Chen, Ju) Department of Cardiology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China (Shi) Department of Cardiology, Affiliated Hospital of Nantong University, Nantong, China (Ruan, Chen) Department of Cardiology, Affiliated Taizhou People's Hospital of Nanjing Medical University, China Abstract BACKGROUND AND AIMS: The optimal long-term antithrombotic strategy after left atrial appendage occlusion (LAAO) remains undetermined. The present study aimed to investigate whether half-dose rivaroxaban (10 mg daily) could better reduce silent cerebral embolic lesions (SCEs) and preserve cognitive function compared to antiplatelet therapy after successful LAAO. METHOD(S): In this investigator-initiated, prospective, multicenter, randomized controlled trial, patients with successful LAAO confirmed 45 days post-procedure were assigned 1:1 to half-dose rivaroxaban or antiplatelet therapy group. Diffusion-weighted magnetic resonance imaging and cognitive assessments were repeated at 90, 180 and 365 days after LAAO. The primary outcome was the patient-level incidence of any newly detected SCE during follow-up. Secondary outcomes included cognitive trajectories, SCE burden, and a composite of all-cause mortality, clinical thromboembolic events and major bleeding. RESULT(S): Between December 2022 and February 2025, 164 patients were randomized. The patient-level incidence of new SCEs was significantly lower in the half-dose rivaroxaban group than in the antiplatelet therapy group (10/82 [12.2%] vs. 26/82 [31.7%]; P = 0.005). At 365 days, model-derived between-group differences favored the half-dose rivaroxaban group for both Mini-Mental State Examination (2.56; 95% confidence interval [CI] 1.11-4.01; P < 0.001) and Montreal Cognitive Assessment (2.67; 95% CI 1.07-4.26; P = 0.001) scores. The composite clinical outcome occurred in 2.4% of the half-dose rivaroxaban group vs. 11.0% of the antiplatelet therapy group (P = 0.057). CONCLUSION(S): In patients eligible for oral anticoagulation after successful LAAO, rivaroxaban 10 mg daily significantly reduced SCEs and better maintained cognitive function compared with antiplatelet therapy, with numerically fewer composite clinical events. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <129> Accession Number 2048867376 Title Hemodynamic effects of dexmedetomidine versus propofol in cardiac surgery: a systematic review and meta-analysis. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 543. Date of Publication: 01 Dec 2026. Author Montaseri M.; Saberian M.; Jackson A.C.; Bahramnejad F.; Bahramnezhad F. Institution (Montaseri) Critical Care Nursing Department, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Saberian) Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Jackson) Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong (Bahramnejad) Department of Health Information Technology, Sirjan School of Medical Sciences, Sirjan, Iran, Islamic Republic of (Bahramnezhad) Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Cardiac surgery, particularly open-heart procedures such as coronary artery bypass grafting and valve surgery, is one of the most common curative options for ischemic heart disease, congenital heart defects, and valvular disease but is also associated with severe hemodynamic hazards. Intravenous anesthetic agents such as propofol and dexmedetomidine are employed to sedate such patients in routine clinical practice. There is, however, conflicting and sporadic evidence in the literature regarding the relative effects of these two agents on hemodynamic parameters. This review systematically analyzed and contrasted the hemodynamic effects of dexmedetomidine and propofol in patients undergoing cardiac surgery. Method(s): Systematic searches in the PubMed, Scopus, Embase, Web of Science, CINAHL, Cochrane Library, and Google Scholar databases were performed for randomized controlled trials published between December 2000 and 18 January 2025. Studies in which adult patients underwent cardiac surgery (e.g., coronary artery bypass grafting or valve surgery) and received dexmedetomidine or propofol for intraoperative or immediate postoperative intensive care unit (ICU) sedation were included. This was a PRISMA-guided review, and the extracted data were meta-analyzed and descriptively analyzed. The primary outcomes were hypotension and bradycardia. Secondary outcomes included vasopressor requirements, tachycardia, heart rate, atrial fibrillation (AF), ventricular tachycardia, and bleeding. Odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were pooled via random-effects models. Sensitivity analysis and assessment of publication bias were performed as needed. Result(s): Compared with propofol, dexmedetomidine significantly increased the risk for hypotension (OR = 1.76; 95% CI: 1.25-2.48; p < 0.001) and bradycardia (OR = 2.89; 95% CI: 1.28-6.49; p = 0.01). Alternatively, dexmedetomidine significantly reduced vasopressor requirements (OR = 0.52; 95% CI: 0.32-0.84; p = 0.007) and lowered the heart rate (MD = - 4.78 beats/min; 95% CI: - 7.47 to - 2.26; p < 0.001). No considerable differences were observed in tachycardia, ventricular tachycardia, AF, or bleeding. Sensitivity analysis was employed to check for the stability of the findings, and no publication bias was detected. Conclusion(s): This meta-analysis revealed that, compared with propofol, dexmedetomidine is associated with a greater incidence of hypotension and bradycardia but lower vasopressor requirements. No considerable differences were observed in ventricular tachycardia, AF, bleeding or any other hemodynamic parameters. Evidence for several secondary outcomes remains limited; therefore, findings for less frequently reported endpoints should be interpreted cautiously. Clinical trial number: Not applicable. Copyright © The Author(s) 2026. <130> Accession Number 652104240 Title Timing of PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 30 Aug 2026. Author Stahli B.E.; Ruschitzka F.; Westermann D.; Linke A.; Mangner N.; Van Mieghem N.M.; Kesterke R.; Oberholzer L.; Rothe J.; von Zur Muhlen C.; Zeus T.; Kim W.-K.; Lauten P.; Werner N.; Burgdorf C.; Alber H.; Schulze P.C.; Joner M.; Michel J.; Candreva A.; Jakob P.; Wurdinger M.; Stehli J.; Gotschy A.; Templin C.; Dzemali O.; Gaede L.; Massberg S.; Lauten A.; van der Kley F.; Ewers A.; Nestelberger T.; Abdel-Wahab M.; Musumeci G.; Barth S.; Hansen M.; Mugge A.; Seiffert M.; Leistner D.M.; Cuisset T.; Schneider S.; Kastrati A.; Ford I.; Kasel M.A. Institution (Stahli, Ruschitzka, Kesterke, Oberholzer, Michel, Candreva, Jakob, Wurdinger, Stehli, Gotschy, Kasel) Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Zurich, Switzerland (Westermann, Rothe, von Zur Muhlen) Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg, Germany (Linke, Mangner) Department of Internal Medicine and Cardiology, Herzzentrum Dresden, University Clinic, Technische Universitat Dresden, Dresden, Germany (Van Mieghem) Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands, and Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (Zeus) Department of Cardiology, Pulmonology, Vascular Medicine, Medical Faculty of the Heinrich Heine University, Dusseldorf, Germany (Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany (Lauten) Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Bad Berka, Germany (Werner) Department of Internal Medicine III, Heart Center Trier, Krankenhaus der Barmherzigen Bruder, Trier, Germany (Burgdorf) Heart and Vascular Center Bad Bevensen, Bad Bevensen, Germany (Alber) Department of Cardiology, Klinikum Klagenfurt am Worthersee, Klagenfurt am Worthersee, Austria (Schulze) Department of Internal Medicine I, Division of Cardiology, University Hospital Jena, Jena, Germany (Joner, Kastrati) Department of Cardiology, Technical University of Munich (TUM) University Hospital, German Heart Center Munich, Munich, Germany (Joner, Massberg, Kastrati) German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany (Templin) Department of Internal Medicine B, Greifswald, University Medicine Greifswald, Germany (Templin) DZHK partner site Greifswald, Greifswald, Germany (Dzemali) Department of Cardiac Surgery, University Heart Center, University Hospital Zurich, City Hospital Zurich-Triemli, Zurich, Switzerland (Dzemali) CTEC, University of Zurich, Zurich, Switzerland (Gaede) Herrsching, Germany (Massberg) Department of Medicine I, Ludwig-Maximilians-Universitat Munchen (LMU Munich), Munich, Germany (Lauten) Department of General and Interventional Cardiology and Rhythmology, Helios Medical Center, Health and Medical University Erfurt, Erfurt, Germany (van der Kley) Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands (Ewers, Seiffert) Department of Cardiology and Angiology, Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (Nestelberger) Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland (Abdel-Wahab) Heart Center Leipzig at Leipzig University, Leipzig, Germany (Musumeci) Cardiology Department, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy (Barth) Department of Cardiology, Cardiovascular Center Bad Neustadt-Saale, Bad Neustadt an der Saale, Germany (Hansen) Division of Cardiology, Center of Internal Medicine, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany (Mugge) Ruhr-University Bochum, Medical Faculty, Institute of Physiology, Department of Cellular and Translational Physiology, Bochum, Germany (Leistner) Department of Cardiology, University Heart Center Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany (Leistner) DZHK partner site Rhine-Main, Frankfurt am Main, Germany (Cuisset) Department of Cardiology, Centre Hospitalier Universitaire Timone and INSERM, Center for Cardiovascular and Nutrition Research, Aix-Marseille University, Marseille, France (Schneider) Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany (Ford) Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom Abstract BACKGROUND: Approximately one half of patients undergoing transcatheter aortic-valve implantation (TAVI) have concomitant coronary artery disease. Although percutaneous coronary intervention (PCI) is often performed before TAVI, the preferred treatment strategy has not been established. METHOD(S): We conducted an international, open-label, randomized, noninferiority trial at 48 centers in Europe. Patients with severe aortic stenosis and coronary artery disease were randomly assigned in a 1:1 ratio to a strategy of either TAVI before PCI (TAVI-first group) or PCI before TAVI (PCI-first group). The primary end point was a composite of death from any cause; nonfatal myocardial infarction; ischemia-driven revascularization; rehospitalization related to the valve, procedure, or heart failure; or life-threatening, disabling, or major bleeding at 1 year after randomization. The noninferiority margin was 6.6 percentage points, with testing for noninferiority of TAVI first as compared with PCI first. RESULT(S): A total of 986 patients underwent randomization: 498 were assigned to the TAVI-first group and 488 to the PCI-first group. A primary end-point event occurred in 105 patients (22.2%) in the TAVI-first group and in 112 patients (24.2%) in the PCI-first group (risk difference, -2.0 percentage points; 95% confidence interval, -7.4 to 3.4; P<0.001 for noninferiority). Serious adverse events occurred in 264 patients in the TAVI-first group and in 273 patients in the PCI-first group. CONCLUSION(S): Among patients with severe aortic stenosis and coronary artery disease, a strategy of TAVI before PCI was noninferior to a strategy of PCI before TAVI with respect to the primary end point at 1 year. (Funded by University Hospital Zurich and others; TAVI PCI ClinicalTrials.gov number, NCT04310046.). Copyright © 2026 Massachusetts Medical Society. <131> Accession Number 652103645 Title All-Cause Mortality Up to 20 Years After PCI or CABG for Left Main Disease. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 14 Aug 2026. Author Desch S.; Pugachova S.; de Waha S.; Thevathasan T.; Freyer L.; Stark K.; Rizas K.; Massberg S.; Sack S.; Valina C.; Westermann D.; Noack T.; Borger M.A.; Boudriot E.; Thiele H. Institution (Desch, Pugachova, Boudriot) Department of Internal Medicine/Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany (de Waha) Department of Cardiac Surgery, Heart Center Leipzig at Leipzig University, Leipzig, Germany; Department of Rhythmology, University Hospital Schleswig-Holstein, Campus Lubeck, Lubeck, Germany (Thevathasan) DZHK (German Center for Cardiovascular Research), Germany; Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus Benjamin Franklin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany (Freyer, Stark, Rizas) Ludwig-Maximilians-Universitat Munchen, Munchen, Germany (Massberg) DZHK (German Center for Cardiovascular Research), Germany; Ludwig-Maximilians-Universitat Munchen, Munchen, Germany (Sack) Klinik fur Kardiologie, Pneumologie und Internistische Intensivmedizin, Munchen, Germany (Valina, Westermann) Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany (Noack, Borger) Department of Cardiac Surgery, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany; DZHK (German Center for Cardiovascular Research), Germany <132> Accession Number 2048929940 Title The role of thoracoplasty in modern thoracic surgery: a narrative review with three illustrative cases. Source Journal of Thoracic Disease. 18(7) (pp 798), 2026. Date of Publication: 31 Jul 2026. Author Baughn C.; Gritsiuta A.I.; Petrov R.V. Institution (Baughn) Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States (Gritsiuta, Petrov) Division of Cardiovascular and Thoracic Surgery, University of Texas Medical Branch, Galveston, TX, United States Publisher AME Publishing Company Abstract Background and Objective: Thoracoplasty, defined as the surgical resection of ribs to reduce pleural space volume, was first introduced in the late nineteenth century for the management of chronic empyema. Its use declined with the advent of effective antimicrobial therapy and advances in thoracic surgery. However, interest in thoracoplasty has reemerged in recent years. Tuberculosis and its sequelae remain prevalent globally, and complex pleural space infections continue to pose significant management challenges, particularly in patients who are not candidates for resection or in whom prior interventions have failed. In this setting, thoracoplasty serves as an important salvage strategy. This narrative review aims to examine the historical evolution of thoracoplasty, summarize its current indications and techniques, and highlight the importance of maintaining this skillset within the modern thoracic surgical repertoire. Method(s): A comprehensive search of PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar was conducted to identify peer reviewed articles on thoracoplasty. Both Medical Subject Headings (MeSH) and free text terms were used. No strict date restrictions were applied, although emphasis was placed on literature published between 2000 and 2025. Eligible studies included randomized controlled trials, observational studies, case series, systematic reviews, and expert opinion articles. Data on clinical indications, operative techniques, adjunctive procedures, and outcomes were extracted and qualitatively synthesized. Key Content and Findings: Thoracoplasty has evolved from a primary treatment for destructive pulmonary tuberculosis and related empyema to a selective salvage procedure in modern thoracic surgery. Contemporary applications focus on chronic empyema, postpneumonectomy space complications, and bronchopleural fistula (BPF), particularly in patients with limited surgical options. Modern techniques emphasize tailored rib resection, preservation of chest wall function, and integration with adjunctive strategies such as muscle or omental flap transposition. Reported outcomes demonstrate acceptable morbidity and mortality, with effective pleural space obliteration and preservation of quality of life in appropriately selected patients. Conclusion(s): Thoracoplasty remains a relevant and effective option in carefully selected patients with complex pleural space disease. Contemporary modifications have improved functional and cosmetic outcomes, supporting its role as a valuable salvage technique. Maintenance of familiarity with thoracoplasty is important to ensure optimal management of challenging cases in modern thoracic practice. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <133> Accession Number 2048923822 Title A comparative analysis of the effects of moderate vs mild hypothermia on serum neuron-specific enolase, S100beta, and near-infrared spectroscopy during cardiopulmonary bypass-assisted open-heart surgery: a single-centre study. Source Cardiovascular Journal of Africa. 37(2) (pp 208-214), 2026. Date of Publication: 2026. Author Tulek F.; Oc B.; Arun O.; Celik J.B.; Unlu A.; Oc M.; Yildirim S.; Duman A. Institution (Tulek) Department of Anesthesiology, Ministry of Health Konya Numune Hospital, Konya, Turkey (Oc, Arun, Celik, Oc) Department of Anesthesiology, Selcuk University Faculty of Medicine, Konya, Turkey (Unlu) Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey (Yildirim) Department of Cardiovascular Surgery, Selcuk University Faculty of Medicine, Konya, Turkey (Duman) Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey Publisher Clinics Cardive Publishing (PTY)Ltd Abstract Purpose: Neurological injury remains a critical concern in cardiac surgery despite advancements in surgical and anaesthetic techniques. Hypothermia is commonly utilised for neuroprotection during cardiopulmonary bypass (CPB); however, the optimal temperature range remains undetermined. This study evaluates the neuroprotective effectiveness of mild versus moderate hypothermia by assessing neuron-specific enolase (NSE) and S100beta levels, near-infrared spectroscopy (NIRS) cerebral oxygenation, and cognitive function in patients undergoing CPB-assisted open-heart surgery. Method(s): Forty elective coronary artery bypass grafting (CABG) patients were randomised to mild (32-34degreeC, n = 20) or moderate (28-32degreeC, n = 20) hypothermia groups. Serum NSE and S100beta levels were measured preoperatively and at 0, 12, 24, and 48 hours postoperatively. Cerebral oxygenation via NIRS and Mini-Mental State Examination (MMSE) scores were evaluated preoperatively and at 24 and 48 hours postoperatively. This is a single-centre study. The primary outcome was the between-group difference in S100beta levels at 24 and 48 hours; all other variables were predefined secondary outcomes. Result(s): Postoperative NSE levels increased in both groups, with no significant intergroup differences (p > 0.05). However, S100beta levels were significantly lower in the moderate hypothermia group at 24 and 48 hours (p = 0.012, p = 0.004). NIRS values and MMSE scores remained comparable between groups (p > 0.05). Conclusion(s): Our findings suggest that moderate hypothermia may offer improved neuroprotection by attenuating S100beta release, while not adversely affecting cerebral oxygenation or cognitive outcomes. Although these results are encouraging, further validation through larger, multicentre studies is warranted before definitive conclusions can be drawn. Copyright © Clinics-Cardiv Publishing (Pty) Ltd. This article is published under the Attribution 4.0 International Creative Commons (CC BY 4.0) License. <134> Accession Number 2048930249 Title Targeted intrapleural analgesia through an integrated chest tube after thoracoscopic lung resection: a randomized controlled trial. Source Journal of Thoracic Disease. 18(7) (no pagination), 2026. Article Number: 796. Date of Publication: 31 Jul 2026. Author Tang H.; Lu J.; Wei S.; Ren Y.; Li Q.; Wang L.; Liu X.; Liu J.; Song J.; Chen C.; Hu X. Institution (Tang, Lu, Ren, Li, Liu, Chen, Hu) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China (Wei, Wang, Liu, Song) Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China (Wei) Outcomes Research Consortium, Houston, TX, United States (Wang) Department of Anesthesiology, Shanghai Shidong Hospital, Shanghai, China Publisher AME Publishing Company Abstract Background: Chest drains are a major contributor to postoperative pain after thoracoscopic lung resection. Localized intrapleural analgesia delivered through the drain itself may provide targeted pain control without additional catheters. This study evaluated whether a drainage-analgesia integrated (DAI) chest tube improves postoperative analgesia after video-assisted thoracoscopic surgery (VATS). Method(s): In this prospective single-center, open-label randomized trial, 47 patients undergoing VATS were allocated to receive either a DAI chest tube (n=22) or standard drainage (STD) chest tube (n=25). Both groups received identical multimodal systemic analgesia, including intravenous patient-controlled analgesia (PCA) with a continuous background sufentanil infusion. The primary endpoint was the visual analog scale (VAS) pain score at 24 hours. The secondary outcomes included PCA activation frequency, sufentanil consumption, drainage outcomes, adverse events, and Quality of Recovery-15 (QoR-15) scores. Result(s): Compared with the STD group, the DAI group had lower VAS pain scores at 24 and 48 hours after surgery (P<0.05). Total sufentanil consumption was similar between the two groups (P=0.49); however, the number of PCA activations was lower in the DAI group than in the STD group (0.1+/-0.4 vs. 0.9+/-1.1; P=0.004). QoR-15 scores at 48 hours were higher in the DAI group than in the STD group, indicating improved patient-reported recovery. No device-related complications were observed. Conclusion(s): In this open-label randomized trial conducted under a standardized background sufentanil PCA regimen, intrapleural local anesthetic delivery through an integrated chest tube was associated with lower early postoperative pain scores and fewer PCA activation attempts. This strategy may represent a simple approach for targeted analgesia within enhanced recovery after surgery (ERAS) pathways for thoracic surgery. Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), https://creativecommons.org/licenses/by-nc-nd/4.0/. <135> Accession Number 2048930126 Title Role of omental flaps in thoracic surgery complications: a narrative review. Source Journal of Thoracic Disease. 18(7) (pp 799), 2026. Date of Publication: 31 Jul 2026. Author Franco C.; Gritsiuta A.I.; Petrov R.V. Institution (Franco) Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States (Gritsiuta, Petrov) Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States Publisher AME Publishing Company Abstract Background and Objective: The greater omentum is a highly vascularized and immunologically active organ with recognized regenerative and antimicrobial properties. Its application in pleural space complications has gained renewed interest with the expansion of minimally invasive harvesting techniques. This review summarizes the current literature regarding the role of omental flaps in the management of post-lobectomy complications. Method(s): This narrative review was conducted using a comprehensive search of MEDLINE (Via PubMed), Scopus, and Cochrane Central Register of Controlled Trials from database inception through February 2026 using the search terms "Omental flap", "pleural space", and "bronchopleural fistula", "post-lobectomy complications", "entrapped lung" and "empyema". Peer-reviewed articles in English and Spanish were included. Data were extracted and synthesized narratively, focusing on indications, techniques, outcomes, advantages, and limitations. Key Content and Findings: Omental flaps are most used for bronchopleural fistula (BPF), empyema, mediastinitis, and prosthetic graft coverage. Rich vascular and lymphatic networks of the omentum enhance infection control and tissue healing, particularly in contaminated or high-risk fields. The size and pliability of the omentum allow effective obliteration of complex pleural dead space problems and durable coverage of critical structures. Reported flap survival rates range from 80-100% in small case series. Conclusion(s): Omental flaps represent a versatile and biologically advantageous option for pleural space complications. Although current evidence is limited and largely observational, reported outcomes are promising, warranting further prospective investigation. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <136> Accession Number 2048930827 Title Prognostic role of triglyceride-glucose index and triglyceride-glucose body mass index in patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 879. Date of Publication: 31 Aug 2026. Author Chen D.; Wei X.; Sun H.; Meng J.; Huang Y.; Lu X.; Gao Y.; Xu Z.; Ma Y. Institution (Chen, Wei, Sun, Meng, Huang, Lu, Gao, Xu, Ma) Department of Cardiac Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China Publisher AME Publishing Company Abstract Background: The prognostic role of triglyceride-glucose (TyG) index and triglyceride-glucose body mass index (TyG-BMI) in patients undergoing coronary artery bypass grafting (CABG) remains unclear. This meta-analysis aimed to clarify prognostic value of TyG index and TyG-BMI among patients undergoing CABG. Method(s): Several databases were searched up to May 20, 2026. Primary prognostic outcomes included major adverse cardiovascular event (MACE) and major adverse cardiovascular and cerebrovascular event (MACCE). Secondary outcomes included all-cause mortality, cardiac mortality, nonfatal myocardial infarction (MI), nonfatal stroke, acute kidney injury (AKI), atrial fibrillation (AF), symptomatic graft failure (SGF) and cerebral infarction. Result(s): Fifteen studies with 16,185 cases were enrolled. The results demonstrated that elevated TyG index was related to increased risk of MACE [odds ratio (OR) =1.91, P<0.001] and MACCE (OR =1.67, P<0.001). Subgroup analysis indicated more significant association between TyG index and risk of MACE (OR =4.27, P=0.001) and MACCE (OR =1.71, P<0.001) among diabetic patients. Besides, TyG index was associated with the risk of all-cause mortality [hazard ratio (HR) =1.37, P=0.02], cardiac mortality (HR =2.59, P=0.001), nonfatal MI (OR =2.02, P=0.04), nonfatal stroke (OR =2.00, P<0.001), AF (OR =1.55, P<0.001), SGF (OR =2.987, P=0.003) and cerebral infarction (OR =1.93, P<0.001). Furthermore, elevated TyG-BMI was related to increased incidence of AKI (OR =1.03, P<0.001) among diabetic patients. Conclusion(s): Preoperative elevated TyG index was associated with worse clinical outcomes such as increased incidence of MACE and MACCE in patients undergoing CABG, especially among diabetes mellitus (DM) patients. Besides, higher TyG-BMI index indicated increased risk of AKI in diabetic patients. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <137> Accession Number 2048943348 Title Comparative Study of 0.75% Hyperbaric Ropivacaine versus 0.75% Hyperbaric Ropivacaine with Clonidine for Lower Limb Surgeries under Spinal Anaesthesia. Source International Journal of Current Pharmaceutical Review and Research. 18(4) (pp 1274-1280), 2026. Date of Publication: 2026. Author Sripriyanka R.; Lalitha R.; Anoumandane A.; Ravi B. Institution (Sripriyanka, Anoumandane, Ravi) Department of Anaesthesia, ACS Medical College and Hospital, Tamil Nadu, Chennai, India (Lalitha) Department of Anaesthesia, Faith Multispeciality Hospital, Perambur, Tamil Nadu, Chennai, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Spinal anaesthesia remains a cornerstone technique for lower-limb surgeries, and optimizing the balance between rapid onset, prolonged analgesia, and hemodynamic stability continues to be an important area of clinical research. Objective(s): To compare the onset, duration, and quality of sensory and motor blockade, along with hemodynamic stability and adverse effects, between 0.75% hyperbaric ropivacaine alone and 0.75% hyperbaric ropivacaine with clonidine in patients undergoing lower-limb surgeries under spinal anaesthesia. Method(s): This single-centre, prospective, randomized controlled study was conducted in the Department of Anaesthesia, ACS Medical College and Hospital, Chennai, from April 2023 to April 2025, after obtaining IHEC approval (Ref: 816/2023/IEC/ACSMCH). Result(s): Both groups (n=60 each) were demographically and hemodynamically comparable at baseline, with similar age (38.7 +/- 10.1 vs 39.3 +/- 7.6 years), BMI (25.4 +/- 4.4 vs 26.3 +/- 5.1 kg/m2), and vitals (p > 0.05). After spinal anaesthesia, both groups showed transient reductions in heart rate and systolic blood pressure that returned to near-baseline by surgery end. Heart rate declined to 71.4 bpm in Group A and 75.5 bpm in Group B, while SBP reached nadirs of 109.0 mmHg and 103.5 mmHg, respectively. Group B exhibited significantly faster onset of sensory (4.1 min) and motor block (5.1 min), whereas Group L showed markedly longer sensory (263.8 min) and motor block (248.9 min) durations (both p < 0.001). Adverse events were more frequent in Group L (30.0% vs 8.3%, p = 0.007), mainly nausea, pruritus, and bradycardia, indicating a trade-off between prolonged analgesia and tolerability. Conclusion(s): Adding clonidine to 0.75% hyperbaric ropivacaine under spinal anaesthesia significantly prolonged sensory and motor blockade and delayed analgesic requirement but increased adverse events, whereas ropivacaine alone achieved a faster onset with fewer side effects, supporting regimen selection based on the desired balance between duration and tolerability. Copyright © 2026, This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided original work is properly credited. <138> Accession Number 2048852609 Title Functional mitral valve regurgitation outcomes by treatment modality: a systematic review and meta-analysis of reconstructed survival data. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 755. Date of Publication: 01 Dec 2026. Author Dastjerdi P.; Tavakoli K.; Narimani-Javid R.; Anaraki N.; Shayesteh H.; Hosseini Mohammadi N.S.; Momeni S.; Nikfar R.; Rahmati S.; Mohsen A.; Hosseini K.; Soleimani H. Institution (Dastjerdi, Tavakoli, Anaraki, Shayesteh, Hosseini Mohammadi, Momeni, Nikfar, Rahmati, Soleimani) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Narimani-Javid) Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mohsen) Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, United States (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Publisher BioMed Central Ltd Abstract Background: Functional mitral regurgitation (FMR) carries poor prognosis, and optimal management remains debated. Mitral Transcatheter Edge-to-Edge Repair (MTEER) is an alternative to surgical repair (SMVR) or optimized medical therapy (OMT), but long-term outcomes are uncertain. Method(s): PubMed, Embase, Scopus, and the Cochrane Library were searched for studies reporting Kaplan-Meier curves of MTEER, SMVR, or OMT in FMR. Individual patient data (IPD) were reconstructed using the Liu method with accuracy checks. Pooled IPD were analyzed with Cox and time-varying Cox models, landmark, time-restricted, and restricted mean survival time analyses. Result(s): Sixteen studies (n = 4,570) were included. Patients undergoing MTEER were older and higher risk, with greater prevalence of atrial fibrillation, prior myocardial infarction, chronic kidney disease, higher EuroSCORE, and more frequent NYHA class >= III compared with SMVR. Over up to 60 months, both MTEER (HR: 0.65; 95% CI: 0.57-0.75; p < 0.001) and SMVR (HR: 0.39; 95% CI: 0.33-0.46; p < 0.001) significantly reduced all-cause mortality versus OMT, whereas MTEER carried higher mortality risk than SMVR (HR: 1.68; 95% CI: 1.43-1.97; p < 0.001). MTEER was less effective than SMVR in reducing recurrent MR > 2 (HR: 3.31; 95% CI: 1.62-6.75; p < 0.001) and reoperation (HR: 4.62; 95% CI: 2.22-9.61; p < 0.001). In contrast, MTEER reduced hospitalization risk by 30% compared to OMT (HR: 0.70; 95% CI: 0.64-0.77; p < 0.001) and decreased MACE by 21% (HR: 0.79; 95% CI: 0.73-0.84; p < 0.001). Conclusion(s): MTEER improves survival and reduces hospitalization and MACE compared with OMT but is less durable than SMVR, with higher risks of recurrent MR, reoperation, and late mortality. Copyright © The Author(s) 2026. <139> Accession Number 2048852610 Title Direct oral anticoagulants versus vitamin K antagonists after left atrial appendage occlusion: a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 754. Date of Publication: 01 Dec 2026. Author Dai Y.; Chang J.; Guo J. Institution (Dai, Chang) International Medical Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (Guo) Department of Nursing, Guang'anmen Hospital, Academy of Chinese Medical Sciences, No. 5 Beixiange, Xicheng District, Beijing, China Publisher BioMed Central Ltd Abstract Background: Non-valvular atrial fibrillation (NVAF) elevates the risk of stroke owing to thrombus development, especially in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) provides stroke prophylaxis for those unable to tolerate prolonged anticoagulant therapy. This meta-analysis evaluates the effectiveness and safety of direct oral anticoagulants (DOACs) in comparison to vitamin K antagonists (VKAs) following LAAO, concentrating on ischemic stroke, systemic embolism (SE), severe bleeding, and device-related thrombosis. Method(s): A comprehensive literature search was conducted in Web of Science, Cochrane Library, Embase, and PubMed for studies published between 2017 and 2025. The inclusion criteria were trials involving patients undergoing LAAO who were treated with either DOAC or VKA regimens. The primary outcomes included transient ischemic attack (TIA), SE, ischemic stroke, and major hemorrhage. Any major adverse event was defined as a composite of major bleeding, stroke, SE, device-related thrombosis, and all-cause mortality, and analyzed as a secondary/exploratory outcome due to heterogeneity in component reporting across studies. Meta-analysis was performed using random-effects models for all pooled analyses, given the anticipated clinical and methodological heterogeneity across studies. Subgroup and sensitivity analyses were conducted to further assess the robustness of the findings. Result(s): Twenty-one studies were included. DOACs had a considerably reduced incidence of serious bleeding (OR = 0.88, 95% CI: 0.80-0.98) and any major adverse event (OR = 0.88, 95% CI: 0.82-0.95) than VKAs, but there was no discernible difference in stroke or SE rates (OR = 0.86, 95% CI: 0.69-1.05). Exploratory subgroup analyses suggested potential differences in certain groups (e.g., North America, longer follow-up), but these should be interpreted as exploratory. Secondary outcomes, including peri-device leaks and device-related thrombosis, did not differ significantly between groups. Conclusion(s): DOACs may provide comparable thromboembolic protection with a lower risk of major bleeding than VKAs after LAAO. However, most available evidence is derived from non-randomized studies and remains subject to residual confounding, selection bias, and moderate-to-low certainty of evidence. Therefore, the observed benefits of DOACs should be interpreted cautiously. Further large-scale prospective studies and randomized controlled trials are needed to confirm these findings and inform optimal post-LAAO anticoagulation strategies. Copyright © The Author(s) 2026. <140> Accession Number 2048930161 Title Mechanical versus bioprosthetic valves for tricuspid valve replacement in Chinese patients: a systematic review and meta-analysis. Source Journal of Thoracic Disease. 18(7) (pp 743), 2026. Date of Publication: 31 Jul 2026. Author Song J.; Zong X.; Hou J. Institution (Zong, Hou) Department of Cardiovascular Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, China (Song, Hou) Department of Cardiovascular Surgery, West China Tianfu Hospital of Sichuan University, Chengdu, China Publisher AME Publishing Company Abstract Background: Tricuspid valve replacement (TVR) is a critical intervention for severe tricuspid valve disease but carries high perioperative mortality. The optimal choice between mechanical and bioprosthetic valves remains controversial, and large-sample evidence specific to the Chinese population is lacking. This study aimed to systematically evaluate the clinical efficacy and safety of mechanical versus bioprosthetic valves in Chinese patients undergoing TVR. Method(s): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP (VIP Database), Chinese Biomedical Literature Database (CBM), and the Chinese Medical Journal Database were searched from inception to December 31, 2025. Eligible study types included randomized controlled trials, prospective or retrospective cohort studies, and case-control studies comparing mechanical and bioprosthetic valves in Chinese TVR patients; case reports, reviews, and conference abstracts were excluded. Participants were Chinese patients (including China's mainland, Hong Kong, Macau, and Taiwan) undergoing TVR. The intervention of interest was TVR with a mechanical prosthesis versus a bioprosthesis. Risk of bias for cohort studies was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed with Review Manager 5.4.1, calculating relative risks for dichotomous outcomes and hazard ratios (HRs) for survival data. A fixed-effect model was used when I^2<50%; otherwise, a random-effects model was applied. Result(s): Eight retrospective cohort studies (1,504 patients: 537 mechanical, 967 bioprosthetic) were included. No statistically significant differences emerged between mechanical and bioprosthetic valves in early mortality [risk ratio (RR) 0.70, 95% confidence interval (CI): 0.48-1.02, P=0.06], long-term survival (HR 1.02, 95% CI: 0.57-1.84, P=0.94), or reoperation rate (RR 1.12, 95% CI: 0.61-2.05, P=0.72). Mechanical valves were associated with significantly higher risks of thromboembolic events (RR 2.09, 95% CI: 1.06-4.13, P=0.03) and bleeding events (RR 4.89, 95% CI: 3.12-7.72, P<0.00001). The rate of pacemaker implantation did not differ significantly between groups (RR 0.82, 95% CI: 0.44-1.53, P=0.54). Conclusion(s): In Chinese TVR patients, overall early and long-term survival as well as reoperation rates do not differ significantly between mechanical and bioprosthetic valves when analyzed across heterogeneous populations. However, this finding does not imply that valve type is unimportant for individual patients. However, mechanical valves significantly increase postoperative thromboembolic and bleeding complications. Clinical decision-making should be individualized, considering patient age, life expectancy, anticoagulation adherence, and bleeding risk. For Chinese patients with good life expectancy and reliable anticoagulation access, mechanical valves remain an option; for those with poor adherence or high bleeding risk, bioprosthetic valves may be safer. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <141> Accession Number 2048930432 Title Impact of modern minimally invasive approaches on pulmonary resection outcomes: a narrative review. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 969. Date of Publication: 31 Aug 2026. Author Stegall C.; Lazar J.F. Institution (Stegall) Department of Surgery, University of Tennessee College of Medicine-Nashville, Ascension Saint Thomas Hospital, Nashville, TN, United States (Lazar) Department of Thoracic Surgery, University of Tennessee College of Medicine-Nashville, Ascension Saint Thomas Hospital, Nashville, TN, United States Publisher AME Publishing Company Abstract Background and Objective: Anatomic pulmonary resection remains the gold standard for resectable non-small cell lung cancer (NSCLC). This review evaluates the evolution, intraoperative outcomes, clinical efficiency, oncological adequacy, and cost-effectiveness of minimally invasive thoracic surgery (MITS) relative to traditional open thoracotomy. Method(s): A systematic literature search was conducted in PubMed, Cochrane Library, and Wiley Library for studies published through early 2026, prioritizing randomized controlled trials (RCTs) and large-scale registry analyses comparing video-assisted thoracoscopic surgery (VATS), robotic-assisted thoracic surgery (RVATS), and open thoracotomy. Key Content and Findings: MITS (comprising VATS and RVATS) is associated with significantly lower perioperative mortality, reduced postoperative pain, shorter hospital stays, and fewer complications compared to open thoracotomy. While intraoperative conversion remains a risk, robotic platforms exhibit lower conversion rates than VATS in several large series. Oncologically, all three modalities provide equivalent nodal upstaging and disease-free survival (DFS), provided oncological principles are rigorously maintained. While robotic surgery incurs higher procedural costs, these are partially mitigated by reduced postoperative resource utilization. Conclusion(s): MITS has become the standard of care for early-stage NSCLC. Recent data suggest that robotic platforms may offer advantages in technical precision and lower conversion rates, although VATS remains a highly cost-effective and efficacious approach. Future innovations in single-port robotics continue to advance the reduction of surgical trauma. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <142> Accession Number 2048854088 Title Effect of Perioperative Benzodiazepine Use on Postoperative Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 5856805. Date of Publication: 2026. Author Cunha M.S.K.; Faria H.S.; Barbosa L.M.; Nascimento L.R.D.; Ferreira C.H.O.; Santos K.D.A.D.; Bendaham L.C.A.R.; Silva A.K.B.; Neto A.P.M.; Amador W.F.O.; Neto I.Q.C.; Treml R.E.; Perete C.A. Institution (Cunha) Faculty of Medicine of Marilia, Sao Paulo, Marilia, Brazil (Faria) Federal University of Santa Maria, Rio Grande do Sul, Santa Maria, Brazil (Barbosa) Federal University of Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Nascimento) Amazonas State University, Amazonas, Manaus, Brazil (Ferreira) Federal University of Paraiba, Paraiba, Joao Pessoa, Brazil (Santos, Bendaham, Neto) Federal University of Roraima, Roraima, Boa Vista, Brazil (Silva) Federal University of Alagoas, Alagoas, Maceio, Brazil (Amador) Federal University of Campina Grande, Paraiba, Cajazeiras, Brazil (Neto) University of Wisconsin-Madison, Madison, United States (Treml) Department of Anesthesiology, Stanford School of Medicine, Stanford, CA, United States (Perete) Department of Anesthesiology, Albert Einstein Israelite Hospital, Sao Paulo, Sao Paulo, Brazil Publisher John Wiley and Sons Ltd Abstract Introduction: Cardiac surgery anesthesia is associated with risks such as postoperative delirium (POD) and stress-related responses. Benzodiazepines have been used perioperatively to reduce anxiety and promote hemodynamic control. However, their use may increase the risk of delirium, particularly in older adults. This systematic review and meta-analysis aims to evaluate the impact of perioperative benzodiazepine use on the incidence of POD in patients undergoing cardiac surgery. Method(s): We systematically searched for randomized controlled trials (RCTs) and observational studies comparing benzodiazepines with placebo or nonbenzodiazepine drugs in adults undergoing cardiac surgery. The primary outcome was POD incidence; secondary outcomes included mini-mental state examination (MMSE), ICU length of stay, and time to extubation. For dichotomous outcomes, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, while mean differences (MDs) were used for continuous outcomes. Analyses were performed using R 4.4.3. Result(s): Eight studies were included, comprising 36,301 patients, of whom 20,747 (68.5%) received benzodiazepines. Follow-up ranged from 1 day to 12 months. There were no significant differences between groups in the incidence of POD (OR 1.05; 95% CI: 0.88 to 1.25; p = 0.55; I2 = 83%). Similarly, there were no significant difference in MMSE score (MD -0.11; 95% CI: -3.17 to 2.95; p = 0.94; I2 = 70%), ICU length of stay (MD 4.72 h; 95% CI: -1.37 to 10.80; p = 0.13; I2 = 99%), and time to extubation (MD -0.53 h; 95% CI: -2.16 to 1.09; p = 0.52; I2 = 72%). Conclusion(s): Perioperative benzodiazepine use was not significantly associated with POD or with secondary outcomes in adults undergoing cardiac surgery. Copyright © 2026 Marcela da Silva Kazitani Cunha et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <143> Accession Number 2048930535 Title Prevention and management of pulmonary vascular complications in anatomic lung resections: a narrative review. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 966. Date of Publication: 31 Aug 2026. Author Cassidy R.; Robinson W.; Dong G.; Schumacher L. Institution (Cassidy, Robinson, Schumacher) Division of Thoracic Surgery, Department of Surgery, Tufts Medical Center, Boston, MA, United States (Dong) Tufts University School of Medicine, Boston, MA, United States Publisher AME Publishing Company Abstract Background and Objective: Pulmonary artery (PA) injury during anatomic lung resection remains a rare but potentially catastrophic complication. With the increasing adoption of robotic-assisted thoracoscopic surgery (RATS), the absence of tactile feedback and the growing use of neoadjuvant therapies introduce unique challenges. This review aims to summarize the epidemiology, risk factors, prevention strategies, and intraoperative management of vascular injuries in the era of minimally invasive thoracic surgery. Method(s): A narrative review of the literature was performed, with inclusion of English-language studies between 2005 and 2026 focusing on studies evaluating intraoperative vascular complications during video-assisted thoracoscopic surgery (VATS) and RATS lung resections. Emphasis was placed on reported incidence, risk factors, perioperative outcomes, and technical strategies for prevention and management. Exclusion criteria included preprints and studies without mention of vascular injury or anatomic lung resection. Key Content and Findings: The incidence of PA injury during minimally invasive lung resection remains low, with reported rates ranging from 1.5-2.9% for VATS and 0.5-2.6% for RATS. Identified risk factors include upper lobe resections, left-sided tumors, bulky or calcified lymphadenopathy, prior thoracic surgery, pleural adhesions, advanced tumor stage, squamous histology, and use of neoadjuvant therapy. Preventative strategies include detailed preoperative planning with three-dimensional computed tomography and careful dissection informed by bronchovascular anatomy. Intraoperative management is multifactorial and relies on adherence to the "four P's": poise, pressure, preparedness, and proximal control. While many injuries can be managed minimally invasively, prompt conversion to thoracotomy remains critical when hemostasis cannot be achieved safely. Conclusion(s): PA injuries during lung resection require a high level of surgical awareness, preparation, and technical proficiency. As the use of RATS and induction therapies continues to expand, structured strategies for prevention and management are essential to maintain patient safety and optimize outcomes. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <144> Accession Number 2048896339 Title Perioperatively acquired muscle weakness (POAW) across cardiac surgical subtypes: a post-hoc repeated measures analysis of the CORTERAS trial. Source Journal of Cardiothoracic and Vascular Anesthesia. Conference: Journal of Cardiothoracic and Vascular Anesthesia. Maastricht Netherlands. 40(10 Supplement) (pp 40-41), 2026. Date of Publication: 01 Sep 2026. Author Renette W.; Meex I.; Stragier H.; Mesotten D.; Thiessen S. Institution (Renette, Meex, Stragier, Mesotten, Thiessen) Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Centre, Ziekenhuis Oost-Limburg, Genk, Belgium (Renette) Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium (Renette, Mesotten, Thiessen) Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium (Renette, Thiessen) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (Renette, Mesotten, Thiessen) Limburg Clinical Research Centre (LCRC), Belgium Publisher W.B. Saunders Abstract Introduction: Intensive care unit-acquired weakness (ICU-AW) is a well-recognised complication associated with physical impairment and markedly reduced quality of life. Patients undergoing major surgery are exposed to a comparable setting and a pronounced surgical stress response. A comparable decline in muscular function may develop in the perioperative period, so-called perioperatively acquired muscle weakness (POAW). As different cardiac surgical procedures may be associated with different degrees of surgical stress, including the use of cardiopulmonary bypass, these differences may result in different degrees of POAW. This post-hoc analysis of the CORTERAS trial aimed to characterise postoperative handgrip strength (HGS) decline across three cardiac surgical subtypes. Method(s): This was a post-hoc subanalysis of the CORTERAS trial (NCT05220319), an RCT on the effects of intravenous methylprednisolone on POAW in older adult patients (>= 60 years) undergoing major surgery. Patients undergoing on-pump CABG, off-pump CABG, or valve surgery were included. HGS was measured at baseline and on postoperative days (POD) 1, 3, and 5 using a handheld dynamometer (mean of three measurements). The percentage decrease from baseline was analysed using a mixed model for repeated measures, including surgical subtype, postoperative timepoint, and their interaction, adjusted for sex, age, and randomisation group. Tukey-Kramer-adjusted pairwise contrasts were performed at each timepoint. Result(s): A total of 289 patients were included (97 on-pump CABG, 96 off-pump CABG, 96 valve surgery). Baseline characteristics were broadly comparable, except sex distribution (on-pump CABG 8%, off-pump CABG 17%, valve surgery 38% female), which was accounted for in the model. Significant main effects were observed for timepoint and surgical subtype (P < 0.001) and postoperative timepoint (P < 0.001), with a significant surgical subtype x timepoint interaction (P = 0.003), indicating divergent recovery trajectories between groups. Randomisation group had no significant effect on HGS decline (P = 0.742). On POD1, on-pump CABG patients showed the greatest mean HGS decline (-20.2%), significantly exceeding both off-pump CABG (-8.3%; EMD -12.0%; P < 0.001) and valve surgery (-13.4%; EMD -6.9%; P = 0.047). Off-pump CABG and valve surgery did not differ significantly on POD1 (EMD -5.1%; P = 0.307). By POD3, group differences narrowed (on-pump CABG -14.4%; off-pump CABG -8.5%; valve surgery -12.0%), and no pairwise comparison reached significance. By POD5, all groups showed substantial recovery (on-pump CABG -10.4%; off-pump CABG -5.2%; valve surgery -6.7%) with no significant between-group differences remaining (all P > 0.05). Discussion(s): On-pump CABG was associated with the greatest and most sustained postoperative HGS decrease, whilst off-pump CABG consistently demonstrated the least muscle strength loss across all timepoints. These findings suggest that surgical subtype is an important determinant of POAW trajectories in cardiac surgery, with possible implications for quality of recovery and postoperative quality of life. Copyright © 2026 <145> Accession Number 2048844028 Title Impact of high fraction of inspired oxygen before extubation on incidence of postoperative atelectasis in children: a randomized controlled trial. Source Pediatric Research. (no pagination), 2026. Date of Publication: 2026. Author Gupta A.; Shephali S.; Yaddanapudi S.; Bhardwaj N.; Malik M.A.; Kumar S.; Khanal S.; Patnaik S. Institution (Gupta, Shephali, Yaddanapudi, Bhardwaj, Kumar, Khanal, Patnaik) Department of Anesthesia and Intensive Care, fourth floor, PGIMER, Chandigarh, India (Malik) Department of Pediatric Surgery, 6th floor, PGIMER, Chandigarh, India Publisher Springer Nature Abstract Background: High fraction of inspired oxygen (FiO<inf>2</inf>) leads to absorption atelectasis during general anesthesia. This can further lead to decreased compliance, increased intrapulmonary shunt, increased pulmonary vascular resistance, hypoxemia, and lung injury. Method(s): To compare the atelectasis formation in pediatric patients receiving different FiO<inf>2</inf> before extubation. We evaluated 64 children, aged 1-14 years, ASA status I/ II, planned for elective non-thoracic, non-abdominal surgery in supine position with anticipated duration of general anesthesia between 1 and 3 h from August 2021 to July 2024. Patients were allocated to receive either low FiO2 (50%) or high FiO2 (100%) before extubation. Lung ultrasound was performed before and after extubation in all patients to assess for the presence of atelectasis. Result(s): A statistically significant difference in incidence of postoperative atelectasis was found between low and high FiO<inf>2</inf> groups (0% versus 56.3%; p < 0.001). There was no case of postoperative desaturation in either group. The incidence of postoperative fever was also similar between the groups (4/32 versus 5/32; p = 1.00) and was not associated with postoperative atelectasis (OR 0.69; 95% CI 0.13;3.72). Conclusion(s): 100% FiO<inf>2</inf> in children before extubation favors postoperative atelectasis formation, which can be reduced with administration of lower oxygen fractions. Impact: This study is the first randomized controlled trial in children to evaluate the effect of pre-extubation inspired oxygen concentration on post-extubation atelectasis, using lung ultrasound. Even short-term administration of 100% FiO2 (10-20 min) before extubation significantly increases the incidence and severity of postoperative atelectasis in children. A lower FiO2 of 50% before extubation can be safely used, challenging the routine practice of 100% oxygen during emergence. The results refine existing knowledge by identifying extubation as a critical, previously under-studied window for oxygen-induced atelectasis, thereby emphasizing on lung-protective extubation strategies in children. Copyright © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2026. <146> Accession Number 2048517904 Title Thoracic Intradural Disc Herniation Mimicking a Meningioma: a Case Report and Review of the Literature. Source Brain and Spine. Conference: Brain and Spine. Lucerne Switzerland. 6(Supplement 1) (no pagination), 2026. Article Number: 106229. Date of Publication: 01 Jan 2026. Author Imwinkelried L.; Ates K.; Chiappini A. Institution (Imwinkelried, Ates, Chiappini) Spine Surgery, University Hospital Basel, Basel, Switzerland Publisher Elsevier B.V. Abstract Objective: Thoracic intradural disc herniation (IDH) is a rare entity, often misdiagnosed because of its nonspecific radiological appearance. We reviewed the literature to characterize the clinical, radiological, and surgical features of thoracic IDH and present a representative T12 case radiologically misdiagnosed as a spinal meningioma on magnetic resonance imaging (MRI). Method(s): A systematic review of MEDLINE (PubMed), Embase, and Cochrane databases was performed on June 1, 2026, following PRISMA guidelines. Search terms combined thoracic disc herniation with intradural, intrathecal, and transdural terminology. English-language studies reporting true soft thoracic IDH were included, whereas calcified lesions with dural erosion and non-thoracic cases were excluded. Demographic, clinical, radiological, surgical, and outcome data were extracted. We further report an 82-year-old woman with progressive myelopathy caused by a T12 intradural lesion radiologically diagnosed as a meningioma. Result(s): Thirteen studies comprising 18 patients met inclusion criteria. Median age was 57 years, and 61.1% were female. The most commonly affected level was T12/L1 (38.9%). Common presentations included myelopathy (83.3%), pain (44.4%), and bladder or sphincter dysfunction (22.2%). Preoperative diagnosis was challenging; only 3 of 13 cases with detailed imaging descriptions were correctly suspected as IDH, while most were misdiagnosed as intradural-extramedullary tumors. Typical MRI findings included T1 iso- to hypointense and T2 hypointense lesions with peripheral ring enhancement. All patients underwent surgical removal. Outcomes were generally favorable, with over half achieving complete neurological recovery and no persistent deterioration. In the illustrative case, surgery revealed a ventral dural defect, and histopathology confirmed IDH. The patient returned to baseline neurological function, and follow-up imaging demonstrated complete decompression. Conclusion(s): Thoracic IDH is a rare but important differential diagnosis of ventral intradural-extramedullary lesions. Because it frequently mimics intradural tumors, recognition of characteristic MRI features, including peripheral ring enhancement, absence of a dural tail, and continuity with the intervertebral disc, may facilitate early diagnosis, improve surgical planning, and optimize neurological outcomes. Copyright © 2026 <147> Accession Number 2048930786 Title Chronic pain after thoracic surgery: mechanisms, risk factors, and limitations of current preventive strategies-a narrative review. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 975. Date of Publication: 31 Aug 2026. Author Gu Y.; Liu J.; Wen Z.; Lv X.; Hu X. Institution (Gu, Liu, Wen, Lv) Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China (Hu) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 507 Zhengmin Road, Shanghai, China Publisher AME Publishing Company Abstract Background and Objective: Despite advances in surgical techniques and perioperative analgesia, chronic pain after thoracic surgery (CPTS) is a common and clinically significant complication. Its continued prevalence suggests that current preventive strategies remain insufficient. This narrative review aimed to synthesize current evidence on the mechanisms, risk factors, and limitations of existing preventive strategies for CPTS, with a focus on the transition from acute to chronic pain. Method(s): PubMed, Embase, and Web of Science were searched from database inception to March 2026 for English-language evidence on thoracic surgery, chronic postsurgical pain, risk factors, mechanisms, and perioperative interventions. Thoracic-specific systematic reviews, randomized trials, and prospective studies were prioritized and narratively synthesized; mechanistically informative and selected non-thoracic translational evidence was included where directly relevant. Key Content and Findings: CPTS is a multifactorial condition involving peripheral nerve injury, neuroinflammation, central sensitization, psychological vulnerability, and the evolving postoperative pain trajectory. Preoperative pain and severe acute postoperative pain are among the most reproducible clinical signals, whereas demographic and procedure-related predictors are less consistent. Multimodal and regional analgesia improve acute recovery, but evidence for CPTS prevention remains inconsistent, partly because brief perioperative interventions may not address prolonged or heterogeneous mechanisms. Early persistent pain may therefore provide a clinically relevant window for reassessment and selective escalation of care. Conclusion(s): No single intervention reliably prevents CPTS. Standard procedure-specific multimodal care should be combined with longitudinal risk assessment, attention to dynamic pain trajectories, and selective psychological or transitional pain support. Future trials should test externally validated, risk-stratified care pathways rather than isolated short-duration interventions. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <148> Accession Number 2048931180 Title Myocardial infarction and lung cancer research from 1995 to 2026: a WoSCC- and PubMed-based bibliometric analysis. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 856. Date of Publication: 31 Aug 2026. Author Zheng X.; Liu Y.; Chen W.; Chen X.; Li T.; Dai Y.; Teng X.; Kong W.; Lin Z.; Guo J.; Fu Z.; Chen S.; Liu J. Institution (Zheng) Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China (Liu, Lin, Fu, Liu) Department of Cardiology, The First Affiliated Hospital of Guangdong Pharmaceutical University, The First Clinical Medical School of Guangdong Pharmaceutical University, Guangdong Pharmaceutical University, Guangzhou, China (Chen, Guo) Department of Cardiovascular Disease, Shantou Hospital of Traditional Chinese Medicine, Shantou, China (Chen) Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, China (Chen) Department of Cardiology, Huizhou Third People's Hospital, Huizhou Hospital Affiliated to Guangzhou Medical University, Huizhou, China (Chen) Department of Pathology, Shenzhen Hospital, Southern Medical University, Shenzhen, China (Li) Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China (Dai) Department of International Medical Services, Cancer Hospital of Shantou University Medical College, Shantou, China (Teng) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Kong) Shantou University Medical College, Shantou, China (Chen) Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China Publisher AME Publishing Company Abstract Background: Myocardial infarction (MI) and lung cancer frequently coexist within the broader context of cardio-oncology, yet the development, contributors, and thematic evolution of this research interface have not been comprehensively mapped. Method(s): English-language articles and reviews published from 1995 through June 2026 were retrieved independently from the Web of Science Core Collection (WoSCC) and PubMed. WoSCC served as the primary dataset for citation, collaboration, co-occurrence, co-citation, and thematic analyses, whereas PubMed was used for supplementary validation using biomedical indexing and Medical Subject Headings. Bibliometric analyses were performed using R/Bibliometrix, CiteSpace, VOSviewer, and Microsoft Excel. Result(s): After screening, 2,274 WoSCC records and 1,326 PubMed records were included. The annual growth rates were 0.91% and 3.35%, respectively. The United States contributed the largest publication output in both databases, followed by China, although the United States showed a stronger international collaboration profile. Harvard University led WoSCC institutional output, whereas Harvard Medical School ranked first in PubMed. PLoS One was the most productive WoSCC source, while the European Journal of Cardio-Thoracic Surgery ranked first in PubMed. Thematic analyses identified mortality, cardiovascular risk, smoking, thromboembolic complications, and clinical outcomes as persistent core topics. Over time, research emphasis shifted from smoking, epidemiology, and conventional cardiovascular risk toward cardio-oncology, cardiotoxicity, immunotherapy, targeted therapies, anticoagulation, thromboembolism, and treatment-related adverse events. Conclusion(s): Research at the MI-lung cancer interface has expanded substantially and increasingly reflects the cardiovascular implications of contemporary lung cancer care. Future work should prioritize prospective multicenter studies, standardized cardiovascular endpoints, and integrated strategies for risk assessment, surveillance, and management in patients with lung cancer who are vulnerable to ischemic cardiovascular events. Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License CC BY-NC-ND 4.0, which permits the non commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited including links to both the formal publication through the relevant DOI and the license. See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <149> [Use Link to view the full text] Accession Number 2048891829 Title Sentinel Cerebral Embolic Protection in Patients with Transcatheter Aortic Valve Replacement: A Meta-analysis of Randomized Controlled Trials and Trial Sequential Analysis. Source Cardiology in Review. (no pagination), 2025. Date of Publication: 2025. Author Joshi D.K.; Kirmani N.; Pinilia J.; Ratan P.; Majeed M.W.; Purohit A.; Desai D.P.; Garg Y.; Maheta D.K.; Agrawal S.P. Institution (Joshi, Purohit) From the Department of Internal Medicine, Narendra Modi Medical College and Sheth L.G. Hospital, Ahmedabad, India (Kirmani) Department of Internal Medicine, Dow Medical College, Karachi, Pakistan (Pinilia) Department of Internal Medicine, School of Medicine, CES University, Medellin, Colombia (Ratan) Department of Internal Medicine, Patna Medical College, Patna, India (Majeed) Department of Internal Medicine, VMMC and Safdarjung Hospital, New Delhi, India (Desai) Department of Internal Medicine, B.J. Medical College, Ahmedabad, India (Garg) Department of Internal Medicine, North Knoxville Medical Center, Powell, TN, United States (Maheta) Department of Public Health, New York Medical College, Valhalla, NY, United States (Agrawal) Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI, United States Publisher Lippincott Williams and Wilkins Abstract Transcatheter aortic valve replacement (TAVR) is widely used to treat severe aortic stenosis, and stroke remains a serious complication. The Sentinel cerebral embolic protection (CEP) device is designed to reduce this risk. However, it is still unclear if it truly improves patient outcomes. This meta-analysis evaluates whether the Sentinel device reduces stroke, death, or neurological complications. We searched PubMed, Embase, and Cochrane Central for randomized controlled trials comparing the use of the Sentinel CEP versus no device in patients undergoing TAVR. Outcomes included stroke within 72 hours, disabling stroke, any stroke, transient ischemic attack, and mortality. Statistical analysis was performed using R version 4.4.2. Heterogeneity was assessed using the I2 statistic. Five randomized controlled trials with 11, 006 patients were included; 50.0% (n = 5502) received the CEP device and 50.0% (n = 5504) did not. Lower risk of stroke within 72 hours was observed with Sentinel CEP, although the difference was nonsignificant [2.3% vs 2.5%; risk ratio (RR): 0.88, 95% confidence interval (CI): 0.69-1.12; P = 0.292; I2 = 0%]. No significant difference was observed in the incidence of transient ischemic attack between both groups (0.4% vs 0.3%; RR: 1.28, 95% CI: 0.66-2.50; P = 0.465; I2 = 0%). All-cause mortality rates were comparable between both groups (0.7% vs 0.7%; RR: 1.08, 95% CI: 0.69-1.69; P = 0.748; I2 = 0%). CEP during TAVR was not associated with a significant reduction in neurological or mortality outcomes, indicating no clear overall clinical benefit in the studied population. Further studies are needed to determine its potential role in selected high-risk patients. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <150> Accession Number 2048840399 Title Chronic kidney disease following pediatric cardiac surgery: a systematic review and meta-analysis. Source BMC Pediatrics. 26(1) (no pagination), 2026. Article Number: 814. Date of Publication: 01 Dec 2026. Author Badeli H.; Motiei M.; Nejad A.T.; Hassanzadeh-Rad A. Institution (Badeli, Motiei, Hassanzadeh-Rad) Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Nejad) Inflammatory Lung Diseases Research Center, Department of Internal Medicine, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet the true burden of CKD remains unclear due to limited data. Objective(s): To determine the pooled prevalence of chronic kidney disease among pediatric patients with a history of cardiac surgery. Material(s) and Method(s): A systematic literature search was conducted in PubMed, Scopus, and Web of Science from inception to March 1, 2025. Eligible studies included those reporting CKD prevalence in patients under 18 years of age who had undergone any type of cardiac surgery. We performed this systematic review and meta-analysis following PRISMA guidelines and Cochrane Collaboration recommendations using a random-effects model. Pooled prevalence estimates were calculated with 95% confidence intervals (95% CI). Result(s): Data from five prospective studies involving 1002 pediatric patients were included. The studies were published between 2016 and 2022 and conducted in Canada, France, the United States, and Belgium. The pooled prevalence of CKD was 16% (95% CI: 9.0-26.0%), with moderate heterogeneity across studies (I2 = 49.5%, p = 0.09). Sensitivity analysis confirmed the stability of the pooled estimate. Conclusion(s): The findings of this analysis highlight the need for long-term renal monitoring in this population, although further high-quality studies with standardized definitions and extended follow-up are warranted to confirm and refine these estimates. Copyright © The Author(s) 2026. <151> Accession Number 2048930474 Title Global research trends in robotic coronary artery bypass grafting: a bibliometric analysis. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 942. Date of Publication: 31 Aug 2026. Author Ren T.; Qiu J.; Yao H.; Ye X.; Zhao Q. Institution (Ren, Qiu, Yao, Ye, Zhao) Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ren) Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Publisher AME Publishing Company Abstract Background: Robotic coronary artery bypass grafting (CABG) has gained increasing attention as a minimally invasive approach to coronary revascularization. This study aimed to characterize the global research landscape, publication trends, and thematic evolution of robotic CABG through bibliometric analysis. Method(s): Publications related to robotic CABG were retrieved from PubMed, Web of Science Core Collection, and Scopus databases, covering the period from January 1, 1997 to December 31, 2025. After data merging and deduplication, bibliometric analyses were performed using CiteSpace, VOSviewer, and the Bibliometrix R package. Annual publication trends, contributions by authors, institutions, countries, journal distribution, collaboration networks, co-citation relationships, and keyword co-occurrence patterns were systematically evaluated. Result(s): Research output on robotic CABG increased steadily over time, with more pronounced growth after 2015 and a peak in 2024. Original articles accounted for the largest proportion of publications. The United States was the leading contributor and the main hub of international collaboration, followed by Austria and Germany, while China showed increasing productivity in recent years. Key journals included Annals of Thoracic Surgery and Innovations. Thematic evolution demonstrated a change from early studies focused on technical feasibility toward later research emphasizing minimally invasive revascularization strategies and clinical outcomes including mortality, graft patency, survival, and quality of life. Conclusion(s): Robotic CABG research has expanded substantially over the past three decades, with its focus gradually changing from technical development to clinical outcome assessment. However, the evidence base remains limited by a predominance of observational studies from specialized centers and a lack of robust randomized comparative data. Future research should prioritize multicenter prospective studies assessing long-term efficacy, patient-reported outcomes, and cost-effectiveness to better define the role of robotic CABG in coronary revascularization. Copyright © AME Publishing Company. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <152> Accession Number 2048930732 Title Impact of preoperative sarcopenia on the mortality risk in patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis. Source Journal of Thoracic Disease. 18(8) (no pagination), 2026. Article Number: 847. Date of Publication: 31 Aug 2026. Author Xu C.; Gao Y.; Pan Q.; Xu Z. Institution (Xu, Gao, Pan, Xu) Department of Cardiac Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1, West Huanghe Road, Huaian, China Publisher AME Publishing Company Abstract Background: The association of preoperative sarcopenia with risk of mortality among patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. This study aimed to clarify the impact of sarcopenia on the mortality risk in such patients. Method(s): PubMed, Embase and Web of Science databases were searched up to June 2, 2026. Primary outcome was the all-cause mortality and secondary outcomes were cardiovascular mortality and noncardiovascular mortality. Subgroup analyses based on the defined indicators of sarcopenia and study design were performed. Result(s): Thirteen studies with 6,865 patients were included and most studies were retrospective. Pooled results demonstrated that the presence of sarcopenia was significantly associated with increased risk of all-cause mortality [hazard ratio (HR) =1.55, 95% confidence interval (CI): 1.31-1.84, P<0.001]. Subgroup analyses based on the defined indicators (cross-sectional area: HR =1.55, P=0.04; skeletal muscle mass index: HR =1.41, P=0.002; psoas muscle area: HR =1.37, P=0.02; psoas muscle volume index: HR =1.77, P=0.003; psoas muscle index: HR =1.68, P<0.001) and study design (retrospective: HR =1.51, P<0.001; prospective: HR =2.69, P=0.02) manifested consistent results. Besides, presence of sarcopenia was also associated with increased risk of cardiovascular mortality (HR =1.14, 95% CI: 1.01-1.28, P=0.03), which was indicated by one available study. Conclusion(s): The presence of preoperative sarcopenia indicated higher risk of all-cause and cardiovascular mortality among patients undergoing TAVI. Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License CC BY-NC-ND 4.0, which permits the non commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited including links to both the formal publication through the relevant DOI and the license. See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <153> Accession Number 2048780865 Title Impact of liposomal bupivacaine parasternal block combined with rectus sheath block on postoperative pain in patients undergoing sternotomy for cardiac surgery: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 533. Date of Publication: 01 Dec 2026. Author Huang Y.; Hong M.; Mao Q.; Liang D.; Liu G.; Huang M.; Zhong H.; Lu Y.; Zhong Y.; Chen Y. Institution (Huang, Hong, Mao, Liang, Liu, Huang, Zhong, Lu, Zhong, Chen) Department of Anesthesiology and Operating Center, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China Publisher BioMed Central Ltd Abstract Objective: To compare the effects of liposomal bupivacaine and ropivacaine for ultrasound-guided parasternal block combined with rectus sheath block (PSB + RSB) on acute and chronic postoperative pain in patients undergoing cardiac sternotomy, so as to provide an evidence-based basis for optimizing the multimodal analgesia regimen for such surgeries. Method(s): A total of 90 patients scheduled for elective median sternotomy cardiac and great vessel surgery at the Institute of Cardiovascular Diseases, The First Affiliated Hospital of Guangxi Medical University from April 2024 to February 2025 were enrolled. They were divided into the liposomal bupivacaine group (group LB, n=45) and the ropivacaine group (group ROP, n=45) using the random number table method. After endotracheal intubation under general anesthesia, group LB was given 40 mL of 266 mg liposomal bupivacaine injection for bilateral PSB+RSB, while group ROP was administered 40 mL of 0.375% ropivacaine injection for the same block regimen.The following outcomes were recorded at different postoperative time points: cumulative consumption of analgesic drugs (calculated as morphine milligram equivalents, MMEs), scores of Numeric Rating Scale (NRS, 0-10 points) for pain assessment, scores of Quality of Recovery-15 (QoR-15) scale, and the incidence of adverse events. Result(s): A total of 88 patients completed the study (2 patients in group LB were excluded due to surgical duration exceeding 8 hours). At 24 h and 48 h after the first postoperative awakening, the cumulative MMEs consumption in group LB was significantly lower than that in group ROP [55.30(47.80,62.10) vs 68.00(48.40,80.00) mg, 76.30(68.80, 83.10) mg vs 86.00(63.40,119.60), all P < 0.05]. At 4 h and 12 h post-extubation, the activity-related NRS scores in group LB were significantly lower than those in group ROP [2.00(2.00, 2.00) points vs 2.00(2.00,3.00) points, 2.00(2.00,3.00) points vs 3.00(2.00,4.00) points, all P < 0.05]. At 24 h, 48 h and 72 h post-extubation, the QoR-15 scores in group LB were significantly higher than those in group ROP [(85.4+/-11.78) points vs (74.7+/-9.89) points, (91.6+/-10.4) points vs (86.8+/-8.6) points, (107.1+/-9.87) points vs (100.0+/-9.15) points, all P < 0.05]. The incidence of postoperative nausea and vomiting in group LB (16.3%, 7/43) was significantly higher than that in group ROP (2.2%, 1/45) (P < 0.05). There were no significant differences between the two groups in postoperative endotracheal extubation time, ICU stay time, hospital stay, and the incidence of chronic postsurgical pain (CPSP) at 3 months after surgery. Conclusion(s): The use of liposomal bupivacaine for PSB+RSB block in patients undergoing cardiac sternotomy can significantly reduce postoperative analgesic consumption, optimize early analgesic effect, and improve postoperative recovery quality. However, attention should be paid to the risk of nausea and vomiting, and individualized selection should be made after balancing the benefits and risks in clinical application. Trial registration: Trial registration:This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400084078) on May 10, 2024 (https://www.chictr.org.cn/). Copyright © The Author(s) 2026. <154> Accession Number 2048816236 Title Efficacy and safety of SP16 in preventing acute kidney injury in at-risk subjects with chronic kidney disease undergoing elective cardiac surgery using the heart-lung-machine (EASE-AKI): study protocol for a prospective, randomised, double-blind, placebo-controlled clinical trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 551. Date of Publication: 01 Dec 2026. Author Jobst-Schwan T.; Bihlmaier K.; Austin D.; Gelber C.; Kaemmerer-Suleiman A.-S.; Suleiman M.; Cesnjevar R.; Harig F.; Schiffer M. Institution (Jobst-Schwan, Bihlmaier, Schiffer) Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, Germany (Austin, Gelber) Serpin Pharma, Manassas, VA, United States (Kaemmerer-Suleiman, Suleiman, Cesnjevar, Harig) Department of Cardiac Surgery, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, Germany Publisher BioMed Central Ltd Abstract Background: Cardiac surgery using cardiopulmonary bypass uses controlled hypoperfusion which leads to relative organ damage. Acute kidney injury is the most frequent and most important organ failure, in particular in patients with chronic kidney disease. To date, there are no approved drug treatments that could effectively prevent acute kidney injury. SP16, an agonist of the low-density lipoprotein receptor-related protein 1, has been shown to exert both kidney- and cardioprotective effects in preclinical trials. Early clinical use of SP16 in phase I trials was safe. Administration of SP16 had beneficial trends on inflammatory response and infarct size in patients with ST-segment elevation myocardial infarction. The primary objective of this phase IIa trial is to demonstrate that injection of SP16 is safe and superior to placebo in preventing cardiac surgery-associated acute kidney injury within 7 days after surgery. Method(s): This randomised, double-blinded, placebo-controlled, single-centre study evaluates the efficacy and safety of SP16 in 120 high-risk chronic kidney disease patients with disease stage G2-G3b undergoing cardiac surgery who are randomised into one of two treatment groups in a 1:1 ratio: SP16 (12 mg) or placebo. The study medication is administered via two subcutaneous injections, with the first dose given before surgery, followed by an additional dose after 9 h. Primary endpoints are the incidence of acute kidney injury during 7 days post-surgery and the frequency of adverse events within 72 h after index surgery. Important secondary endpoints include the incidence of major adverse kidney events at day 90 and impact on cardiac function. Safety assessments encompass adverse events, vital signs, electrocardiograms and routine safety laboratory tests. Additional evaluations include pharmacokinetics and immunological biomarkers. Discussion(s): This single-centre phase IIa trial will assess the incidence of cardiac surgery-associated acute kidney injury, describing the kidney-protective potential of SP16 and its safety profile in patients undergoing cardiac surgery. Trial registration: EUCT, EUCT number 2025-522491-89-00. Registered on February 2, 2026, https://euclinicaltrials.eu/ctis-public/view/2025-522491-89-00. Patient recruitment is planned to start on August 1, 2026. Copyright © The Author(s) 2026. <155> Accession Number 652088298 Title Personalizing myocardial revascularization strategies in the setting of acute myocardial infarction. Source Expert review of cardiovascular therapy. (no pagination), 2026. Date of Publication: 29 Aug 2026. Author Mandala A.; Gabara L.; Curzen N.; Jabbour R.J. Institution (Mandala, Gabara, Curzen, Jabbour) Coronary & Structural Heart Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (Curzen, Jabbour) Faculty of Medicine, University of Southampton, Southampton, United Kingdom Abstract INTRODUCTION: Revascularization post myocardial infarction is a complex interplay of patient and anatomical factors. There are a growing number of interventional tools providing both physiological and anatomical delineation of disease burden which can help determine method and extent of revascularization. A tailored approach is required taking into consideration shared decision making, co-morbidities and evolving treatment options. AREAS COVERED: This review article explores the wide array of revascularization techniques of both the culprit lesion and non-culprit lesions in the setting of acute myocardial infarction. A scoping literature review was undertaken of the Pubmed database using key words highlighted below. EXPERT OPINION: Prompt and durable revascularization of the infarct-related coronary artery remains the cornerstone of treatment for acute myocardial infarction. Specifically, timely restoration of normal flow and implantation of a DES during the index procedure remains the gold standard; however, deferred treatment and novel devices such as DCB may have an emerging role. Despite much evidence, complete revascularization of non-culprit coronary artery disease in acute myocardial infarction is still the subject of contention. <156> [Use Link to view the full text] Accession Number 2048792091 Title Efficacy and Safety of Minimally Invasive Maze Versus Conventional Maze for the Treatment of Atrial Fibrillation: A Meta-Analysis of Clinical Outcomes. Source Cardiology in Review. (pp 1-6), 2025. Date of Publication: 2025. Author Cheema S.; Ijaz H.; Faheem M.S.B.; Areeb-Ul-Haq M.; Hassan M.F. Institution (Cheema, Ijaz, Hassan) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Faheem) Department of Medicine and Surgery, Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan (Areeb-Ul-Haq) Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan Publisher Lippincott Williams and Wilkins Abstract The minimally invasive MAZE (mi-MAZE) procedure, a less invasive form of conventional MAZE (c-MAZE) procedure developed by Dr. Randall Wolf, has demonstrated promising outcomes in the treatment of atrial fibrillation. We conducted a meta-analysis by searching PubMed, Embase, Cochrane, and clinical trials databases. After screening 3771 studies, we included 7 studies, a total of 1486 patients, in our analysis. We analyzed dichotomous and continuous outcomes, with 95% confidence intervals (CI), using RevMan 5.4. Heterogeneity was calculated by I2 and chi2. P value <0.05 was deemed significant. This meta-analysis included 7 cohort studies involving 1486 patients. There was a significant decrease in length of hospital stay (days) in the mi-MAZE group (mean difference (MD), -1.22, 95% CI, -1.36 to -1.08, I2 = 97%). At both 6 months and 12 months, sinus rhythm maintenance in the mi-MAZE group was noninferior to the c-MAZE (6 months = odds ratio (OR), 1.48, 95% CI, 0.88-2.51, I2 = 0%, 12 months = risk ratio (RR), 0.99, 95% CI, 0.94-1.03, I2 = 38). mi-MAZE was noninferior to c-MAZE in the safety outcomes such as pneumonia (RR, 0.80, 95% CI, 0.46-1.41, I2 = 27%), stroke (RR, 0.54, 95% CI, 0.11-2.58), and kidney injury (RR, 1.18; 95% CI, 0.38-3.64). In our meta-analysis, mi-MAZE showed a reduction in the length of hospital stay. mi-MAZE was noninferior to c-MAZE in efficacy and safety outcomes. These trends warrant well-designed clinical trials to determine their clinical significance further. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <157> Accession Number 2038572131 Title Does Concurrent Carotid Endarterectomy with Coronary Artery Bypass Grafting Improve Outcomes in Patients with Dual Arterial Disease? A Systematic Review and Meta-Analysis. Source Journal of Cardiovascular and Thoracic Research. 18(2) (pp 93-102), 2026. Date of Publication: 2026. Author Santos K.; Scremin G.M.; Patel N.; Zakani A.; Maris M.I.; Plonek T. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Santos, Plonek) Medisch Spectrum Enschede, Enschede, Netherlands (Scremin) Pontifical Catholic University of Parana, Curitiba, Brazil (Zakani) Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco (Maris) Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Timisoara, Romania Publisher Tabriz University of Medical Sciences Abstract Patients with coexisting carotid and coronary artery disease face a complex surgical decision regarding whether to undergo coronary artery bypass grafting (CABG) alone or combined with carotid endarterectomy (CEA). Evidence remains conflicting, with some studies suggesting stroke reduction from a combined approach while others report increased perioperative morbidity without a survival advantage, contributing to weak ACCF/AHA and ESC/EACTS guideline recommendations. We conducted a systematic review and meta-analysis of randomised controlled trials and propensity-matched studies comparing CABG alone versus CABG+CEA. Five studies involving 23,916 patients were included, of whom 29% underwent combined surgery. CABG+CEA was associated with a significantly higher incidence of perioperative stroke (OR 1.5; 95% CI 1.1-2.0; P = 0.03), but no significant differences were observed in 30-day mortality, major adverse cardiovascular events, myocardial infarction, or hospital length of stay. These findings indicate that adding CEA to CABG increases stroke risk without providing a clear survival benefit, supporting guideline recommendations for a selective, risk-based strategy. Until higher-quality evidence becomes available, concurrent CEA+CABG should be reserved for carefully selected patients in whom the anticipated benefits outweigh potential harms. Copyright © 2026 The Author(s). <158> Accession Number 2048832068 Title Dynamic parameter-guided goal-directed fluid therapy and postoperative acute kidney injury in non-cardiac surgery: a meta-analysis of 11 randomized controlled trials. Source Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Sun X.; Liu Y.; Ren W. Institution (Sun, Liu, Ren) Department of Anesthesiology, Tianjin Hospital, No. 406, Jiefang South Road, Hexi District, Tianjin, China Publisher Springer Abstract The efficacy of goal-directed fluid therapy (GDFT) in preventing postoperative acute kidney injury (AKI) remains controversial. This meta-analysis specifically examined dynamic parameter-guided GDFT using fluid challenges alone in non-cardiac, non-transplant surgery. We systematically searched PubMed, Embase, and the Cochrane Library from inception to December 25, 2025. Randomized controlled trials comparing dynamic index-guided GDFT (SVV, PPV, or PVI) with conventional fluid management in adults undergoing major non-cardiac surgery were included. The primary outcome was postoperative AKI. Subgroup analyses by surgical site and monitoring device invasiveness were pre-specified. The GRADE framework was used to assess evidence certainty. Eleven RCTs comprising 1698 patients were included. Overall, GDFT did not significantly reduce postoperative AKI compared with conventional management (OR 0.93; 95%CI 0.59-1.45; low certainty evidence). No significant differences were observed in 180-day mortality (OR 1.30; 95%CI 0.28-5.99; very low certainty evidence) or ICU length of stay (MD -0.20 days; 95%CI -1.72 to 1.31; very low certainty evidence). GDFT was associated with significantly higher intraoperative colloid administration (MD 167.51 mL; 95% CI 36.02-299.01; very low certainty evidence), though with substantial heterogeneity. Subgroup analysis by surgical site showed no significant differences between groups. A pre-specified subgroup analysis by monitoring device invasiveness showed a significant interaction: invasive devices showed no benefit (OR 1.10; 95%CI 0.78-1.55; very low certainty evidence), while minimally invasive/non-invasive devices were associated with reduced AKI risk (OR 0.13; 95%CI 0.02-0.79; very low certainty evidence), though based on only two small studies. In this meta-analysis, dynamic parameter-guided GDFT did not significantly reduce postoperative AKI in non-cardiac, non-transplant surgery compared with conventional management (low certainty evidence). The substantial heterogeneity in colloid administration highlights variability in GDFT protocols across studies. Trial Registration: PROSPERO Registration, CRD420251274571. Copyright © The Author(s), under exclusive licence to Japanese Society of Anesthesiologists 2026. <159> Accession Number 2048795232 Title Effect of the active cycle breathing technique on pain, anxiety and arterial blood oxygen saturation in patients undergoing coronary artery bypass grafting. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 529. Date of Publication: 01 Dec 2026. Author Solati Kooshkqazi M.; Rakhshan M.; Roosta H.; Shirazi F. Institution (Solati Kooshkqazi) School of Nursing and Midwifery, Shiraz University of Medical Sciences, Namazi Square, Shiraz, Iran, Islamic Republic of (Rakhshan) Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Roosta) Al-Zahra Heart and Martyr Hejazi Hospital, Astaneh Crossroads, Shiraz, Iran, Islamic Republic of (Shirazi) Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Purpose: Addressing pain and anxiety after coronary artery bypass grafting (CABG) is essential. This research evaluates the associations between the Active Cycle of Breathing Technique (ACBT) and pain levels, anxiety, and blood oxygen saturation in patients recovering from CABG surgery. Method(s): Seventy-six patients undergoing CABG surgery were randomly assigned using permuted block randomization (19 blocks of 4 participants) to either the intervention group (n = 38) or the control group (n = 38). After exclusions (2 reoperations in control, 1 withdrawal in intervention), 73 patients completed the study (intervention: n = 37; control: n = 36). The intervention group received ACBT alongside standard respiratory care, consisting of four sessions (two sessions daily at 10:00 AM and 5:00 PM on postoperative days 2 and 3), with each session lasting 10 min and including three phases: breathing control, thoracic expansion exercises, and coughing technique. The control group received standard respiratory care with incentive spirometry (10-20 deep breaths per session) over the same schedule. Outcome measures pain (Visual Analog Scale), anxiety (State-Trait Anxiety Inventory), and arterial oxygen saturation (pulse oximetry) were assessed before intervention and after each of the four sessions by a blinded research assistant. Data were analyzed using repeated measures ANOVA. Result(s): Baseline pain levels differed significantly between groups (p = 0.005), with the intervention group reporting higher pain. After adjusting for baseline differences, the ACBT group demonstrated significantly lower pain scores after the second (p < 0.001), third (p = 0.007), and fourth (p < 0.001) sessions compared to the control group. Anxiety levels were significantly lower in the ACBT group after all four sessions (p = 0.005, p = 0.019, p = 0.010, p = 0.004, respectively). Arterial oxygen saturation was significantly higher in the ACBT group after all four sessions (p < 0.001). Repeated measures ANOVA revealed significant group effects for pain (p < 0.001), anxiety (p = 0.006), and oxygen saturation (p < 0.001). Time effects were significant for anxiety (p < 0.001) and oxygen saturation (p < 0.001), but not for pain (p = 0.491). The group x time interaction was significant only for oxygen saturation (p < 0.001). Conclusion(s): ACBT was associated with lower pain and anxiety and higher arterial oxygen saturation in patients after CABG surgery. These findings suggest that ACBT may warrant consideration for integration into postoperative respiratory care protocols, pending further research with stronger methodological controls. However, the absence of participant blinding and potential attention bias limit causal inference, and future studies with sham controls are needed. Copyright © The Author(s) 2026. <160> Accession Number 2048800825 Title Stellate ganglion block for attenuating postoperative sore throat after double-lumen tube intubation in thoracic surgery: a randomized clinical study. Source Perioperative Medicine. 15(1) (no pagination), 2026. Article Number: 77. Date of Publication: 01 Dec 2026. Author Zhang S.; Wang S.; He Z.; Wang Y. Institution (Zhang) Graduate School, Qinghai University, Qinghai, Xining, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China (He, Wang) Department of Anesthesiology, Qinghai Provincial People's Hospital, Qinghai, Xining, China Publisher BioMed Central Ltd Abstract Background: For thoracic surgery patients who undergo double-lumen endotracheal intubation, postoperative sore throat (POST) remains one of the most common postoperative complication. Objective(s): To evaluate whether preoperative ultrasound-guided stellate ganglion block (SGB) can reduce the incidence and severity of POST, and decrease the postoperative throat VAS score in patients undergoing double-lumen tube (DLT) intubation for thoracic surgery. Method(s): This prospective, randomized, double-blind, controlled clinical trial enrolled 120 patients undergoing elective thoracic surgery with DLT intubation. Participants were randomized into two groups: the SGB group (n = 60) received 2-3 ml of 0.25% ropivacaine under ultrasound guidance on the right stellate ganglion, while the control group (n = 60) received no regional anesthetic intervention prior to anesthesia induction. The primary outcomes included the incidence and severity of POST and the visual analogue scale (VAS) scores for throat pain. Secondary outcomes included the incidence of postoperative hoarseness, cough, and postoperative pulmonary complications (PPCs), as well as the levels of serum inflammatory markers before and 1 day after surgery. Result(s): The incidence of POST was significantly lower in the SGB group at 1 h, 6 h, and 24 h postoperatively compared to the control group (10.3%, 13.8%, and 5.2% vs. 44.1%, 35.6%, and 20.3%, respectively, p < 0.05). The severity grading of POST in the SGB group was also lower than that in the control group at all three time points (p < 0.05). Additionally, the throat VAS scores in the SGB group at 1 h and 6 h postoperatively (0.45 +/- 1.45 and 0.34 +/- 1.05, respectively) were significantly lower than those in the control group (1.88 +/- 2.54 and 0.93 +/- 1.41, respectively; p < 0.05). Cough incidence was significantly lower in the SGB group at 1 h and 6 h (both 5.2%) than in the control group (both 20.3%, P = 0.014). Conclusion(s): Preoperative ultrasound-guided SGB significantly alleviates POST and reduces the early postoperative cough incidence in thoracic surgery patients undergoing DLT intubation. Trial registration: The study was registered on Chinese Clinical Trial Registry, (ChiCTR2500106117) on 17/07/2025. Copyright © The Author(s) 2026. <161> Accession Number 2048602853 Title Lipoprotein(a) and calcific aortic stenosis: from inherited risk marker to therapeutic target. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1908850. Date of Publication: 2026. Author Epelde F. Institution (Epelde) Internal Medicine Department, Parc Tauli Hospital Universitari, Institut d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Universitat Autonoma de Barcelona, Sabadell, Spain (Epelde) Internal Medicine Department, APTIMA Centre Clinic, Mutua de Terrassa, Terrassa, Spain Publisher Frontiers Media SA Abstract Background - Calcific aortic valve stenosis (CAVS) is the most common valvular heart disease in older adults and remains a condition for which valve replacement is the only established disease-modifying treatment. Converging genetic, epidemiological, imaging and mechanistic evidence supports an active disease process involving lipid deposition, inflammation, extracellular matrix remodeling, osteogenic differentiation and progressive mineralization. Lipoprotein(a) [Lp(a)] has emerged as an inherited risk factor of particular interest because it links apolipoprotein(a), apolipoprotein B, oxidized phospholipids (OxPL), autotaxin (ATX)-lysophosphatidic acid signaling and valvular calcification. Objective - To review the evidence connecting Lp(a) with the initiation and progression of CAVS, distinguish levels of evidence and plausible mediators, and discuss the current and future clinical implications of Lp(a) measurement and Lp(a)-lowering therapy in aortic valve disease. Methods - A narrative review was performed using PubMed/MEDLINE, major cardiovascular guidelines, consensus statements and reference lists of key articles. Searches were updated to June 2026 and prioritized genetic studies, Mendelian randomization analyses, prospective cohorts, imaging studies, tissue and mechanistic studies, systematic reviews, randomized trials and early-phase pharmacological studies relevant to Lp(a), oxidized phospholipids and CAVS. Results - Genetic and Mendelian randomization studies support a likely causal contribution of the LPA locus and lifelong exposure to apoB-containing lipoproteins to aortic valve calcification and incident CAVS. Clinical and imaging studies associate higher Lp(a) concentrations with prevalent valve calcification, incident aortic stenosis and, in selected cohorts, faster haemodynamic progression. Mechanistically, Lp(a)-associated particles and lipid mediators have been detected in valve tissue, and OxPL, autotaxin-derived lysophosphatidic acid and related inflammatory pathways can promote valve interstitial cell osteogenic transformation. However, evidence for progression is heterogeneous, and established calcific disease is also shaped by baseline calcium burden, valve anatomy, renal-mineral pathways, inflammation, fibrosis and mechanical stress. Existing statin-based and mineral-targeted therapies have not slowed established CAVS, while potent Lp(a)-lowering agents can markedly reduce Lp(a) but still lack definitive valvular outcome data. Conclusions - Lp(a) should be considered a cardiovascular risk enhancer and a plausible causal contributor to calcific aortic valve disease, especially during earlier lipid-inflammatory and microcalcific phases. Measuring Lp(a) at least once in adulthood is supported by contemporary lipid guidance and may be particularly informative in premature CAVS, family clustering, coexisting premature atherosclerotic cardiovascular disease or unexplained rapid progression. Whether pharmacological Lp(a) lowering can prevent CAVS or slow progression remains an important but unproven translational question. Copyright © 2026 Epelde. <162> Accession Number 652088139 Title Short-Term Anticoagulant Therapy and Subclinical Leaflet Thickening in Transcatheter Aortic Valves: The NOTION-4 Trial. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 30 Aug 2026. Author Jorgensen T.H.; Larsen A.F.; Jensen J.M.; Jensen R.V.; Willemen Y.; Phoksiri A.; Khokhar A.; Thuraiaiyah J.; Pedersen K.B.; Bieliauskas G.; Terkelsen C.J.; Sondergaard L.; Kofoed K.F.; Norgaard B.L.; De Backer O. Institution (Jorgensen) Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (Larsen) The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark (Jensen, Jensen, Pedersen, Terkelsen, Norgaard) Department of Cardiology, Aarhus University Hospital, SkejbyAarhus, Denmark (Willemen, Phoksiri, Khokhar, Thuraiaiyah, Bieliauskas, Kofoed, De Backer) Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (Sondergaard) Abbott Structural Heart, Santa Clara, CA, United States Abstract BACKGROUND: Following transcatheter aortic valve replacement (TAVR), subclinical leaflet thrombosis-visualized on cardiac computed tomography (CT) as hypoattenuated leaflet thickening (HALT)-is common and might be associated with thromboembolic events. OBJECTIVE(S): The NOTION-4 trial investigates different antithrombotic treatment strategies for the prevention of HALT. METHOD(S): NOTION-4 was a randomized controlled trial enrolling patients without an indication for oral anticoagulation shortly after successful TAVR. Patients were randomized to lifelong single antiplatelet therapy (SAPT) or 3 months of direct oral anticoagulant (DOAC) therapy followed by lifelong SAPT (DOAC-3m). The primary endpoint was HALT prevalence at 12 months. The trial was powered for superiority of the experimental strategy. RESULT(S): Of 352 patients randomized 1:1, 5 were screen failures or withdrew consent, leaving 176 in the SAPT group and 171 in the DOAC-3m group. At 3 months, HALT was observed in 31.8% of patients receiving SAPT compared with 12.1% of those receiving DOAC-3m. At 1 year, HALT occurred in 32.2% of SAPT patients and 28.3% of DOAC-3m patients with available CT scans (risk difference: -3.9%; 95% CI: -14.4% to 6.6%; P = 0.54). The combined risk of all-cause mortality, stroke, or major/life-threatening bleeding at 12 months was 2.3% in the SAPT group vs 8.2% in the DOAC-3m group (risk difference: 5.9%; 95% CI: 1.2% to 10.6%). CONCLUSION(S): Among TAVR patients without an indication for oral anticoagulation, 3 months of DOAC therapy significantly reduced the prevalence of HALT at 3 months compared with SAPT; however, this effect was attenuated by 9 months after discontinuation of DOAC therapy. (The Nordic Aortic Valve Intervention Trial 4 [NOTION-4]; NCT06449469). Copyright © 2026 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. <163> Accession Number 2048729435 Title Contributing Factors to Infectious Disease Risk and Vaccine Strategy Optimization in Cardiac Surgery Patients. Source Vaccines. 14(8) (no pagination), 2026. Article Number: 686. Date of Publication: 01 Aug 2026. Author Tokarczyk-Kloc M.; Ciecierska J.; Margula R.; Herbetko K.; Shmorhun B.; Szenborn L.; Sokolski M.; Ludwikowska K.M. Institution (Tokarczyk-Kloc, Szenborn, Ludwikowska) Department of Pediatric Infectious Diseases, Wroclaw Medical University, Ludwika Pasteura 1, Wroclaw, Poland (Ciecierska, Herbetko, Shmorhun) Faculty of Medicine, Wroclaw Medical University, Ludwika Pasteura 1, Wroclaw, Poland (Ciecierska, Margula, Herbetko, Shmorhun) Student Science Club of Transplantology and Advanced Therapies of Heart Failure, Faculty of Medicine, Wroclaw Medical University, Ludwika Pasteura 1, Wroclaw, Poland (Margula) 4th Military Clinical Hospital, Rudolfa Weigla 5, Wroclaw, Poland (Sokolski) Clinical Department of Heart Transplantation and Mechanical Circulatory Support, Department of Cardiac Surgery and Heart Transplantation, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, Borowska 213, Wroclaw, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Patients undergoing cardiac surgery are particularly vulnerable to infectious diseases, which may adversely affect perioperative outcomes and long-term prognosis both before and after the procedure. Moreover, those requiring heart transplantation must take immunosuppressive medications, further compromising their immunity. This narrative review aims to look for the sources of increased risk for infections as well as synthesize vaccination recommendations for these patient groups based on the available literature and guidelines. We considered the influence of age, comorbidities, length of hospitalization, procedure-related risks, and blood product transfusions on the increased risk of vaccine-preventable diseases. By comprehensively addressing these factors, healthcare providers can develop tailored vaccination strategies that maximize protection for cardiac surgical patients while minimizing potential complications and optimizing overall health outcomes. Copyright © 2026 by the authors. <164> Accession Number 2048747272 Title Response by Rodes-Cabau et al to Letter Regarding Article, "Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial". Source Circulation. 154(4) (pp e44-e45), 2026. Date of Publication: 28 Jul 2026. Author Rodes-Cabau J.; Nombela-Franco L.; Pavesi M.; Cote M.; Salaun E. Institution (Rodes-Cabau, Cote, Salaun) Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Canada (Rodes-Cabau) Department of Research and Innovation, Clinic Barcelona, Spain (Rodes-Cabau, Pavesi) Department of Biostatistics, Barcelona Clinical Coordinating Center, Mon Clinic Foundation, Spain (Nombela-Franco) Department of Cardiology, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria Hospital Clinico San Carlos, Madrid, Spain Publisher Lippincott Williams and Wilkins Abstract We appreciate the interest from Li et al and Zhang et al in our work reporting the primary results of the ANDES trial (Short-term anticoagulation versus antiplatelet treatment for preventing device thrombosis following left atrial appendage closure).1 We offer the following response to their comments. Copyright © 2026 American Heart Association, Inc. <165> Accession Number 652086823 Title Propofol-Supplemented Cardioplegic Solution Effect on Myocardial Protection: A Systematic Review and Bayesian Meta-analysis of Randomized Controlled Trials. Source Journal of cardiothoracic and vascular anesthesia. (no pagination), 2026. Date of Publication: 06 Aug 2026. Author Rios Esparza R.A.; Rodriguez Milan R.; Abbas M.S.; Ahmad A.; Quiroz de la Rosa D.; Retana E.P.; Fuentes Puga V. Institution (Rios Esparza) Instituto de Ciencias Biomedicas, Universidad Autonoma de Ciudad Juarez, Ciudad Juarez, Mexico (Rodriguez Milan) Universidad Autonoma Metropolitana Unidad Xochimilco, Ciudad de Mexico, Mexico (Abbas, Ahmad) Gomal Medical College, Khyber Medical University, Peshawar, Pakistan (Quiroz de la Rosa) Universidad Autonoma de Guadalajara, Guadalajara, Mexico (Retana) Instituto de Ciencias Biomedicas, Universidad Autonoma de Ciudad Juarez, Ciudad Juarez, Mexico (Fuentes Puga) Cardiovascular Anesthesiology, Hospital Universitario Jose E. Gonzalez, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico Abstract OBJECTIVES: To determine the probability of a clinically relevant reduction in postoperative myocardial injury following the use of propofol-supplemented cardioplegia. DESIGN: Systematic review and Bayesian meta-analysis. SETTING: Perioperative cardiac surgery. PARTICIPANTS: Adult patients (N = 523) undergoing cardiac surgery requiring cardiopulmonary bypass. INTERVENTIONS: Propofol-supplemented cardioplegic solution versus standard cardioplegia. MEASUREMENTS AND MAIN RESULTS: The primary endpoint was postoperative troponin levels. A Bayesian hierarchical random-effects model using weakly informative priors yielded a pooled standardized mean difference (SMD) of -0.05 (95% credible interval [CrI], -0.33 to 0.24). The posterior probability of any reduction in postoperative troponin levels (SMD < 0) was 70.8%. Secondary endpoints showed similarly uncertain evidence of benefit, including postoperative creatinine levels (SMD, -0.06; 95% CrI, -0.71 to 0.46; probability of benefit, 59.8%), serious complications (risk ratio [RR], 0.77; 95% CrI, 0.18 to 2.28; probability of benefit, 70.3%), and postoperative arrhythmias (RR, 0.96; 95% CrI, 0.51 to 1.62; probability of benefit, 56.4%). CONCLUSION(S): Current evidence suggests moderate posterior probabilities of benefit across endpoints. However, substantial uncertainty remains regarding the magnitude and direction of the true treatment effects. These findings do not provide convincing evidence to support routine addition of propofol to standardized cardioplegic protocols, and the use of propofol-supplemented cardioplegia should remain at the discretion of the heart surgery team. Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved. <166> Accession Number 2048819338 Title Comparing the Safety and Efficacy of Outpatient Parenteral Antibiotic Therapy Versus Hospital-Based Antibiotic Therapy in Patients with Infective Endocarditis: A Systematic Review and Meta-Analysis. Source American Journal of Therapeutics. (no pagination), 2026. Date of Publication: 2026. Author Alkuwaiti M.A.; Al-Harbi F.A.; Alkuwaiti F.A.; Alsaif A.K.; Ashraf H. Institution (Alkuwaiti) College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, United Arab Emirates (Al-Harbi) Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Alkuwaiti) Division of Cardiology, Department of Internal Medicine, King Fahad Hospital of the University, Academic Medical City, Imam Abdulrahman Bin Faisal University, Al-Khobar, United Arab Emirates (Alsaif) College of Medicine, Al-Rayan Colleges, Al-Madinah, United Arab Emirates (Ashraf) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan Publisher Lippincott Williams and Wilkins Abstract Introduction: - Infective endocarditis (IE) requires 4 to 6 weeks of intravenous antibiotics. Outpatient parenteral antibiotic therapy (OPAT) is increasingly used and guideline endorsed, but IE-specific comparative evidence is limited, as prior meta-analyses pooled single-arm data without an inpatient comparator. We compared the safety and efficacy of OPAT versus continued hospital-based antibiotic therapy. Method(s): - This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. PubMed/MEDLINE, Embase, Cochrane CENTRAL, and Web of Science were searched to 18 April 2026 for comparative studies of adults with IE. Two reviewers screened using Rayyan and extracted data, and risk of bias was assessed with Risk Of Bias In Non-randomized Studies of Interventions. Random-effects meta-analyses (DerSimonian-Laird) produced risk ratios with 95% confidence intervals (CIs) (RevMan 5.4). Result(s): - Five comparative studies (3497 adults) were included. OPAT was associated with lower all-cause mortality (risk ratio [RR]: 0.40, 95% CI: 0.18-0.90; I2 = 87%, P = 0.03) and with lower acute kidney failure (RR: 0.71, 95% CI: 0.59-0.86, P = 0.0004). No significant differences were seen for readmission (RR: 1.09), relapse (0.73), valve replacement (1.15), arrhythmia, sepsis, stroke, embolic complications, or heart failure. Conclusion(s): - In appropriately selected, stabilized patients, OPAT was associated with lower all-cause mortality and acute kidney failure, with no significant differences in major other adverse events. Protocol: CRD420261410723. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <167> Accession Number 2048747277 Title Letter by Li and Xiong Regarding Article, "Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial". Source Circulation. 154(4) (pp e40-e41), 2026. Date of Publication: 28 Jul 2026. Author Li W.; Xiong Q. Institution (Li) Department of Cardiology, Fengcheng People's Hospital, The Affiliated Fengcheng Hospital of Yichun University, Jiangxi, China (Xiong) Department of Cardiology, Fengcheng People's Hospital, The Affiliated Fengcheng Hospital of Yichun University, Jiangxi, China Publisher Lippincott Williams and Wilkins Abstract We read with great interest the report by Rodes-Cabau et al on the ANDES randomized clinical trial comparing short-term direct oral anticoagulation (DOAC) with dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC).1 This pragmatic, multicenter trial substantially advances the evidence base in an area previously informed mainly by small randomized studies and observational data. We would like to offer several methodological considerations focusing on the estimand and effect measures, the handling of multicenter and device heterogeneity, and the integration of device-related thrombosis (DRT) with clinical outcomes in a time-dependent framework. Copyright © 2026 American Heart Association, Inc. <168> Accession Number 2048747275 Title Letter by Zhang and Zhang Regarding Article, "Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial". Source Circulation. 154(4) (pp e42-e43), 2026. Date of Publication: 28 Jul 2026. Author Zhang X.; Zhang P. Institution (Zhang, Zhang) Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China Publisher Lippincott Williams and Wilkins Abstract We read with great interest the article by Rodes-Cabau and colleagues1 entitled, "Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial," published in Circulation. The authors are to be commended for conducting the largest randomized trial to date comparing short-term direct oral anticoagulant (DOAC) therapy with dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC), with transesophageal echocardiography (TEE) images assessed by a blinded core laboratory, an important methodological strength in this evolving field. Copyright © 2026 American Heart Association, Inc. <169> Accession Number 2048836980 Title Machine Learning Models for Predicting Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Scoping Review. Source Cardiology in Review. (pp 1-7), 2026. Date of Publication: 2026. Author Saleh Y.; Afridi M.; Blackledge M.; Phaneuf A.; El Sherbini A.; El-Wakeel A.; El Diasty M. Institution (Saleh, Afridi, Phaneuf, El Sherbini) Faculty of Health Sciences, Queen's University, Kingston, ON, Canada (Blackledge) Case Western Reserve University School of Medicine, Cleveland, OH, United States (El-Wakeel) Lane Department of Computer Science and Electrical Engineering, West Virginia University, Morgantown, WV, United States (El Diasty) Department of Cardiac Surgery, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States Publisher Lippincott Williams and Wilkins Abstract Permanent pacemaker (PPM) implantation has been reported in up to 26% of patients undergoing transcatheter aortic valve replacement (TAVR). Machine learning (ML) models have increasingly been developed to predict the need for PPM after TAVR, offering the potential to improve preprocedural risk stratification and optimize perioperative management. We conducted a systematic literature search of MEDLINE, Embase, Cochrane Central, ClinicalTrials.gov, and Google Scholar to identify primary studies evaluating ML models for predicting PPM implantation following TAVR. Data extracted included study characteristics, ML methodologies, predictor variables, and model performance metrics. Seven studies comprising 4528 patients who underwent TAVR met the inclusion criteria. The evaluated TAVR devices included balloon-expandable, self-expandable, and mechanically expandable Lotus valves. The incidence of PPM implantation ranged from 14% to 41.7%. ML approaches included random forest, gradient boosting, neural networks, support vector machines, and logistic regression. Predictive performance varied across studies, with area under the receiver operating characteristic curve values ranging from 0.61 to 0.92. Frequently identified predictors of PPM implantation included prosthetic valve size, preprocedural right bundle branch block, atrioventricular block, leaflet calcification, larger left ventricular outflow tract diameter, prior aortic valve interventions, and use of self-expanding valves. Overall, ML models demonstrate promising predictive capability for identifying patients at risk of requiring PPM after TAVR, although model performance remains inconsistent across studies. Further external validation, standardization of model development, and prospective evaluation are needed before these tools can be confidently incorporated into routine clinical decision-making and risk stratification following TAVR. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <170> Accession Number 2048806821 Title Optimizing hemostasis in thoracic surgery: a systematic review and meta-analysis of perioperative antifibrinolytic therapy. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 39. Date of Publication: 01 Dec 2026. Author Hamza M.; Shah Z.; Saqib H.W.; Shahid S.R.; Khurshid M.M.; Irfan S.; Khalid A.A.; Singh A.; Chaudhry I.U.H.; Shah A.R. Institution (Hamza, Chaudhry) Abbottabad International Medical Institute, Abbottabad, Pakistan (Shah) Frontier Medical and Dental College, Abbottabad, Pakistan (Saqib) Islamic International Medical College, Rawalpindi, Pakistan (Shahid) Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan (Khurshid) Anglia Ruskin University, Chelmsford, United Kingdom (Irfan) Services Institute of Medical Sciences, Lahore, Pakistan (Khalid) Peshawar Medical College, Peshawar, Pakistan (Singh) Southampton General Hospital, University Hospital, Southampton, United Kingdom (Shah) Freeman Hospital High Heaton, Newcastle Upon Tyne, United Kingdom Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Excessive perioperative bleeding remains a major challenge in non-cardiac thoracic surgeries. Antifibrinolytic therapy can enhance hemostasis and reduce transfusion requirements, although its use carries a theoretical risk of postoperative thromboembolic complications that warrants evaluation alongside its hemostatic benefits. Main text: Methods: For this systematic review and meta-analysis, we searched multiple databases for studies that compared antifibrinolytic therapy with placebo or no intervention in adult patients undergoing non-cardiac thoracic surgery. Primary outcomes included intraoperative and early postoperative bleeding and blood transfusion requirements. Additionally, thromboembolic events, length of hospital and ICU stay, respiratory complications, and all-cause postoperative mortality were also analyzed. Standardized mean differences (SMDs), mean differences (MDs), or odds ratios (ORs) with 95% confidence intervals (CIs) were used for pooled estimates, while the I2 statistic was used to assess heterogeneity. Result(s): Fifteen studies were included. Antifibrinolytics significantly reduced postoperative 24-hour (SMD - 1.04, 95% CI - 1.64 to - 0.43) and 12-hour (SMD - 1.06, 95% CI - 2.22 to 0.10) blood loss, intraoperative blood loss (SMD - 0.48, 95% CI - 1.05 to 0.08), total RBC transfusion (SMD - 0.54, 95% CI - 0.80 to - 0.28) and duration of hospital stay (MD - 0.96 days, 95% CI - 1.84 to - 0.08). IV route reduced 24-hour blood loss same topical, and aprotinin shortened hospital stay. Sensitivity analyses confirmed robustness, while meta regression identified publication year as a key moderator, explaining 19% of variance. No significant differences were observed for ICU stay, hemoglobin levels, thromboembolic events, respiratory complications, or mortality. Conclusion(s): Perioperative antifibrinolytic therapy in non-cardiac thoracic surgery improves hemostatic control, reduces transfusion requirements, and shortens hospitalization, with no significant increase in thromboembolic, respiratory, or mortality outcomes observed; however, these safety analyses were based on a limited number of studies and should be interpreted with caution. Copyright © The Author(s) 2026. <171> Accession Number 652088038 Title Anticoagulation Monotherapy vs Antiplatelet Monotherapy After Transcatheter Aortic Valve Implant: The ACASA-TAVI Randomized Clinical Trial. Source JAMA. (no pagination), 2026. Date of Publication: 30 Aug 2026. Author Dodgson C.S.; Herstad J.; Klove S.F.; Flygel M.; Akhavi M.; Hoie S.; Beitnes J.O.; Eek C.H.; Broch K.; Cunen C.; Gullestad L.; Aaberge L.; Lunde K.; Bendz B.; Lie OH. Institution (Dodgson, Klove, Beitnes, Eek, Broch, Aaberge, Lunde, Bendz, Lie) Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway (Dodgson, Gullestad, Bendz) Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Herstad, Flygel) Department of Cardiology, Haukeland University Hospital, Bergen, Norway (Akhavi) Intervention Centre, Oslo University Hospital, Oslo, Norway (Hoie) Department of Cardiology, Sorlandet Hospital Arendal, Arendal, Norway (Cunen) Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway Abstract Importance: Transcatheter aortic valve implant (TAVI) is increasingly being performed in younger and healthier patients with severe aortic valve stenosis. Antithrombotic therapy after TAVI is a key element of optimizing valve durability and clinical outcomes. Objective(s): To evaluate the safety and efficacy of a factor Xa inhibitor non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy strategy vs an acetylsalicylic acid (ASA) monotherapy strategy after TAVI. Design, Setting, and Participant(s): Between December 2021 and June 2025, 360 participants between the ages of 65 and 80 years undergoing TAVI for severe aortic valve stenosis were enrolled in this prospective, randomized, open-label, blinded end point trial conducted at 3 Norwegian centers managing the majority of TAVI procedures nationally. The last patient completed follow-up on May 19, 2026. Intervention(s): A total of 360 participants were randomly assigned (1:1) to receive 12 months of monotherapy with either NOAC (intervention) or ASA (control). Main Outcomes and Measures: A predefined co-primary end point strategy was chosen to address both efficacy and safety. The primary efficacy end point was TAVI valve leaflet thrombosis defined as the presence of hypoattenuated leaflet thickening (HALT) on blinded core laboratory 4-dimensional cardiac computed tomographic (CT) scan at 12 months. The primary safety end point was a composite of adjudicated Valve Academic Research Consortium 3 (VARC-3) bleeding events, thromboembolic events, and all-cause death at 12 months. Result(s): Of the 360 participants randomized (mean age, 74.5 years [SD, 3.7]; 134 females [37%]), 336 completed the trial (168 in each group). The primary efficacy end point occurred in 27 participants (16.2%) allocated to the NOAC group and in 48 participants (28.6%) allocated to the ASA group (risk ratio, 0.55; 95% CI, 0.37 to 0.82, P = .004). The primary safety end point occurred in 13 participants (7.5%) in the NOAC group and in 19 participants (10.6%) in the ASA group (risk difference, -3.3%; 95% CI, -9.5% to 2.8%; P for noninferiority <.001). Conclusions and Relevance: A strategy of NOAC monotherapy after TAVI reduced the incidence of HALT and was noninferior for bleeding, thromboembolic events, or death compared with acetylsalicylic acid monotherapy. These findings suggest that anticoagulation therapy can be beneficial after TAVI in selected patients. Trial Registration: ClinicalTrials.gov Identifier: NCT05035277. <172> Accession Number 2048815277 Title Perioperative outcomes and predictors of mortality after pericardiectomy for constrictive pericarditis in Africa: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 38. Date of Publication: 01 Dec 2026. Author Afolabi O.G.; Okunlola A.I.; Ishola D.T.; Adegbamigbe A.B.; Oluwajuyigbe M.E. Institution (Afolabi) Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria (Okunlola, Adegbamigbe, Oluwajuyigbe) Department of Surgery, Federal Teaching Hospital Ido-Ekiti, Ido-Ekiti, Nigeria (Ishola) Kharkov National Medical University, Kharkiv, Ukraine Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Constrictive pericarditis remains a significant cause of heart failure in Africa, predominantly due to tuberculosis; however, pericardiectomy outcomes across African settings have not been systematically synthesised. This review aimed to determine the pooled perioperative mortality following pericardiectomy for constrictive pericarditis in the African population and identify predictors of early death. Method(s): We searched PubMed, Scopus, African Journals Online, Cochrane Library, and Web of Science from inception to May 2026, supplemented by Google Scholar and citation tracking. Two reviewers independently screened the records and extracted the data, with a third reviewer resolving any disagreements. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Series. Perioperative mortality and aetiology were pooled using a random-effects model with Freeman-Tukey double arcsine transformation. The certainty of evidence was rated using GRADE. This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 statement. Result(s): Of the 2148 records identified, 16 studies met the eligibility criteria and were included in the narrative synthesis, spanning South Africa, Cote d'Ivoire, Ethiopia, Ghana, Senegal, Gabon, and Nigeria. Eleven studies (604 patients) contributed to the pooled mortality analyses. The pooled perioperative mortality was 10.0% (95% confidence interval 6.5-14.0%), with substantial heterogeneity (I2 = 51.5%) and evidence of funnel plot asymmetry on Egger's test (p = 0.004). Mortality was numerically highest in the East African cohorts (12.9%) and lowest in the Southern African cohorts (8.5%) in the subgroup analysis. In eleven studies with extractable presumed or clinically diagnosed aetiological data, the pooled proportion attributed to tuberculous or infectious aetiology was 72.5% (95% confidence interval 51.4 to 89.3%; I2 = 96.4%), whereas in the nine studies reporting histology- or culture-confirmed ('definite') tuberculous aetiology as a distinct category, the pooled proportion was 32.5% (95% confidence interval 26.1 to 39.2%; I2 = 60.9%), indicating that diagnostic certainty was a major driver of the heterogeneity in the broader aetiological estimate. Preoperative New York Heart Association functional class IV was the most consistently reported predictor of early mortality across studies. The certainty of evidence for the pooled mortality estimate was rated as very low. Conclusion(s): Pericardiectomy for constrictive pericarditis in Africa carries a pooled perioperative mortality of approximately 10%. Tuberculous aetiology was common but highly heterogeneous in how it was diagnosed across studies, and advanced preoperative NYHA functional class IV was consistently associated with higher perioperative mortality, although this association was derived predominantly from retrospective, unadjusted, or single-study analyses. Given the very low certainty of the underlying evidence, these findings should be regarded as hypothesis-generating associations rather than established causal predictors; standardised, prospectively collected outcome data across African surgical centres are needed to determine whether earlier referral or other interventions could reduce this mortality burden. Clinical trial number: Not applicable. Copyright © The Author(s) 2026. <173> Accession Number 2048747283 Title Major Adverse Cognitive Events (MACE-Cog): A New "MACE" Framework for Cognitive Outcomes in Cardiovascular Diseases and Stroke. Source Circulation. 154(4) (pp 378-394), 2026. Date of Publication: 28 Jul 2026. Author Ganesh A.; Sujanthan S.; Muir R.T.; Joundi R.A.; Hill M.D.; Quinn T.J.; Menon B.; Sajobi T.; Rabin J.S.; Dainty K.N.; Barense M.D.; Lanctot K.L.; Kennedy J.; Kharbanda R.K.; Lee D.S.; Gaudio M.F.L.; Fremes S.; Masterson Creber R.M.; Smith E.E.; Swartz R.H. Institution (Ganesh, Hill, Menon, Sajobi, Smith) Calgary Stroke Program, Departments of Clinical Neurosciences, Radiology, Medicine, and Community Health Sciences, Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, and O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, AB, Canada (Sujanthan, Muir, Swartz) Institute of Medical Sciences, ON, Canada (Sujanthan, Muir, Rabin, Swartz) Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Canada (Rabin) Rehabilitation Sciences Institute, ON, Canada (Dainty, Fremes) Institute of Health Policy, Management and Evaluation, ON, Canada (Barense) Department of Psychology, ON, Canada (Lanctot) Department of Psychiatry, Sunnybrook Health Sciences Centre, ON, Canada (Lanctot) Departments of Psychiatry and Pharmacology and Toxicology, ON, Canada (Fremes) Department of Surgery, Division of Cardiac Surgery, ON, Canada (Sujanthan, Muir, Rabin, Dainty, Barense, Lanctot, Lee, Fremes, Swartz) University of Toronto, ON, Canada (Lee) Peter Munk Cardiac Center of University Health Network, Toronto, ON, Canada (Lanctot) Geriatric Psychopharmacology Research Group, Toronto, ON, Canada (Rabin) Harquail Centre for Neuromodulation, Toronto, ON, Canada (Sujanthan, Muir, Rabin, Swartz) Hurvitz Brain Science Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Joundi) Population Health Research Institute, McMaster University and Hamilton Health Sciences, ON, Canada (Quinn) School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom (Dainty) North York General Hospital Toronto, ON, Canada (Barense) Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, North York, ON, Canada (Kennedy) Acute Multidisciplinary Imaging and Interventional Centre, University of Oxford, United Kingdom (Kharbanda) Radcliffe Department of Medicine, University of Oxford, United Kingdom (Kennedy) NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom (Kharbanda) National Institute for Health and Care Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, United Kingdom (Kharbanda) Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, United Kingdom (Lee) ICES (formerly Institute for Clinical Evaluative Sciences), Toronto, ON, Canada (Gaudio) Weill Cornell Medicine, New York, NY, United States (Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Masterson Creber) Columbia University School of Nursing, Columbia University Irving Medical Center, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract Cardiovascular diseases, particularly stroke, are leading causes of dementia. Several common cardiac interventions such as coronary artery bypass grafting and transcatheter aortic valve implantation are also associated with cognitive decline. However, cognitive outcomes continue to be poorly collected in clinical trials of cardiovascular diseases. In this article, we review the limitations of current approaches to cognitive assessment in cardiovascular disease studies. When assessed, there is wide variation in cognitive tasks used, and tasks have limited population-specific validation, are subject to floor and ceiling effects, and may suffer from sociocultural and linguistic biases. Many tasks are not available in multilingual formats and often rely on face-to-face testing with trained coordinators. All conventional cognitive outcomes in cardiovascular trials are associated with substantial incompletion, especially among older and more impaired individuals, the very people most important to capture. This nonrandom missingness generates survivor and attrition biases, an unacceptable situation for any trial outcome. Last, the meaning of measured cognitive outcomes is often unclear for patients, caregivers, clinicians, and regulators. To help address these limitations, we propose a new framework, major adverse cognitive events (MACE-Cog), to better capture cognitive outcomes in stroke and other cardiovascular populations. As an inclusive construct reflecting the multidimensional nature of cognitive decline, major adverse cognitive events do not rely solely on performance on cognitive testing but also consider inability to complete cognitive testing due to cognitive-behavioral factors, reported symptoms of cognitive decline, impairment in activities of daily living as a result of cognitive impairment, new clinical diagnoses of dementia, and care home admission. We hope that the proposed composite outcome and multiple use cases presented spark progress in cardiovascular research toward more inclusive approaches to the study of cognitive outcomes that move beyond the confines of cognitive tests alone. Copyright © 2026 American Heart Association, Inc. <174> Accession Number 652072868 Title BARTONELLA QUINTANA ENDOCARDITIS CAUSING CATASTROPHIC AORTIC VALVE DESTRUCTION REQUIRING MECHANICAL VALVE REPLACEMENT AND CABG IN A PREVIOUSLY HEALTHY YOUNG MALE AFTER MISLEADING VECTOR EXPOSURE. Source Journal of General Internal Medicine. Conference: 2026 Annual Meeting of the Society of General Internal Medicine. Washington United States. 41(1 Supplement 1) (pp S140-S141), 2026. Date of Publication: 01 Jul 2026. Author Makonyonga R.D.; Amedetowou S.F.; Brothers V. Institution (Makonyonga, Amedetowou, Brothers) Medical Center Internal Medicine Residency, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States Publisher Springer Abstract CASE: Bartonella quintana is a rare cause of culture-negative infective endocarditis (IE), typically associated with homelessness, body lice exposure, poor hygiene, or alcoholism. Diagnosis is often delayed because blood cultures are frequently negative, and early serologies may be falsely low. Although infection usually presents subacutely, B. quintana can cause rapidly destructive valvular disease requiring urgent surgery. We present a case of B. quintana endocarditis in a patient without classic risk factors, initially misdirected by an acute coronary syndrome like presentation. A 41-year-old man with a history of smoking presented with acute chest pain several days after a bug bite. He had no fever, chills, or stigmata of IE. ECG showed lateral T-wave inversions and subtle ST depressions, but serial troponins remained flat at approximately 150 ng/L. A new holosystolic murmur was noted on exam. CTA showed a calcified-appearing aortic valve. Echocardiography revealed a mobile aortic-valve mass, leaflet perforation, and severe aortic regurgitation. Coronary angiography showed left-dominant anatomy with 90% mid-RCA stenosis. He underwent mechanical AVR and CABG x1. Postoperatively, broad infectious and autoimmune testing was negative, including blood cultures and serologies for Coxiella burnetii, Brucella, fungal pathogens, and ANA. Preoperative Bartonella titers were mildly positive (1:64) but rose to 1:512 and 1:1024, confirming B. quintana IE. He was treated with doxycycline and rifampin. IMPACT/DISCUSSION: Bartonella quintana endocarditis is rare and difficult to recognize, especially without classic risk factors. It can mimic ACS, as in this case where ischemic ECG changes and chest pain misled early evaluation, though flat troponins suggested a non-ischemic cause. A systematic review shows its severity: 98% require valve surgery and mortality approaches 10%. Culture-negative status and low early titers often delay diagnosis, reinforcing the need for repeat Bartonella testing. This patient's rapid valve destruction and need for AVR/CABG highlight the organism's aggressive nature. Clinicians should consider B. quintana in severe culture-negative IE, even in atypical hosts. CONCLUSION(S): This case demonstrates that Bartonella quintana endocarditis can occur in patients without traditional risk factors and may closely mimic acute coronary syndrome, particularly when ischemic ECG changes dominate the presentation. Persistently flat troponins, culture-negative testing, and early echocardiography were essential in redirecting the diagnostic pathway. Delayed serologic conversion ultimately confirmed the diagnosis, underscoring the importance of repeat Bartonella testing when suspicion persists. Given its potential for rapid and destructive valvular injury requiring urgent surgical intervention, clinicians should maintain B. quintana on the differential for severe culture-negative endocarditis-even in atypical hosts. <175> Accession Number 652066598 Title "Heart in a Box," a Novel Organ Care System for Heart Transplantation. Source Cardiology in review. (no pagination), 2026. Date of Publication: 26 Aug 2026. Author Kallash M.; Frishman W.H. Institution (Kallash) From the Department of Medicine, Montefiore Medical Center, Bronx, NY, United States (Frishman) Department of Medicine, School of Medicine, New York Medical College, Valhalla, NY, United States (Frishman) Department of Medicine, Westchester Medical Center, Valhalla, NY, United States Abstract As the global burden of heart failure continues to rise, heart transplantation-the only definitive therapy for heart failure-has become a major focus of clinical research aimed at increasing the availability of suitable donor allografts. Historically, heart transplantation has been limited to the availability of hearts obtained from donors after brain death within relatively short distances. The TransMedics Organ Care System (OCS) Heart is a novel technology that allows for portable extracorporeal nonischemic perfusion of the heart after the circulatory death of the donor. Often referred to as "Heart in a Box," the OCS Heart is a potential major advancement in heart transplantation because of its ability to preserve the heart in a metabolically active state after the circulatory death of the donor, allowing for longer-distance transport compared to traditional cold storage methods. Numerous randomized controlled trials studying the efficacy of the OCS Heart technology from donors after circulatory death compared to traditional cold storage methods from donors after brain death demonstrated noninferiority. By allowing for preservation after circulatory death and for longer transport times, the OCS Heart can potentially significantly expand the donor pool and increase the number of heart transplants. The major limitations of its use include the expensive costs of operation, the increased level of training required for personnel, and the risk of technological malfunctions compared to traditional cold storage methods. Nevertheless, the OCS Heart is poised as a critical development in the field of heart transplantation, with an expectation that adoption rates for its use will increase in the coming years. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <176> Accession Number 652067607 Title Left atrial appendage closure versus medical therapy in atrial fibrillation: An updated meta-analysis of randomized trials on the trade-off between stroke prevention and bleeding. Source Kardiologia polska. (no pagination), 2026. Date of Publication: 27 Aug 2026. Author Di Pietro G.; Improta R.; Bruno E.; Musto C.; Gaspardone A.; Mancone M. Institution (Di Pietro, Improta, Bruno, Mancone) Department of Clinical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy (Musto) Cardiology Unit, Ospedale S. Giovanni Evangelista, Tivoli, Italy (Gaspardone) Division of Cardiology, Sant' Eugenio Hospital, Rome, Italy Abstract BACKGROUND: Long-term oral anticoagulation remains the standard of care for patients with atrial fibrillation, despite the non-negligible risk of bleeding. Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative strategy for preventing stroke with inconclusive modern data. AIMS: Our aim was to evaluate the comparative efficacy and safety of LAAC vs. medical therapy in patients with atrial fibrillation. METHOD(S): A systematic search of PubMED, Scopus and EMBASE was conducted up to April 2026 to identify randomized controlled trials comparing LAAC with medical therapy. The primary endpoint was overall stroke. The secondary endpoints were ischemic stroke, hemorrhagic stroke, systemic embolism, mortality, major bleeding and non-procedural bleeding. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model with restricted maximum likelihood estimation and Hartung-Knapp adjustment. RESULT(S): Six randomized controlled trials, encompassing 7004 patients globally (device group: 3681 patients; medical therapy group: 3323 patients), were included in the analysis. LAAC was associated with a similar risk of stroke to medical therapy (OR, 0.92; 95% CI, 0.65-1.3; P = 0.55) at a median 39 (interquartile range 36-47) months of follow-up. No significant differences were observed in ischemic stroke, hemorrhagic stroke, systemic embolism, all-cause mortality or cardiovascular mortality. Rates of major bleeding were comparable (OR, 1.13; 95% CI, 0.90-1.43; P = 0.23). However, medical therapy was associated with a significantly higher risk of non-procedural bleeding compared with LAAC (OR, 1.95; 95% CI, 1.67-2.27; P <0.001). These findings were consistent across subgroup analyses. CONCLUSION(S): LAAC provides thromboembolic protection comparable to medical therapy while reducing non-procedural bleeding. These findings support its role as an alternative strategy in selected patients at increased bleeding risk. <177> [Use Link to view the full text] Accession Number 2047709150 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: 2026. Author Kumar N.; Bardia A.; Hussain N.; Gerner P. Institution (Kumar, Bardia, Gerner) Department of Anesthesia, Critical Care Medicine, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Hussain) Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States Publisher Lippincott Williams and Wilkins 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 <178> Accession Number 652073042 Title HOW LOW CAN YOU GO? LDL MANAGEMENT IN HIGH-RISK ATHEROSCLEROTIC CARDIOVASCULAR DISEASE PATIENTS. Source Journal of General Internal Medicine. Conference: 2026 Annual Meeting of the Society of General Internal Medicine. Washington United States. 41(1 Supplement 1) (pp S31), 2026. Date of Publication: 01 Jul 2026. Author Battle L.; Rahman I.; Koransky A. Institution (Battle, Rahman, Koransky) Mount Sinai Health System, New York, NY, United States Publisher Springer Abstract CASE: A 71-year-old male with history of coronary artery disease post stenting, hypertension (HTN), and hemorrhagic stroke presented with vertigo and headache, and was found to have a cerebral aneurysm. Neurosurgery recommended noninvasive monitoring and strict blood pressure and lipid control. Patient had been on a high intensity statin for years. At presentation, lipid panel showed cholesterol 71 mg/dL, HDL 29 mg/dL, and LDL 33 mg/dL. Routine follow up one year later showed LDL 13 mg/dL. IMPACT/DISCUSSION: Observational data suggests association between low LDL and increased risk of hemorrhagic stroke and cerebral aneurysms. Cohort studies found an association with low LDL and increased risk of hemorrhagic stroke; however randomized trial data has not shown significant increased risk at LDL <70 mg/dL. It is thought that low LDL does not increase risk of hemorrhagic stroke in patients with no prior cerebrovascular disease, however in patients with history of hemorrhage, the American Heart Association (AHA) states there is not yet a consensus on optimal LDL management. Additionally, metaanalyses have shown hypercholesterolemia is associated with lower risk of cerebral aneurysm rupture, and statins have not been shown to significantly reduce aneurysm growth. These studies are limited, and further exploration is needed to determine the role of LDL lowering therapy in aneurysm growth and rupture risk. Multiple cardiovascular societies recommend aggressive LDL reduction in patients with atherosclerotic cardiovascular disease (ASCVD) to LDL <70 mg/dL, and <55 mg/dL in very high-risk patients. Very high-risk patients have history of multiple major ASCVD events, or one major ASCVD event and >=2 high risk conditions (>=65 years, familial hypercholesterolemia, coronary revascularization, diabetes mellitus (DM), congestive heart failure, HTN, chronic kidney disease, tobacco use, LDL >=100 mg/dL despite maximal therapy). This is associated with a reduced risk of major ASCVD events, shown to be inversely proportional to the LDL to as low as <20 mg/dL. Notably, society guidelines have not specified a minimum threshold of LDL in ASCVD patients, with an AHA review article endorsing, "lowest is best". Statin therapy has been associated with a modest increase incidence of DM, as mechanistically statins may impair insulin sensitivity and secretion. Yet, multi society guidelines agree that ASCVD benefits outweigh the risk of new DM. Importantly, there remains a gap in knowledge regarding low LDL, especially in patients with history of cerebrovascular disease, which warrants further exploration as lipid lowering recommendations intensify. This case exemplifies why further investigation is needed in this area. CONCLUSION(S): 1. Guidelines recommend aggressive LDL reduction in patients with ASCVD, however goals must be individualized in patients with cerebrovascular disease namely hemorrhagic stroke 2. Further exploration is required on patients with low LDL and cerebrovascular disease <179> Accession Number 652078200 Title Transcatheter Aortic Valve Replacement or Medical Treatment for Paradoxical Low-Flow, Low-Gradient Aortic Valve Stenosis: REBOOT-PARADOX. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 28 Aug 2026. Author Mehilli J.; Steffen J.; Rudolph T.; Haum M.; Giannini C.; Stark K.; Ince H.; Conradi L.; Joner M.; Schafer A.; Karcher A.-K.; Landt M.; Adam M.; Thiele H.; Geisler T.; Jochheim D.; Hagl C.; Zeymer U.; Windecker S.; Massberg S. Institution (Mehilli) LA-Regio Kliniken, Klinik Landshut-Achdorf, Landshut, Germany; Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Steffen, Haum, Stark, Massberg) Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany (Rudolph) Klinik fur Kardiologie, Bad Oeynhausen, Germany (Giannini) Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Ince) Klinik und Poliklinik fur Kardiologie, Department fur Innere Medizin, Universitatsmedizin Rostock, Rostock, Germany (Conradi) Universitares Herz- und Gefaszentrum Hamburg, Klinik und Poliklinik fur Herz- und Gefaschirurgie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany; Herzzentrum der Universitat Koln, Klinik und Poliklinik fur Herzchirurgie, Uniklinik Koln, Cologne, Germany (Joner) DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany; TUM Universitatsklinikum Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany (Schafer) Klinik und Poliklinik fur Herz- und Gefaschirurgie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany (Karcher) Medizinische Klinik B, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany (Landt) Kardiologie und Angiologie, HerzzentrumSegeberger Kliniken, Bad Segeberg, Germany (Adam) Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany (Thiele) Department of Cardiology and Leipzig Heart Science, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Geisler) Innere Medizin III, Universitatsklinikum Tubingen, Tubingen, Germany (Jochheim) Medizinische Klinik und Poliklinik I, LMU University Hospital, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Hagl) DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany; Herzchirurgische Klinik und Poliklinik, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Zeymer) Medizinische Klinik B, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany; Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Windecker) Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Abstract BACKGROUND: Paradoxical low-flow, low-gradient (pLFLG) aortic stenosis (AS) has an adverse prognosis in comparison to other AS subtypes. Transcatheter aortic valve replacement (TAVR) has never been compared with optimal medical therapy (OMT) alone in a dedicated randomized trial in this population. OBJECTIVE(S): The trial sought to determine whether TAVR added to OMT reduces all-cause mortality in symptomatic patients with pLFLG AS. METHOD(S): In this multicenter, open-label trial, patients with symptomatic pLFLG AS (aortic valve area <=1.0 cm2, mean gradient <40 mm Hg, stroke volume index <35 mL/m2, ejection fraction >=50%) were randomly assigned 2:1 to TAVR plus OMT or OMT alone. The primary endpoint was all-cause death, assessed 2 years after enrollment of the last patient. Enrollment was stopped prematurely for slow recruitment. RESULT(S): Of 783 planned patients, 120 (median age 82 years; 53.3% women) were randomized (80 TAVR, 40 OMT). A total of 19 OMT patients eventually crossed over to TAVR, most for symptom progression. The primary endpoint occurred in 29.0% vs 37.1% (HR: 0.83; 95% CI: 0.41-1.66; P = 0.60), and 5-year mortality was 44.9% vs 56.6% (HR: 0.76; 95% CI: 0.43-1.35; P = 0.35). TAVR was associated with improved symptoms (NYHA functional class I/II at 1 year, 83.0% vs 59.0%) and lower cumulative incidence of first endpoint-related rehospitalizations, and there were no differences in functional capacity or quality of life. CONCLUSION(S): Although the effect of TAVR on mortality remains unresolved, these findings support an individualized strategy with close surveillance and timely TAVR upon clinical deterioration in selected patients with pLFLG AS. Adequately powered randomized trials are needed to define the effect of early TAVR on prognosis. (accuRate Evaluation of Benefit with Optimal medical treatment with or withOut Transcatheter valve repair of PARADOXical low flow low gradient aortic stenosis [REBOOT-PARADOX Trial]; NCT03863132). Copyright © 2026 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. <180> Accession Number 652079563 Title Response-Tailored or Standard-Duration Antibiotic Treatment for Infective Endocarditis. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 28 Aug 2026. Author Bundgaard H.; Pries-Heje M.; Hjulmand J.; Hasselbalch R.; Jorgensen P.G.; Fano S.; Kober N.; Tuxen C.; Kader N.; Seven E.; Rasmussen L.E.; Wienberg M.; Bruun N.E.; Tofterup M.; Rasmussen M.; Baden L.R.; Woolley A.; Lange T.; Helweg-Larsen J.; Povlsen J.A.; Fosbol E.; Moser C.; Iversen K. Institution (Bundgaard, Pries-Heje, Hjulmand, Hasselbalch, Kader, Fosbol) Department of Cardiology, Copenhagen University Hospital-Hjertecentret and Rigshospitalet, Copenhagen, Denmark (Bundgaard, Seven, Bruun, Fosbol, Iversen) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Hasselbalch, Jorgensen, Fano, Iversen) Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte Hospital, Copenhagen, Denmark (Hasselbalch, Iversen) Department of Emergency Medicine, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev, Denmark (Hasselbalch) Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark (Kober, Tuxen) Department of Cardiology, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (Seven) Department of Cardiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark (Rasmussen) Department of Cardiology, Godstrup Regional Hospital, Denmark (Wienberg) Department of Cardiology, Copenhagen University Hospital-North Zealand, Denmark (Bruun) Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (Bruun) Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark (Tofterup) Department of Cardiology, Odense University Hospital, Odense, Denmark (Rasmussen) Department of Infectious Diseases, Skane University Hospital, Lund, Sweden (Rasmussen) Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden (Baden, Woolley) Harvard Medical School, Boston, United States (Baden) Dana-Farber Cancer Institute, Boston, United States (Baden, Woolley) Division of Infectious Diseases, Brigham and Women's Hospital, Boston, United States (Lange) Department of Public Health, University of Copenhagen, Copenhagen, Denmark (Helweg-Larsen) Department of Infectious Diseases, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Povlsen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Moser) Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Moser) Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark Abstract BACKGROUND: In patients with infective endocarditis on the left side of the heart, the current recommendation of up to 6 weeks of antibiotic therapy is based largely on expert consensus opinion. Whether a clinical response-tailored antibiotic management strategy can shorten treatment duration without compromising safety is unclear. METHOD(S): In this international, open-label, randomized trial, we assigned adults in stable condition with infective endocarditis caused by Staphylococcus aureus, Enterococcus faecalis, or streptococcus species to receive either response-tailored or standard-duration antibiotic therapy. Before randomization, all the patients received at least the prespecified 2 to 4 weeks of therapy and met criteria for clinical stabilization. After randomization, patients in the tailored-therapy group discontinued antibiotics and those in the standard-therapy group continued standard treatment (total duration, 4 to 6 weeks). The primary efficacy end point was days alive without antibiotic treatment for infective endocarditis or bacteremia within 6 months after randomization (tested for superiority). The primary safety end point was a composite of death from any cause, unplanned cardiac surgery, or symptomatic embolic events within 6 months after randomization (tested for noninferiority; margin, 7.5 percentage points). Relapse of bacteremia or infective endocarditis was a key secondary end point. RESULT(S): A total of 508 patients underwent randomization, with 255 assigned to response-tailored therapy and 253 to standard-duration therapy. The median time alive without antibiotic treatment was 183 days (interquartile range, 181 to 183) with tailored therapy and 169 days (interquartile range, 166 to 171) with standard therapy (Hodges-Lehmann estimated difference, 13 days; 95% confidence interval [CI], 12 to 13; P<0.001 for superiority). A primary safety end-point event occurred in 21 patients (8.2%) with tailored therapy and in 27 patients (10.7%) with standard therapy (absolute between-group difference, -2.4 percentage points; 95% CI, -7.7 to 2.7; P<0.001 for noninferiority), indicating noninferiority. Relapse occurred in 13 patients (5.1%) with tailored therapy and in 4 patients (1.6%) with standard therapy (P = 0.04). CONCLUSION(S): Among patients with infective endocarditis on the left side of the heart, the use of a response-tailored antibiotic strategy resulted in a longer time alive without antibiotic therapy than standard-duration therapy and met the criterion for noninferiority with respect to safety but was associated with a higher incidence of relapse of bacteremia or infective endocarditis. (Funded by Sygeforsikringen "danmark" and others; POET II ClinicalTrials.gov number, NCT03851575.). Copyright © 2026 Massachusetts Medical Society. <181> Accession Number 652067773 Title Treatment effects of dapagliflozin in patients with aortic stenosis undergoing transcatheter aortic valve implantation across left ventricular ejection fraction. Source European journal of heart failure. (no pagination), 2026. Date of Publication: 27 Aug 2026. Author Raposeiras Roubin S.; Gonzalez-Manzanares R.; Amat-Santos I.; Melendo Viu M.; Dobarro D.; Lopez Otero D.; Nombela Franco L.; Gheorge L.; Sanz-Sanchez J.; Carlos B.Z.; Ojeda S.; Iniguez Romo A.; Munoz Garcia A.J.; Vilalta V.; Veiga Fernandez G.; Cordoba Soriano J.G.; Regueiro A.; Sandin Rollan M.; Flores Rios X.; Uribarri A.; Martin Reyes R.; Romaguera R.; Avanzas P.; Garcia Blas S.; Franco-Pelaez J.A.; Martin Moreiras J.; Gonzalez Juanatey J.R.; Tirado G.; Calle G.; Diez J.L.; Santos-Martinez S.; Gonzalez Ferreiro R.; Munoz Garcia E.; Carrillo Suarez X.; Sanmartin X.; Gonzalo N.; Gutierrez Barri A.; Asmarats L.; Diaz Del Hoyo F.; Camacho Freire S.; Yanes G.; Astorga Burgo J.C.; Molina Navarro E.; Caballero Borrego J.; Gonzalez Bermudez I.; Fuster V.; Ibanez B. Institution (Raposeiras Roubin, Melendo Viu, Dobarro, Iniguez Romo, Gonzalez Ferreiro, Gonzalez Bermudez) Cardiology Department, University Hospital Alvaro Cunqueiro, Vigo, Spain (Raposeiras Roubin, Melendo Viu, Dobarro, Lopez Otero, Iniguez Romo, Gonzalez Ferreiro, Sanmartin, Gonzalez Bermudez) Cardiology Department, Instituto de Investigacion Sanitaria Galicia Sur, Vigo, Spain (Raposeiras Roubin) Medicine Department, University of Santiago de Compostela, Spain (Raposeiras Roubin, Fuster, Ibanez) Cardiology Department, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (Gonzalez-Manzanares, Ojeda) Department of Cardiology, Reina Sofia University Hospital, Cordoba, Spain (Gonzalez-Manzanares, Ojeda) Cardiology Department, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain (Gonzalez-Manzanares, Ojeda) Department of Medicine, University of Cordoba, Cordoba, Spain (Gonzalez-Manzanares, Amat-Santos, Carlos, Ojeda, Santos-Martinez) Cardiology Department, Centro de Investigacion Biomedica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (Amat-Santos, Carlos, Santos-Martinez) Cardiology Department, University Clinical Hospital of Valladolid, Valladolid, Spain (Lopez Otero, Sanmartin) Cardiology Department, University Hospital Montecelo, Pontevedra, Spain (Nombela Franco, Tirado, Gonzalo) Cardiology Department, Clinical Hospital San Carlos, Madrid, Spain (Gheorge, Calle, Gutierrez Barri) Cardiology Department, University Hospital Puerta del Mar, Cadiz, Spain (Sanz-Sanchez, Vilalta, Diez) Cardiology Department, University Hospital La Fe, Valencia, Spain (Munoz Garcia, Munoz Garcia) Cardiology Department, University Hospital Virgen de la Victoria, Malaga, Spain (Veiga Fernandez) Cardiology Department, University Hospital Marques de Valdecilla, Santander, Spain (Veiga Fernandez) Cardiology Department, Instituto de Investigacion Valdecilla, Santander, Spain (Cordoba Soriano) Cardiology Department, University Hospital of Albacete, Albacete, Spain (Regueiro) Cardiology Department, University Clinical Hospital, Barcelona, Spain (Sandin Rollan) Cardiology Department, University General Hospital of Alicante, Alicante, Spain (Flores Rios) Cardiology Department, University Hospital Juan Canalejo, A Coruna, Spain (Uribarri) Cardiology Department, University Hospital Vall D'Hebron, Barcelona, Spain (Martin Reyes) Cardiology Department, University Hospital Quiron Salud La Luz, Madrid, Spain (Romaguera) Cardiology Department, University Hospital Bellvitge, Barcelona, Spain (Avanzas) Cardiology Department, University Hospital Central de Asturias, Oviedo, Spain (Garcia Blas) Cardiology Department, Clinic University Hospital of Valencia, Valencia, Spain (Garcia Blas) Cardiology Department, INCLIVA Biomedical Research Institute, Valencia, Spain (Franco-Pelaez, Ibanez) Cardiology Department, University Hospital Fundacion Jimenez Diaz, Madrid, Spain (Martin Moreiras) Cardiology Department, University Clinical Hospital of Salamanca, Salamanca, Spain (Gonzalez Juanatey) Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain (Carrillo Suarez) Cardiology Department, University Hospital German Trias I Pujol, Badalona, Spain (Asmarats) Cardiology Department, University Hospital Santa Creu I Sant Pau, Barcelona, Spain (Diaz Del Hoyo) Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain (Camacho Freire) Cardiology Department, University Hospital Juan Ramon Jimenez, Huelva, Spain (Yanes) Cardiology Department, University Hospital of Canarias, Tenerife, Spain (Astorga Burgo) Cardiology Department, University Hospital of Cruces, Spain (Molina Navarro) Cardiology Department, University Hospital Virgen de las Nieves, Granada, Spain (Caballero Borrego) Cardiology Department, University Hospital San Cecilio, Granada, Spain (Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY, United States Abstract AIMS: Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in heart failure (HF) across the left ventricular ejection fraction (LVEF) spectrum, but patients with severe valvular heart disease have been excluded from pivotal trials. We investigated the efficacy and safety of dapagliflozin across the full range of baseline LVEF in elderly patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: DapaTAVI was a pragmatic, multicentre, randomized, open-label trial with blinded endpoint adjudication conducted at 39 Spanish centres. Patients with severe aortic stenosis undergoing TAVI were randomized after the procedure to dapagliflozin 10 mg once daily or standard of care. The primary endpoint was a composite of all-cause death or worsening HF. Among 1223 patients with available baseline LVEF, 213 (17.4%) had LVEF <=40% and 1010 (82.6%) had LVEF >40%. During 1-year follow-up, the primary endpoint occurred in 20.2% of patients with LVEF <=40% and 17.0% of those with LVEF >40% (adjusted HR 1.28, 95% CI 0.91-1.80; P = .15). Dapagliflozin reduced the risk of the primary endpoint consistently across LVEF subgroups, with no significant interaction between treatment effect and baseline LVEF (P for interaction = .41). Analyses modelling LVEF as a continuous variable confirmed a homogeneous treatment effect across the entire LVEF spectrum. Dapagliflozin was well tolerated, with a safety profile comparable to control across all LVEF categories, although genitourinary infections were more frequent with dapagliflozin. CONCLUSION(S): In elderly patients undergoing TAVI, dapagliflozin reduced the risk of all-cause death or worsening HF irrespective of baseline LVEF and was safe across the full LVEF spectrum. These findings extend the benefits of SGLT2 inhibition to patients with severe aortic stenosis treated with TAVI, independent of systolic function. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <182> Accession Number 2048759588 Title PCSK9 Inhibition Lowers LDL Cholesterol After Heart Transplantation: An Updated Systematic Review and Meta-Analysis. Source Lipids. (no pagination), 2026. Date of Publication: 2026. Author Megantara H.P.; Anjanie N.; Soelistyaningroem J. Institution (Megantara) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia (Anjanie) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Soelistyaningroem) Department of Cardiovascular Medicine, Mitra Keluarga Cibubur General Hospital, Bekasi, Indonesia Publisher John Wiley and Sons Inc Abstract Lipid management after heart transplantation (HT) is complicated by post-transplant dyslipidemia, immunosuppression, statin intolerance, and cardiac allograft vasculopathy (CAV). Proprotein convertase subtilisin/kexin Type 9 (PCSK9) inhibitors lower LDL-C in non-transplant populations, but HT recipients were under-represented in pivotal lipid trials. This updated systematic review and exploratory meta-analysis synthesized full-text evidence of PCSK9 inhibition after adult HT, predominantly with alirocumab or evolocumab. LDL-C lowering was the primary lipid outcome. CAV imaging/physiology, rejection, donor-specific antibodies, immunosuppression stability, and safety were secondary outcomes. PubMed/MEDLINE, Scopus, Cochrane Library, and Google Scholar were searched through June 20, 2026. Sixteen primary studies were included. Two independent randomized trials, EVOLVD and CAVIAR, both conducted during the first post-transplant year, provide the highest-quality evidence. The remaining evidence consists of an EVOLVD physiology/OCT substudy and observational or case-based reports. Ten studies contributed LDL-C effect and variance data. The exploratory random-effects summary estimated an LDL-C reduction of 73.6 mg/dL (95% CI, 58.8-88.4, I2 = 89.8%). The randomized-trial subgroup showed a smaller but consistent reduction of 41.8 mg/dL (95% CI, 35.9-47.7). Observational estimates were larger but derived from selected, lower-certainty cohorts. Randomized first-year evidence did not show clear improvement in CAV imaging or coronary physiology. PCSK9 inhibition lowers LDL-C after HT and appears tolerable, but CAV modification and graft-outcome benefit remain unproven. Copyright © 2026 AOCS. <183> Accession Number 2048854498 Title Off-Pump CABG With and Without Sternotomy: A Meta-Analysis of Comparative Studies. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 3088217. Date of Publication: 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Publisher John Wiley and Sons Inc Abstract Objectives: Minimally invasive coronary artery bypass grafting (MICS-CABG) has emerged as a less invasive alternative to conventional off-pump CABG (OPCAB), but direct comparative evidence remains limited. This meta-analysis synthesizes outcomes from randomized controlled trials (RCTs) and propensity-adjusted observational studies comparing these two off-pump strategies. Method(s): A comprehensive literature search was conducted according to PRISMA 2020. Eligible studies compared MICS-CABG and sternotomy OPCAB under strictly off-pump conditions. Quantitative synthesis was limited to RCTs and cohort studies using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW) to reduce confounding. Random-effects meta-analyses accounted for clinical and methodological heterogeneity. Result(s): Twelve of 40 eligible studies were included in the meta-analysis, comprising 3 RCTs, 1 IPTW cohort study, and 8 PSM cohort studies. Although the primary analysis suggested lower postoperative mortality (OR 0.54, 95% CI 0.38-0.77), this finding was not consistently supported across complementary analyses. Exclusion of the largest IPTW study reversed the direction of the pooled estimate (OR 1.34), and no significant mortality difference was observed in the multivessel subgroup (OR 1.55). In the subgroup analysis restricted to patients with multivessel disease, no statistically significant difference in mortality was observed (OR 1.55). MICS-CABG was consistently associated with longer operative time but shorter length of hospital stay, although substantial heterogeneity was observed. Conclusion(s): In comparisons restricted to off-pump strategies, MICS-CABG was associated with shorter hospital stay but longer operative time, without consistent differences in major adverse cardiovascular and cerebrovascular events. The apparent mortality benefit observed in the primary analysis was not consistently supported across complementary analyses. Sternotomy OPCAB remains a robust standard strategy, whereas MICS-CABG may represent a less invasive alternative for selected patients. Copyright © 2026 Shotaro Yoshida et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd.

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