EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2042993295
Title
Non-invasive pressure-volume analysis: a novel method for evaluating
ventricular function in patients with aortic stenosis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2026. Article
Number: 1740710. Date of Publication: 2026.
Author
Ribic D.; Remme E.W.; Smiseth O.A.; Massey R.J.; Eek C.H.; Kvitting
J.-P.E.; Gullestad L.; Broch K.; Russell K.
Institution
(Ribic, Massey, Eek, Gullestad, Broch, Russell) Department of Cardiology,
Oslo University Hospital, Oslo, Norway
(Ribic, Smiseth, Kvitting, Gullestad, Broch) Institute for Clinical
Medicine, University of Oslo, Oslo, Norway
(Remme, Smiseth) Institute of Surgical Research, Oslo University Hospital,
Oslo, Norway
(Remme) The Intervention Centre, Oslo University Hospital, Oslo, Norway
(Kvitting) Department of Cardiothoracic Surgery, Oslo University Hospital,
Oslo, Norway
Publisher
Frontiers Media SA
Abstract
Background and aims: Conventional echocardiographic measurements like
ejection fraction (EF) and global longitudinal strain (GLS) evaluate left
ventricular (LV) function without considering concurrent loading
conditions. A more comprehensive characterization of cardiac function and
energetics can be achieved through pressure-volume analysis, but its
clinical application is limited by the requirement for invasive
measurements. We aimed to develop a clinically accessible, non-invasive
method for pressure-volume loop analysis. <br/>Method(s): We obtained
simultaneous 3-dimensional echocardiograms and invasive LV pressures with
micromanometer-tipped catheters during transcatheter aortic valve
replacement (TAVR) for severe aortic stenosis. Volume-time traces from the
echocardiograms were combined with invasive LV pressures and non-invasive
pressure estimates to construct pressure-volume loops. We used
echocardiograms before and after TAVR to evaluate changes in myocardial
function via non-invasive pressure-volume studies. <br/>Result(s): In
same-beat comparisons, stroke work calculated using non-invasive LV
pressure estimations correlated well with stroke work calculated using
invasive LV pressures (r = 0.95, ICC = 0.95, p < 0.0001, y = 0.90X +
1,836, mean bias -549 mmHg*mL, standard deviation 774 mmHg*mL; 95% limits
of agreement: -2,006 to +967 mmHg*mL). After TAVR, stroke work fell
substantially, ventricular efficiency increased, ventriculo-arterial
coupling improved, and both total and resting energy consumption
decreased. On the other hand, LV biplane EF and GLS remained unchanged.
<br/>Conclusion(s): This study confirms the validity and clinical
accessibility of non-invasive pressure-volume loop analysis in patients
with aortic stenosis. The method identified and characterized changes in
myocardial energetics, function, and ventriculo-arterial interaction, that
are not typically detected by conventional echocardiography. These
findings highlight the potential of non-invasive pressure-volume analysis
in clinical and research practice.<br/>Copyright 2026 Ribic, Remme,
Smiseth, Massey, Eek, Kvitting, Gullestad, Broch and Russell.

<2>
Accession Number
2043220501
Title
The effect of postoperative back massage on pain, sleep outcomes and serum
cortisol after open-heart surgery: A randomized controlled trial.
Source
International Journal of Nursing Studies. 176 (no pagination), 2026.
Article Number: 105343. Date of Publication: 01 Apr 2026.
Author
Ozhanli Y.; Gunes A.; Akyuz N.; Uzun S.; Kurt M.; Omay O.; Sik B.Y.; Sahin
Institution
(Ozhanli, Sahin) Kocaeli University Faculty of Health Sciences, Umuttepe
Campus, Kocaeli, Izmit, Turkey
(Gunes) Istanbul Beykent University Faculty of Health Sciences, Beylikduzu
Campus, Istanbul, Beylikduzu, Turkey
(Akyuz) Istanbul University-Cerrahpasa Florence Nightingale Faculty of
Nursing, Abide-i Hurriyet Street, Istanbul, Sisli, Turkey
(Uzun, Kurt) Kocaeli University Research and Practice Hospital,
Cardiovascular Surgery Intensive Care, Umuttepe Campus, Kocaeli, Izmit,
Turkey
(Omay) Kocaeli University Faculty of Medicine, Cardiovascular Surgery
Department, Umuttepe Campus, Kocaeli, Izmit, Turkey
(Sik) Kocaeli University Faculty of Medicine, Biochemistry Department,
Umuttepe Campus, Kocaeli, Izmit, Turkey
Publisher
Elsevier Ltd
Abstract
Background: Massage is widely recognized as an effective
non-pharmacological intervention for reducing pain and anxiety after
cardiac surgery. However, its effects on sleep outcomes and biological
stress markers remain underexplored. <br/>Aim(s): To evaluate the impact
of back massage on postoperative pain, subjective and objective sleep
outcomes, and serum cortisol levels in patients undergoing open-heart
surgery. <br/>Method(s): A prospective randomized controlled trial was
conducted with 72 patients scheduled for elective open-heart surgery.
Participants were randomized (1:1) to an intervention group (back massage)
or a control group (routine care with light touch). The intervention
consisted of three standardized sessions (15-20 min each) on the first
postoperative day. Outcomes included pain (Numeric Rating Scale-Pain),
subjective sleep quality (Richard-Campbell Sleep Scale), objective sleep
duration (smartwatch measurement), and serum cortisol levels. Data were
analyzed using repeated-measures analysis of variance and Brunner-Langer
tests in a per-protocol population (n = 64). <br/>Result(s): Back massage
was associated with significantly longer total sleep duration (p = 0.037)
and greater reduction in pain scores, with significant group, time, and
group x time effects (p = 0.002, p < 0.001, p = 0.048). Cortisol levels
decreased over time in both groups (p < 0.001), but without significant
between-group differences. Subjective sleep quality improved in both
groups, and analgesic use declined, with no significant variation between
groups. No adverse events were observed. <br/>Conclusion(s): This
randomized controlled trial demonstrates that back massage is a safe and
feasible intervention after open-heart surgery, improving objectively
measured sleep duration and reducing pain. By incorporating objective
sleep measures and a biological stress marker (serum cortisol), this study
provides novel insights that extend beyond the traditionally reported
outcomes of pain and anxiety, supporting massage as a complementary
strategy within multimodal nursing care.<br/>Copyright &#xa9; 2026
Elsevier Ltd

<3>
Accession Number
2043137004
Title
Comparative Performance of Machine Learning and Traditional Risk Scores in
Predicting Adverse Events After Transcatheter Aortic Valve Replacement in
Patients With Atrial Fibrillation.
Source
American Journal of Cardiology. 262 (pp 91-97), 2026. Date of Publication:
01 Mar 2026.
Author
Nicolas J.; Dangas G.; Borrow A.; Smolnik R.; Just F.; Chen C.;
Padmanabhan K.; Fronk E.-M.; Hengstenberg C.; Van Mieghem N.; Unverdorben
M.
Institution
(Nicolas, Dangas) Mount Sinai Fuster Heart Hospital, Icahn School of
Medicine at Mount Sinai, New York, New York, United States
(Borrow, Chen, Unverdorben) Daiichi Sankyo, Inc., Basking Ridge, NJ,
United States
(Smolnik, Just, Fronk) Daiichi Sankyo Europe, GmbH, Munich, Germany
(Padmanabhan) Cytel, Cambridge, Massachusetts, United States
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Vienna General Hospital, Medical University, Vienna, Austria
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Patients with atrial fibrillation (AF) following transcatheter aortic
valve replacement (TAVR) remain at risk of ischemic stroke (IS) and
bleeding. However, traditional risk scores provide modest predictions of
IS and bleeding in these patients. We aimed to develop machine learning
(ML) models that predict IS, major gastrointestinal bleeding (MGIB), all
clinically relevant bleeding (CRB), and net adverse clinical events (NACE)
using data from patients in the ENVISAGE-TAVI AF trial. Ten ML algorithms
were trained per outcome using nested cross-validation; the
best-performing model (highest F1 score) was validated on a 25% holdout
set. Model performance was compared with logistic regression models using
CHADS-VA or HAS-BLED. Among 1,377 patients, 41 had an IS, 83 had MGIB, 375
had CRB, and 255 experienced NACE. The predictive abilities of a linear
discriminant analysis algorithm for IS (F1 score = 0.08) and CHADS-VA (F1
score = 0.09) were similarly low, but numerically better than HAS-BLED (F1
score = 0.05). Prediction of MGIB was similarly low for a logistic-lasso
algorithm (F1 score = 0.11), CHADS-VA (F1 score = 0.09), and HAS-BLED (F1
score = 0.12). For CRB, the predictive performance of a Naive Bayes
algorithm (F1 score = 0.39) was similar to CHADS-VA (F1 score = 0.38) and
HAS-BLED (F1 score = 0.41). The predictive ability of a logistic
regression algorithm for NACE (F1 score = 0.33) was numerically better
than CHADS-VA (F1 score = 0.22) or HAS-BLED (F1 score = 0.27). In
conclusion, ML offered similar predictive ability to established risk
scores for thromboembolic and bleeding outcomes among TAVR patients with
AF.<br/>Copyright &#xa9; 2025 The Authors

<4>
Accession Number
2041011598
Title
Prevalence and prognostic value of elevated computed tomography coronary
artery calcium scores in Indigenous peoples globally: A systematic review.
Source
International Journal of Cardiovascular Imaging. 42(1) (pp 61-70), 2026.
Date of Publication: 01 Jan 2026.
Author
Cheung K.; Pant A.; Dang D.; Ridsdill-Kenny E.; Marschner S.; Kuhn L.;
Wing-Lun E.; Mitchell J.; Bittencourt M.; Zaman S.
Institution
(Cheung, Dang) Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia
(Cheung, Dang) Alfred Health, Melbourne, VIC, Australia
(Pant, Ridsdill-Kenny, Marschner, Wing-Lun, Zaman) Westmead Applied
Research Centre, Faculty of Medicine and Health, University of Sydney,
Sydney, NSW, Australia
(Ridsdill-Kenny) Logan Hospital, Meadowbrook, QLD, Australia
(Kuhn) School of Nursing, Midwifery and Paramedicine, Australian Catholic
University, Melbourne, VIC, Australia
(Kuhn) Monash Emergency Research Collaborative, Monash Health, Melbourne,
VIC, Australia
(Wing-Lun) Menzies School of Health Research, Royal Darwin Hospital,
University of Sydney, Sydney, NSW, Australia
(Mitchell) School of Medicine, Washington University, St Louis, MO, United
States
(Bittencourt) Department of Medicine, Department of Radiology, University
of Pittsburgh, Pittsburgh, PA, United States
(Zaman) Department of Cardiology, Westmead Hospital, Sydney, NSW,
Australia
Publisher
Springer Science and Business Media B.V.
Abstract
Despite the significant burden of disease in Indigenous Peoples globally,
the validity of computed tomography (CT) coronary artery calcium (CAC)
scoring has been poorly described. Thus, we aimed to identify the
prevalence and predictive utility of a CT CAC score > 0 in this
population. A systematic search was conducted on MEDLINE, EMBASE, CINAHL,
Scopus and Web of Science databases from 1990 to 2022. Primary
observational studies that reported CT CAC scores and Indigenous ethnicity
were included. The primary outcome was the prevalence of a CT CAC score >
0. The secondary outcome was MACE. Eight studies on CT CAC scoring
stratified results according to Indigenous ethnicity (n = 30,845 and 1,677
Indigenous). Prevalence of CT CAC score > 0 was higher in Australian First
Nations people than non-Indigenous people [adjusted odds ratios (aOR)
2.36, 95% confidence interval (CI) 1.32-4.23; p = 0.004 and aOR 2.76, 95%
CI 1.30-5.87; p = 0.008] but not in Native Americans (aOR 0.70, 95% CI
0.42-1.18) or Indigenous Brazilians (aOR 0.96, 95% CI 0.30-3.11). Two
studies assessed the interaction of Indigenous ethnicity on the
association between CAC > 0 and MACE. Neither found a significant
interaction (p = 0.64 and 0.53). From 2431 studies, eight reported CT CAC
scores stratified by Indigenous ethnicity. From limited data, prevalence
of CT CAC score > 0 was higher in Australian First Nations people compared
to non-Indigenous Australians and CT CAC score > 0 was similarly able to
predict MACE in Indigenous Peoples. Future research on CT CAC scoring
should stratify outcomes according to Indigenous status to better
understand its utility.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Nature B.V. 2025.

<5>
Accession Number
2043177752
Title
Management of asymptomatic severe aortic stenosis: A systematic review and
meta-Analysis of randomized controlled trials.
Source
Minerva Cardiology and Angiology. 73(6) (pp 778-786), 2025. Date of
Publication: 01 Dec 2025.
Author
Johnson N.; Anil S.; Craig N.J.; Shah B.N.; Ring L.; Tsampasian V.;
Vassiliou V.S.
Institution
(Johnson, Anil, Tsampasian, Vassiliou) Norwich Medical School, Bob
Champion Research and Education, Norwich, United Kingdom
(Craig) British Heart Foundation Centre of Research Excellence, University
of Edinburgh, Edinburgh, United Kingdom
(Craig) Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh,
United Kingdom
(Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton,
United Kingdom
(Ring) West Suffolk Hospital, Bury St. Edmunds, United Kingdom
(Tsampasian, Vassiliou) Norfolk and Norwich University Hospital, Norwich,
United Kingdom
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Whilst aortic stenosis remains the most prevalent valvular
abnormality, the management of asymptomatic severe aortic stenosis remains
a clinical challenge. Recently, two randomised-controlled trials (RCTs)
EVOLVED(Early Intervention in Patients With Asymptomatic Severe Aortic
Stenosis and Myocardial Fibrosis) and Early TAVR(Transcatheter
Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis) have
been published, alongside an extended follow-up from the AVATAR(Aortic
Valve Replacement Versus Conservative Treatment in Asymptomatic Severe
Aortic Stenosis) study. EVIDENCEACQUISITION: In response, we conducted a
systematic review of PubMed, Ovid, and Cochrane databases, identifying
RCTs up to October 29, 2024, that compared early intervention with
conventional management. EVIDENCESYNTHESIS: Four studies met the inclusion
criteria, with a combined total of 1427 patients across the trials.
Meta-Analysis of the primary endpoints across these studies demonstrated a
benefit with early intervention (HR=0.50, 95% CI: 0.35-0.73). However, we
did not find mortality and cardiac mortality to show significant
reductions (HR=0.68, 95% CI: 0.40-1.18 and HR=0.66, 95% CI: 0.33-1.29,
respectively). Crucially, stroke outcomes were improved with early
intervention (HR=0.60, 95% CI: 0.38-0.95), as were unplanned
hospitalizations (HR=0.40, 95% CI: 0.30-0.53). <br/>CONCLUSION(S): These
findings confirm the safety of early intervention and suggest a reduction
in stroke incidence, although no significant benefits were observed in
overall or cardiac mortality; results which can help to guide shared
decision-making with patients and prevent adverse health outcomes. (Cite
this article as: Johnson N, Anil S, Craig NJ, Shah BN, Ring L, Tsampasian
V, et al. Management of asymptomatic severe aortic stenosis: A systematic
review and meta-Analysis of randomized controlled trials. Minerva Cardiol
Angiol 2025;73:778-86. DOI: 10.23736/S2724-5683.25.06950-9)<br/>Copyright
&#xa9; 2025 EDIZIONIMINERVAMEDICA.

<6>
Accession Number
2041616088
Title
Outcomes of Ventricular Tachycardia Ablation in Cardiac Laminopathy: An
Updated Systematic Review and Single-Arm Meta-Analysis.
Source
Journal of Cardiovascular Electrophysiology. 37(2) (pp 268-274), 2026.
Date of Publication: 01 Feb 2026.
Author
Castrichini M.; Ferreira Felix I.; Karlinski Vizentin V.; Garmany R.;
Huynh T.; Haq I.U.; Swain W.H.; Siontis K.C.; Killu A.M.; Deshmukh A.J.;
Ackerman M.J.; Giudicessi J.R.
Institution
(Castrichini, Garmany, Haq, Swain, Siontis, Killu, Deshmukh, Ackerman,
Giudicessi) Department of Cardiovascular Medicine (Division of Heart
Rhythm Services), Mayo Clinic, Rochester, MN, United States
(Castrichini, Karlinski Vizentin, Garmany, Huynh, Ackerman, Giudicessi)
Department of Molecular Pharmacology and Experimental Therapeutics
(Windland Smith Rice Sudden Cardiac Death Genomics Laboratory), Mayo
Clinic, Rochester, MN, United States
(Ferreira Felix, Huynh) Department of Internal Medicine, Mayo Clinic,
Rochester, MN, United States
(Garmany) Mayo Clinic Medical Scientist Training Program, Mayo Clinic
Graduate School of Biomedical Sciences, Mayo Clinic Alix School of
Medicine, Rochester, MN, United States
(Ackerman) Department of Pediatric and Adolescent Medicine (Division of
Pediatric Cardiology), Mayo Clinic, Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Ventricular tachycardia (VT) is a life-threatening arrhythmia
frequently observed in structural heart diseases, including LMNA-related
cardiomyopathy, a genetic disorder associated with high risk of sudden
cardiac death and progressive systolic dysfunction. While catheter
ablation is an established therapeutic option for VT, its efficacy in
cardiac laminopathy remains poorly defined. <br/>Objective(s): To
synthesize available evidence on the role and outcomes of VT ablation in
patients with cardiac laminopathy. <br/>Method(s): A systematic review and
single-arm meta-analysis was performed in accordance with PRISMA
guidelines. PubMed, Embase, and Cochrane databases were searched for
studies reporting VT ablation outcomes in LMNA-related cardiomyopathy. An
inverse variance random-effects model was applied for meta-analysis of
proportions. <br/>Result(s): Seven studies (six cohorts, one abstract)
comprising 62 patients (mean age 53.2 +/- 9.7 years; 85% male; 88% with
implantable cardioverter-defibrillator) were included. An
endocardial/endo-epicardial approach was used in 93% of cases. Acute
procedural success was achieved in 37% (95% CI: 14%-63%; I2 = 27.4%), and
28% required multiple procedures. Over a median follow-up of 26 (9-35)
months, VT recurrence occurred in 91% (95% CI: 76%-100%; I2 = 37.2%).
All-cause mortality was 54% (95% CI: 39%-70%; I2 = 28%), predominantly
from cardiac causes (51%, 95% CI: 25%-76%; I2 = 53%), and 14% (95% CI:
1%-34%; I2 = 42%) underwent heart transplantation. <br/>Conclusion(s): In
LMNA-related cardiomyopathy, catheter ablation is associated with high VT
recurrence, limited long-term success, and substantial cardiovascular
mortality and transplantation rates, underscoring the importance of ICD
implantation and the need for alternative strategies, including
variant-specific and molecularly targeted therapies.<br/>Copyright &#xa9;
2025 Wiley Periodicals LLC.

<7>
Accession Number
2042514150
Title
Cardiac Allograft Vasculopathy in Heart Transplantation From Circulatory
Death Donors: A Systematic Review and Meta-Analysis.
Source
Clinical Transplantation. 40(1) (no pagination), 2026. Article Number:
e70435. Date of Publication: 01 Jan 2026.
Author
Safdar W.; Chan M.A.G.; D'Angelo L.; Kumar A.; Patel S.R.; Saeed O.;
Goldstein D.J.; Jorde U.P.; Madan S.
Institution
(Safdar) Department of Internal Medicine, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Chan) Division of Cardiology, New York-Presbyterian, Queens, Flushing,
NY, United States
(D'Angelo, Saeed, Jorde, Madan) Division of Cardiology, Montefiore Medical
Center, Albert Einstein College of Medicine, Bronx, NY, United States
(Kumar) Albert Einstein College of Medicine, Bronx, NY, United States
(Patel) Division of Cardiology, North Shore University Hospital, Zucker
School of Medicine at Hofstra, Manhasset, NY, United States
(Goldstein) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiac allograft vasculopathy (CAV) remains a major cause of
long-term morbidity and mortality after heart transplantation (HT). With
the growing use of donation after circulatory death (DCD) donors, it is
crucial to assess the incidence of CAV in this population. <br/>Method(s):
We conducted a systematic review and meta-analysis of studies published
between January 2010 and December 2024. comparing 1-year CAV incidence and
1-year mortality between DCD and donation after brain death (DBD) HT
recipients. Odds ratios (OR) with 95% confidence intervals (CI) were
pooled using fixed and random-effects models. <br/>Result(s): Four studies
met inclusion criteria, comprising 951 HTs (576 DBD and 375 DCD). Of
these, 594 HTs contributed to the CAV analysis and 914 to the mortality
analysis. Pooled analysis demonstrated no significant difference in 1-year
CAV incidence between DCD and DBD recipients (OR = 0.71, 95% CI:
0.43-1.17, p = 0.17). Similarly, no difference was observed in 1-year
mortality (OR = 0.87, 95% CI: 0.48-1.58, p = 0.66). <br/>Conclusion(s):
DCD and DBD-HT recipients demonstrated comparable 1-year CAV incidence and
mortality. These findings support the continued and expanded use of DCD
donors to address the ongoing shortage of suitable donor
hearts.<br/>Copyright &#xa9; 2026 John Wiley & Sons A/S. Published by John
Wiley & Sons Ltd.

<8>
Accession Number
2037632693
Title
Beta-Blockers in Stable Coronary Artery Disease: A Systematic Review and
Meta-Analysis of Observational Studies.
Source
Reviews in Cardiovascular Medicine. 26(12) (no pagination), 2025. Article
Number: 44520. Date of Publication: 01 Dec 2025.
Author
Liu J.-X.; Zheng S.-Y.; Guo F.; He C.-H.; Lin J.; Fu H.; Du X.; Dong J.-Z.
Institution
(Liu, Zheng, Guo, He, Lin, Fu, Du, Dong) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: The efficacy of beta-blockers in stable coronary artery
disease (CAD) patients with preserved left ventricular function remains
controversial. We aimed to evaluate the cardiovascular associations of
beta-blocker therapy in this population through a comprehensive
meta-analysis. <br/>Method(s): We conducted a systematic review and
meta-analysis following Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) guidelines, searching PubMed, EMBASE, Web of
Science, Scopus, Google Scholar, and Cochrane databases from inception to
May 2025, updating and extending the previous meta-analysis. We included
observational studies comparing beta-blocker therapy versus control in
stable CAD patients, defined as those without acute coronary syndrome
manifestations for a sufficient period (typically >6 months) to ensure
clinical stability, with preserved left ventricular ejection fraction
(left ventricular ejection fraction >50%). Primary outcome was cardiac
death. Secondary outcomes included all-cause mortality, heart failure,
myocardial infarction (MI), and stroke. Random-effects models were used
for all analyses. Subgroup analyses were conducted for cardiac and
all-cause death stratified by propensity score matching status and prior
beta-blocker use exclusion criteria. Publication bias was assessed using
funnel plots and Peter's test. <br/>Result(s): Nine observational studies
encompassing 903,870 patients (616,645 beta-blocker users vs. 287,225
controls) were included. Beta-blocker therapy showed no significant
association with the primary endpoint: cardiac death (hazard ratio (HR)
0.98, 95% CI: 0.93-1.04, p = 0.54). Secondary outcomes similarly
demonstrated no significant associations: all-cause mortality (HR 0.98,
95% CI: 0.91-1.05, p = 0.49), MI (HR 1.02, 95% CI: 0.93-1.11, p = 0.72),
stroke (HR 1.02, 95% CI: 0.97-1.08, p = 0.43), and heart failure (HR 1.10,
95% CI: 0.95-1.27, p = 0.20). Substantial heterogeneity was observed for
all-cause death (I² = 87%) and heart failure (I²=
95%). Subgroup analyses failed to identify populations with clear
associations between beta-blocker therapy and improved outcomes.
<br/>Conclusion(s): Beta-blocker therapy was not significantly associated
with cardiovascular benefits in stable CAD patients with preserved left
ventricular function. These findings provide additional contemporary
evidence supporting current guideline recommendations from both American
Heart Association (AHA)/American College of Cardiology (ACC) and European
Society of Cardiology (ESC) regarding beta-blocker use in this population.
Clinicians should conduct individualized risk-benefit assessments rather
than adopting routine prescribing patterns. The PROSPERO Registration:
CRD420251141812,
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=1141812.<b
r/>Copyright &#xa9; 2025 The Author(s).

<9>
Accession Number
2041561397
Title
Amustaline/glutathione pathogen-reduced red cell hemoglobin utilization in
complex cardiac surgery: A post hoc analysis of the phase 3 ReCePI trial.
Source
Transfusion. 66(1) (pp 72-83), 2026. Date of Publication: 01 Jan 2026.
Author
Welsby I.J.; Sekela M.E.; Snyder E.L.; Gorham J.D.; McNeil J.S.; Liu K.;
Bentow S.; Gniadek T.; Corash L.; Mufti N.; Benjamin R.J.
Institution
(Welsby) Duke University Medical Center, Durham, NC, United States
(Sekela) Gill Heart Institute, University of Kentucky, Lexington, KY,
United States
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Gorham, McNeil) University of Virginia Health System, Charlottesville,
VA, United States
(Liu, Bentow, Gniadek, Corash, Mufti, Benjamin) Cerus Corporation,
Concord, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The ReCePI randomized, controlled trial compared
amustaline/glutathione pathogen-reduced (PR) and conventional red blood
cell (RBC) transfusions in cardiac surgery. Study design and methods: We
performed a post-hoc analysis of hemoglobin (Hb) utilization and safety
outcomes. Hb content of study RBCs was measured at manufacture. Subject Hb
levels, estimated blood loss and blood product use were recorded during
and for 7 days post-surgery. Acute kidney injury (AKI) incidence was
graded over 7 days, and adverse events were assessed for 28 days.
<br/>Result(s): PR-RBCs contained 5.2% less Hb (mean [SD] Test 58.1 [6.5]
g; Control 61.5 [6.8] g Hb, p <.001) due to manufacturing volume losses.
Four hundred fifty-six PR- and 524 conventional RBCs were transfused to
159 Test and 162 Control subjects, respectively. Mean subject baseline and
post-surgery Hb levels, and blood loss were not different between groups.
Test subjects tended to require fewer total RBCs (3.5 [2.7] Test vs. 4.0
[3.5] Control, p =.08) resulting in 17.6% significantly less mean total Hb
transfused (Test 203.2 g; Control 246.8 g Hb, p =.01). The proportions of
subjects transfused with, and the number of platelet and cryoprecipitate
units transfused were not different. Test subjects received less plasma
(2.3 [1.8] units Test vs. 3.5 [3.8] Control, p =.03). Overall incidence of
adverse events and AKI were not clinically different. Imbalances in AKI
severity (Grade III Test 15/159 [9.4%]; Control 7/162 [4.3%], p =.07) may
suggest under-transfusion in the highest-risk Test subjects.
<br/>Discussion(s): Test patients required less transfused Hb than control
subjects to maintain equivalent daily hemoglobin levels following similar
blood loss.<br/>Copyright &#xa9; 2025 The Author(s). Transfusion published
by Wiley Periodicals LLC on behalf of AABB.

<10>
Accession Number
2043298838
Title
Comparative effectiveness of exercise training modalities in heart
transplant recipients: a systematic review and network meta-analysis of
randomized controlled trials.
Source
European Journal of Preventive Cardiology. 33(2) (pp 251-264), 2026. Date
of Publication: 01 Jan 2026.
Author
Beust de Lima J.; Ferrari F.; Dos Santos Soares D.; Carvas Junior N.;
Carvalho G.; Alonso Tobar Leitao S.; Adams Goldraich L.; Klarmann
Ziegelmann P.; Clausell N.; Stein R.
Institution
(Beust de Lima, Ferrari, Dos Santos Soares, Carvalho, Alonso Tobar Leitao,
Klarmann Ziegelmann, Clausell, Stein) Graduate Program in Cardiology and
Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul,
Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, RS, Porto
Alegre, Brazil
(Beust de Lima, Ferrari, Carvalho, Stein) Exercise Cardiology Research
Group, Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de
Porto Alegre, Rua Ramiro Barcelos, 2350, RS, Porto Alegre, Brazil
(Carvas Junior) Department of Evidence-Based Health, Brazilian Cochrane
Center, Universidade Federal de Sao Paulo, SP, Sao Paulo, Brazil
(Alonso Tobar Leitao) Interdisciplinary Research Group in Translational
Cardiology, Clinical Research Center, Hospital de Clinicas de Porto
Alegre, RS, Porto Alegre, Brazil
(Adams Goldraich, Clausell) Heart Failure and Cardiac Transplant Unit,
Cardiology Division, Hospital de Clinicas de Porto Alegre, RS, Porto
Alegre, Brazil
(Klarmann Ziegelmann) Graduate Program in Epidemiology, Universidade
Federal do Rio Grande do Sul, RS, Porto Alegre, Brazil
(Stein) Internal Medicine Department, Universidade Federal do Rio Grande
do Sul, Rua Ramiro Barcelos, 2350, RS, Porto Alegre, Brazil
Publisher
Oxford University Press
Abstract
Aims Exercise training (ET) provides numerous benefits for heart
transplant (HTx) recipients. However, direct comparisons between ET
modalities remain limited. This study aims to compare the efficacy and
safety of multiple ET modalities on peak oxygen consumption (peak
VO<inf>2</inf>) and key secondary outcomes in HTx recipients. Methods and
results We systematically searched eight electronic databases from
inception to September 2024. Traditional random-effects models and
Bayesian network meta-analysis were employed. Confidence in the results
was evaluated using the Confidence in Network Meta-Analysis (CINeMA) tool.
Thirteen randomized controlled trials involving 473 HTx recipients were
analysed. The network meta-analysis identified high-intensity interval
training (HIIT) [mean difference (MD): 4.34 mL.kg1.min1; 95% credible
interval (CrI), 1.41-5.6] and combined training (CT) (MD: 3.49
mL.kg1.min1; 95%CrI, 1.15-7.44) as the most effective interventions for
improving peak VO<inf>2</inf> compared to usual care. HIIT was also more
effective than moderate-intensity continuous training (MICT) (MD: 2.09
mL.kg1.min1; 95%CrI, 0.05-4.03). No significant differences were observed
between MICT, home-based MICT, home-based CT, and usual care. The
certainty of evidence ranged from moderate to very low across comparisons.
No significant differences were observed between ET modalities regarding
heart rate response or ventilatory efficiency. ET was associated with
improvements in specific quality of life subdomains. No exercise-related
adverse events were reported. Conclusion This review demonstrates that ET
significantly improves peak VO<inf>2</inf> in HTx recipients, with HIIT
and CT outperforming usual care. HIIT also surpasses MICT in improving
peak VO<inf>2</inf>. Overall, ET modalities are safe and effective for
this population. Lay summary This study compared different types of
exercise training (ET) to determine which are most effective and safe for
people who have received a heart transplant (HTx). High-intensity interval
training (HIIT) and combined training significantly improved fitness
levels, measured by peak oxygen consumption (peak VO<inf>2</inf>), in HTx
recipients compared to usual care. Additionally, HIIT resulted in greater
improvements in peak VO<inf>2</inf> than moderate-intensity continuous
training. No major differences in safety outcomes were observed between
the ET modalities, suggesting that various exercise approaches may be safe
for this population.<br/>Copyright &#xa9; The Author(s) 2025. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<11>
Accession Number
2042972384
Title
Neurofilament light chain as a potential biomarker of perioperative
neurocognitive disorders: a systematic review and meta-analysis.
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e102444. Date of
Publication: 14 Jan 2026.
Author
Chen F.; Wu Z.-X.; Chen Q.; Zuo D.-K.; Ye X.-M.; Li H.
Institution
(Chen, Wu, Chen, Zuo, Ye, Li) Department of Anesthesiology, Second
Affiliated Hospital of Army Medical University, Army Medical University,
Chongqing, China
Publisher
BMJ Publishing Group
Abstract
Objectives Although neurofilament light chain (NfL) is used as a biomarker
of neurodegenerative decline, its application in surgery- and
anaesthesia-induced acute cognitive dysfunction remains uncertain. We
aimed to synthesise existing evidence to evaluate the potential of NfL as
a biomarker for perioperative neurocognitive disorder (PND). Design
Systematic review and meta-analysis. Data sources PubMed, EMBASE, MEDLINE,
the Cochrane Library and the Cochrane Central Register of Clinical Trials
were systematically searched up to March 2024. Eligibility criteria
Observational studies-including cohort, case-control and cross-sectional
designs-were included if they reported cerebrospinal fluid (CSF) or blood
NfL levels in individuals with and without PND. Data extraction and
synthesis Three independent reviewers assessed each article. Quality
scoring was conducted, and the extracted data were analysed using STATA.
Risk of bias was evaluated using the Newcastle-Ottawa Scale.
Meta-analytical model selection was guided by the I² statistic,
with I²<=40% indicating low heterogeneity and the use of a
fixed-effect model; random-effects models were used when this threshold
was exceeded. Results Within-group analyses showed significant
postoperative increases in blood NfL levels in both the postoperative
delirium (POD) group (standardised mean difference (SMD) = 0.49; 95% CI
0.34 to 0.64) and the no-POD group (SMD=0.67, 95%CI 0.53 to 0.81).
Between-group comparisons revealed significantly higher preoperative CSF
NfL levels in the POD group (SMD=0.27, 95%CI 0.07 to 0.47). Both
preoperative and postoperative blood NfL levels were also significantly
elevated in the POD group (SMD=0.53, 95%CI 0.40 to 0.66, and SMD=0.58,
95%CI 0.43 to 0.73, respectively). Conclusions This meta-analysis suggests
that NfL may be a potential biomarker for POD. Further research is needed
to clarify the association between CSF and blood NfL levels and other
forms of PND.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2026.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<12>
Accession Number
2036876769
Title
Successful cutaneous sensory blockade following single-injection and
double-injection techniques of ultrasound-guided superficial parasternal
intercostal plane block: a randomized clinical trial.
Source
Regional Anesthesia and Pain Medicine. 51(2) (pp 174-180), 2026. Date of
Publication: 01 Feb 2026.
Author
Samerchua A.; Sroiwong C.; Lapisatepun P.; Leurcharusmee P.; Pipanmekaporn
T.; Sukhupragarn W.; Boonsri S.; Bunchungmongkol N.; Pansuan K.; Phothikun
A.
Institution
(Samerchua, Sroiwong, Lapisatepun, Leurcharusmee, Pipanmekaporn,
Sukhupragarn, Boonsri, Bunchungmongkol, Pansuan) Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
Publisher
BMJ Publishing Group
Abstract
Background While superficial parasternal intercostal plane blocks can
improve analgesia after cardiac surgery, the optimal site and the number
of injections remain uncertain. This study aimed to compare the efficacy
of single versus double injections of superficial parasternal blocks,
hypothesizing that double injections would achieve superior cutaneous
sensory blockade. Methods 70 cardiac patients undergoing median sternotomy
were randomly assigned to receive either single or double injections of
superficial parasternal blocks bilaterally. Each patient received 40mL of
0.25% bupivacaine with epinephrine 5microg/mL and dexamethasone 10mg. The
single-injection group received 20mL/side at the third costal cartilage,
while the double-injection group received 10mL/injection at the second and
fourth costal cartilages. The primary outcome was a successful block,
defined as sensory loss in the T2-T6 dermatomes. Secondary outcomes
included sensory block of T1, T7, and T8 dermatomes, block-related
complications, intraoperative hemodynamics, postoperative pain intensity,
opioid consumption, and recovery quality. Results Double injections
achieved an overall higher success rate compared with the single-injection
technique (81% vs 51%, relative risk 1.6; 95%CI 1.2, 2.0; p<0.001).
Additionally, higher blockade percentages were observed in dermatomes T1
(83% vs 59%, p=0.003), T7 (67% vs 46%, p=0.017), and T8 (61% vs 39%,
p=0.011) with double injections. Other secondary outcomes did not differ
significantly between groups. Conclusions Compared with single injection,
double injections of superficial parasternal blocks provided more reliable
coverage of the T2-T6 dermatomes, crucial for median sternotomy. However,
no differences were observed in intraoperative hemodynamic effects or
postoperative pain control after cardiac surgery.<br/>Copyright &#xa9;
American Society of Regional Anesthesia & Pain Medicine 2026. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<13>
[Use Link to view the full text]
Accession Number
2042620745
Title
Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing
Device Thrombosis Following Left Atrial Appendage Closure: The ANDES
Randomized Clinical Trial.
Source
Circulation. 152(25) (pp 1759-1768), 2025. Date of Publication: 23 Dec
2025.
Author
Rodes-Cabau J.; Nombela-Franco L.; Cruz-Gonzalez I.; Hibbert B.; Freixa
X.; Masson J.-B.; Ibrahim R.; Estevez-Loureiro R.; Millan X.; Kass M.;
Paradis J.-M.; Champagne J.; Salinas P.; Laffond A.; Abdel-Razek O.;
Labinaz M.; Cepas-Guillen P.; Arzamendi D.; Vidal-Cales P.; Pavesi M.;
Cote M.; O'Hara G.; Salaun E.
Institution
(Rodes-Cabau, Paradis, Champagne, Vidal-Cales, Cote, O'Hara, Salaun)
Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Rodes-Cabau, Freixa, Cepas-Guillen) Clinic Barcelona, Barcelona, Spain
(J.R.-C., X.F., P.C.-G.)
(Rodes-Cabau, Pavesi) Barcelona Clinical Coordinating Center, Mon Clinic
Foundation, Barcelona, Spain
(Nombela-Franco, Salinas) Hospital Clinico San Carlos, Instituto de
Investigacion Sanitaria Hospital Clinico San Carlos, Madrid, Spain
(Cruz-Gonzalez, Laffond) Hospital Universitario de Salamanca, IBSAL, CIBER
CV, Salamanca, Spain
(Hibbert, Abdel-Razek, Labinaz) Ottawa Heart Institute, Ottawa, ON, Canada
(Masson) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada (J.-B.M.)
(Ibrahim) Montreal Heart Institute, Montreal, QC, Canada (R.I.)
(Estevez-Loureiro) Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
(R.E.-L.)
(Millan, Arzamendi) Department of Cardiology, Hospital Universitari de la
Santa Creu i Sant Pau, IB Sant Pau, Barcelona, Spain
(Kass) Saint Boniface Hospital, Winnipeg, MB, Canada (M.K.)
(Hibbert) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
MN (B.H.)
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - The optimal antithrombotic treatment after transcatheter
left atrial appendage closure (LAAC) remains to be determined. The
objective of this trial was to compare anticoagulation and antiplatelet
therapy for preventing device-related thrombosis (DRT) after LAAC.
<br/>METHOD(S): - This was a prospective multicenter international
randomized trial comparing 2 different antithrombotic strategies for
preventing DRT after LAAC in patients with nonvalvular atrial
fibrillation. Patients were randomized (1:1) to receive direct oral
anticoagulants (DOACs) or dual antiplatelet therapy (DAPT;
aspirin+clopidogrel) for 60 days. Patients underwent transesophageal
echocardiography at 60 days, and the images were analyzed in a central
echocardiography laboratory by experienced echocardiographers blinded to
the allocated treatment. The primary outcome was DRT as determined by
transesophageal echocardiography 60 days after LAAC in patients receiving
the allocated treatment at the time of transesophageal echocardiography
(per-protocol analysis). The safety outcome included all-cause mortality,
stroke, bleeding, or site-reported DRT within 60 days after LAAC in all
randomized patients (intention-to-treat analysis). <br/>RESULT(S): - A
total of 510 patients (mean age 77+/-9 years, 35% women) were included
between October 2018 and May 2025, and 253 and 257 patients were
randomized to the DOAC and DAPT groups, respectively. Of these, 399
patients underwent transesophageal echocardiography and were receiving the
allocated treatment at 60 days after LAAC. The primary outcome occurred in
3 patients (1.5%) in the DOAC group compared with 8 patients (4.1%) in the
DAPT group (difference, -2.7% [95% CI, -6.0% to 0.6%]; P=0.110). The
safety outcome occurred in 52 patients (22.5%) in the DOAC group compared
with 82 patients (34.9%) in the DAPT group (difference, -12.4% [95% CI,
-20.6% to -4.2%]; P=0.003), and differences were mainly driven by a lower
rate of bleeding events in the DOAC group (44 patients [17.4%] versus 64
patients [24.9%]; difference, -7.5% [95% CI, -14.6% to -0.4%]; P=0.038).
<br/>CONCLUSION(S): - The use of DOACs after LAAC failed to reduce DRT
compared with DAPT, but it was associated with an improved safety profile.
The results of this study should be interpreted with caution because of
statistical power issues related to the narrower-than-expected
between-group differences and will need confirmation in future larger
studies. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique
identifier: NCT03568890.<br/>Copyright &#xa9; 2025

<14>
Accession Number
2040679272
Title
Peri-operative rehabilitation in patients undergoing elective cardiac
valve surgery: a randomised controlled trial.
Source
Anaesthesia. 81(3) (pp 362-372), 2026. Date of Publication: 01 Mar 2026.
Author
Liu F.; Xu M.; Zhou H.; Wang H.; Liu Y.; He X.; Huang H.; Sun T.; Jian X.;
Wu M.; Sun Y.; Cao P.; Chen J.; Guo L.; Ma H.
Institution
(Liu, Liu, Xu, Zhou, Wang, Liu, He, Chen, Guo, Ma) Department of
Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical
University, Guangdong, Guangzhou, China
(Huang, Sun, Jian, Chen, Wu) Department of Cardiac Surgery, Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou, China
(Huang, Sun, Jian, Chen, Wu) Guangdong Provincial Key Laboratory of South
China Structural Heart Disease, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou, China
(Sun, Cao) Clinical Research Center, Zhujiang Hospital, Southern Medical
University, Guangdong, Guangzhou, China
(Sun, Cao) Department of Biostatistics, School of Public Health, Southern
Medical University, Guangdong, Guangzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Patients with valvular heart disease are at high risk of
postoperative pulmonary complications, which contribute to morbidity and
mortality. However, few studies have focused specifically on
peri-operative rehabilitation in this patient population. We aimed to
evaluate whether peri-operative rehabilitation benefits patients
undergoing elective cardiac valve surgery by reducing the incidence of
postoperative pulmonary complications, the duration of postoperative
hospitalisation and mortality. <br/>Method(s): This single-centre,
randomised controlled trial compared usual care (usual care group) with a
peri-operative rehabilitation bundle (rehabilitation group) comprising
four components: education; inspiratory muscle training; active cycle of
breathing techniques; and early mobilisation. The primary outcome was a
composite measure of the occurrence of postoperative pulmonary
complications within the first 7 days; incidence of prolonged
postoperative hospitalisation > 7 days; and in-hospital all-cause
mortality. Secondary outcomes included each component of primary outcome
measure; duration of stay in the ICU; total duration of postoperative
hospitalisation; and 3-month all-cause mortality. <br/>Result(s): On an
intention-to-treat basis, data from 818 patients were analysed (419
allocated to the usual care group and 399 to the rehabilitation group).
The primary composite outcome did not differ between groups, occurring in
224/419 (53.5%) patients allocated to the usual care group and 206/399
(51.6%) patients allocated to the rehabilitation group (odds ratio 0.88,
95%CI 0.66-1.17, p = 0.376). Postoperative pulmonary complications were
present in 197 (47.1%) patients allocated to the usual care group and 161
(40.4%) patients allocated to the rehabilitation group (odds ratio 0.720,
95%CI 0.541-0.956, p = 0.023). There was no significant difference between
the groups in terms of duration of postoperative hospital stay of > 7 days
or in-hospital mortality. <br/>Discussion(s): Peri-operative
rehabilitation reduced the incidence of postoperative pulmonary
complications in patients having surgery for valvular heart disease. We
recommend incorporating comprehensive peri-operative rehabilitation into
the clinical management of these patients.<br/>Copyright &#xa9; 2025 The
Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<15>
Accession Number
2042013065
Title
Sex Differences in Dilated Cardiomyopathy: Evidence Gaps and Future
Directions.
Source
Journal of the American College of Cardiology. 87(6) (pp 723-735), 2026.
Date of Publication: 17 Feb 2026.
Author
Stroeks S.L.V.M.; Oko-Osi S.; Arasu A.; Hirst J.E.; Tayal U.P.
Institution
(Stroeks) Department of Cardiology, Maastricht University, Cardiovascular
Research Institute Maastricht, Maastricht, Netherlands
(Stroeks) KU Leuven, Cardiovascular Sciences, Leuven, Belgium
(Stroeks) Department of Clinical Genetics, Maastricht University Medical
Center, Maastricht, Netherlands
(Stroeks) European Reference Network for Rare, Low Prevalence and Complex
Diseases of the Heart (ERN GUARD-Heart), Amsterdam, Netherlands
(Oko-Osi, Arasu, Tayal) National Heart Lung Institute, Imperial College
London, London, United Kingdom
(Oko-Osi, Arasu, Tayal) Royal Brompton & Harefield Hospitals, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Hirst) George Institute for Global Health, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Dilated cardiomyopathy (DCM), which affects 1 in 250 people, is a leading
global cause of heart failure and the most common indication for heart
transplantation. Evidence suggests that DCM is more prevalent in men, but
whether this reflects biological differences or underdiagnosis in women
remains uncertain. This review explores the impact of sex on DCM,
examining differences in epidemiology, etiology, clinical presentation,
treatment response, and outcomes. Women often present with less severe
cardiac phenotypes, including lower levels of fibrosis and better left
ventricular function, yet the long-term prognosis of DCM in women is less
clear. Through a systematic review and meta-analysis, we found that male
DCM patients with variants in PLN, DSP, and LMNA had higher arrhythmic
event rates compared with TTNtv and BAG3 carriers. In female patients with
DCM, those with RBM20, DSP, and PLN variants faced the highest arrhythmic
risk, and TTNtv carriers the lowest. PLN and LMNA variants had the highest
heart failure risk in both sexes, whereas BAG3, RBM20, and TTN variants
had lower heart failure rates in female compared with male carriers. These
findings highlight the influence of sex and genotype on clinical outcomes.
Current risk-stratification tools, such as those used for implantable
cardioverter-defibrillators, may undertreat women owing to reliance on
sex-neutral thresholds. We highlight the role of genetic, environmental,
and reproductive factors in shaping these disparities, including the
influence of pregnancy, pregnancy complications, and menopause. This
review identifies key gaps in knowledge and calls for expanded
representation of women in DCM studies and the development of sex-specific
risk models. Addressing these gaps is essential to improving outcomes and
advancing equitable personalized care for all DCM patients.<br/>Copyright
&#xa9; 2026 American College of Cardiology Foundation

<16>
Accession Number
2043322381
Title
Comparison of Meta-Analytical Estimates Between Surgical Repair and
Transcatheter Edge-to-Edge Repair for Atrial Functional Mitral
Regurgitation.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 41(1) (no
pagination), 2026. Article Number: ivaf269. Date of Publication: 01 Jan
2026.
Author
Khairallah S.; Rahouma M.; Demetres M.; Girardi L.; Gaudino M.; Hirofuji
A.; Reisman M.; Mick S.L.
Institution
(Khairallah, Rahouma, Girardi, Gaudino, Hirofuji, Mick) Cardiothoracic
Surgery Department, Weill Cornell Medicine, WCM, New York-Presbyterian
Hospital, New York, NY, United States
(Khairallah, Rahouma) Surgical Oncology Department, National Cancer
Institute, Cairo University, Cairo, Egypt
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library, C.V. Starr
Biomedical Information Center, WCM, New York, NY, United States
(Reisman) Structural Heart Program, Weill Cornell Medical Center, New
York, NY, United States
Publisher
Oxford University Press
Abstract
OBJECTIVES Atrial functional mitral regurgitation (MR) lacks well-defined
treatment guidelines. Medical therapy alone is insufficient, and either
TEER (transcatheter edge-to-edge) or surgery is recommended. Short- and
long-term comparative outcomes remain unclear. We aim to address this gap
using available data. METHODS We performed a meta-analysis of studies
examining the outcomes of surgery and/or transcatheter edge-to-edge.
MEDLINE, EMBASE, and the Cochrane Library were assessed. The incidence
rate of late severe MR was the primary outcome. A random model was
performed. Leave-one-out, subgroup, and meta-regression analyses were
conducted. RESULTS Thirty-two studies (1923 patients); 20 in surgery
(1166) vs 12 in TEER (757), were selected. TEER patients were, on average,
10 years older, with twice the rate of New York Heart Association
Classification (NYHA) III/IV symptoms and more than double the Society of
Thoracic Surgeons Risk (STS) score. At a weighted mean follow-up of 3.2
years, compared to isolated transcatheter, surgery was associated with
decreased incidence of late severe MR (2.53 vs 6.66 events per 100
person-years, P-interaction=.03), late all-cause mortality (3.00 vs 8.84,
P-interaction=.024), late heart failure hospitalization (4.44 vs 17.03,
P-interaction <.01), and late NYHA III/IV (2.98 vs 22.47, P-interaction
<.01). However, significantly better long-term outcomes associated with
surgery showed high heterogeneity. There were no differences in early
all-cause mortality, early cardiac-specific mortality, late
cardiac-specific mortality, postprocedural morbidities, or atrial
diameter. On meta-regression, preprocedural heart failure (beta=0.0224,
P<.01) and coronary artery disease (beta=0.0294, P<.00001) were linked to
increased late severe MR. Older age, hypertension, mitral valve
replacement, and associated aortic valve surgery were linked to increased
late all-cause mortality. CONCLUSIONS Surgery and isolated transcatheter
edge-to-edge repair showed comparable short-term outcomes, with surgery
appearing more effective long-term; however, due to study limitations and
heterogeneity, these findings are hypothesis-generating and require
validation through prospective studies.<br/>Copyright &#xa9; The Author(s)
2025. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<17>
[Use Link to view the full text]
Accession Number
2040304895
Title
Patient selection in robotic mitral valve surgery.
Source
Current Opinion in Cardiology. Publish Ahead of Print (no pagination),
2025. Date of Publication: 2025.
Author
Gillinov M.; Malas T.; Rabbani M.; Wierup P.
Institution
(Gillinov, Malas, Rabbani, Wierup) Department of Thoracic and
Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review - National databases reveal increased application of the
surgical robot to facilitate mitral valve repair. Single-center and
multiinstitutional studies confirm that excellent results are achievable
with robotic mitral valve repair. However, not all patients with
degenerative mitral valve disease are appropriate candidates for robotic
mitral valve repair. Recent findings - With increased experience, surgeons
have successfully applied the surgical robot to perform mitral valve
repair in conjunction with concomitant procedures. Concurrently, selection
criteria have expanded, enabling more patients to enjoy the benefits of a
less invasive approach. A small group of patient-related and anatomic
factors are best managed via a standard sternal approach. Summary -
Approaching 15% of all mitral valve repairs for degenerative disease,
robotic mitral valve repair has reached an inflection point in its growth.
Well tolerated application of this technology requires understanding of
both its advantages and its limitations.<br/>Copyright &#xa9; 2025

<18>
Accession Number
2042629038
Title
Management of new-onset postoperative atrial fibrillation after coronary
artery bypass grafting.
Source
Expert Review of Cardiovascular Therapy. 24(2) (pp 81-92), 2026. Date of
Publication: 2026.
Author
Herrmann F.E.M.; Jeppsson A.; Taha A.
Institution
(Herrmann, Jeppsson, Taha) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Herrmann) Department of Cardiac Surgery, LMU University Hospital, LMU
Munich, Munich, Germany
(Herrmann) DZHK (German Center for Cardiovascular Research) Partner Site
Munich Heart Alliance, Munich, Germany
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Taha) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: New-onset postoperative atrial fibrillation (POAF) is the
most common arrhythmia after coronary artery bypass grafting (CABG).
Traditionally regarded as a benign and self-limiting event, more recent
evidence highlights its association with prolonged hospitalization,
increased healthcare utilization, and a heightened risk of stroke,
recurrent atrial fibrillation, and heart failure. Understanding its
significance is essential for patient care and long-term outcomes. PubMed
was searched using terms related to POAF and CABG, supplemented by the
review of relevant guidelines and key publications. Areas covered: This
narrative review summarizes recent evidence on the epidemiology,
pathophysiology, prophylaxis, and treatment of POAF after CABG. Evidence
for pharmacological prophylaxis (e.g. amiodarone, beta-blockers) and
surgical strategies (e.g. posterior pericardiotomy, atrial pacing) is
summarized, along with current approaches for acute management and stroke
prevention. The literature reveals significant heterogeneity in treatment
strategies, particularly regarding anticoagulation, with emerging trials
expected to refine clinical practice. Expert opinion: Current evidence
suggests that POAF functions more as an indicator of underlying patient
vulnerability than as a direct driver of adverse outcomes. Clinically,
management must balance arrhythmia control, stroke and bleeding risk, and
individualized anticoagulation decisions. Research efforts should
prioritize robust risk stratification tools and randomized evidence to
guide tailored therapy.<br/>Copyright &#xa9; 2026 Informa UK Limited,
trading as Taylor & Francis Group.

<19>
Accession Number
2033147397
Title
Serial Lactate in Clinical Medicine - A Narrative Review.
Source
Journal of Intensive Care Medicine. 41(3) (pp 175-185), 2026. Date of
Publication: 01 Mar 2026.
Author
Falter F.; Tisherman S.A.; Perrino A.C.; Kumar A.B.; Bush S.; Nordstrom
L.; Pathan N.; Liu R.; Mebazaa A.
Institution
(Falter) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
(Tisherman) Center for Critical Care and Trauma, University of Maryland
School of Medicine, Baltimore, United States
(Perrino) Department of Anesthesiology, Yale School of Medicine, New
Haven, United States
(Kumar) Department of Anesthesiology and Critical Care, Vanderbilt
University Medical Center, Nashville, United States
(Bush) Department of Emergency Medicine, Stephen Bush, Leeds Teaching
Hospitals, Leeds, United Kingdom
(Nordstrom) Department of Women's and Children's Health, Karolinska
University, Stockholm, Sweden
(Pathan) Department of Paediatrics, Cambridge University Hospitals,
Cambridge, United Kingdom
(Liu) Sutter Health, San Francisco, United States
(Mebazaa) Department of Anaesthesiology and Critical Care, Universite
Paris Cite, Paris, France
Publisher
SAGE Publications Inc.
Abstract
Background: Blood lactate is commonly used in clinical medicine as a
diagnostic, therapeutic and prognostic guide. Lactate's growing importance
in many disciplines of clinical medicine and academic enquiry is
underscored by the tenfold increase in publications over the past 10
years. Lactate monitoring is presently shifting from single to serial
measurements, offering a means of assessing response to therapy and to
guide treatment decisions. With the promise of wearable lactate sensors
and their potential integration in electronic patient records and early
warning scores, the utility of serial lactate measurement deserves closer
scrutiny. <br/>Method(s): Articles included in this review were identified
by searching MEDLINE, PubMed and EMBASE using the term "lactate" alone and
in combination with "serial", "point of care", "clearance", "prognosis"
and "clinical". Authors were assigned vetting of publications according to
their specialty (anesthesiology, intensive care, trauma, emergency
medicine, obstetrics, pediatrics and general hospital medicine). The
manuscript was assembled in multidisciplinary groups guided by underlying
pathology rather than hospital area. <br/>Finding(s): Lactate's clinical
utility as a dynamic parameter is increasingly recognized. Several
publications in the last year highlight the value of serial measurements
in guiding therapy. Outside acute clinical areas like the emergency room,
operating room or intensive care, obtaining lactate levels is often
fraught with difficulty and delays. <br/>Interpretation(s): Measuring
serial lactate and lactate clearance offers regular feedback on response
to therapy and patient status. Particularly on the ward, wearable devices
integrated in early warning scores via the hospital IT system are likely
to identify deteriorating patients earlier than having to rely on
observations by an often-overstretched nursing workforce.<br/>Copyright
&#xa9; The Author(s) 2025. This article is distributed under the terms of
the Creative Commons Attribution-NonCommercial 4.0 License
(https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access page
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<20>
Accession Number
2043051101
Title
Augmenting Venous Return in Fontan Circulation: The Role of the Skeletal
Muscle Pump and Implications for Mechanical Compression Devices-A Review
of the Literature.
Source
Pediatric Cardiology. (no pagination), 2026. Date of Publication: 2026.
Author
Makam R.; Balaji A.; Bocchetta N.; Nadeem M.; Azam A.; Sherif M.; Hussein
N.; Loubani M.
Institution
(Balaji, Makam, Balaji, Bocchetta, Nadeem, Azam, Loubani) Hull York
Medical School, University of Hull, Hull, United Kingdom
(Balaji, Makam, Sherif, Loubani) Hull University Teaching Hospitals Trust,
Hull, United Kingdom
(Balaji, Makam, Balaji, Bocchetta, Nadeem, Azam, Hussein, Loubani)
Aspiring Congenital Heart Surgeons Association, Hull, United Kingdom
(Hussein) Great Ormond Street Hospital for Children NHS Foundation Trust,
London, United Kingdom
Publisher
Springer
Abstract
Post-Fontan patients often face significant hemodynamic challenges,
including systolic dysfunction and diminished cardiac output due to
reduced preload and venous return. Long-term complications such as hepatic
dysfunction and protein-losing enteropathy arise from poor venous return,
increasing morbidity and mortality. Enhancing venous return could
potentially improve long-term outcomes for these patients. This literature
review examines the role of the skeletal muscle pump in Fontan circulation
and evaluates non-pharmacological strategies to augment venous return,
with discussion of mechanical compression devices as a potential
translational application. A comprehensive literature search identified 26
studies focusing on the relationship between lower limb muscle mass,
venous return, and cardiac performance in post-Fontan patients, as well as
the efficacy of peristaltic leg pumps in enhancing venous return. Across
included studies, higher lower-limb skeletal muscle mass and structured
exercise interventions were consistently associated with improved
functional and cardiopulmonary performance metrics in Fontan patients.
Additionally, the use of peristaltic leg pumps in other patient cohorts
enhanced venous return across various patient positions, suggesting an
avenue for implementation in the Fontan patient. Peristaltic leg pumps may
serve as a valuable tool in managing the hemodynamic challenges of
post-Fontan patients, potentially leading to better long-term outcomes.
Further research, particularly randomized controlled trials, is necessary
to establish the efficacy and optimal application of these devices in the
paediatric Fontan population.<br/>Copyright &#xa9; The Author(s) 2026.

<21>
Accession Number
2040534007
Title
Association between pre-operative sodium-glucose cotransporter-2 inhibitor
use and postoperative outcomes: a propensity score-matched analysis of the
TriNetX database.
Source
Anaesthesia. 81(3) (pp 351-361), 2026. Date of Publication: 01 Mar 2026.
Author
Wu H.-L.; Chen J.-T.; Cata J.P.; Hsieh C.-H.; Cherng Y.-G.; Tai Y.-H.
Institution
(Wu) School of Medicine, National Yang Ming Chiao Tung University, Taipei,
Taiwan (Republic of China)
(Wu) Department of Anaesthesiology, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Chen, Cherng, Tai) Department of Anaesthesiology, School of Medicine,
College of Medicine, Taipei Medical University, Taipei, Taiwan (Republic
of China)
(Chen, Cherng, Tai) Department of Anaesthesiology, Shuang Ho Hospital,
Taipei Medical University, New Taipei City, Taiwan (Republic of China)
(Cata) Department of Anaesthesiology and Perioperative Medicine, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Hsieh) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan (Republic of
China)
Publisher
John Wiley and Sons Inc
Abstract
Introduction: While sodium-glucose cotransporter-2 inhibitors offer
cardiovascular and renal benefits, their peri-operative safety and effect
profile remain unclear. This study aimed to evaluate the association
between pre-operative sodium-glucose cotransporter-2 inhibitor use and
postoperative adverse events in patients with type 2 diabetes mellitus.
<br/>Method(s): This nationwide propensity-score matched cohort study
utilised the TriNetX database to analyse data from patients with type 2
diabetes mellitus who underwent surgery in the USA. Patients were
categorised based on whether they had received a prescription for
sodium-glucose cotransporter-2 inhibitors 90 days before surgery. The
primary outcome was 30-day all-cause mortality. Secondary outcomes
included the incidence of major adverse cardiovascular events; acute
kidney injury; and diabetic ketoacidosis. <br/>Result(s): In 98,118
matched pairs, 30-day all-cause mortality was significantly lower in
patients in the sodium-glucose cotransporter-2 inhibitor group compared
with those in the control group (RR 0.61, 95%CI 0.55-0.67, p < 0.001).
Patients receiving sodium-glucose cotransporter-2 inhibitor treatment also
showed lower risks of major adverse cardiovascular events (RR 0.89, 95%CI
0.86-0.91); acute kidney injury (RR 0.71, 95%CI 0.69-0.74); and diabetic
ketoacidosis (RR 0.31, 95%CI 0.18-0.540) (p < 0.001 for all comparisons).
Subgroup analyses revealed a more pronounced reduction in mortality among
females, patients living with obesity or proteinuria, and those undergoing
cardiovascular surgery. <br/>Discussion(s): Our study showed a
significantly reduced risk of postoperative mortality and morbidity
associated with pre-operative sodium-glucose cotransporter-2 inhibitor use
in patients with type 2 diabetes mellitus, including a notably lower rate
of diabetic ketoacidosis, contrary to previous concerns. Randomised
controlled trials are warranted to validate these findings.<br/>Copyright
&#xa9; 2025 Association of Anaesthetists.

<22>
Accession Number
2037676888
Title
Evaluation of Central Venous-to-Arterial Carbon Dioxide Difference
(DCO)-Guided Goal-Directed Therapy in Cardiac Surgery: A Randomized
Controlled Study.
Source
SSR Institute of International Journal of Life Sciences. 11(6) (pp
8891-8897), 2025. Date of Publication: 2025.
Author
Behera C.S.; Subudhi B.S.K.; Singh S.
Institution
(Behera, Subudhi, Singh) Department of Anaesthesiology, SCB Medical
College and Hospital, Odisha, Cuttack, India
Publisher
Society for Scientific Research
Abstract
Background: Goal-directed therapy (GDT) aims to optimize hemodynamic
parameters and tissue perfusion in perioperative care. The central
venous-to-arterial carbon dioxide difference (DCO) is an emerging marker
of tissue hypoperfusion and may complement conventional parameters such as
central venous oxygen saturation (ScvO). This study evaluated the
effectiveness of DCO-guided GDT in improving perioperative outcomes in
patients undergoing elective cardiac surgery. <br/>Method(s): A
prospective, randomized, controlled, single-blind study was conducted at
S.C.B. Medical College and Hospital, Cuttack, Odisha, from August 2024 to
January 2025. One hundred ASA I-II patients aged >18 years undergoing
elective cardiac surgery were randomized into control (conventional
management) and intervention (goal-directed DCO <6 mmHg, ScvO >70%)
groups, 50 each. Intraoperative and postoperative parameters, including
hemoglobin, DCO, ScvO, lactate, fluids, urine output, and outcomes, were
recorded. Data were analyzed using SPSS v25.0; p<0.05 was considered
significant. <br/>Result(s): Baseline characteristics were comparable
between groups. Intraoperative DCO was significantly lower in the
intervention group (5.93+/-1.96 mmHg) than controls (8.46+/-3.05 mmHg,
p<0.001) and remained lower postoperatively (5.6+/-1.64 vs. 8.59+/-2.8
mmHg, p<0.001), while ScvO was higher (74.39+/-5.76% vs. 67.51+/-6.45%,
p<0.001). ICU stay was shorter in the GDT group (1.48+/-0.85 vs.
2.46+/-1.06 days, p=0.002), with similar hospital stay and complications.
<br/>Conclusion(s): Goal-directed therapy guided by DCO and ScvO
significantly improved perioperative hemodynamic optimization and reduced
ICU stay in patients undergoing cardiac surgery, without increasing
complications or hospital stay. Incorporating DCO into GDT protocols may
enhance perioperative management and align with the principles of enhanced
recovery after surgery (ERAS).<br/>Copyright &#xa9; 2025.

<23>
Accession Number
2037674838
Title
A comparative evaluation of efficacy of lignocaine and dexmedetomidine to
attenuate hemodynamic and airway responses to endotracheal extubation in
elective coronary artery bypass graft surgery: a prospective randomized
double-blind clinical study.
Source
Anesthesia and Pain Medicine. 21(1) (pp 91-100), 2026. Date of
Publication: 01 Jan 2026.
Author
Kumar M.; Hussain M.; Bharti A.K.; Kumar A.
Institution
(Kumar, Kumar, Hussain, Bharti, Kumar) Department of Anesthesiology and
Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, India
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Extubation is more stressful than intubation because it leads
to unpredictable hemodynamic and airway responses. Therefore, in this
study, we compared the efficacy of dexmedetomidine and lignocaine in
attenuating hemodynamic and airway responses during extubation in patients
undergoing on-pump coronary artery bypass graft (CABG) surgeries.
<br/>Method(s): Seventy patients, aged 18-65 years, classified as American
Society of Anesthesiologists physical status III and IV, were scheduled
for elective on-pump CABG surgery under general anesthesia and prepared
for extubation in the cardiac postoperative recovery room. They were
randomly assigned to one of two groups: Dexmedetomidine Group (Group D, n
= 35) received an intravenous (IV) bolus of dexmedetomidine at a dose of
0.5 microg/kg, while Lignocaine Group (Group L, n = 35) received an IV
bolus of lignocaine at a dose of 1.5 mg/ kg, administered 5 min before
extubation. Heart rate (HR) and mean arterial pressure (MAP) were measured
at several intervals: prior to drug administration and at various times
post-extubation. Statistical analysis was performed using the chi-squared
test and a repeated-measures analysis of variance with Bonferroni
correction. <br/>Result(s): The mean HR in Group D significantly decreased
from E1 to E20 when compared with A0 (P < 0.05) and from E5 to E20 when
compared with A1 (P < 0.05). By contrast, Group L showed significant
variations in HR, at various time intervals. <br/>Conclusion(s): A single
dose of dexmedetomidine (0.5 microg/kg) given 5 min prior to extubation
significantly reduced post-extubation HR and improved extubation quality
compared with lignocaine (1.5 mg/kg) in patients undergoing on-pump CABG
surgeries.<br/>Copyright &#xa9; 2026, Korean Society of Anesthesiologists.
All rights reserved.

<24>
[Use Link to view the full text]
Accession Number
649390443
Title
The Impact of Music on Patients After Cardiac Surgery.
Source
The Journal of cardiovascular nursing. 41(2) (pp E52-E56), 2026. Date of
Publication: 01 Mar 2026.
Author
Carroll D.L.; Ait Ali R.L.; Zamora N.H.; LaValle V.; Ommerborn C.; Mancuso
J.M.; Porto F.A.; Hall K.E.; Donahue V.
Institution
(Carroll) Diane L. Carroll, PhD, RN, FAHA, FESC, FAAN, Nurse Researcher,
Munn Center for Nursing Research, Massachusetts General Hospital (MGH),
Boston
(Ait Ali) DNP, APRN, Nurse Practitioner, Cardiac Surgery, MGH, Boston,
United States
(Zamora) Nghi Huynh Zamora, MSN, AGPCNP-BC, RN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston
(LaValle) Vlasta LaValle, BS, MSN, CNP, RN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston
(Ommerborn) Christine Ommerborn, MSN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston, United States
(Mancuso) Julia M. Mancuso, PA-C, Senior Clinical Research Coordinator,
MGH-Translational and Clinical Research Centers, Boston, MS, United States
(Porto) MSN, Nursing Practice Specialist, MGH-Translational and Clinical
Research Centers, Boston, United States
(Hall) Kathryn E. Hall, DNP, MGH-Translational and Clinical Research
Centers, Boston, MS, United States
(Donahue) MSN, ACNS-BC, CCRN, MGH, Cardiac Surgical Intensive Care Unit,
Massachusetts General Hospital, Boston, United States
Abstract
BACKGROUND: Cardiac surgery causes adverse physical and psychological
responses. Listening to music could modulate these responses.
<br/>OBJECTIVE(S): To measure physical/psychological responses pre and
post 30 minutes of music (TX) compared with usual care (UC) in patients
after cardiac surgery. <br/>METHOD(S): In this randomized, 2-group trial
the impact of listening to music was examined in a sample of adults, ages
18-89 years who had undergone cardiac surgery. Cortisol, immunoglobulin A,
vital signs, pain, and anxiety data were collected pre and post study
period. <br/>RESULT(S): There were 120 subjects, 61 in the TX group and 59
in the UC group. There were 84 males and 36 females, with mean age of 62.4
years. There were no differences between TX and UC groups on
preintervention outcomes. Postintervention, the TX group had lower pain
scores (3.8 vs. 4.5, P < .04) and lower heart rate (beats per minute) (78
vs. 81, P < .05) compared with the UC group. <br/>CONCLUSION(S): Listening
to music may be effective in reducing pain, and lowering heart rate,
serving as a safe adjunct for pain management after cardiac
surgery.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<25>
Accession Number
2043072194
Title
A Bayesian Meta-Analysis of Renin-Angiotensin System Inhibitors Following
TAVR.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2026.
Date of Publication: 2026.
Author
Oliveira V.M.R.; Barbosa L.M.; Sousa P.A.D.; Lima A.P.D.; Akabane M.A.C.;
Borges A.; Bertoli E.D.; Bulhoes E.; Farias C.A.; Mazetto R.; Tartuce
Filho P.R.F.; Alcantara R.W.A.; Bignoto T.; Pileggi B.; Moreira H.G.;
Tartuce L.P.
Institution
(Oliveira, Borges, Moreira) Federal University of Goias, Goiania, Brazil
(Oliveira, Tartuce Filho, Tartuce) Instituto de Cardiologia e Radiologia
Intervencionista de Rio Verde, Rio Verde, Brazil
(Barbosa) Federal University of Minas Gerais, Belo Horizonte, Brazil
(Barbosa, Bignoto, Pileggi) Instituto do Coracao-InCor-Faculdade de
Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
(Sousa) Federal University of Uberlandia, Uberlandia, Brazil
(Lima) University of Rio Verde, Rio Verde, Brazil
(Akabane) Federal University of Juiz de Fora, Juiz de Fora, Brazil
(Bertoli) Hospital e Maternidade Marieta Konder Bornhausen, Itajai, Brazil
(Bulhoes) Universidade da Amazonia Reunida, Redencao, Brazil
(Farias) Universidade Nove de Julho, Sao Paulo, Brazil
(Mazetto) State University of Amazon, Manaus, Brazil
(Alcantara) Clinica Aurus, Oliveira, Brazil
(Alcantara) Interventional Cardiology Unit, Hospital Sao Judas Tadeu,
Oliveira, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Aortic stenosis leads to left ventricular remodeling,
hypertrophy, and fibrosis, increasing the risk of heart failure.
Renin-angiotensin system (RAS) inhibitors may mitigate these adverse
effects and improve clinical outcomes. Despite advancements in
transcatheter aortic valve replacement (TAVR), substantial mortality,
heart failure readmissions, and other complications persist. <br/>Aim(s):
This study aimed to evaluate the impact of RAS inhibitor therapy following
TAVR on clinical outcomes. <br/>Method(s): We conducted a systematic
review and Bayesian meta-analysis following the Cochrane Handbook for
Systematic Reviews of Interventions. A comprehensive search of PubMed,
Embase, and Cochrane was performed to identify studies comparing RAS
inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic
stenosis. Odds ratios (OR) and 95% credible intervals (CrI) were estimated
using a Bayesian random-effects model. Between-study heterogeneity was
quantified using the posterior distribution of the heterogeneity parameter
(tau). Posterior probabilities (PP) of treatment benefit were calculated,
with clinically meaningful effects defined as P (OR < 0.8). All analyses
were performed using R version 4.5.0. <br/>Result(s): A total of 12
studies comprising 35,988 patients were included, of whom 17,026 (47.3%)
received RASi therapy. The mean age ranged from 78.9 to 84.4 years.
Post-TAVR RASi use was associated with a 79.4% probability of a clinically
relevant reduction in all-cause mortality and a 99.5% probability of a
clinically relevant reduction in cardiovascular mortality. There was a 54%
probability of a clinically relevant reduction in heart failure
hospitalization and a negligible (2.26%) probability of a reduction in the
odds of myocardial infarction in the RASi group. <br/>Conclusion(s): RASi
therapy following TAVR is associated with reduced odds of mortality and
heart failure readmission.<br/>Copyright &#xa9; 2026 Wiley Periodicals
LLC.

<26>
Accession Number
2039727721
Title
Reduced stent strategy versus conventional percutaneous coronary
revascularization in patients presenting with STEMI: design of the
COPERNICAN trial.
Source
Revista Espanola de Cardiologia. 79(2) (pp 100-105), 2026. Date of
Publication: 01 Feb 2026.
Author
Sanz-Sanchez J.; Santos Martinez S.; Rumiz Gonzalez E.; Oteo Dominguez
J.F.; Tejada Ponce D.; Gomez Menchero A.; Sanchez Elvira G.; Fuertes Ferre
G.; Rivero Crespo F.; Lukic Otanovic A.; Diaz Fernandez J.; Galindo
Fernandez E.; Urbano Carrillo C.; Salvatella Giralt N.; Torres Sanchez M.;
Garcia Touchard A.; Ibanez Cabeza B.; Stefanini G.; Alfonso Manterola F.;
Garcia Garcia H.; Amat-Santos I.J.
Institution
(Sanz-Sanchez) Hospital Universitari i Politecnic La Fe, Valencia, Spain
(Sanz-Sanchez, Ibanez Cabeza, Amat-Santos) Centro de Investigacion
Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de
Salud Carlos III, Madrid, Spain
(Santos Martinez) Hospital General Universitario de Elche, Alicante,
Elche, Spain
(Rumiz Gonzalez) Hospital General Universitario de Valencia, Valencia,
Spain
(Oteo Dominguez, Garcia Touchard) Hospital Universitario Puerta de Hierro,
Majadahonda, Madrid, Spain
(Tejada Ponce) Hospital Provincial de Castellon, Castellon, Spain
(Gomez Menchero) Hospital Universitario Juan Ramon Jimenez, Huelva, Spain
(Sanchez Elvira) Hospital Universitario de Navarra, Pamplona, Navarra,
Spain
(Fuertes Ferre) Hospital Universitario Miguel Servet, Zaragoza, Spain
(Rivero Crespo, Alfonso Manterola) Hospital Universitario de La Princesa,
Madrid, Spain
(Lukic Otanovic) Hospital Clinico Universitario Lozano Blesa, Zaragoza,
Spain
(Diaz Fernandez) Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Galindo Fernandez) Hospital de Merida, Merida, Badajoz, Spain
(Urbano Carrillo) Hospital Universitario Regional de Malaga, Malaga, Spain
(Salvatella Giralt) Hospital Universitari de Bellvitge, L'Hospitalet de
Llobregat, Barcelona, Spain
(Torres Sanchez) Hospital Universitari Joan XXIII, Tarragona, Spain
(Ibanez Cabeza) Centro Nacional de Investigaciones Cardiovasculares Carlos
III, Madrid, Spain
(Ibanez Cabeza) Hospital Fundacion Jimenez Diaz, Madrid, Spain
(Stefanini) Cardiology Department, Humanitas Clinical and Research
Hospital, Humanitas Cancer Center (IRCCS), Milan, Rozzano, Italy
(Garcia Garcia) Cardiology Department, MedStar Washington Hospital Center,
Washington D.C., United States
(Amat-Santos) Hospital Clinico Universitario de Valladolid, Valladolid,
Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Primary percutaneous coronary intervention
(PCI) with drug-eluting stent implantation (DES) is the standard of
treatment in patients presenting with ST-segment elevation myocardial
infarction (STEMI). However, target lesion failure can occur due to stent
underexpansion, malapposition, hypersensitivity, fracture, and
neoatherosclerosis. Drug-coated balloons (DCB) represent a potential
alternative supported by the concept of "leaving nothing behind." The aim
is to compare a reduced stent strategy based on DCB- with DES-PCI in
patients presenting with STEMI. <br/>Method(s): Prospective, pragmatic,
multicenter, noninferiority, randomized clinical trial. <br/>Result(s): A
total of 1 272 patients presenting with STEMI will be randomized to any
paclitaxel-DCB vs any sirolimus-DES (both with CE approval) for all
culprit and nonculprit lesions during PCI. The primary endpoint will be
target-lesion failure: cardiac death, target-vessel myocardial infarction,
or ischemia-driven target lesion revascularization at 12-month follow-up.
An independent clinical events committee masked to treatment allocation
will adjudicate all suspected events. Clinical follow-up will be performed
after 1 month (30 days +/- 5 days) and 1 year (365 days +/- 30 days). An
extended follow-up at 3, 5, and 10 years is planned. <br/>Conclusion(s):
The COPERNICAN trial will be the first randomized study comparing clinical
outcomes of DCB vs DES in STEMI patients. ClinicalTrials.gov:
NCT06353594.<br/>Copyright &#xa9; 2025 Sociedad Espanola de Cardiologia

<27>
[Use Link to view the full text]
Accession Number
2037431828
Title
Use of Protamine for Heparin Reversal in Patients Undergoing Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
American Journal of Therapeutics. 33(1) (pp e110-e113), 2026. Date of
Publication: 2026.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Burhan M.; Hashmi T.M.; Ahmed R.; Shahid
F.; Alkhouli M.
Institution
(Ahmed, Burhan, Hashmi) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahsan) Foundation University Medical College, Islamabad, Pakistan
(Shafiq) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic Alix School
of Medicine, Rochester, MN
Publisher
Lippincott Williams and Wilkins
Abstract
Supplemental Digital Content is Available in the Text.<br/>Copyright
&#xa9; 2025

<28>
Accession Number
2043392006
Title
Right Ventricular Outflow Tract Reconstruction in Truncus Arteriosus-With
or Without a Conduit? A Systematic Review and Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2026. Date of Publication: 2026.
Author
Santos K.; Hakkeem B.; Pereira H.; Schettino Samad N.; Planinc M.
Institution
(Santos) New Vision University School of Medicine, Tbilisi, Georgia
(Hakkeem) Government Medical College Kozhikode, Kozhikode, India
(Pereira) University of Messina, Messina, Italy
(Schettino Samad) New York University, New York, NY, United States
(Planinc) Department of Cardiac Surgery, University Hospital Centre
Zagreb, Zagreb, Croatia
Publisher
SAGE Publications Inc.
Abstract
Background: Surgical repair of truncus arteriosus (TA) requires right
ventricle-to-pulmonary artery continuity, achieved through either
conduit-based (CB) reconstruction or a nonconduit-based (NCB) approach. As
the optimal right ventricular outflow tract (RVOT) strategy is still
debatable, we conducted a meta-analysis to compare outcomes.
<br/>Method(s): A systematic literature search was performed focusing on
studies that compared CB and NCB RVOT reconstruction techniques for the
primary correction of TA. Statistical analyses were conducted using RevMan
8.13.0, with effect estimates reported as odds ratios (ORs) and mean
differences, along with 95% confidence intervals (CIs). <br/>Result(s): We
included seven studies comprising 360 patients, with 174 neonates (48.3%)
allocated to the CB group. No significant difference was observed in early
mortality [OR 0.61; 95% CI 0.13-2.92; P = .43; I2 = 43%] or long-term
mortality [OR 1.22; 95% CI 0.09-17.23; P = .83; I2 = 78%] between CB and
NCB RVOT reconstruction techniques. However, the incidence of RVOT
reoperation [OR 3.70; 95% CI 2.02-6.76; P = .003; I2 = 0%] and the overall
reintervention rate, including both surgical and catheter-based
interventions, were higher in the CB cohort [OR 2.45; 95% CI 1.33-4.52; P
= .01; I2 = 0%]. <br/>Conclusion(s): While CB and NCB approaches yield
similar early and long-term survival outcomes, CB reconstruction is
associated with a significantly higher risk of RVOT reoperation and
overall reintervention. These findings suggest that NCB approaches may
offer superior long-term durability, reducing the need for subsequent
interventions in neonates undergoing primary repair of TA.<br/>Copyright
&#xa9; The Author(s) 2026

<29>
Accession Number
2042871188
Title
Impact of osteosarcopenia in older people on prognosis following major
surgery: a scoping review.
Source
PeerJ. 14 (no pagination), 2026. Article Number: e20527. Date of
Publication: 08 Jan 2026.
Author
Silva-Diaz Y.A.; Odar-Rojas C.; Pasten-Hidalgo W.; Gallegos-Chavez E.;
Barros-Osorio C.; Sepulveda-Loyola W.
Institution
(Silva-Diaz, Odar-Rojas) Instituto de Salud Integral Intercultural (ISI),
Facultad de Ciencias de la Salud (FACISA), Universidad Nacional Toribio
Rodriguez de Mendoza (UNTRM), Chachapoyas, Peru
(Silva-Diaz, Odar-Rojas) Grupo de Investigacion Plantas Medicinales y
Medicina Alternativa (PYMA), Centro de Investigacion Plantas Medicinales,
Terapias Alternativas y Comunidades Nativas y Rurales (CIPMAYCOM),
Instituto de Salud Integral Intercultural (ISI), Facultad de Ciencias de
la Salud (FACISA), Universidad Nacional Toribio Rodriguez de Mendoza
(UNTRM), Amazon, Peru
(Pasten-Hidalgo) Departamento de Kinesiologia, Facultad de Ciencias de la
Salud, Universidad de Atacama, Copiapo, Chile
(Gallegos-Chavez) Unidad de Cuidados Agudos, Hospital Dr. Sotero del Rio,
Programa de Especialidad de Geriatria USACH- Capredena, Santiago, Chile
(Gallegos-Chavez, Barros-Osorio, Sepulveda-Loyola) Grupo de Estudios del
Envejecimiento (GEE), Santiago, Santiago, Chile
(Barros-Osorio, Sepulveda-Loyola) Faculty of Health and Social Sciences,
Universidad de Las Americas, Region Metropolitana, Santiago, Chile
(Sepulveda-Loyola) Centro de Investigacion en Ciencias Biologicas y
Quimicas (CICBQ), Universidad de Las Americas (UDLA), Santiago, Chile
Publisher
PeerJ Inc.
Abstract
Purpose. This review aims to map the existing literature on the
prevalence, diagnostic criteria, and impact of osteosarcopenia on
postoperative clinical outcomes in older adults. Methods. The search for
this scoping review followed the PRISMA extension guidelines across five
databases (Medline, Scopus, Web of Science, Scielo, and PEDro) from their
inception until August 2025. Eligible studies included older adults with
osteosarcopenia who underwent major surgeries and reported clinical
outcomes. Additionally, data extraction covered three themes: study and
population characteristics; prevalence and impact of osteosarcopenia on
post-major surgery clinical outcomes; and diagnostic criteria for
osteosarcopenia. Results. A total of 164 studies were identified, of which
18 met the inclusion criteria, involving 3,235 participants aged between
60.7 and 83 years. The impact of osteosarcopenia varies depending on the
type of procedure: (1) in oncological surgeries, the prevalence ranged
from 12% to 44%, with reported complications including prolonged surgical
time and reduced survival; (2) in orthopedic surgeries, prevalence ranged
from 28% to 100%, with issues such as delayed recovery and increased
mortality; and (3) in cardiovascular and gastrointestinal surgeries, the
prevalence of osteosarcopenia ranged from 6.5% to 38.5%, associated with
delayed wound healing and higher infection rates. Diagnostic approaches to
osteosarcopenia showed substantial heterogeneity, most frequently relying
on skeletal muscle mass index and bone mineral density, but applying
different cutoff values. Conclusions. The prevalence of osteosarcopenia
differs across populations and surgical contexts. This syndrome represents
an important risk factor for adverse postoperative outcomes in older
adults undergoing major surgery. Furthermore, considerable variability
persists in the diagnostic criteria employed, underscoring the need for
standardized definitions to improve clinical applicability and
comparability across studies.<br/>Copyright &#xa9; (2026), (PeerJ Inc.).
All rights reserved.

<30>
Accession Number
2040599962
Title
Revascularisation strategies for non-acute myocardial ischaemic syndromes.
Source
Heart. (no pagination), 2025. Article Number: heartjnl-2025-326101. Date
of Publication: 2025.
Author
Kawczynski M.J.; Barili F.; Brophy J.M.; Zoccai G.B.; Anselmi A.; Boden
W.E.; Albuquerque A.; Almeida R.; Beurtheret S.; Biondi-Zoccai G.; Borger
M.; Brophy J.; Buttiglione G.; Dayan V.; De Caterina R.; de la Cuesta M.;
Firstenberg M.; Garcia-Villareal O.; Gomes W.; Heuts S.; Kaul S.;
Kawczynski M.; Mandrola J.; Cuartas M.M.; Misfield M.; Musumeci F.;
Parolari A.; Quintana E.; Redberg R.; Riad R.; Rodriguez-Roda Stuart J.;
Ronco D.; Uva M.S.; Tomasi J.; Verhoye J.-P.; Zenati M.; Dib N.
Institution
(Kawczynski, Heuts) Department of Cardiothoracic Surgery, Maastricht
University Medical Center, Maastricht, Netherlands
(Kawczynski, Heuts) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Barili, Parolari) Universita Degli Studi Di Milano, Milan, Italy
(Barili) IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
(Barili) Harvard T.H. Chan School of Public Health, Boston, MA, United
States
(Brophy) McGill University, Montreal, QC, Canada
(De Caterina) Cardiology Division, Pisa University Hospital, Pisa, Italy
(Zoccai) Department of Medical Surgical Sciences and Biotechnologies,
Sapienza University of Rome, Rome, Italy
(Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Anselmi) Department of Thoracic and Cardiovascular Surgery, University
Hospital Centre Rennes, Rennes, France
(Boden) VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
Publisher
BMJ Publishing Group
Abstract
Background Contemporary guidelines by the European Society for Cardiology
and American College of Cardiology/American Heart Association for the
treatment of non-acute myocardial ischaemic syndromes dispute the value of
revascularisation and differ in their recommendation to perform
revascularisation. A Bayesian network meta-analysis was performed,
evaluating the strength of evidence for the comparative incremental
effectiveness of coronary artery bypass grafting (CABG) versus
percutaneous coronary intervention (PCI) over medical therapy on long-term
outcomes. Methods A hierarchical Bayesian network meta-analysis was
designed (PROSPERO CRD42024541215, date 20 May 2024), including randomised
controlled trials (RCTs) published between 2005 and 10 June 2025, which
consisted of three initial treatment modalities: optimal medical therapy
(OMT), PCI+OMT and CABG+OMT. The primary outcome was all-cause mortality
at maximum follow-up; secondary outcomes were trates of the rates of
myocardial infarction, stroke and re-revascularisation at maximum
follow-up, expressed in HRs and 95% credible intervals (CrIs), accompanied
by surface under the cumulative ranking curve (SUCRA) scores. Results 10
RCTs, comprising 10 742 patients, were included. For all-cause mortality,
the estimated median HR of CABG+OMT versus OMT was 0.84 (95% CrI
0.68-1.07); the HR of PCI+OMT versus OMT was 0.93 (0.79-1.16); and the HR
of CABG+OMT versus PCI+OMT was 0.91 (0.71-1.13). The SUCRAs of a CABG+OMT
strategy ranking as the optimal revascularisation treatment regarding
mortality, myocardial infarction, stroke and re-revascularisation were
88.1%, 99.7%, 17.5% and 99.5%, respectively. Results were consistent
across sensitivity analyses, including in the node-splitting models.
Conclusions This Bayesian network meta-analysis found that an initial CABG
(+OMT) revascularisation strategy was associated with higher probabilities
of optimal outcomes, with the exception of stroke, compared with an
initial PCI (+OMT) revascularisation strategy, although CrIs overlapped,
suggesting that some uncertainty remains.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2025.

<31>
Accession Number
2043391996
Title
Three Decades of Evidence on Pulsatile Cardiopulmonary Bypass in
Pediatrics: No Significant Clinical Benefit.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2026. Date of Publication: 2026.
Author
Undar A.; Lussier M.J.; Rajesh S.; Dayi K.
Institution
(Undar, Lussier, Rajesh, Dayi) Penn State Hershey Pediatric Cardiovascular
Research Center, Penn State College of Medicine, Hershey, PA, United
States
(Undar) Division of Pediatric Cardiology, Department of Pediatrics, Penn
State College of Medicine, Hershey, PA, United States
(Undar) Penn State College of Medicine, Department of Surgery, Hershey,
PA, United States
(Undar) Department of Biomedical Engineering, College of Engineering, The
Pennsylvania State University, University Park, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Drawing on more than 30 years of valuable expertise in
in-vitro, in-vivo, and clinical trials, we report the key findings of our
institutional research on pulsatile cardiopulmonary bypass (CPB).
<br/>Method(s): A detailed search was performed in the National Institutes
of Health National Library of Medicine, focusing on the PubMed database.
This search combined key terms such as "Pulsatile flow," "Cardiopulmonary
Bypass," "Undar A," "Vital Organ Injury," "Clinical outcomes,"
"Pediatrics," and "Neonates and infants" to find relevant peer-reviewed
publications. <br/>Result(s): A comprehensive review article was crafted
by analyzing 88 peer-reviewed studies published between 1996 and 2025.
This research provided substantial scientific evidence on optimizing
neonatal and pediatric cardiopulmonary bypass (CPB) circuitry, focusing
not only on pump performance but also on selecting appropriate oxygenators
and arterial cannulas for effective pulsatile flow. While significant
benefits regarding cerebral hemodynamics were observed in neonatal piglet
models using pulsatile flow in conjunction with deep hypothermic
circulatory arrest, the results from randomized clinical trials and
retrospective studies raised questions regarding its efficacy. Despite
some promising indications of improved Apolipoprotein E and plasminogen
activator inhibitor-1/tissue plasminogen activator ratios, a rigorous
randomized clinical trial involving 159 patients, along with a
comprehensive retrospective study of 284 patients at Penn State Health
Children's Hospital, demonstrated no significant clinical advantage of
pulsatile flow compared with nonpulsatile flow. Importantly, while
pulsatile flow did not provide a measurable benefit, it also did not
result in any adverse outcomes in our clinical trials. <br/>Conclusion(s):
The existing evidence clearly indicates that pulsatile CPB does not
provide significant short-term or long-term benefits for pediatric
patients undergoing congenital heart surgery.<br/>Copyright &#xa9; The
Author(s) 2026. This article is distributed under the terms of the
Creative Commons Attribution 4.0 License
(https://creativecommons.org/licenses/by/4.0/) which permits any use,
reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<32>
Accession Number
2043006376
Title
Invasive versus conservative strategy in older adults >=70 years of age
with non-ST-segment-elevation myocardial infarction: a GRADE-assessed
systematic review and meta-analysis of randomized controlled trials with
trial sequential analysis.
Source
Future Cardiology. (no pagination), 2026. Date of Publication: 2026.
Author
Khan U.; Ali J.; Khan M.H.; Abdelgalil M.S.; Majeed Z.; Naveed M.A.; Amin
A.M.; Nawaz A.; Abuelazm M.; Turkmani M.; Aamir M.; Vyas A.V.; Dani S.
Institution
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Ali) Department of Medicine, Saint Peter's University Hospital, New
Brunswick, NJ, United States
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Abdelgalil) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Naveed) Department of Medicine, Dow Medical University, Karachi, Pakistan
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Turkmani) Division of Pulmonary and Critical Care, University of Toledo,
Toledo, OH, United States
(Aamir, Vyas) Department of Cardiology, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Dani) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Older adults with Non-ST-Segment Elevation Myocardial
Infarction (NSTEMI) are often undertreated invasively due to concerns
about risks and comorbidities, despite potential benefits. Their limited
inclusion in clinical trials leaves a gap in evidence-based management.
This meta-analysis compared invasive versus conservative strategies in
elderly NSTEMI patients. <br/>Method(s): A systematic search was conducted
across PubMed, CENTRAL, Web of Science, Scopus, and Embase through
December 2024. Pooled results were reported using risk ratios (RR) for
dichotomous outcomes and mean differences (MD) for continuous outcomes
with 95% confidence intervals (CI). <br/>Result(s): A total of 11
randomized controlled trials involving 4114 patients were included.
Invasive treatment significantly reduced the composite of all-cause
mortality and non-fatal MI (RR: 0.82; 95% CI: 0.68-0.99; p = 0.04) and MI
alone (RR: 0.68; 95% CI: 0.56-0.84; p = 0.0003). There was no significant
difference in all-cause mortality (RR: 1.04; 95% CI: 0.92-1.16; p = 0.55)
or cardiovascular death (RR: 0.96; 95% CI: 0.78-1.18; P = 0.67). Invasive
strategy significantly lowered the need for revascularization (RR: 0.29;
95% CI: 0.21-0.40; p < 0.0001). <br/>Conclusion(s): In NSTEMI patients
aged >=70, invasive management reduces the risk of MI and
revascularization without increasing mortality risk. More elderly-focused
trials are warranted. <br/>Protocol Registration:
https://www.crd.york.ac.uk/prospero identifier is
CRD42025633157.<br/>Copyright &#xa9; 2026 Informa UK Limited, trading as
Taylor & Francis Group.

<33>
Accession Number
2042932407
Title
Video-assisted thoracoscopic surgery versus chemical pleurodesis via chest
tube in malignant pleural effusion management: a randomized clinical
trial.
Source
Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 5.
Date of Publication: 01 Dec 2026.
Author
Elghanam A.R.; Abdelaal M.M.; Elfeky W.M.; Mogahed M.A.; Elesawy M.M.;
Ettish A.A.
Institution
(Elghanam, Abdelaal, Elfeky, Mogahed, Elesawy, Ettish) Cardiothoracic
Surgery Department, Faculty of Medicine, Kafr Elsheikh University, Kafr
Elsheikh, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Malignant pleural effusion (MPE) is a frequent and
debilitating complication of advanced malignancy, often resulting in
significant morbidity and impaired quality of life. The optimal approach
for durable pleural control and symptom relief remains debated. This
randomized controlled trial compared the efficacy and clinical outcomes of
video-assisted thoracoscopic surgery (VATS) pleurodesis versus
conventional thoracostomy tube drainage with chemical pleurodesis in
patients with MPE. A total of 100 patients with a confirmed MPE diagnosis
were randomized equally into two groups (n = 50 each): VATS pleurodesis
and thoracostomy tube drainage with bleomycin pleurodesis. The primary
endpoint was successful pleurodesis (complete response) after 30 days.
Secondary outcomes included hospital stay, pain score, postoperative
performance status, and complications. <br/>Result(s): VATS achieved a
significantly higher pleurodesis success rate (90% vs 72%; p = 0.022) and
better postoperative performance status (ECOG I: 50% vs. 10%; p < 0.001).
Median hospital stay was shorter in the VATS group (4 vs. 7.5 days; p <
0.001), and postoperative pain scores were lower (p = 0.039). Both
interventions improved dyspnea scores significantly (p < 0.001). No
significant differences were observed in ICU admission (36% vs 38%; p >
0.05) or complication rates. <br/>Conclusion(s): VATS pleurodesis using
mechanical abrasion and/or electrocautery provides superior short-term
outcomes compared with thoracostomy tube drainage with bleomycin
pleurodesis for malignant pleural effusion, offering higher treatment
success, improved functional recovery, reduced postoperative pain, and
shorter hospitalization without added morbidity.<br/>Copyright &#xa9; The
Author(s) 2026.

<34>
Accession Number
649820956
Title
Effect of intraoperative ventilation strategy on postoperative pulmonary
complications in thoracic surgery under general anesthesia: a
meta-analysis.
Source
Journal of cardiothoracic surgery. 21(1) (pp 66), 2026. Date of
Publication: 04 Jan 2026.
Author
Wang Y.; Ouyang F.; Ding Z.; Xu L.; Wang J.; Chen Z.; Zhang L.
Institution
(Wang, Xu, Wang, Zhang) Department of Anesthesiology, Wuhan No.1 Hospital,
No. 215, Qiaokou District, Wuhan, China
(Ouyang) Department of Anesthesiology, Thrid People's Hospital of Hubei
Province, Wuhan, China
(Ding) Department of Painology, Wuhan No.1 Hospital, Wuhan, China
(Chen) Department of Anesthesiology, Wuhan No.1 Hospital, No. 215, Qiaokou
District, Wuhan, China

<35>
Accession Number
2042966699
Title
The impact of thoracic paravertebral nerve block at different positions on
pain relief in patients undergoing single-port thoracoscopic partial lung
resection: study protocol for a randomized controlled trial.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 99. Date of
Publication: 01 Dec 2026.
Author
Zhu X.; Peng P.; Guo J.; Zhang L.; Zhong H.; Zhu J.; Xie H.
Institution
(Zhu, Peng, Guo, Zhang, Zhong, Zhu, Xie) Department of Anesthesiology, The
Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road,
Jiangsu, Suzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Despite the widespread adoption of uniportal video-assisted
thoracoscopic surgery (VATS), postoperative pain associated with this
procedure remains a significant concern. Effective postoperative analgesia
is essential for facilitating the recovery of patients undergoing thoracic
surgery. Thoracic paravertebral block (TPVB) is widely recognized as an
extremely effective method of analgesia in such surgeries. Our previous
study has demonstrated that the diffusion of local anesthetic during nerve
blocks is related to body position. Therefore, this study aimed to
evaluate the impact of thoracic paravertebral nerve block in various body
positions on the analgesic outcomes for patients undergoing single-port
thoracoscopic lung resection. <br/>Method(s): A randomized controlled
trial was conducted to assess the impact of different body positions
during thoracic paravertebral nerve blocks on the analgesic effect in
patients undergoing single-port thoracoscopic partial lung resection.
Patients scheduled for thoracoscopic lung resection will be included in
this study. Participants (n = 200) will undergo thoracic paravertebral
nerve block under ultrasound guidance. After the injection of the drug,
they will be placed in either a supine position or a lateral position with
the puncture side up. The NRS scores will be assessed at 1 h, 2 h, 8 h, 12
h, 24 h, and 48 h postoperatively. Postoperative opioid consumption,
rescue analgesia time and frequency, patient satisfaction, incidence of
adverse reactions, and length of hospital stay will also be recorded.
<br/>Discussion(s): This research project mainly aimed to investigate the
impact of different perioperative positions for thoracic paravertebral
nerve block on the analgesic effects in patients undergoing single-port
thoracoscopic lung resection. The results may provide important
implications for the development of effective analgesic strategies and
robust clinical evidence to support the recovery of patients undergoing
thoracic surgery. Trial registration: ClinicalTrials.gov NCT06789276.
Registered on 10 January 2025.<br/>Copyright &#xa9; The Author(s) 2026.

<36>
Accession Number
2036431434
Title
Efficacy and safety of left atrial appendage occlusion for atrial
fibrillation in patients with a history of prior intracranial hemorrhage:
a systematic review and meta-analysis of observational studies.
Source
Journal of Interventional Cardiac Electrophysiology. 69(2) (pp 285-295),
2026. Date of Publication: 01 Mar 2026.
Author
Hammad A.; Ahmad A.; Khalid N.; Munshi H.; Khraisat O.; Kumar V.; Muhammad
H.; Iyer A.; Ozgur S.; Dajani A.R.; Afzal A.; Patel S.; Tiyyagura S.;
Shamoon F.E.; Vasudev R.
Institution
(Hammad, Khraisat, Iyer, Ozgur, Dajani, Afzal) Department of Internal
Medicine, Englewood Hospital Medical Center, Englewood, NJ, United States
(Ahmad, Khalid, Munshi, Tiyyagura, Shamoon, Vasudev) Department of
Cardiology, St. Joseph's University Medical Center, Paterson, NJ, United
States
(Kumar) Department of Critical Care, George Washington University,
Washington, DC, United States
(Muhammad) Department of Cardiology, Newark Beth Israel Medical Center,
Newark, NJ, United States
(Patel) Rowan University School of Osteopathic Medicine, Glassboro, NJ,
United States
Publisher
Springer
Abstract
Background: Left atrial appendage occlusion (LAAO) is emerging as
alternative to anticoagulation in patients with nonvalvular atrial
fibrillation (AF) to reduce ischemic stroke risk, particularly in those at
high bleeding risk. <br/>Objective(s): Assess LAAO efficacy and safety in
patients with prior intracranial hemorrhage (ICH). <br/>Method(s):
Systematic review was performed using PubMed, Embase, and Cochrane Central
Register of Controlled Trials. Observational studies reporting outcomes of
percutaneous LAAO for AF thromboembolic stroke prophylaxis in patients
with prior ICH were included. Classic meta-analysis with risk ratios (RR)
for outcomes with control groups and proportions for outcomes without
controls were conducted. <br/>Result(s): A total of 19 observational
studies (13 retrospective and 6 prospective) involving 1671 patients met
the inclusion criteria. The mean CHA2DS2-VASc score was 4.59 +/- 0.46, and
the mean HAS-BLED score was 3.66 +/- 0.56. The mean follow-up duration was
19.1 +/- 10.2 months, with follow-up ranging from 6 months to 3.7 years.
LAAO was successfully implanted in 99.3% of patients. Periprocedural
complications included ICH (0.4%), ischemic stroke (0.3%), pericardial
effusion/cardiac tamponade (1.3%), device embolization (0.5%), and
device-related thrombosis (0.1%). During follow-up, the incidence of ICH
was 1.9%, ischemic stroke/TIA 2.9%, device-related thrombosis 1.4%, and
all-cause mortality 3.3%. Using the CHA2DS2-VASc score, LAAO significantly
reduced ischemic stroke risk (RR = 0.28, 95% CI 0.21-0.39). Similarly,
using the HAS-BLED score, bleeding events were reduced (RR = 0.61, 95% CI
0.44-0.84). <br/>Conclusion(s): LAAO is effective and relatively safe
treatment for reducing ischemic stroke risk in nonvalvular AF patients
with history of ICH.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<37>
Accession Number
2042802634
Title
Colchicine therapy in transcatheter aortic valve replacement: Modulating
inflammation and outcomes.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
29 (no pagination), 2026. Article Number: 200575. Date of Publication: 01
Jun 2026.
Author
Abdul-Hafez H.A.; Awashra A.; Ahmad M.; Hawawrah A.R.; Mahafdah B.;
AbuBaha M.; Alazizi I.; Shubietah A.; Elgendy M.S.; Emara A.
Institution
(Abdul-Hafez, Awashra, Ahmad, Hawawrah, AbuBaha, Alazizi) Department of
Medicine, Faculty of Medicine and Health Sciences, An-Najah National
University, Nablus, Palestine
(Mahafdah) Faculty of Medicine, Yarmouk University, Irbid, Jordan
(Shubietah) Department of Medicine, Advocate Illinois Medical Center,
Chicago, IL, United States
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Publisher
Elsevier B.V.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is frequently
accompanied by inflammation-related complications, including conduction
disturbances, atrial fibrillation, and subclinical leaflet thrombosis.
Colchicine, with its anti-inflammatory and antithrombotic properties, has
emerged as a potential adjunctive therapy to mitigate these
post-procedural events. However, its specific role in the TAVR population
remains insufficiently defined. Methods A narrative review approach was
used. Searches of PubMed, Scopus, Web of Science, and Google Scholar were
performed through September 2025 using terms related to "transcatheter
aortic valve replacement," "TAVR," and "colchicine." Randomized trials,
observational studies, mechanistic investigations, and guideline documents
were screened. Findings were organized thematically to summarize
mechanisms, therapeutic rationale, and clinical outcomes. Results Only one
randomized controlled trial and one observational study have directly
evaluated colchicine after TAVR. Both demonstrated reductions in
inflammatory biomarkers and signals toward improved conduction-related
parameters, but clinical endpoints such as pacemaker implantation,
sustained arrhythmias, and imaging-confirmed leaflet thrombosis remain
insufficiently studied. Mechanistic and perioperative cardiac evidence
from non-TAVR settings supports colchicine's potential by targeting
inflammasome activity, microtubule regulation, and early
thrombo-inflammatory remodeling. Conclusions Colchicine is a promising
adjunctive strategy for attenuating inflammation-related complications
after TAVR. Its multimodal actions align with the pathways implicated in
conduction disturbances, atrial fibrillation, and leaflet thrombosis.
However, current evidence is preliminary, with only two post-TAVR
intervention studies available. Larger trials are needed to determine
whether colchicine can translate mechanistic advantages into clinically
meaningful improvements in post-TAVR outcomes.<br/>Copyright &#xa9; 2026
The Authors.

<38>
[Use Link to view the full text]
Accession Number
2042432233
Title
Nitric Oxide to Reduce Acute Kidney Injury in Patients with Pre-existing
Endothelial Dysfunction Requiring Prolonged Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
Anesthesiology. (no pagination), 2025. Date of Publication: 2025.
Author
Arora P.; Di Fenza R.; Shetty N.S.; Giammatteo V.; Marrazzo F.; Spina S.;
Zadek F.; Gianni S.; Fakhr B.S.; La Vita C.; Shann K.; Zheng H.; Gaonkar
M.; Yu B.; Feelisch M.; Thompson T.B.; Akeju O.; Sundt T.M.; Bonventre J.;
Ichinose F.; Berra L.
Institution
(Arora, Gaonkar) Division of Cardiovascular Disease, University of Alabama
at Birmingham, Birmingham, AL, United States
(Arora) Section of Cardiology, Birmingham Veterans Affairs Medical Center,
Birmingham, AL, United States
(Di Fenza, Shetty, Giammatteo, Marrazzo, Spina, Zadek, Gianni, Fakhr, Yu,
Akeju, Ichinose, Berra) Department of Anesthesia, Critical Care and Pain
Medicine, Massachusetts General Hospital, Boston, MA, United States
(Di Fenza, Shetty, Giammatteo, Marrazzo, Spina, Zadek, Gianni, Fakhr, Yu,
Akeju, Ichinose, Berra) Harvard Medical School, Boston, MA, United States
(La Vita, Berra) Respiratory Care Services Department, Massachusetts
General Hospital, Boston, MA, United States
(Shann) Perfusion Services, Division of Cardiac Surgery, Corrigan Minehan
Heart Center, Massachusetts General Hospital, Boston, MA, United States
(Zheng) Biostatistics, Massachusetts General Hospital, Boston, MA, United
States
(Feelisch) Experimental Medicine & Integrative Biology, Faculty of
Medicine, University of Southampton, United Kingdom
(Thompson) Pulmonary Division Unit, Department of Medicine, Massachusetts
General Hospital, Boston, MA, United States
(Sundt) Division of Cardiac Surgery, Corrigan Minehan Heart Center,
Massachusetts General Hospital, Boston, MA, United States
(Bonventre) Renal Unit, Department of Medicine, Brigham and Women's
Hospital, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Prolonged cardiopulmonary bypass (CPB) causes hemolysis,
reducing nitric oxide (NO) availability and increasing the risk of acute
kidney injury (AKI) after cardiac surgery. While prior studies suggest
inhaled NO may reduce AKI in certain populations, its effect in patients
with pre-existing endothelial dysfunction, a condition marked by impaired
NO production is unknown. This trial investigates whether perioperative NO
administration reduces AKI in patients with pre-existing endothelial
dysfunction undergoing prolonged CPB. <br/>Method(s): - We conducted a
double-blind, single-center, placebo-controlled, randomized clinical trial
involved 250 adult cardiac surgery patients with pre-existing endothelial
dysfunction undergoing cardiopulmonary bypass lasting more than 90
minutes. Participants were randomized to either receive NO at 80 ppm via
the oxygenator during cardiopulmonary bypass, continuing post-operatively
via ventilator and facemask, or a placebo of nitrogen-oxygen gas mixture
for 24 hours. The primary outcome was the incidence of post-operative AKI,
defined by KDIGO criteria. Secondary outcomes included AKI severity, and
the need for renal replacement therapy (RRT) during hospitalization and at
6 weeks, 90 days, and 1 year. <br/>Result(s): - Of the 250 patients
[median age: 66 (59, 73) years; 56 (22.4%) females], 125 were assigned to
each group. AKI occurred in 55 (44.0%) patients in the NO group and 54
(43.2%) patients in the control group [ORadj: 1.00 (95%CI: 0.59-1.69)].
Secondary outcomes, including stage 1, 2, or 3 AKI and RRT at all time
points, were also similar between groups. <br/>Conclusion(s): - In cardiac
surgery patients with pre-existing endothelial dysfunction undergoing
prolonged cardiopulmonary bypass, peri-operative administration of 80 ppm
NO for 24 hours did not significantly reduce post-operative AKI. These
findings do not support the routine use of NO in this patient population.
Trial Registration: - ClinicalTrials.gov Identifier:
NCT02836899<br/>Copyright &#xa9; 2025 American Society of
Anesthesiologists. All Rights Reserved.

<39>
Accession Number
2041566940
Title
Impact of Concomitant Mitral Regurgitation on Cardiovascular Events and
Mortality After Transcatheter Aortic Valve Replacement: A Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(2) (pp 577-592),
2026. Date of Publication: 01 Feb 2026.
Author
Darouei B.; Shafie D.; Amani-Beni R.; Elyasi Bakhtiari P.; Etemadi M.H.;
Bagherikaram S.; Eshraghi R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.;
Emami Meybodi M.; Movahed M.R.
Institution
(Darouei, Amani-Beni) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shafie) Heart Failure Research Center, Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Elyasi Bakhtiari, Etemadi, Bagherikaram) Student Research Committee,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Emami Meybodi) Yazd Cardiovascular Research Center, Non-Communicable
Diseases Research Institute, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona College of
Medicine, Tucson, AZ, United States
(Movahed) Department of Medicine, University of Arizona Sarver Heart
Center, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Mitral regurgitation (MR) is common in patients undergoing transcatheter
aortic valve replacement (TAVR). However, it is unclear how MR severity
affects prognosis. This meta-analysis evaluated the associations among
baseline MR severity, cardiovascular outcomes, and mortality after TAVR.
Eligible studies included adult patients undergoing TAVR with stratified
MR severity (MR >= 2 or MR >= 3) and reported the post-TAVR clinical
outcomes. Sensitivity analyses stratified by follow-up duration,
leave-one-out sensitivity, and meta-regression were also conducted.
Forty-two studies (n = 67,257 patients) were included. MR >= 2 was
associated with increased all-cause mortality during follow-up (> 30 days)
(hazard ratio [HR]: 1.40; 95% confidence interval [CI]: 1.26, 1.55) and
cardiovascular mortality (risk ratio [RR]: 1.80; 95% CI: 1.05, 3.08), but
not with stroke, transient ischemic attack, myocardial infarction (MI), or
heart failure hospitalization. MR >= 3 conferred an even higher risk of
all-cause mortality during follow-up (RR: 1.55; 95% CI: 1.24, 1.94) and
rehospitalization (RR: 1.40; 95% CI: 1.17, 1.67), but not for stroke and
MI. MR improvement occurred in 41% of patients within < 1-year post-TAVR,
declined to 15% at > 1-year post-TAVR. Baseline moderate-to-severe MR (MR
>= 2) predicts all-cause mortality during follow-up and cardiovascular
mortality after TAVR, particularly severe MR (MR >= 3). While no
consistent associations were found with nonfatal outcomes such as stroke,
TIA, MI, or heart failure hospitalization, the prognostic impact of MR
appears to be predominantly mortality-centered.<br/>Copyright &#xa9; 2025
Wiley Periodicals LLC.

<40>
Accession Number
2038319898
Title
Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic
Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical
Trial.
Source
JAMA. 333(20) (pp 1781-1792), 2025. Date of Publication: 27 May 2025.
Author
Karkouti K.; Callum J.L.; Bartoszko J.; Tanaka K.A.; Knaub S.; Brar S.;
Ghadimi K.; Rochon A.; Mullane D.; Couture E.J.; Lin Y.; Harle C.; Zeller
M.; Tran D.T.T.; Solomon C.; Rao V.; Law M.; Butt A.L.; Chen E.P.; Martins
M.R.; Saha T.; Shih A.W.; Vezina M.-C.; Moussa F.; Pereira Cezar Zamper
R.; Syed S.; Buyukdere H.; Werner S.; Grewal D.; Wong D.; Vandyck K.B.;
Tanzola R.; Hughes B.; Royer O.; Wong S.; Levy J.H.; Tran D.; Tanaka K.;
Lewis R.J.; Sellke F.; Cushing M.; Jones M.; Kowalski J.; Amaral J.;
Asmail S.; Thilagaratnam S.; Suthar P.; Azenabor M.; Cyr J.; Kucheryava
O.; Pascaru S.; Peer M.; Abrahamyan L.; Achen B.; Coley M.; Demers P.;
Devine D.; Flexman A.; Grocott H.; Lamarche Y.; de Souza C.M.; Payne D.;
Peterson M.; Scales D.; Sun T.; Tinmouth A.; Tomlinson G.; McCluskey S.;
Lieberman L.; Carroll J.; Firouzian S.; Liyanage N.; Poonawala H.; Selby
S.; Kabir R.; Oliver S.; Escorcia A.; Medic S.; Wong M.; Yan M.; Mozel M.;
Kaur R.; Randall R.; Bizovie K.; Buchko S.; Khakh S.; Gonzales R.A.;
Sutherland K.; Van Roekel J.; Babul A.; Lertnamvongwan R.; Monteiro L.;
Johnson P.; Okada H.; DuMerton D.; Tod R.; Smethurst B.; Jain S.; Scholey
A.; Sirosky-Yanyk A.; Stevens A.; Haider W.; Cisneros-Aguilera E.;
Belanger G.; Hutspardol S.; Lim S.; Mi J.; Kalar D.; Eang M.;
Lorenzana-Saldivar E.; Gupta A.; Jerath A.; Lau P.; D'Empaire P.P.; Armali
C.; Kaustov L.; Malkin A.; Colavecchia C.; Meirovich H.; Yang J.; Bergeron
A.; Laforge F.; Paradis K.; Gagne N.; Soleil M.; Dumont E.; Charest M.-E.;
Quantz M.; Mayer R.; Kinney J.; Fochesato L.-A.; Bai Y.; Jaffar I.;
Alhomsi N.; Guevarra J.; Jamula E.; Hsu W.C.; Drew A.; Rubens F.; Patel
D.; Tokessy M.; Watt E.; Arabi H.; Luciano K.; Pavenski K.; Moorehead A.;
Bisleri G.; Mazer D.; Kasimova K.
Institution
(Karkouti, Bartoszko, Grewal) Department of Anesthesia and Pain
Management, University Health Network, Sinai Health, Women's College
Hospital, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko, Rao, Grewal) Peter Munk Cardiac Centre, Toronto
General Hospital Research Institute, University Health Network, Toronto,
ON, Canada
(Karkouti, Bartoszko, Wong) Department of Anesthesiology and Pain
Medicine, University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Queen's University, Kingston, ON, Canada
(Callum) Sunnybrook Research Institute, Toronto, ON, Canada
(Tanaka, Butt, Vandyck) Department of Anesthesiology, University of
Oklahoma Health Sciences Center, Oklahoma City, United States
(Knaub, Solomon) Octapharma AG, Lachen, Switzerland
(Brar, Law) Department of Anesthesiology and Perioperative Medicine, Royal
Columbian Hospital, Vancouver, BC, Canada
(Brar, Law) University of British Columbia, Vancouver, Canada
(Ghadimi) Clinical Research Unit, Department of Anesthesiology & Critical
Care, Duke University Health System, Durham, NC, United States
(Rochon, Martins) Department of Anesthesia, University of Montreal,
Montreal Heart Institute, Montreal, QC, Canada
(Mullane, Hughes) Department of Anesthesiology, Pharmacology &
Therapeutics, University of British Columbia, Canada
(Mullane, Shih, Hughes, Hutspardol, Lim, Mi, Kalar, Eang) Vancouver
General Hospital, Vancouver, BC, Canada
(Couture, Vezina, Royer) Department of Anesthesiology, Quebec Heart and
Lung Institute, Laval University, Quebec, QC, Canada
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Harle, Pereira Cezar Zamper) London Health Sciences Centre, London, ON,
Canada
(Harle) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Zeller) Micheal G. DeGroote Centre for Transfusion Research, Department
of Medicine, McMaster University, Hamilton, ON, Canada
(Zeller) Canadian Blood Services, Ottawa, ON, Canada
(Tran) Division of Cardiac Anesthesiology and Critical Care, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Rao, Moussa) Department of Surgery, University of Toronto, Toronto, ON,
Canada
(Chen) Cardiothoracic Surgery Division, Department of Surgery, Duke
University Health System, Durham, NC, United States
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada
(Ghadimi, Lorenzana-Saldivar) Duke University Health System, Durham, NC,
United States
(Moussa) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
Schulich Heart Centre, Toronto, ON, Canada
(Syed) Department of Anesthesia, McMaster University, Hamilton Health
Sciences Corporation, Hamilton, ON, Canada
(Syed) Department of Anesthesia, Oakville Trafalgar Memorial Hospital,
Oakville, ON, Canada
(Buyukdere) Division of Hematopathology and Transfusion Medicine,
University of Ottawa, Ottawa, ON, Canada
(Werner) Octapharma USA Inc, Paramus, NJ, United States
(Wong) Division of Cardiac Surgery, Royal Columbian Hospital, New
Westminster, BC, Canada
(Wong) Department of Surgery, University of British Columbia, Vancouver,
Canada
(Wong) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Levy) Department of Anesthesiology, Critical Care, and Surgery, Duke
University School of Medicine, Durham, NC, United States
(Bartoszko) Toronto General Hospital, Toronto, Canada
(Lin, Gupta, Jerath, Lau, D'Empaire, Armali, Kaustov, Malkin, Colavecchia,
Meirovich, Yang) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Tran) University of Ottawa Heart Institute, Ottawa, Canada
(Saha, DuMerton, Tod, Smethurst, Jain, Scholey, Sirosky-Yanyk, Stevens)
Kingston Health Sciences Centre, Kingston, ON, Canada
(Johnson, Okada) Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Quantz, Mayer, Kinney, Fochesato, Bai) University Hospital, London Health
Sciences Centre, London, ON, Canada
(Zeller) Hamilton General Hospital, Hamilton, Canada
(Brar) Royal Columbian Hospital, New Westminster, Canada
(Couture) Institut Universitaire de Cardiologie, Pneumologie de
Quebec-Universite Laval, QC, Canada
(Rochon, Haider, Cisneros-Aguilera, Bergeron, Belanger) Montreal Heart
Institute, Montreal, QC, Canada
(Tanaka) University of Oklahoma Health Sciences Center, Oklahoma City,
United States
(Lewis) Berry Consultants, LLC, Department of Emergency Medicine,
Harbor-UCLA Medical Center, Austin, TX, United States
(Sellke) Rhode Island Hospital and Brown Medical School, Providence, RI,
United States
(Cushing) Clinical Pathology and Laboratory Medicine, Weill Cornell
Medicine, New York City, NY, United States
(Jones, Kowalski) Ergomed GmbH Guildford, Surrey, United Kingdom
(Pavenski, Moorehead, Bisleri, Mazer, Kasimova) St. Michael's Hospital
(Unity Health Toronto), Toronto, ON, Canada
(Amaral, Asmail, Thilagaratnam, Suthar, Azenabor, Cyr, Kucheryava,
Pascaru) Ozmosis Research Inc., Toronto, ON, Canada
(Wong, Yan, Mozel, Kaur, Randall, Bizovie, Buchko, Khakh, Gonzales,
Sutherland, Van Roekel, Babul, Lertnamvongwan, Monteiro) Royal Columbian
Hospital, Fraser Health Authority, New Westminster, BC, Canada
(McCluskey, Lieberman, Carroll, Firouzian, Liyanage, Poonawala, Selby,
Kabir, Oliver, Escorcia, Medic) Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Rubens, Patel, Tokessy, Watt, Arabi, Luciano) Ottawa Heart Research
Institute, University of Ottawa, Ottawa, ON, Canada
(Jaffar, Alhomsi, Guevarra, Jamula, Hsu, Drew) McMaster University
(Hamilton Health Sciences), Hamilton, ON, Canada
(Bergeron, Laforge, Paradis, Gagne, Soleil, Dumont, Charest) Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Universite
Laval, Quebec City, QC, Canada
Publisher
American Medical Association
Abstract
Importance: Excessive bleeding is a common and prognostically important
complication of cardiac surgery. For bleeding related to coagulation
factor deficiency, frozen plasma is the most used therapy. Preliminary
trials indicate that 4-factor prothrombin complex concentrate (PCC) may be
a suitable alternative. <br/>Objective(s): To compare the efficacy and
safety of PCC with frozen plasma in patients undergoing cardiac surgery
with coagulopathic bleeding. <br/>Design, Setting, and Participant(s):
Unblinded randomized noninferiority controlled clinical trial at 12
hospitals in Canada and the US involving adults (>=18 years) who had
developed bleeding related to coagulation factor deficiency after
termination of cardiopulmonary bypass during surgery (November 30, 2022,
to May 28, 2024). Final 30-day follow-up visit was completed on June 28,
2024. <br/>Intervention(s): A total of 265 patients were randomized to
receive PCC (1500 IU <=60 kg; 2000 IU >60 kg) and 263, frozen plasma (3 U
<=60 kg; 4 U >60 kg) in the operating room. A second dose was allowed over
the next 24 hours if indicated; thereafter, only frozen plasma could be
used. <br/>Main Outcomes and Measures: The primary outcome was hemostatic
response (effective if no hemostatic interventions occurred from 60
minutes to 24 hours after treatment initiation). The noninferiority of PCC
vs frozen plasma was assessed using a 10% margin and a 1-sided alpha of
.025, with subsequent testing for superiority if noninferiority was
demonstrated. Secondary outcomes included allogeneic blood transfusions
and adverse events. Patients were followed up until postoperative day 30.
<br/>Result(s): Of 538 enrolled patients, 420 patients (median age, 66
years [IQR, 57-73 years]; 74%, male; 10%, Asian; 1%, Black; and 65%,
White) were included in the primary analysis; of those, 296 (70%)
underwent complex surgeries. Compared with the 207 patients in the frozen
plasma group, the 213 patients in the PCC group had higher hemostatic
effectiveness (166 [77.9%] vs 125 [60.4%]; difference, 17.6%; 95% CI,
8.7%-26.4%; P <.001 for noninferiority and superiority) and had received
fewer transfusions including red blood cells, platelets, and
noninvestigational frozen plasma units (mean, 6.6 units; 95% CI, 5.7-7.7
vs 9.3 units; 95% CI, 8.0-10.8; difference, 2.7; 95% CI, 1.0-4.4; P
=.002). Seventy-seven patients (36.2%) in the PCC group vs 98 (47.3%) in
the frozen plasma group experienced serious adverse events (relative risk
[RR], 0.76; 95% CI, 0.61-0.96; P =.02). Twenty-two patients (10.3%) in the
PCC group and 39 (18.8%) in the frozen plasma group had acute kidney
injury (RR, 0.55; 95% CI, 0.34-0.89; P =.02). <br/>Conclusions and
Relevance: In this unblinded randomized clinical trial, PCC had superior
hemostatic efficacy and safety advantages to frozen plasma among patients
requiring coagulation factor replacement for bleeding during cardiac
surgery.<br/>Copyright &#xa9; 2025 American Medical Association.

<41>
Accession Number
649822374
Title
Exploring the role of fathers' preoperative preparation in reducing
anxiety and enhancing self-efficacy before pediatric open-heart surgery.
Source
BMC psychology. 14(1) (pp 158), 2026. Date of Publication: 05 Jan 2026.
Author
Zamani R.; Khoshab H.; Shirinabadi Farahani A.; Nourian M.; Nasiri M.;
Najafi K.; Valadkhani S.
Institution
(Zamani, Nourian, Nasiri, Valadkhani) Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Khoshab, Najafi) Bam University of Medical Sciences, Bam, Iran, Islamic
Republic of
(Shirinabadi Farahani) Shahid Beheshti University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Abstract
INTRODUCTION: Parents of children undergoing cardiac surgery face
significant anxiety. This study evaluated a preoperative preparation
program for fathers of children (aged 3-7 years) having open-heart
surgery. <br/>METHOD(S): In this semi-experimental study, 60 fathers were
randomly assigned to an intervention group (n = 30) receiving structured
preparation (hospital tours, group counseling, education) or a control
group (n = 30) receiving standard care. Anxiety and self-efficacy were
measured using the VAS-A and PSAM at three timepoints. <br/>RESULT(S):
Preoperative preparation significantly reduced fathers' anxiety (mean
difference: -2.1 points; 95% CI - 3.4 to - 0.8, p = 0.002) and increased
self-efficacy (+ 8.7 points, 95% CI 5.2 to 12.1; p < 0.001) compared to
controls. These improvements persisted through discharge (p < 0.05).
Structured interventions, including education and hospital tours,
effectively alleviated paternal distress while enhancing confidence during
their child's cardiac surgery. <br/>CONCLUSION(S): Preoperative
preparation for fathers, including education about their child's condition
and treatment, significantly reduces anxiety and enhances self-efficacy.
These interventions alleviate psychological distress and improve coping
strategies, demonstrating the value of targeted support for fathers of
children undergoing cardiac surgery.<br/>Copyright &#xa9; 2026. The
Author(s).

<42>
Accession Number
2042464193
Title
The Effect of Cognitive Training After Heart Valve Surgery: A Systematic
Review.
Source
Journal of Clinical Medicine. 15(1) (no pagination), 2026. Article Number:
370. Date of Publication: 01 Jan 2026.
Author
Yi Y.G.; Kim Y.; Kwon D.; Yang S.; Chang M.C.
Institution
(Yi, Kim, Yang) Department of Rehabilitation Medicine, College of
Medicine, Ewha Womans University, Seoul, South Korea
(Kwon) Department of Physical Medicine and Rehabilitation, Daegu Myungsung
Medical Center, Daegu, South Korea
(Chang) Department of Physical Medicine and Rehabilitation, College of
Medicine, Yeungnam University, Daegu, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Neurocognitive complications are common after cardiac surgery,
and postoperative cognitive decline remains a clinically relevant concern
in patients undergoing heart valve surgery. This impairment may persist
over time and negatively affect quality of life and increase mortality
risk. This review aimed to explore the potential benefits of cognitive
training in patients after heart valve surgery. <br/>Method(s): We
systematically searched PubMed, Embase, Cochrane Library, and Scopus to
identify articles published from database inception to 19 June 2025.
Studies that investigated the effects of cognitive training in patients
who underwent heart valve surgery were included. <br/>Result(s): A total
of 1506 articles were identified. After title and abstract screening, 1476
articles not meeting the inclusion criteria were excluded. Thirty
full-text articles were assessed for eligibility, of which four studies
were ultimately included in this review. Cognitive training was found to
significantly improve cognitive outcomes and health-related quality of
life, with benefits sustained for up to 12 months postoperatively.
<br/>Conclusion(s): This review highlights cognitive training as a
promising, feasible, and effective intervention for preserving cognitive
function in patients following heart valve surgery. By enhancing
neuroplasticity, cognitive training may prevent or mitigate cognitive
decline across multiple domains. Further large-scale studies are warranted
to confirm the efficacy of this treatment in this patient
population.<br/>Copyright &#xa9; 2026 by the authors.

<43>
Accession Number
2040980752
Title
Dual antiplatelet therapy after percutaneous coronary intervention
according to bleeding risk (HOST-BR): an open-label, multicentre,
randomised clinical trial.
Source
The Lancet. 406(10516) (pp 2244-2256), 2025. Date of Publication: 08 Nov
2025.
Author
Park K.W.; Han J.-K.; Hwang D.; Yang H.-M.; Park S.; Kang T.S.; Koh J.-S.;
Bang D.W.; Yoon H.-J.; Kim H.-S.; Kang J.; Lim Y.-H.; Lee S.R.; Choi Y.J.;
Ahn H.-S.; Hwang K.-K.; Kim B.G.; Jeong J.-O.; Ahn J.-H.; Rhew J.Y.; Jang
J.Y.; Park H.; Kang T.-S.; Koh J.S.; Park K.-T.; Bang D.-W.; Goh C.-W.;
Yoon H.J.; Jo S.-H.; Ki Y.-J.; Kim Y.H.; Park M.-W.; Yang T.-H.; Hong
S.J.; Park S.-H.; Kwon S.-W.; Han G.-R.; Chae I.-H.; Han S.H.; Lee N.; Cho
J.-M.; Ahn S.-K.; Kim S.-Y.; Lee H.-C.; Lee S.-J.; Seo S.-M.; Oh J.-H.;
Kang S.H.; Heo J.H.; Rha S.-W.; Woo J.S.; Kim S.; Kim S.-H.; Shin E.-S.;
Kim C.-H.; Park W.J.; Lee C.-H.; Her S.-H.; Jeon D.-S.; Lee K.-S.; Lee
S.-U.; Kim U.
Institution
(Kang, Park, Han, Hwang, Yang, Park, Kim, Kim, Kang, Lim, Lee, Choi, Ahn,
Hwang, Kim, Jeong, Ahn, Rhew, Jang, Park, Kang, Koh, Park, Bang, Goh,
Yoon, Jo, Ki, Kim, Park, Yang, Hong, Park, Kwon, Han, Chae, Han, Lee, Cho,
Ahn, Kim, Lee, Lee, Seo, Oh, Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim,
Park, Lee, Her, Jeon, Lee, Lee, Kim) Seoul National University Hospital,
Seoul, South Korea
(Kang, Park, Han, Hwang, Yang, Park, Kim, Kim, Kang, Lim, Lee, Choi, Ahn,
Hwang, Kim, Jeong, Ahn, Rhew, Jang, Park, Kang, Koh, Park, Bang, Goh,
Yoon, Jo, Ki, Kim, Park, Yang, Hong, Park, Kwon, Han, Chae, Han, Lee, Cho,
Ahn, Kim, Lee, Lee, Seo, Oh, Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim,
Park, Lee, Her, Jeon, Lee, Lee, Kim) Seoul National University College of
Medicine, Seoul, South Korea
(Ahn, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Uijeongbu St Mary&apos;s Hospital, Seoul, South Korea
(Hwang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew,
Jang, Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang,
Hong, Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh,
Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee,
Kim) Chungbuk National University Hospital, Cheongju, South Korea
(Kim, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Sanggye Paik Hospital, Seoul, South Korea
(Jeong, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew,
Jang, Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang,
Hong, Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh,
Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee,
Kim) Chungnam National University Hospital, Daejeon, South Korea
(Ahn, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gyeongsang National University Changwon Hospital, Changwon, South Korea
(Rhew, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Presbyterian Medical Center, Jeonju, South Korea
(Park, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gangneung Asan Hospital, Gangneung, South Korea
(Kang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Dankook University Hospital, Cheonan, South Korea
(Koh, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gyeongsang National University Hospital, Jinju, South Korea
(Park, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Chung-Ang University Hospital, Seoul, South Korea
(Bang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Soonchunhyang University Seoul Hospital, Seoul, South Korea
(Goh, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Ewha Womans University Seoul Hospital, Seoul, South Korea
(Yoon, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Keimyung University Dongsan Hospital, Daegu, South Korea
(Jo, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Hallym University Sacred Heart Hospital, Anyang, South Korea
(Jang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
National Health Insurance Service Ilsan Hospital, Goyang, South Korea
(Choi, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Sejong General Hospital, Bucheon, South Korea
(Lee, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Jeonbuk National University Hospital, Jeonju, South Korea
(Lim, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Hanyang University Seoul Hospital, Seoul, South Korea
Publisher
Elsevier B.V.
Abstract
Background The optimal duration of dual antiplatelet therapy (DAPT) after
coronary stenting according to bleeding risk is not well established. We
aimed to evaluate the optimal duration of DAPT after coronary stenting
according to bleeding risk. Methods In this open-label, multicentre,
randomised clinical trial, patients aged 19 years and older who received
percutaneous coronary intervention with a drug-eluting stent at 50
high-volume cardiology centres in South Korea were stratified into high
bleeding risk (HBR) or non-HBR strata, according to Academic Research
Consortium for High Bleeding Risk criteria. Patients in the HBR stratum
were randomly assigned (1:1) to 1-month or 3-month DAPT, and those in the
non-HBR stratum were randomly assigned (1:1) to 3-month or 12-month DAPT.
The three coprimary endpoints were net adverse clinical events (all-cause
death, myocardial infarction, stent thrombosis, stroke, or major
bleeding), major adverse cardiac or cerebral events (cardiovascular death,
myocardial infarction, definite or probable stent thrombosis, or ischaemic
stroke), and any actionable non-surgical bleeding at 1 year after
randomisation. Primary endpoints were assessed in hierarchical order in
the intention-to-treat population. This study is registered with
cris.nih.go.kr, KCT0005356, and ClinicalTrials.gov , NCT05631769 , and is
complete. Findings From July 24, 2020, to Sept 25, 2023, 4897 patients
were enrolled (1598 in the HBR stratum and 3299 in the non-HBR stratum).
In the HBR stratum, 1-month compared with 3-month DAPT did not reach
non-inferiority for net adverse clinical events (144 [18.4%] of 798 vs 110
[14.0%] of 800 patients; hazard ratio [HR] 1.337 [95% CI 1.043-1.713];
p=0.82 for non-inferiority). Major adverse cardiac or cerebral events
occurred in 74 (9.8%) patients in the 1-month DAPT group and 44 (5.8%) in
the 3-month group; bleeding occurred in 105 (13.8%) patients in the
1-month group and 122 (15.8%) in the 3-month group. In the non-HBR
stratum, 3-month was non-inferior to 12-month DAPT regarding net adverse
clinical events (47 [2.9%] of 1649 vs 72 [4.4%] of 1650 patients; HR 0.657
[0.455-0.949]; p<0.0001 for non-inferiority) and major adverse cardiac or
cerebral events (36 [2.2%] vs 37 [2.3%]; HR 0.984 [0.622-1.558]; p=0.0082
for non-inferiority), and superior for bleeding (120 [7.4%] vs 190
[11.7%]; HR 0.631 [0.502-0.793]; p<0.0001). Interpretation In east Asian
patients with HBR, 1-month DAPT did not reach non-inferiority to 3-month
DAPT for net adverse clinical events. In patients without HBR, 3-month
DAPT was non-inferior to 12-month DAPT regarding net adverse clinical
events and major adverse cardiac or cerebral events, and superior for
bleeding. Funding Medtronic and Abbott.<br/>Copyright &#xa9; 2025 Elsevier
Ltd.

<44>
Accession Number
2032635170
Title
Albuminuria Prevalence in Fontan Patients: A Systematic Review and
Meta-Analysis.
Source
Pediatric Cardiology. 47(1) (pp 141-152), 2026. Date of Publication: 01
Jan 2026.
Author
Van Belle H.; Van den Eynde J.; Cieplucha A.; Ladouceur M.; Martinod K.;
Pierard S.; Coats L.; Jansen K.; Opotowsky A.; Van Craenenbroeck A.H.;
Budts W.; Van De Bruaene A.
Institution
(Van Belle, Van den Eynde, Cieplucha, Martinod, Budts, Van De Bruaene)
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Budts, Van De Bruaene) Division of Structural and Congenital Cardiology,
University Hospitals Leuven, Herestraat 49, Leuven, Belgium
(Cieplucha) Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ladouceur) Departement of Cardiology, University Hospital of Geneva,
Geneva, Switzerland
(Pierard) Department of Cardiology, Cliniques Universitaires Saint-Luc,
Brussels, Belgium
(Coats, Jansen) Adult Congenital Heart Unit, Freeman Hospital, Newcastle
upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United
Kingdom
(Coats, Jansen) Population Health Sciences Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Opotowsky) Department of Pediatrics, Heart Institute, Cincinnati
Children's Hospital, University of Cincinnati College of Medicine,
Cincinnati, OH, United States
(Van Craenenbroeck) Department of Microbiology, Immunology and
Transplantation, Nephrology and Kidney Transplantation Research Group, KU
Leuven, Leuven, Belgium
(Van Craenenbroeck) Department of Nephrology and Kidney Transplantation,
University Hospitals Leuven, Leuven, Belgium
Publisher
Springer
Abstract
Patients with a Fontan circulation are at risk for chronic kidney disease
(CKD), which is defined as persistently reduced glomerular filtration rate
(GFR) <60ml/min/1.73² or elevated marker of kidney injury such
as urinary albumin-to-creatinine ratio (UACR) >30mg/g. We determined the
prevalence of albuminuria in patients with a Fontan circulation. The
MEDLINE, EMBASE, Trip, and Cochrane databases were searched for studies
reporting the prevalence of albuminuria in Fontan patients. Case reports,
reviews, and univentricular patients pre-Fontan completion or post-heart
transplantation were excluded. Studies were assessed for potential
confounders and measurement, patient selection, intervention, and
reporting biases, reported in a table. After systematic review, the pooled
prevalence of albuminuria was calculated using the quality effects model
for meta-analysis. Secondary outcomes were the clinical determinants of
albuminuria. Thirteen studies were included in the systematic review, of
which 11 were included in the meta-analysis (6 prospective, sample size
per study 25-195 patients, 873 patients in total). The pooled prevalence
of albuminuria was 28.4% (95% confidence interval 23.5-33.5%). GFR was
mostly preserved in these patients. Albuminuria was associated with
elevated systemic venous pressure in 5 studies. Other associations were
inconclusive. The main limitations of our study are the predominantly
retrospective and cross-sectional nature of the included studies with
small sample sizes and heterogeneous study populations. Our findings show
albuminuria is more prevalent than reduced GFR in patients with a Fontan
circulation, implicating the potential value of UACR in addition to GFR
when screening for CKD in these patients.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<45>
Accession Number
2034220669
Title
Combined Catheter Ablation and Left Atrial Appendage Occlusion in Atrial
Fibrillation: From Data to Clinical Reality.
Source
Cardiovascular Drugs and Therapy. 40(1) (pp 361-392), 2026. Date of
Publication: 01 Feb 2026.
Author
Dimitriadis K.; Adamopoulou E.; Pyrpyris N.; Iliakis P.; Beneki E.;
Konstantinidis D.; Fragkoulis C.; Antonopoulos A.; Papanikolaou A.;
Aznaouridis K.; Aggeli K.; Tsioufis K.
Institution
(Dimitriadis, Adamopoulou, Pyrpyris, Iliakis, Beneki, Konstantinidis,
Fragkoulis, Antonopoulos, Papanikolaou, Aznaouridis, Aggeli, Tsioufis)
First Department of Cardiology, School of Medicine, National and
Kapodistrian University of Athens, Hippokration General Hospital, Vas
Sofias 114, Athens, Greece
Publisher
Springer
Abstract
Purpose: Atrial fibrillation (AF) requires treatment that focuses on two
main goals: symptom control and prevention of thromboembolic events.
Catheter ablation and left atrial appendage occlusion (LAAO) constitute
two well-established treatment methods in selected patients that
accomplish these two goals correspondingly. Recently, there is increasing
interest in performing the two procedures concomitantly in a so-called
"combined" or "one-stop" procedure. This review aims to summarize the
current data on the combined procedure, from the rationale and the
techniques to its clinical efficacy, indications and future directions.
<br/>Method(s): An extensive search has been conducted using the
MEDLINE/PubMed database to identify the relevant studies. <br/>Result(s):
The reported success rates of the combined procedure are very high and
frequently reach 100% when performed by experienced operators. The
periprocedural and follow-up complications are low, the procedure is
cost-effective, while there is significant stroke, bleeding and arrhythmia
incidence reduction that does not seem to be undermined by interference
between the two interventions. There are also a few indications that the
one-stop procedure has a positive effect on left atrial mechanical
function as it has been correlated with left atrial reverse remodeling. On
the other hand, some studies suggest possible increase in peri-device
leaks (PDLs), compared with LAAO alone, which could in turn negatively
affect the clinical outcomes. Most available studies are small and
observational, with a lack of randomized controlled trials.
<br/>Conclusion(s): Catheter ablation and left atrial appendage occlusion
can be safely and effectively combined in a cost-effective single
procedure in carefully selected patients.<br/>Copyright &#xa9; The
Author(s) 2025.

<46>
Accession Number
2042575431
Title
Levosimendan vs. Milrinone in cardiac surgery: A GRADE-assessed systematic
review and meta-analysis.
Source
European Journal of Clinical Pharmacology. 82(2) (no pagination), 2026.
Article Number: 34. Date of Publication: 01 Feb 2026.
Author
Emara A.; Ellebedy M.; Aboeldahab H.; Nazir A.; Elgendy M.S.; Hassan A.M.;
Barakat Y.; Saad O.A.; Elawady A.; Elnady M.; Abdelaziz A.
Institution
(Emara, Barakat, Saad, Elawady) Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Ellebedy) Faculty of Medicine, Sohag University, Sohag, Egypt
(Aboeldahab) Clinical Research Department, El-Gomhoria General Hospital,
Ministry of Health and Population, Alexandria, Egypt
(Nazir) Department of Internal Medicine, Mercy Health- The Jewish
hospital, Cincinnati, OH, United States
(Nazir) Faculty of Medicine, King Edward Medical University, Lahore,
Pakistan
(Elgendy, Hassan) Faculty of Medicine, Tanta University, Tanta, Egypt
(Elnady) Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh,
Egypt
(Abdelaziz) Division of Cardiology, Montefiore Medical Center/Albert
Einstein College of Medicine, Bronx, NY, United States
(Aboeldahab, Hassan, Barakat, Saad, Elawady, Elnady, Abdelaziz) Medical
Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, United
States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Levosimendan and Milrinone are commonly used inotropic agents
in patients undergoing cardiac surgery; there is a lack of evidence
regarding the comparative safety and efficacy of both drugs. We aim to
compare the clinical efficacy and safety of levosimendan versus Milrinone
in these patients. <br/>Method(s): We conducted a systematic review and
meta-analysis following PRISMA guidelines. PubMed, Scopus, Web of Science,
and Cochrane Central were searched up to November 30, 2024, for studies
comparing levosimendan and Milrinone in adult and pediatric cardiac
surgery patients. We used R statistical software to pool dichotomous data
using odds ratio (OR) and continuous data using mean difference (MD) with
a 95% confidence interval (CI). <br/>Result(s): Seventeen studies (15 RCTs
and 2 observational) involving 890 patients were included. Across all
efficacy outcomes, including cardiac index (MD 0.02, 95% CI -0.15-0.19),
mean arterial pressure (MAP) (MD -0.09, 95% CI -1.97-1.79), and mPAP (mean
pulmonary artery pressure) (MD -0.88, 95% CI -2.66, 0.89), no significant
differences were found between the two drugs (P > 0.05). Safety outcomes,
including all-cause mortality (OR 0.97, 95% CI 0.48-1.93), acute kidney
injury (OR 0.89, 95% CI 0.55-1.44), and arrhythmias (OR 0.87, 95% CI
0.41-1.88), showed no statistically significant differences (P > 0.05).
<br/>Conclusion(s): Levosimendan and Milrinone showed no significant
differences in efficacy or safety in cardiac surgery patients. However,
wide confidence intervals indicate potential clinically relevant effects.
Current evidence does not favor any single agent universally, supporting
individualized use based on patient phenotype and institutional practice.
Further high-quality trials are needed to confirm.<br/>Copyright &#xa9;
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature 2026.

<47>
Accession Number
2043341775
Title
Mechanical ventilation strategies and lung protection during
cardiopulmonary bypass: A scoping review.
Source
Perfusion (United Kingdom). (no pagination), 2026. Date of Publication:
2026.
Author
Wang Y.; Lu S.; Zhang X.; Huang C.; Li Y.; Zhang N.
Institution
(Wang, Zhang) Healthy Examination & Management Center, The Second Hospital
& Clinical Medical School, Lanzhou University, Lanzhou, China
(Wang, Lu, Zhang, Huang, Li) Department of Cardiac Surgery, The Second
Hospital & Clinical Medical School, Lanzhou University, Lanzhou, China
(Wang, Lu, Zhang, Huang, Li, Zhang) The Second Hospital & Clinical Medical
School, Lanzhou University, Lanzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Cardiopulmonary bypass (CPB), which induces pulmonary injury,
significantly impacts the quality of life in patients undergoing cardiac
surgery. Preventing and treating pulmonary complications has become a
critical clinical issue. Optimizing ventilation strategies during the
preoperative, intraoperative, and postoperative stages is essential for
adequate lung protection and preventing CPB-related pulmonary injury.
<br/>Method(s): A comprehensive search of multiple databases including
PubMed, Embase, and the Cochrane Library was conducted. After removing the
duplicate studies, full-text review was performed, and all studies that
reported mechanical ventilation strategies and lung protection during CPB
were included. <br/>Result(s): This review systematically examines
ventilation strategies during CPB, outlining optimized parameters and
pharmacologic approaches across pre-, intra-, and post-CPB phases to
reduce lung injury. Various modes - including volume control ventilation
(VCV), pressure control ventilation (PCV), and pressure-controlled
ventilation-volume guaranteed (PCV-VG) - demonstrate unique benefits and
limitations. When combined with protective measures (low tidal volume
[LTV], moderate positive end-expiratory pressure [PEEP], and recruitment
maneuvers), they show clinical efficacy in lung protection. Pharmacologic
agents like ambroxol, neutrophil elastase inhibitors, and sivelestat
further enhance protection, underscoring the promise of combined
mechanical-pharmacological strategies against CPB-induced lung injury.
<br/>Conclusion(s): A comprehensive approach integrating individualized
ventilation management and pharmacological intervention is key to reducing
CPB-induced lung injury, enhancing postoperative respiratory function, and
improving patient outcomes.<br/>Copyright &#xa9; The Author(s) 2026

<48>
Accession Number
2034207378
Title
Opioid-Sparing Effects of Erector Spinae Plane Block in Off-Pump Coronary
Artery Bypass Grafting with Median Sternotomy: A Randomized Controlled
Trial.
Source
Cardiovascular Drugs and Therapy. 40(1) (pp 241-249), 2026. Date of
Publication: 01 Feb 2026.
Author
Zhang Y.; Liu J.; Lv K.; Wang F.; Shi Y.; You P.; Wang W.
Institution
(Zhang, Lv, Wang, You, Wang) Department of Anesthesiology, Jining No. 1
People's Hospital, Shandong, Jining, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Shi) Department of Cardiac and Vascular Surgery, Jining No. 1 People's
Hospital, Shandong, Jining, China
Publisher
Springer
Abstract
Purpose: This study assessed the efficacy of preoperative erector spinae
plane block (ESPB) in reducing intraoperative opioid use and enhancing
recovery in off-pump coronary artery bypass grafting (OPCABG) patients,
who typically require high-dose opioids with associated postoperative
risks. <br/>Method(s): A prospective, double-blind randomized controlled
trial was conducted on 37 patients. Patients were randomized to receive
either bilateral ESPB with 0.375% ropivacaine or a sham block with normal
saline. Primary outcomes included intraoperative sufentanil consumption,
while secondary outcomes encompassed hemodynamic stability, postoperative
pain scores, mechanical ventilation (MV) duration, and hospital stay.
<br/>Result(s): The ESPB group demonstrated a significant reduction in
intraoperative sufentanil consumption compared to the sham group (150.3
+/- 36.1 microg vs. 194.4 +/- 38.3 microg, p = 0.001). Postoperatively,
ESPB patients exhibited lower pain scores at rest and during coughing
within the first 6 h post-extubation (p < 0.001) and required less rescue
analgesia (5.3% vs. 50.0%, p = 0.003). Additionally, ESPB shortened MV
duration (5.43 +/- 1.65 h vs. 6.88 +/- 1.68 h, p = 0.013). No significant
differences were observed in cardiac care unit or hospital stay lengths.
<br/>Conclusion(s): Preoperative ESPB effectively reduces intraoperative
opioid requirements and provides sustained analgesia in the early
postoperative period, facilitating earlier extubation. These findings
support ESPB as a valuable component of multimodal analgesia in OPCABG,
though further large-scale studies are needed to validate these results
and optimize its application. Clinical Trial Registration: The trial was
registered with the China Clinical Trials Center
(http://www.chictr.org.cn, ChiCTR2200066902) on December 21,
2022.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<49>
Accession Number
2034754514
Title
Comparison of Short-Term Outcomes of Extubation in the Operating Room and
Extubating in the Intensive Care Unit After Cardiac Surgery: Systematic
Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 30(1) (pp 46-62),
2026. Date of Publication: 01 Mar 2026.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Inc.
Abstract
Objectives: This study aimed to compare short-term outcomes in patients
extubated in the operating room (ORE) vs those extubated in the intensive
care unit (ICUE) following cardiac surgery. <br/>Method(s): A systematic
search of MEDLINE and EMBASE was conducted from inception through
September 2024. Pooled outcome estimates were calculated, and subgroup
analyses were performed focusing on studies utilizing propensity score
matching, weighting, or randomization. <br/>Result(s): Fourteen studies
published between 2000 and 2024, encompassing 679,749 patients, were
included. Of these, 6 utilized propensity score matching, 1 applied
overlap weighting, and 1 employed randomization. Overall, ORE group had
shorter aortic cross-clamp (P = 0.02) and cardiopulmonary bypass (P <
0.01) times. ORE patients had shorter ICU (P < 0.01) and hospital stays (P
< 0.01). Rates of reintubation (P = 0.78), reoperation for bleeding (P =
0.18), prolonged mechanical ventilation (P = 0.12), and hospital
readmission (P = 0.71) were comparable between the groups. Postoperative
stroke rate (P < 0.01) and short-term mortality (P = 0.04) were lower in
the ORE group. In the subgroup analysis, ICU stay, hospital stay, and
cardiopulmonary bypass time remained shorter in ORE groupfund, while
reoperation for bleeding was significantly higher (P < 0.01). However, the
differences in postoperative stroke (P = 0.52) and short-term mortality (P
= 0.42) were no longer statistically significant. <br/>Conclusion(s): This
meta-analysis demonstrates that ORE after cardiac surgery can be performed
in selected patients, with comparable postoperative outcomes to ICUE. The
ORE strategy may result in shorter ICU and hospital stays.<br/>Copyright
&#xa9; The Author(s) 2025

<50>
Accession Number
2040654371
Title
The Effect of Transport Manual and Mechanical Ventilation on Hemodynamics
Change: Randomized Clinical Trial.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 30(1) (pp 28-36),
2026. Date of Publication: 01 Mar 2026.
Author
Morita Y.; Sakata T.; Nakamura Y.; Kikuchi Y.; Wang J.; Kaneyuki D.;
Kariya T.; Raphael J.
Institution
(Morita, Wang, Raphael) Department of Anesthesiology, Thomas Jefferson
University, Philadelphia, PA, United States
(Sakata, Nakamura, Kikuchi) Department of Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Kaneyuki) Department of Surgery, Independence Health System Westmoreland
Hospital, Greensburg, PA, United States
(Kariya) Department of Anesthesiology, University of Tokyo, Tokyo, Japan
Publisher
SAGE Publications Inc.
Abstract
Background: Ventilation methods during ICU transport after cardiac surgery
are critical. This study aimed to assess the effects of manual and
mechanical ventilation on post-transport hypotension in patients
undergoing cardiac surgery. <br/>Method(s): This prospective clinical
trial was conducted at a tertiary academic hospital. Adult patients who
underwent open heart surgery were randomized to either (1) manual
ventilation or (2) mechanical ventilation during transport. The primary
outcomes were the hemodynamic parameters change. The secondary outcomes
were the PaO2/FiO2 ratio and PaCO2 change. <br/>Result(s): A total of 78
patients were randomized into two groups: manual ventilation (n = 39) and
mechanical ventilation (n = 39). Significant hypotension (>20% drop in
mean arterial pressure post-transport) was noted in nine patients in the
manual ventilation arm, but not in any patient in the mechanical
ventilation arm. In manually ventilated patients, receiver operating
characteristic curve analysis of systemic vascular resistance for
significant hypotension showed that the area under the curve was 0.962
(95% CI, 0.891-1). No mechanically ventilated patients had significant
hypotension. No significant difference was observed in % change in PaO2
and PaCO2 between the manual and mechanical ventilation arms.
<br/>Conclusion(s): This study demonstrated that significant
post-transport hypotension was more common in the manually ventilated arm
than in the mechanically ventilated arm. No significant differences in
oxygenation or ventilation were observed between the groups. The low
systemic vascular resistance showed excellent predictive value for
significant post-transport hypotension. Further research is warranted to
identify patient-specific risk factors to enhance transportation
safety.<br/>Copyright &#xa9; The Author(s) 2025

<51>
Accession Number
2026748415
Title
Impact of Complete Revascularization in the ISCHEMIA Trial.
Source
Journal of the American College of Cardiology. 82(12) (pp 1175-1188),
2023. Date of Publication: 19 Sep 2023.
Author
Stone G.W.; Ali Z.A.; O'Brien S.M.; Rhodes G.; Genereux P.; Bangalore S.;
Mavromatis K.; Horst J.; Dressler O.; Poh K.K.; Nath R.K.; Moorthy N.;
Witkowski A.; Dwivedi S.K.; Bockeria O.; Chen J.; Smanio P.E.P.; Picard
M.H.; Chaitman B.R.; Berman D.S.; Shaw L.J.; Boden W.E.; White H.D.;
Fremes S.E.; Rosenberg Y.; Reynolds H.R.; Spertus J.A.; Hochman J.S.;
Maron D.J.; Harrington R.; Williams D.; Alexander K.P.; Berger J.; Mark
D.; Ballantyne C.; Beyar R.; Bhargava B.; Buller C.; Carvalho A.T.; Diaz
R.; Doerr R.; Dzavik V.; Goodman S.; Gosselin G.; Hachamovitch R.; Hamm
C.; Held C.; Helm M.; Huber K.; Jiang L.; Keltai M.; Kohsaka S.; Lang I.;
Lopes R.; Maggioni A.; Mancini J.; Bairey Merz C.N.; Min J.; Peterson E.;
Ruzyllo W.; Selvanayagam J.; Senior R.; Sharir T.; Steg G.; Szwed H.; Van
de Werf F.; Weintraub W.; White H.; Calfas K.; Champagne M.A.; Davidson
M.; Fleg J.; McCullough P.A.; Newman J.; Stone P.; Menasche P.; Fremes S.;
Guyton R.; Mack M.; Mohr F.; Rao A.; Sabik J.; Shapira O.; Taggart D.;
Tatoulis J.; Blankenship J.; Brener S.; Colombo A.; de Bruyne B.;
Kereiakes D.; Lefevre T.; Moses J.; Mahaffey K.; Cruz-Flores S.; Danchin
N.; Feen E.; Garcia M.J.; Hauptman P.; Laddu A.A.; Passamani E.; Pina
I.L.; Simoons M.; Skali H.; Thygesen K.; Waters D.; Endsley P.; Esposito
G.; Kanters J.; Pownall J.; Stournaras D.; Friedrich M.; Kwong R.; Oliver
D.; Harrell F.; Blume J.; Lee K.; Kullo I.; McManus B.; Newby K.; Cohen
D.; Bugiardini R.; Celutkiene J.; Escobedo J.; Hoye A.; Lyubarova R.;
Mattina D.; Peteiro J.; Smanio P.; Berman D.; Leipsic J.; Mathew R.; Sidhu
M.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Gibson C.M.; Lamas G.;
Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.; Kirby R.;
Jeffries N.; Denaro J.E.; Mavromichalis S.; Chan K.; Cobb G.; Contreras
A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.; Naumova A.;
Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison C.; Hogan I.;
Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.; Lang B.;
Mohamed S.; Esquenazi-Karonika S.; Mathews P.; Setang V.; Xavier M.; Bagai
A.; Broderick S.; Crowder M.; Cyr D.; Garg J.; Gu X.; Hatch L.; Heath A.;
Huang Z.; Leimberger J.; Marcus J.; Page C.; Parker W.; Pennachi W.;
Rockhold F.; Stevens S.; Stone A.; Thompson O.; Ussery S.; White J.;
Williams M.K.; Xing W.; Zhu S.; Anstrom K.; Baloch K.; Blount J.; Cowper
P.; Davidson-Ray L.; Drew L.; Harding T.; Knight J.D.; Minshall Liu D.;
O'Neal B.; Redick T.; Jones P.; Nugent K.; Jingyan Wang G.; Phillips L.;
Goyal A.; Hetrick H.; Hayes S.W.; Friedman J.D.; Gerlach R.J.; Hyun M.;
Miranda-Peats R.; Slomka P.; Thomson L.; Mongeon F.P.; Michael S.; Hung
J.; Scherrer-Crosbie M.; Zeng X.; Eckstein J.; Guruge B.; Streif M.;
Alfonso M.A.; Corral M.P.; Garcia J.J.; Jankovic I.; Konigstein M.; Lustre
M.B.; Peralta Y.; Sanchez R.; Arsanjani R.; Budoff M.; Elmore K.; Gomez
M.; Hague C.; Hindoyan N.; Mancini G.J.; Nakanishi R.; Srichai-Parsia
M.B.; Yeoh E.; Youn T.; Maggioni A.P.; Bianchini F.; Ceseri M.; Lorimer
A.; Magnoni M.; Orso F.; Sarti L.; Tricoli M.; Carvalho A.; Barbosa L.M.;
Bello Duarte T.; Colaiacovo Soares T.; de Aveiro Morata J.; Carvalho P.;
de Carvalho Maffei N.; Egydio F.; Kawakami A.; Oliveira J.; Restelli
Piloto E.; Pozzibon J.; Camara D.; Mowafy N.; Spindler C.; Dai H.; Feng
F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.; Zhang J.; Zhang L.; Zhang N.;
Zhong H.; Escobar C.; Martin M.E.; Pascual A.; Lopez-Sendon J.; Moraga P.;
Hernandez V.; Castro A.; Posada M.; Fernandez S.; Narro Villanueva J.L.;
Selgas R.; Abergel H.; Juliard J.M.; Alsweiler C.; Claes K.; Goetschalckx
K.; Luyten A.; Robesyn V.; Murphy D.; Garcevic N.; Stojkovic J.; Ahmed A.;
Bhatt R.; Chadha N.; Kumar V.; Lubna S.; Naik P.; Pandey S.; Ramasamy K.;
Saleem M.; Sharma P.; Siddaram H.
Institution
(Stone, Shaw) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Ali) St Francis Hospital, Roslyn, NY, United States
(Ali, Horst, Dressler) Cardiovascular Research Foundation, New York, NY,
United States
(O'Brien, Rhodes) Duke Clinical Research Institute, Durham, NC, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, New York,
NY, United States
(Mavromatis) Emory University School of Medicine, Atlanta, GA, United
States
(Poh) National University Heart Center Singapore and the Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Nath) Dr Ram Manohar Lohia Hospital, New Delhi, India
(Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bangalore-Karnataka, India
(Witkowski) National Institute of Cardiology, Warsaw, Poland
(Dwivedi) King George Medical University, Lucknow Up, India
(Bockeria) National Research Center for Cardiovascular Surgery, Moscow,
Russian Federation
(Chen) Guangdong Provincial People's Hospital, Guangdong, China
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Picard) Massachusetts General Hospital and Harvard Medical School,
Boston, MA, United States
(Chaitman) St Louis University School of Medicine Center for Comprehensive
Cardiovascular Care, St Louis, MO, United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Boden) Boston University School of Medicine, Boston, MA, United States
(White) Auckland City Hospital Green Lane Cardiovascular Services and
University of Auckland, Auckland, New Zealand
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Rosenberg) National Heart, Lung, and Blood Institute, Washington, DC,
United States
(Spertus) Saint Luke's Mid America Heart Institute and the University of
Missouri, Kansas City, Kansas City, MO, United States
(Maron) Department of Medicine, Stanford School of Medicine, Stanford, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Anatomic complete revascularization (ACR) and functional
complete revascularization (FCR) have been associated with reduced death
and myocardial infarction (MI) in some prior studies. The impact of
complete revascularization (CR) in patients undergoing an invasive (INV)
compared with a conservative (CON) management strategy has not been
reported. <br/>Objective(s): Among patients with chronic coronary disease
without prior coronary artery bypass grafting randomized to INV vs CON
management in the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial, we examined the
following: 1) the outcomes of ACR and FCR compared with incomplete
revascularization; and 2) the potential impact of achieving CR in all INV
patients compared with CON management. <br/>Method(s): ACR and FCR in the
INV group were assessed at an independent core laboratory.
Multivariable-adjusted outcomes of CR were examined in INV patients.
Inverse probability weighted modeling was then performed to estimate the
treatment effect had CR been achieved in all INV patients compared with
CON management. <br/>Result(s): ACR and FCR were achieved in 43.4% and
58.4% of 1,824 INV patients. ACR was associated with reduced 4-year rates
of cardiovascular death or MI compared with incomplete revascularization.
By inverse probability weighted modeling, ACR in all 2,296 INV patients
compared with 2,498 CON patients was associated with a lower 4-year rate
of cardiovascular death or MI (difference -3.5; 95% CI: -7.2% to 0.0%). In
comparison, the event rate difference of cardiovascular death or MI for
INV minus CON in the overall ISCHEMIA trial was -2.4%. Results were
similar but less pronounced with FCR. <br/>Conclusion(s): The outcomes of
an INV strategy may be improved if CR (especially ACR) is achieved.
(International Study of Comparative Health Effectiveness With Medical and
Invasive Approaches [ISCHEMIA]; NCT01471522)<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<52>
Accession Number
650177914
Title
Comparing the Impact of Surgical and Transcatheter Aortic Valve
Replacement Methods on the Incidence of Post-Operative Pacemaker
Implantation.
Source
Scottish Medical Journal. Conference: 33rd Annual General Meeting of
Scottish Cardiac Society. Edinburgh United Kingdom. 70(2) (pp NP26), 2025.
Date of Publication: 01 May 2025.
Author
Al-Horoub M.
Institution
(Al-Horoub) Centre for Anatomy and Human Identification (CAHID), Medical
Sciences Institute, University of Dundee, Dow St, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background and Aims: Aortic stenosis (AS) is a severe symptomatic
narrowing of the aortic valve, which affects 12% of over 75-year-olds. The
primary cause is Calcific Aortic Valve Disease (CAVD). To improve AS
survival, aortic valve replacement (AVR) is undertaken through a surgical
(SAVR) or transcatheter (TAVR) method. Recently, TAVR has become the most
used method of AVR, with continual expansion of the patient group
receiving the procedure. Between the methods, a common complication exists
that causes excess mortality: development of post procedural conduction
disorders, which require permanent pacemaker implantation (PPMI). Various
risk factors can predispose to this: pre-existing conduction disorders (eg
left and right bundle branch block, LBBB and RBBB respectively), valve
oversizing, short membranous septum (MS) length of the heart (which the AV
node and bundle branches run through), and deep valve implantation. The
literature describes novel techniques of measuring the MS to optimise TAVR
implantation depth. This reduces the higher risk of PPMI historically
associated with TAVR. However, this association comes from analysis done
on older, 1st generation TAVR valves. This systematic review aims to
clarify if this historical association is accurate, by comparing
post-procedure PPMI incidence between SAVR to the latest TAVR valves.
<br/>Method(s): Three electronic databases yielded 838 articles. After
duplication filtering and manual abstract review, 13 single arm
retrospective studies matched inclusion criteria with a pool of 874 SAVR
patients and 29,950 TAVR patients. SPSS was used to conduct independent
samples T-tests for homogeneity of the only consistent preoperative risk
factors reported among these studies for post procedure conduction
abnormality, LBBB and RBBB. A meta-analysis of proportions with a random
effects model (DerSimeon-Laird) with Freeman-Tukey double arcsine
transformation was done using Jamovi (MAJOR) to compare rates of PPMI
between SAVR and TAVR. <br/>Result(s): SPSS T-tests yielded results that
lacked significance (p>0.05), suggesting homogeneity of LBBB and RBBB
among studies. Mean post procedure PPMI rate of 16% (95% CI, 8-24%) for
SAVR and 39% (95% CI, 35-43%) for TAVR were reported from a meta-analysis
of proportions done in each respective method group. Lack of confidence
interval overlap between these two results suggests a significant
difference between the rates of post procedure PPMI <br/>Conclusion(s):
TAVR has a higher rate of post procedure PPMI when compared to SAVR, even
in the latest (non-1st generation) valves. More research is required to
mitigate this common complication of conduction disorders that require
PPMI. This can take the form of guidelines to standardise TAVR
implantation depth, informed by individual patient anatomical MS length.

<53>
Accession Number
650189104
Title
BEYOND INTENTION-TO-TREAT: WIN RATIO and HIERARCHICAL COMPOSITE
CARDIOVASCULAR DISEASE OUTCOMES in the VITAL and COSMOS TRIALS.
Source
Clinical Trials. Conference: 45th Annual Meeting of the Society for
Clinical Trials, SCT 2024. Boston, MA United States. 21(6 Supplement) (pp
83-84), 2024. Date of Publication: 01 Dec 2024.
Author
Ogata S.; Sesso H.D.; Chiu Y.-H.; Hamaya R.; Manson J.E.
Institution
(Ogata) National Cerebral and Cardiovascular Center, United States
(Sesso, Hamaya, Manson) Brigham and Women's Hospital, Harvard Medical
School, United States
(Chiu) Penn State College of Medicine, United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Results for the effect of n-3 fatty acid (i.e. omega-3 fatty
acid) supplementation and cocoa extract supplementation in two previous
clinical trials on cardiovascular disease (CVD) events may have been mixed
due to use of intention-to-treat (ITT) time-to-first event analyses with
Cox proportional hazard models that ignore the clinical severities of
components of a composite outcome, ranging from non-fatal to
life-threatening events. A new statistical method called the "win ratio"
can prioritize individual components of a composite outcome based on their
clinical severity to consider differences in the clinical severities of
individual components of a composite outcome. <br/>Aim(s): We modeled
hierarchical composite CVD outcomes prioritized by clinical severities
with the win ratio analysis in secondary analyses to evaluate whether
risks of the prioritized composite CVD outcomes were reduced by marine n-3
fatty acid supplementation in the VITamin D and OmegA-3 TriaL (VITAL), and
by cocoa extract supplementation in the COcoa Supplement and Multivitamin
Outcomes Study (COSMOS). In addition, we conducted the win ratio analyses
in subgroups based on their baseline consumption of dietary fish to
evaluate if n-3 fatty acid supplementation might offer greater
cardiovascular protection to individuals who typically consume lower
amounts of n-3 fatty acids. This approach was similar to what was observed
in the VITAL study. <br/>Method(s): VITAL (n = 25,871) and COSMOS (n =
21,442) originally evaluated whether n-3 fatty acids and vitamin D3, and
cocoa flavanol and multivitamins reduced CVD and cancer among middle-aged
and older US adults. Our analyses estimated win ratios of the composite of
CVD outcomes for the primary outcome defined in each trial. For the VITAL
interventions, we prioritized fatal coronary heart disease, other fatal
CVD including stroke, non-fatal myocardial infarction (MI), and non-fatal
stroke. For the COSMOS interventions, we prioritized fatal CVD, non-fatal
MI, non-fatal stroke, and non-fatal coronary revascularization.
<br/>Result(s): The win ratio analyses in VITAL indicated a suggestive but
statistically nonsignificant benefit for n-3 fatty acid supplementation on
the prioritized primary CVD composite outcome: its reciprocal win ratio
(95% confidence interval) was 0.90 (0.78-1.04), mirroring the hazard ratio
of 0.92 (0.80-1.06) from the ITT analyses with Cox proportional hazard
models that did not prioritize the primary composite outcome components.
Reductions in the win ratio for CVD came from reducing CHD (0.83
[0.71-0.96]) and MI (0.71 [0.57-0.88]), but not stroke (1.01 [0.80-1.28]),
components. For the prioritized primary CVD composite outcome, individuals
who consumed less fish initially gained more benefit (0.79 [0.65-0.96])
compared to those with higher fish intake (1.05 [0.85-1.30]). Win ratio
analyses for the COSMOS trial are in progress and will be reported at our
presentation. <br/>Conclusion(s): The win ratio analyses in the VITAL
trial showed that n-3 fatty acid supplementation prevented CHD events but
not stroke, and participants with low fish consumption benefiting more.
Our win ratio results are slightly stronger reductions than previously
published ITT analyses with Cox proportional hazard models from the VITAL
trial without outcome prioritization.

<54>
Accession Number
650196690
Title
A Systematic Review and Meta-Analysis of Rigid Plate Fixation versus Wire
Cerclage Sternotomy Closure after Cardiac Surgery.
Source
Irish Journal of Medical Science. Conference: 48th Sir Peter Freyer
Surgical Symposium 2023. Galway Ireland. 193(1 Supplement) (pp S51), 2024.
Date of Publication: 01 Jan 2024.
Author
Higgins P.; Hallinan N.; Doddakula K.
Institution
(Higgins, Hallinan, Doddakula) Department of Cardiothoracic Surgery, Cork
University Hospital, Wilton, Cork, Ireland
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction Wire cerclage is the traditional method of re-approximating
the sternum after sternotomy for cardiac surgery. However, recent evidence
suggests that rigid-plate fixation may reduce the risk of sternal
complications, and particularly so in high-risk patients. Methods A
systematic literature review was performed to identify all observational
studies and randomised controlled trials (RCTs) to date comparing wire
cerclage to rigid-plate fixation as a method of median sternotomy closure
in patients undergoing cardiac surgery. The review was conducted in
accordance with the PRISMA guidelines using the Embase and Medline
databases. Random-effects analysis using Rev-Man (v5.4,Cochrane) compared
(i)primary outcome:rates of sternal complications(superficial or deep
sternal wound infection, sternal dehiscence, sternal instability,
specified re-operation)(ii)secondary outcomes:early and late mortality,
length of stay. Results Six RCTs and eleven unmatched-observational
studies met the inclusion criteria(n=3456 patients).There was a
statistically significant reduction in sternal wound complications
associated with the use of rigid-plate fixation versus wire cerclage at a
median follow up of six months OR0.57(95%CI:0.34,0.95,p = 0.005).This
treatment effect appears more pronounced in high risk patients OR0.48
(95%CI:0.34,0.91) and persisted when the lowest quality studies were
excluded OR0.51 (95%CI. 0.24,0.92, p=0.03).This observation was not seen
when comparing RCTs alone OR 0.86 (95%CI:0.22,3.36,p=0.46). Overall, there
was no significant difference in <30day mortality rates (Risk difference
-0.01(95%CI:0.03,0,p=0.08). Conclusion Overall, this study which
represents the largest meta-analysis to date suggests a significant trend
towards lower sternal wound complications associated with the use of
sternal plating. However, these results amongst others appear driven
primarily by uncontrolled-observational studies of low-moderate (GRADE)
quality. Additional randomisedcontrolled studies are required to confirm
possible benefits of plating.

<55>
Accession Number
2042904029
Title
Randomized evaluation of comparative effects of optimized static cold
storage, hypothermic and normothermic machine perfusion, and colchicine
pretreatment on ischemia-reperfusion injury in a porcine model.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2026. Date of
Publication: 2026.
Author
Ughetto A.; Delmas C.; Benezech L.; Battistella P.; Gaudard P.; Molina A.;
Andre G.; Maamar S.; Guihaire J.; Audo R.; Martinez M.C.; Guilbeau-Frugier
C.; Roland D.; Herman F.; Lacampagne A.; Roubille F.
Institution
(Ughetto, Benezech, Battistella, Gaudard, Molina, Andre, Maamar, Audo,
Martinez, Roland, Lacampagne, Roubille) PhyMedExp, University of
Montpellier, CNRS, INSERM, CHU Montpellier, France
(Ughetto, Gaudard, Andre) Department of Anesthesiology and Critical Care
Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, University of
Montpellier, Montpellier, France
(Delmas, Benezech) Intensive Cardiac Care Unit, Cardiology department,
Rangueil University Hospital, Toulouse, France / Toulouse University,
Toulouse, France
(Delmas) REICATRA (Recherche et Enseignement en Insuffisance Cardiaque
Avancee Transplantation et Assistance), Institut Saint Jacques, CHU de
Toulouse, France
(Battistella, Roubille) Cardiology department, CHU de Montpellier,
University of Montpellier, Montpellier, France
(Molina, Maamar, Roland) Cardio-thoracic and Vascular Surgery department,
CHU de Montpellier, University of Montpellier, Montpellier, France
(Guihaire) Adult Cardiac Surgery and Transplantation, Marie Lanelongue
Hospital, Paris Saclay University, France
(Guilbeau-Frugier) INSERM U1297, Institute of Metabolic and Cardiovascular
Diseases (I2MC), 31432, Toulouse CEDEX 4, France
(Herman) Clinical Research and Epidemiology Unit, La Colombiere University
Hospital, Montpellier, France
Publisher
Elsevier Inc.
Abstract
Background Heart transplantation remains limited by ischemia-reperfusion
injury (IRI). Optimizing graft preservation and modulating inflammation
may improve early graft quality. We compared optimized static cold storage
(SCS), hypothermic machine perfusion (HMP), and normothermic machine
perfusion (NMP), and evaluated colchicine pretreatment as an adjunct
anti-inflammatory strategy. Methods Thirty-six pigs were randomized to
colchicine or placebo (n=18 each) and subsequently assigned to SCS, HMP,
or NMP (n=12 per group). After 4 h of preservation, all hearts underwent 1
h of normothermic reperfusion. Myocardial injury, lactate extraction,
systemic cytokines, and histological assessments were performed.
Mixed-effects models accounting for repeated measures and
treatment-preservation interactions were used for all longitudinal
analyses. Results HMP was associated with lower H-FABP levels than SCS
(beta -92.6; 95% CI -183 to -2.6; p=0.04), while NMP showed no difference.
Troponin I release was significantly higher in NMP versus SCS (beta 97.9;
95% CI 63.4-132; p<0.001). Lactate extraction was greater with HMP
compared with SCS (beta 10.2; 95% CI -0.2 to 20.6; p=0.05), with no
difference for NMP. Preservation modality strongly influenced
inflammation: IL-6 (beta 3.72; p<0.001) and TNF-alpha (beta 0.25; p=0.003)
were markedly increased in NMP, whereas IL-10 was reduced in HMP versus
SCS (beta -0.38; p<0.001). Colchicine had no significant effect on any
biomarker. Oxidative stress proteins, apoptosis markers, and histological
injury scores did not differ across preservation modalities or treatment
groups. Conclusions In this randomized large-animal model, hypothermic
preservation (SCS, HMP) provides superior metabolic and inflammatory
profiles compared with NMP. Colchicine did not confer additional benefit
under these conditions.<br/>Copyright &#xa9; 2026 International Society
for the Heart and Lung Transplantation.

<56>
Accession Number
2043093532
Title
Climate change and the immune system.
Source
Expert Review of Clinical Immunology. (no pagination), 2026. Date of
Publication: 2026.
Author
Rijkers G.T.; Timraliyeva Z.; Mackie E.; Lupusoara M.
Institution
(Rijkers, Timraliyeva, Mackie, Lupusoara) Department of Health, Cognition,
and Behavior, University College Roosevelt, Middelburg, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Climate change and global warming have major consequences
for human health, including effects on the immune system. Areas covered:
The impact of global warming on vector transmitted infectious diseases,
such as West Nile Virus and dengue. Changes in pollen grain composition
and pollen season duration, along with increased frequencies of dust
storms, have detrimental impacts on asthmatic and allergic patients. The
direct and indirect effects of climate change on autoimmune and
cardiovascular diseases are also discussed. Literature on climate and the
immune system was retrieved from PubMed and Google Scholar up to 21 July
2025. Expert opinion: Climate change will lead to the spread of tropical
infectious diseases toward moderate climate regions. Recommended
vaccination schedules should be adapted to include these diseases. The
changing climate has also extended pollen season and increased both the
frequency and severity of dust storms, which impacts asthmatic patients.
There are indications that next to extreme heath, pollen exposure
contributes to acute cardiac events and complications after cardiovascular
surgery. More insight into the underlying mechanisms of the negative
effects of climate changes on the immune system could allow to take the
appropriate measures and interventions to mitigate climate-associated
immune-mediated diseases.<br/>Copyright &#xa9; 2026 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<57>
Accession Number
2043422411
Title
Perioperative intravenous fluid management in paediatric surgery: a
scoping review protocol.
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e112113. Date of
Publication: 06 Feb 2026.
Author
Sanchez V.L.; Pinzon Rodas V.; Bautista G.; Florez I.D.; Klimek M.;
Calvache J.A.
Institution
(Sanchez, Calvache) Department of Anesthesiology, Universidad del Cauca,
Popayan, Colombia
(Pinzon Rodas, Bautista) Department of Pediatrics, Universidad del Cauca,
Popayan, Colombia
(Florez) Department of Pediatrics, Universidad de Antioquia, Medellin,
Colombia
(Florez) Pediatric Intensive Care Unit, Clinica Las Americas, Medellin,
Colombia
(Florez) School of Rehabilitation Science, McMaster University, Hamilton,
ON, Canada
(Klimek, Calvache) Department of Anesthesiology, Erasmus MC, Rotterdam,
Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Intravenous fluids are essential components of perioperative
care, supporting intravascular volume, acid-base balance and electrolyte
homeostasis. Despite extensive research in adult surgical populations,
paediatric-specific evidence remains limited, and clinical practice
frequently relies on extrapolated adult-based recommendations. This gap is
particularly relevant in paediatric non-cardiac surgery, where fluid
choice may influence key physiological outcomes such as acid-base status,
electrolyte balance, renal function and haemodynamic stability. Given the
heterogeneity of study designs, perioperative phases, age groups and
reported outcomes in the paediatric literature, a comprehensive synthesis
of the existing evidence is needed before a systematic review can be
undertaken. Methods and analysis We will conduct this scoping review
following the methodological guidance of the Joanna Briggs Institute
Manual for Evidence Synthesis, and the reporting will adhere to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
extension for Scoping Reviews guideline. This scoping review will map
existing evidence on perioperative intravenous fluid management in
paediatric patients (<18 years) undergoing elective non-cardiac surgery in
outpatient and inpatient settings. Eligible study designs will include
randomised trials, observational studies and systematic reviews. A
comprehensive search will be developed with a medical librarian and
applied to MEDLINE (PubMed), Ovid, Embase, Web of Science, CENTRAL, Google
Scholar and ClinicalTrials.gov, with no date restrictions and limited to
English, Spanish and German. Eligibility is framed using participants,
concept and context: paediatric patients (<18 years) undergoing
non-cardiac surgery; concepts related to preoperative fasting/replacement
period, intraoperative period and postoperative period up to 24 hours,
intravenous fluid management for maintenance/replacement; and
hospital/outpatient surgical settings. Study selection and data charting
will follow established scoping review methodology. Data will be
synthesised descriptively using narrative and tabular formats. No
meta-analysis or formal risk-of-bias appraisal is planned, consistent with
scoping review methodology. Ethics and dissemination This scoping review
involves no primary data collection and relies exclusively on published
literature; therefore, formal ethical approval is not required. The
protocol received administrative approval from the Comite de Etica para la
Investigacion Cientifica of Universidad del Cauca (approval no. 6553, 11
June 2025). Findings will be disseminated through peer-reviewed
publications, conference presentations and targeted communication with
paediatric anaesthesia and surgical communities.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY.
Published by BMJ Group.

<58>
Accession Number
2037688750
Title
The Effect of Infusion of Dexmedetomidine to the Aortic Root before Aortic
Cross-Clamp Removal on the Myocardial Protection in Patients Undergoing
Mitral Valve Surgery; A Triple-Blinded Randomized Clinical Trial.
Source
Razavi International Journal of Medicine. 14(1) (pp 22-32), 2026. Article
Number: e1427. Date of Publication: 01 Jan 2026.
Author
Amini S.; Hajipour F.; Sistani M.R.N.; Zandi Z.; Yaghubi M.
Institution
(Amini) Department of Anesthesiology, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Hajipour) Department of Extra-Corporeal Circulation (ECC), Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Sistani) Pediatric and Congenital Cardiology Division, Department of
Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Zandi) Department of Cardiovascular disease, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Imam Reza International University, Mashhad, Iran, Islamic
Republic of
Publisher
Mashhad Razavi Hospital
Abstract
Background: Myocardial protection during cardiopulmonary bypass is a
challenging dilemma. Some protective strategies have been introduced to
ameliorate ischemic-reperfusion injury, although no optimal strategy has
emerged. <br/>Objective(s): Herein, we evaluated the effect of aortic root
infusion of Dexmedetomidine before cross-clamp removal on myocardial
preservation. <br/>Method(s): This randomized, multicenter, triple-blinded
controlled trial enrolled 56 patients who underwent mitral valve surgery.
After randomization, the patients were allocated to the case group
(Dexmedetomidine infusion in the aortic root before cross-clamp removal)
and the control group (isotonic saline). Based on the study goals,
Troponin-I and Creatinine kinase-MB were measured as primary outcomes at
different time points during the study. Other clinical parameters were
also measured as secondary outcomes. Statistical analysis was performed
using SPSS software version 26.0 (Chicago, IL, USA). The significance
level was considered as P<0.05. <br/>Result(s): A total of 54 patients in
the case and control groups were included in the analysis. The main
finding of this study was that troponin-I levels at all time points showed
statistical differences between the two groups (P=0.001). Also, evaluation
of CK-MB levels showed a significant decrease at 1 hour (P=0.001), 12
hours (P=0.001), and 24 hours (P=0.001) after ICU admission, in the case
group compared with the control group. <br/>Conclusion(s): This study
found that administering a Dexmedetomidine infusion before aortic
cross-clamp removal can ameliorate ischemia-reperfusion injury-induced
myocardial damage.<br/>Copyright &#xa9; 2026 The Authors.

<59>
[Use Link to view the full text]
Accession Number
2043316749
Title
Management of Direct Oral Anticoagulants in Adult Patients Undergoing
Cardiac Surgery: A Joint Consensus Statement by the Society of
Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons.
Source
Anesthesia and Analgesia. (no pagination), 2026. Date of Publication:
2026.
Author
Budd A.N.; Kertai M.D.; Wyler von Ballmoos M.C.; Raphael J.; Ghadimi K.;
Levy J.H.; Shore-Lesserson L.J.; Mazzeffi M.A.; Sniecinski R.M.; Tanaka
K.A.; Bolliger D.; Abdalla M.; Ural K.G.; Upchurch P.A.; Rozental O.;
Hunter C.B.; Seibert A.R.; Klick J.C.; Carroll D.; Lobner K.; Hensley N.B.
Institution
(Budd) From the Department of Anesthesiology, Northwestern University
Feinberg School of Medicine, Chicago, Illinois, United States
(Kertai) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, Tennessee, United States
(Wyler von Ballmoos) Department of Cardiovascular and Thoracic Surgery,
Texas Health Fort Worth, Fort Worth, Texas, United States
(Raphael) Department of Anesthesiology and Perioperative Medicine, Thomas
Jefferson University Hospital, Sidney Kimmel Medical College,
Philadelphia, Pennsylvania, United States
(Ghadimi, Levy) Department of Anesthesiology, Duke University School of
Medicine, Durham, North Carolina, United States
(Shore-Lesserson) Department of Anesthesiology, Zucker School of Medicine
at Hofstra/Northwell, Manhasset, New York, United States
(Mazzeffi) Department of Anesthesiology, University of Virginia Health,
Charlottesville, Virginia, United States
(Sniecinski) Department of Anesthesiology, Emory Healthcare, Atlanta,
Georgia
(Tanaka) Department of Anesthesiology, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma, United States
(Bolliger) Clinic for Anaesthesia, Intermediate Care, Prehospital
Emergency Medicine and Pain Therapy, University Hospital Badel, University
of Basel, Basel, Switzerland
(Abdalla) Department of Anesthesiology and Perioperative Medicine,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, United
States
(Ural) Department of Anesthesiology and Perioperative Medicine, The
University of Queensland Medical School, Ochsner Clinical School, New
Orleans, Louisiana, United States
(Upchurch) Department of Anesthesiology, Health University of Utah, Salt
Lake City, Utah, United States
(Rozental) Department of Anesthesiology, New York Presbyterian/Weill
Cornell Hospital, New York, New York, United States
(Hunter) Department of Anesthesiology, The Warren Alpert Medical School of
Brown University, Providence, Rhode Island, United States
(Seibert) Department of Anesthesiology, Virginia Commonwealth University
School of Medicine, Richmond, Virginia, United States
(Klick) Department of Anesthesiology, University of Vermont, Larner
College of Medicine, Burlington, Vermont, United States
(Carroll) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, South Carolina, United States
(Lobner) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania, Philadelphia, Pennsylvania, United States
(Hensley) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins Medicine, Baltimore, Maryland, United States
Publisher
Lippincott Williams and Wilkins
Abstract
The Society of Cardiovascular Anesthesiologists (SCA) along with the
Society of Thoracic Surgeons (STS) sought to improve the care of adult
patients undergoing cardiac surgery who are taking direct oral
anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors.
To fulfill this, a systematic review of the literature on cessation of
DOACs before cardiac surgery, options for monitoring DOACs, the need for
bridging, reversal agents, and resuming the medications after surgery was
performed. Additionally, an expert consensus around the management of
these patients was completed. Summary statements were created using
evidence and expert consensus to guide care of patients in each of these
domains, with the ultimate goal to enhance patient safety and
outcomes.<br/>Copyright &#xa9; 2026 by International Anesthesia Research
Society and The Society of Thoracic Surgeons

<60>
Accession Number
2043152985
Title
Preoperative Nutrition-Based Interventions in Children Undergoing Cardiac
Surgeries-A Systematic Review and Meta-Analysis.
Source
Nutrients. 18(3) (no pagination), 2026. Article Number: 544. Date of
Publication: 01 Feb 2026.
Author
Strozyk A.; Halicki P.; Kolodziej M.; Horvath A.; Buczynski M.; Pietrzak
R.
Institution
(Strozyk, Kolodziej, Horvath) Department of Pediatrics, Medical University
of Warsaw, Warsaw, Poland
(Halicki, Pietrzak) Department of Pediatric Cardiology and General
Pediatrics, Medical University of Warsaw, Warsaw, Poland
(Buczynski) Department of Cardiothoracic Surgery and Transplantology,
Medical University of Warsaw, Warsaw, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: This systematic review aimed to evaluate the efficacy and
safety of preoperative nutrition-based interventions on pre-, intra-, and
postoperative outcomes in children undergoing cardiac surgical procedures.
<br/>Method(s): CENTRAL, MEDLINE, and EMBASE were systematically searched
for interventional and observational studies comparing any nutritional
preoperative intervention with a control or alternative strategy in
pediatric patients undergoing cardiac surgery, up to July 2025. The main
outcome was the postoperative length of stay in the intensive care unit
(ICU). The certainty of evidence was assessed using the GRADE approach.
<br/>Result(s): Nineteen studies were included (8 randomized controlled
trials [RCTs], 1 non-randomized trial, and 10 observational studies),
evaluating heterogeneous interventions or exposures, including fatty
acids, vitamin D supplementation, and structured preoperative nutritional
protocols. Two RCTs demonstrated shorter ICU and hospital stays with
extended preoperative nutritional support (2 weeks vs. 1 week; n = 40; and
1 month vs. no support; n = 80). Observational data indicated an
association between preoperative nutritional support and reduced hospital
length of stay (meta-analysis of four studies; n = 278), as well as fewer
days to achieve full enteral feeding postoperatively (meta-analysis of
three studies; n = 138). No significant difference in postoperative ICU
stay was observed between groups (meta-analysis of two studies; n = 175).
No intervention-related serious adverse events were reported. The overall
certainty of evidence was very low. <br/>Conclusion(s): This systematic
review provides very low-certainty evidence suggesting that preoperative
nutrition-based interventions in children undergoing cardiac surgery are
safe and may offer clinical benefits. Substantial heterogeneity across
studies underscores the need for well-designed trials and standardized
preoperative nutritional protocols. PROSPERO number:
CRD420251085196.<br/>Copyright &#xa9; 2026 by the authors.

<61>
Accession Number
650206078
Title
Evaluation of a pharmacist-led patient-self-testing model for warfarin
management in patients undergoing mechanical heart valve replacement in
China: a multicentre, open-label, randomised, controlled trial.
Source
BMJ open. 16(2) (pp e105575), 2026. Date of Publication: 09 Feb 2026.
Author
Wang C.; Luo J.; Zhou X.; Guo Y.; Cao W.; Zhang D.; Song L.; Tan S.
Institution
(Wang, Luo, Tan) Department of Pharmacy, Second Xiangya Hospital of
Central South University, Changsha, Hunan, China
(Zhou) Department of Cardiovascular Surgery, Second Xiangya Hospital of
Central South University, Changsha, Hunan, China
(Guo) Department of Pharmacy, Taoyuan People's Hospital, Hunan, China
(Cao) Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, Hunan,
China
(Zhang) Department of Pharmacy, First People's Hospital of Pingjiang,
Yueyang, Hunan, China
(Song) Department of Pharmacy, People's Hospital of Ningxiang City,
Changsha, Hunan, China
Abstract
OBJECTIVES: Patient self-testing (PST) for warfarin management is
well-established in developed countries but remains underused in
developing regions. This study compared the safety and effectiveness of
PST with usual care (UC) in China. DESIGN: A multicentre, open-label,
randomised, controlled trial. SETTING: A total of five centres
participated in this study, including one provincial tertiary hospital,
two municipal tertiary hospitals and two primary hospitals. PARTICIPANTS:
Patients undergoing mechanical heart valve (MHV) replacement at five
centres were prospectively enrolled. Patients were trained and stratified
according to time on warfarin at enrolment and were randomly assigned to
the PST or UC group. INTERVENTIONS: The PST group used a point-of-care
testing device for at-home international normalised ratio (INR) monitoring
with pharmacist-guided warfarin dosing, while the UC group attended
outpatient clinics for INR monitoring and dosing. PRIMARY AND SECONDARY
OUTCOME MEASURES: The primary outcome was the difference in time in
therapeutic range (TTR). The secondary outcomes were incidences of major
bleeding, thromboembolism and all-cause deaths in 12 months.
<br/>RESULT(S): From March 2021 to March 2023, a total of 556 patients
were enrolled, with a mean age of 47.5 years, 45.1% being male. 342 were
newly initiating warfarin therapy, while 214 had been on warfarin for over
6 months. Baseline characteristics were similar between the PST and UC
groups. The PST group showed significantly higher TTR (67.2% vs 55.1%,
p<0.001) and lower incidences of major bleeding (0.7% vs 7.9%, p<0.001)
and thromboembolism (0.4% vs 6.8%, p<0.001), with no difference in
all-cause mortality (0.4% vs 1.8%, p=0.22). Logistic regression identified
that using PST and younger age were independent factors associated with
fewer warfarin-related adverse events. <br/>CONCLUSION(S): A
pharmacist-led PST intervention with ongoing education and counselling led
to improved TTR and clinical outcomes in patients with MHV in China. TRIAL
REGISTRATION NUMBER: China Clinical Trial Registry
(ChiCTR2000038984).<br/>Copyright &#xa9; Author(s) (or their employer(s))
2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<62>
Accession Number
2043533365
Title
Updated 5-year outcomes of transcatheter versus surgical aortic valve
replacement in patients with severe aortic stenosis at low- to
intermediate-surgical risk.
Source
Heart. (no pagination), 2026. Article Number: heartjnl-2025-327092. Date
of Publication: 2026.
Author
Marin-Cuartas M.; Kawczynski M.J.; de Waha S.; Kiefer P.; Falk V.; Siepe
M.; Bowdish M.E.; Akowuah E.; Verbrugghe P.; Oosterlinck W.; Klautz
R.J.M.; Lorusso R.; Bidar E.; Rahouma M.M.; Redfors B.; Biondi-Zoccai G.;
Bhatt D.L.; Gaudino M.; Borger M.A.; Heuts S.
Institution
(Marin-Cuartas, de Waha, Kiefer, Borger) University Department of Cardiac
Surgery, Leipzig Heart Centre University Hospital, SN, Leipzig, Germany
(Kawczynski, Lorusso, Bidar, Heuts) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, LI, Maastricht, Netherlands
(Kawczynski, Lorusso, Bidar, Heuts) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
(de Waha) Department of Rhythmology, University Hospital Schleswig
Holstein, Kiel, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany
(Falk) Charite - Universitatsmedizin Berlin, Freie Universitat Berlin,
Humboldt-Universitat zu Berlin, Berlin, Germany
(Falk) DZHK (Deutsches Zentrum fur Herz-Kreislauf-Forschung), Partner Site
Berlin, Berlin, Germany
(Falk) Department of Health Science and Technology, Translational
Cardiovascular Technologies, ETH Zurich, Zurich, Switzerland
(Siepe) Department of Cardiac Surgery, Bern University Hospital, Bern,
Switzerland
(Bowdish) Department of Cardiac Surgery, Smidt Heart Institute, Los
Angeles, CA, United States
(Akowuah) James Cook University Hospital, Middlesbrough, United Kingdom
(Verbrugghe, Oosterlinck) Department of Cardiac Surgery, University
Hospitals Leuven, Leuven, Belgium
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
(Rahouma, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York City, NY, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York City, NY, United States
Publisher
BMJ Publishing Group
Abstract
Objectives The comparative long-term safety and efficacy of transcatheter
aortic valve implantation (TAVI) versus surgical aortic valve replacement
(SAVR) remains under continued investigation, particularly in patients at
low- to intermediate-surgical risk. This study aims to synthesise and
update contemporary long-term TAVI versus SAVR data. Methods This study
comprised a systematic review and meta-analysis and employed a Bayesian
hierarchical design. Randomised controlled trials (RCTs) comparing TAVI to
SAVR in low-risk to intermediate-risk patients with at least 5-year
follow-up were included. The primary outcome was 5-year all-cause
mortality; secondary outcomes were the 5-year incidence of stroke and the
5-year incidence of the composite of mortality and stroke. Review methods
Time-to-event data were reconstructed. Relative risks (RRs) with 95%
credible intervals (CrIs) were estimated from reported 5-year event rates
using minimally informative priors. Sensitivity analyses were performed
using various meta-analytical models, and using conventional frequentist
random-effects and fixed-effects models for sensitivity purposes. Results
A total of six RCTs, enrolling 7249 low- to intermediate-risk patients
reported 5-year outcomes (TAVI n=3704, SAVR n=3545). The 5-year all-cause
mortality rate was 29.7% (28.2-31.2%, TAVI) and 27.6% (26.1-29.1%, SAVR).
The median RR for all-cause mortality was 1.12 (95% CrI 1.02-1.22,
heterogeneity tau²=0), with a 99.3% posterior probability that
SAVR is superior to TAVI for this endpoint. For stroke, the median RR was
1.13 (95% CrI 0.93-1.39, heterogeneity tau²=0.04), resulting in
an 88.0% posterior probability that SAVR outperformed TAVI for this
outcome. These results were consistent across conventional frequentist
random-effects and fixed-effects models employing p values (RR 1.13, 95%
CI 1.05 to 1.22, p=0.001, and RR 1.12, 95% CI 1.03 to 1.23, p=0.011,
respectively). There was no evidence for an interaction effect of surgical
risk category (p=0.470). Conclusion In this meta-analysis of RCTs, TAVI
resulted in a clinically relevant increase in all-cause mortality, and a
high probability of an increased risk of stroke, at 5 years of follow-up
in low-risk to intermediate-risk patients, when compared to
SAVR.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2026. Re-use
permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<63>
[Use Link to view the full text]
Accession Number
650206077
Title
Normothermic machine perfusion applications in kidney transplantation.
Source
Current opinion in organ transplantation. (no pagination), 2026. Date of
Publication: 10 Feb 2026.
Author
Holzner M.L.; Jaynes C.; Garonzik-Wang J.
Institution
(Holzner) Recanti/Miller Transplantation Institute, Icahn School of
Medicine at Mount Sinai, NY, United States
(Jaynes) Public Benefit Company, West Lafayette, IN, United States
(Jaynes) Department of Surgery-Organ Donation and Transplantation,
University Medical Center Groningen, Netherlands
(Garonzik-Wang) Comprehensive Transplant Institute, Department of Surgery,
University of Alabama at Birmingham, Birmingham, AL, United States
Abstract
PURPOSE OF REVIEW: Normothermic machine perfusion (NMP) has emerged as
technology for organ preservation and assessment. While NMP has been
widely adopted for liver, lung, and heart transplantation, kidney NMP has
faced slower clinical integration. Normothermic perfusion may potentially
improve kidney transplant through improved preservation, graft viability
assessment, mitigation of ischemia reperfusion injury, and treatment prior
to transplant. The purpose of this review is to highlight the applications
of NMP in kidney transplantation. RECENT FINDINGS: Kidney NMP has been
proven well tolerated and feasible in multiple studies. Two recent
randomized controlled trials did not demonstrate a benefit of NMP compared
to cold storage. The use of NMP may increase utilization through improved
logistics. Graft assessment during perfusion may allow for well tolerated
transplantation of marginal kidneys. Successful long-term perfusion up to
4 days of discarded kidneys has been performed. Gene therapies and
treatments, including immune modification, have been carried out during
kidney NMP. SUMMARY: Normothermic perfusion has several applications to
kidney transplantation including preservation, assessment, and treatment.
Perfusion protocols viability criteria need to be defined. A portable,
commercially available device is needed to increase clinical use. Further
studies are needed to compare NMP to current preservation
methods.<br/>Copyright &#xa9; 2026 Wolters Kluwer Health, Inc. All rights
reserved.

<64>
Accession Number
650206141
Title
Effect of preoperative prehabilitation on the 6-minute walk distance and
postoperative outcomes in adult patients: meta-analysis.
Source
BJS open. 10(1) (no pagination), 2025. Date of Publication: 29 Dec 2025.
Author
Diaz-Vidal P.; Gil-Casado C.; Fernandez-Vazquez U.; Diz-Ferreira E.;
Luna-Rojas P.; Diz J.C.
Institution
(Diaz-Vidal, Gil-Casado, Fernandez-Vazquez, Diz-Ferreira, Luna-Rojas)
School of Medicine, University of Santiago de Compostela, Santiago de
Compostela, Spain
(Diz-Ferreira, Diz) Well-Move Research Group, Galicia Sur Health Research
Institute (IIS Galicia Sur), Vigo, Spain
(Diz) Department of Anaesthesia and Postoperative Critical Care, Hospital
Alvaro Cunqueiro, Vigo, Spain
(Diz) Department of Functional Biology and Health Sciences, University of
Vigo, Vigo, Spain
Abstract
BACKGROUND: Low cardiorespiratory fitness (CRF) has been demonstrated to
be associated with increased perioperative morbidity and mortality.
However, evidence regarding the effect of prehabilitation on CRF and
postoperative outcomes remains inconclusive. <br/>METHOD(S): A systematic
review and meta-analysis were conducted in accordance with the PRISMA
statement encompassing randomized clinical trials (RCTs) published in
PubMed and Web of Science up to June 2025 on the effects of
prehabilitation with exercise, measured using the 6-minute walk test, for
adult patients undergoing surgery. The primary objective was to examine
the effect of prehabilitation based on physical exercise on the
preoperative physical condition of adults scheduled to undergo elective
surgery, measured as the change in the 6-minute walk distance (6MWD).
Factors associated with changes in the 6MWD and the effect of
prehabilitation on postoperative CRF were analysed, as were the length of
hospital stay and mortality. Effect sizes and their 95% confidence
interval (c.i.) were estimated with a random-effects model.
<br/>RESULT(S): Of 107 RCTs screened, 21 were included in the analysis,
comprising 1649 patients (828 undergoing prehabilitation) across several
specialities, the most prevalent being cardiac (501 patients), colorectal
(423 patients), and thoracic surgery (364 patients). The prehabilitation
group exhibited a greater improvement in the 6MWD before surgery (mean
difference (MD) 29 m; 95% c.i. 14 to 42 m; P < 0.001; I2 = 84%) and in the
first month after surgery (MD 22 m; 95% c.i. 0 to 43 m; P = 0.05; I2 =
92%). A greater proportion of patients in the prehabilitation group had a
clinically significant improvement in the 6MWD both before (odds ratio
(OR) 2.66; 95% c.i. 1.76 to 4.0; P < 0.001; I2 = 53%) and after (OR 2.59;
95% c.i. 1.05 to 6.35; P = 0.04; I2 = 69%) surgery. There were no
differences between the groups in length of hospital stay (MD -0.24; 95%
c.i. -0.65 to 0.17; P = 0.25; I2 = 25%) or mortality (OR 0.71; 95% c.i.
0.26 to 1.92; P = 0.5; I2 = 0%). <br/>CONCLUSION(S): Prehabilitation
involving physical exercise before surgery was associated with an
improvement in preoperative CRF. However, no differences were observed
between the groups in length of hospital stay or postoperative mortality.
The improvement in CRF persists in the postoperative period, suggesting a
potential benefit for patient recovery.<br/>Copyright &#xa9; The Author(s)
2026. Published by Oxford University Press on behalf of BJS Foundation
Ltd.

<65>
Accession Number
650185990
Title
A randomized controlled trial of artificial intelligence-based analytics
for clinical deterioration.
Source
Scientific reports. (no pagination), 2026. Date of Publication: 05 Feb
2026.
Author
Keim-Malpass J.; Ratcliffe S.J.; Clark M.T.; Krahn K.N.; Monfredi O.J.;
Hamil S.; Yousefvand G.; Jones M.K.; Nelson A.; Moorman L.P.; Moorman
J.R.; Bourque J.M.
Institution
(Keim-Malpass) Center for Advanced Medical Analytics, School of Medicine,
University of Virginia, Charlottesville, VA, United States
(Keim-Malpass) Department of Pediatrics, Hematology-Oncology Division,
School of Medicine, University of Virginia, Charlottesville, VA, United
States
(Keim-Malpass) Pediatric Hematology-Oncology, University of Virginia, P.O.
Box 800386, Charlottesville, VA, United States
(Ratcliffe, Jones) Department of Public Health Sciences, Biostatistics
Division, University of Virginia, Charlottesville, VA, United States
(Clark, Moorman) Nihon Kohden Digital Health Solutions, Irvine, CA, United
States
(Krahn, Hamil, Yousefvand, Moorman, Bourque) Center for Advanced Medical
Analytics, School of Medicine, University of Virginia, Charlottesville,
VA, United States
(Krahn, Monfredi, Hamil, Yousefvand, Nelson, Moorman, Bourque) Department
of Internal Medicine, Cardiovascular Division, School of Medicine,
University of Virginia, Charlottesville, VA, United States
Abstract
This pragmatic randomized controlled trial aimed to assess the effect of a
passive display of artificial intelligence (AI)-based predictive analytics
on hours free of clinical deterioration events among medical and surgical
patients in an acute care cardiology medical-surgical ward. 10,422
inpatient visits were randomly assigned by cluster to the intervention
group of a display of risk trajectories or to a control group of usual
medical care. The trial was undertaken on an 85-bed inpatient cardiology
and cardiac surgery ward of an academic hospital with a substantial
implementation and education plan. This was a passive display with no
specific response mandated. The primary analysis compared events of
clinical deterioration (death, emergent ICU transfer, emergent
endotracheal intubation, cardiac arrest, or emergent surgery) and compared
mortality 21 days after admission. Patients with a large spike in risk
score had, on average, twice the length of hospital stay (6.8 compared to
3.4 days). There was no change in the primary outcome between groups.
Among those who had a clinical event, there were more event-free hours in
the intervention/display-on group compared to the
standard-of-care/display-off, but this did not reach statistical
significance. Clinicians chose to transfer 11% of patients into or out of
display beds, a censoring event removing them from the analysis, thereby
undermining aspects of the randomized nature of the study. Predictive
analytics monitoring incorporating continuous cardiorespiratory monitoring
and displays of risk trajectories coupled with an education plan did not
improve patient outcomes. While necessary to conduct the study, the
pragmatic design allowed for significant movement towards
intervention/displayed beds for sicker patients. Design considerations in
the future must focus on understanding clinicians' interpretation, care
processes, and communication practices.Clinical trial registration number:
NCT04359641 Registered 4/24/20.<br/>Copyright &#xa9; 2026. The Author(s).

<66>
Accession Number
650197898
Title
Comparison of Left Atrial Appendage Closure and Oral Anticoagulation after
Catheter Ablation for Atrial Fibrillation: Concomitant and Sequential
Cohorts of the OPTION Randomized Controlled Trial.
Source
Journal of Cardiovascular Electrophysiology. Conference: 30th Annual
Atrial Fibrillation Symposium. Boston, MA United States. 36(5) (pp
1120-1121), 2025. Date of Publication: 01 May 2025.
Author
Saliba W.; Nair D.; Swarup V.; Hall T.; Iyer V.; Calle Perez G.; Weiner
S.; Shah M.; Islam N.; Grygier M.; Ibanez Criado J.L.; Duthoit G.; Reddy
Y.M.; Roy K.; Christen T.; Sutton B.; Wazni O.
Institution
(Saliba, Nair, Swarup, Hall, Iyer, Calle Perez, Weiner, Shah, Islam,
Grygier, Ibanez Criado, Duthoit, Reddy, Roy, Christen, Sutton, Wazni)
Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction Objectives: Guidelines recommend continuation of
anticoagulation following atrial fibrillation (AF) ablation in patients at
high risk for stroke. Left atrial appendage closure (LAAC) has not been
well-studied for routine use post ablation. LAAC can be performed in
separate procedures with cardiac ablation (sequentially) or concomitantly
in the same operative session. In this prespecified subanalysis of the
OPTION trial, timing of ablation relative to LAAC will be evaluated.
<br/>Method(s): OPTION is a multicenter, prospective randomized clinical
trial. Patients with AF and an elevated CHA2DS2-VASc score undergoing
catheter ablation were randomly assigned (1:1) to catheter-based LAAC
versus oral anticoagulation. Patients underwent an AF catheter ablation
procedure between 90 and 180 days prior to randomization (sequential) or
were planning to have catheter ablation within 10 days of randomization
(concomitant). The primary safety endpoint was nonprocedural major or
clinically-relevant non-major bleeding. The primary efficacy endpoint was
the composite of all-cause death, stroke, or systemic embolism at 36
months. The secondary endpoint was major bleeding through 36 months,
including procedural bleeding. <br/>Result(s): A total of 1600 patients
with a mean age (+/-SD) of 70+/-8 years, and a CHA2DS2-VASc score of
3.5+/-1.3 were randomized to anticoagulation. LAAC (n=803) was performed
concomitantly with (n=328; 41%) or sequentially after (n=475; 59%) AF
ablation. In the control arm (n=797), AF ablation was concomitant with
randomization in 41% of patients (n=326) or sequential in 59% (n=471).
Generally, patients in the sequential cohort had more clinical
comorbidities. Clinical outcomes at 3 years will be available at the time
of the presentation. <br/>Conclusion(s): This subanalysis of OPTION will
examine whether LAAC is a reasonable alternative to contemporary OAC after
sequential or concomitant AF ablation in patients currently guideline
recommended to stay on oral anticoagulation..

<67>
Accession Number
650188944
Title
CHARACTERIZING PATIENT PREFERENCES for OPTIMAL MANAGEMENT of CORONARY
ARTERY DISEASE: A SYSTEMATIC REVIEW of the LITERATURE.
Source
Clinical Trials. Conference: 45th Annual Meeting of the Society for
Clinical Trials, SCT 2024. Boston, MA United States. 21(6 Supplement) (pp
93-94), 2024. Date of Publication: 01 Dec 2024.
Author
Abatan D.; Wilson T.A.; Sajobi T.
Institution
(Abatan, Wilson, Sajobi) University of Calgary, Canada
Publisher
SAGE Publications Ltd
Abstract
Background: The selection of an optimal treatment strategy remains one of
the most challenging decisions in the management of coronary artery
disease (CAD). Coronary artery bypass graft and percutaneous coronary
intervention are widely used revascularization procedures for managing CAD
and are known to result in improved outcomes compared to optimal medical
therapy. Currently, clinical guidelines recommend revascularization
(coronary artery bypass graft or percutaneous coronary intervention) for
managing patients with complex CAD. However, there remains substantial
uncertainty about whether revascularization or optimal medical therapy is
optimal for managing patients with complex CAD who are increasingly
presenting with frailty, multimorbidity, and/or disability. Shared
decision-making, that incorporates patient preferences, is essential for
achieving patient-centered cardiovascular care delivery in people with
complex CAD. However, there remains substantial uncertainty about the
appropriateness of endpoints used to evaluate the effectiveness of
electronic decision support tools for promoting shared decision-making in
CAD management. We conducted a systematic review to understand
patient-preference attributes for optimal CAD management. <br/>Method(s):
We systematically searched three databases (PUBMED, EMBASE, and SCOPUS) to
identify relevant studies. The included articles are those that (1)
examined patient preferences toward revascularization and/or optimal
medical treatment in individuals, (2) elicited patient preference
attributes, (3) adopted a quantitative or qualitative approach to
eliciting patient preference attributes, and (4) were published in English
Language up to May 2023. <br/>Result(s): Ten articles met the inclusion
criteria. Renal failure, periprocedural death, stroke, repeat
revascularization, and myocardial infarction were identified as the most
important attributes to patients. Of the 10 articles, only 2 (20%)
employed discrete choice experiments for eliciting the most important
attributes; the other studies employed quantitative surveys and
qualitative interviews. <br/>Conclusion(s): The identified patient
attributes are recommended for use as endpoints in the development of
electronic decision aids to support shared decision-making between cardiac
care providers and patients with CAD.

<68>
Accession Number
650188949
Title
RE-INTERPRETATION of the COSMOS TRIAL RESULTS USING A BAYESIAN APPROACH.
Source
Clinical Trials. Conference: 45th Annual Meeting of the Society for
Clinical Trials, SCT 2024. Boston, MA United States. 21(6 Supplement) (pp
60-61), 2024. Date of Publication: 01 Dec 2024.
Author
Hamaya R.; Wu S.M.; Rist P.M.; Manson J.E.; Sesso H.D.
Institution
(Hamaya, Rist, Manson, Sesso) Brigham and Women's Hospital, United States
(Wu) Harvard T.H. Chan School of Public Health, United States
Publisher
SAGE Publications Ltd
Abstract
Background: The effect of cocoa flavanols on the prevention of
cardiovascular disease (CVD) events remains unclear and limited to a
single large-scale randomized clinical trial (RCT), the COcoa Supplement
and Multivitamin Outcomes Study (COSMOS). The primary analysis of COSMOS
showed a non-significant effect of cocoa flavanols on CVD prevention
(hazard ratio [HR]: 0.90; 95% CI: 0.78, 1.02; P = 0.11), while reliance
upon a fixed P-value cutoff of 0.05 for judgment is controversial. We used
a Bayesian framework to re-interpret the effect of cocoa flavanols on
incident CVD in COSMOS based on informative prior findings.
<br/>Method(s): The COSMOS trial randomized 21,442 older US adults with
median follow-up of 3.6 years. The primary CVD outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction, stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina. In
our primary analyses, we used a Weibull proportional hazards model
adopting the Hamiltonian Monte Carlo sampling method. We conducted series
of sensitivity analyses using different priors. Prior Specification: We
constructed an informative prior based on a mechanistic approach, assuming
that the major cardio-protective effects of cocoa flavanols were through
improvements in endothelial function and reductions in blood pressure (BP)
and inflammation. Based on meta-analyses of RCTs, cocoa flavanols improved
flow-mediated dilation by 1.34 % [1.00, 1.68] and decreased systolic BP
and C-reactive protein by 2.37 mmHg [95% CI: 0.44, 4.3] and 0.98 mg/l
[0.27, 1.69], respectively. In addition, previous studies showed that the
HR of CVD for BP lowering per 5 mmHg was 0.91 [0.88, 0.95], that for
C-reactive protein lowering by 1.85 mg/l was 0.86 [0.75, 0.99], and for
that for flow-mediated dilation by 1% was 0.88 [0.84, 0.91]. An
informative prior was constructed based on this information assuming
independent, additive effects of BP, inflammation, and endothelial
function on CVD. <br/>Result(s): Using an informative prior based on
additive effects of the different mechanistic pathways, we estimated the
posterior HR was 0.83 (95% CrI: 0.75, 0.92). This compared with an HR of
0.90 (95% credible interval [CrI]: 0.79, 1.03) using a non-informative
prior, which was similar to the primary frequentist survival analysis
approach. The posterior estimate indicates a > 99.0% probability that
cocoa flavanols supplementation decreased total CVD risk.
<br/>Conclusion(s): The Bayesian interpretation of the COSMOS trial data
in the context of previous knowledge suggested with reasonably high
probability that supplementation with cocoa flavanols may lead to a lower
incidence of total CVD compared with placebo among older US women and men.

<69>
Accession Number
650188912
Title
CLARITY in SAFETY REPORTING VERSUS DATA ENTRY BURDEN: LESSONS LEARNED.
Source
Clinical Trials. Conference: 45th Annual Meeting of the Society for
Clinical Trials, SCT 2024. Boston, MA United States. 21(6 Supplement) (pp
91-92), 2024. Date of Publication: 01 Dec 2024.
Author
Crosby-Thompson A.
Institution
(Crosby-Thompson) Carelon Research, United States
Publisher
SAGE Publications Ltd
Abstract
Adequate safety reporting is a key requirement in any clinical trial.
International Committee on Harmonization of Good Clinical Practice (ICH
GCP) and the US Food and Drug Administration (FDA) provide clear
guidelines for the collection and reporting of adverse events (AEs) in
clinical trials. In this presentation, we will review the lessons learned
from strategies employed by a large pediatric research network to balance
adequate safety reporting with data entry burden across three research
studies. Network trials follow FDA requirements and ICH GCP guidelines for
safety reporting. In 2020 and 2021, the network launched two studies, an
Investigational New Drug trial and a randomized clinical trial. Both
enrolled neonates undergoing surgery for congenital heart disease, and
every untoward medical event was collected. AE pages programmed in the
Electronic Data Capture system collected 25 individual fields and a
narrative for each event. Study participants were medically complex and
experienced frequent AEs related to cardiac anatomy, surgical course, and
study intervention, thus requiring a large amount of detailed data entry.
Network leadership determined that an acceptable approach to reducing data
entry burden was to collect non-serious, expected and related to cardiac
anatomy or surgical course AEs in an abbreviated form. The most common
non-serious, expected, related AEs experienced by the study population
were compiled into a code list. Once the AE strategy and event code list
received regulatory approval, a shortened AE form was programmed in the
Electronic Data Capture, and for non-serious, expected, related AEs, only
date of onset, event name, and description of the event was collected.
Serious AEs, and non-serious AEs that were unexpected, related to the
study intervention, or not on the event code list continued to be
collected in the long form. Initially, the new process alleviated data
entry burden, so the method was implemented in another network study, an
Investigational Device Exemption trial in neonates with congenital heart
disease; however, inefficiencies in the process were soon identified. The
event code list was not exhaustive; some AEs were entered as "Other," a
term that became a catchall for diagnoses that were not on the code list,
resulting in Electronic Data Capture queries to request additional details
about the event. Site staff often needed to consult with study PIs and DCC
staff to determine which AE form was most appropriate. The trial's medical
monitor frequently required more information from the sites when reviewing
AE data entered on the short form to ensure events were being adequately
reported. Ultimately, it became clear that for the Investigational Device
Exemption trial, the shortened AE form was not reducing data entry burden
but creating it through increased queries to resolve questions about each
event. Study leadership determined that the best process for ensuring that
safety was adequately monitored according to FDA requirements was to
require all AEs be entered on the longer AE form. Safety reporting and
data entry burden must be considered at the launch of any clinical trial
or study. While methods to reduce data entry burden may be appropriate for
some studies, the tradeoff between data entry burden and clarity for data
entry and safety assessment must be considered.

<70>
Accession Number
2043103591
Title
Anatomical Variations of the Lung Lobes and Fissures: A Systematic Review
and Meta-Analysis.
Source
Clinical Anatomy. (no pagination), 2026. Date of Publication: 2026.
Author
Abdu S.M.; Ali S.Y.; Assefa E.M.; Muhaba E.S.
Institution
(Abdu, Assefa, Muhaba) School of Biomedical Sciences, College of Medicine
and Health Sciences, Wollo University, Dessie, Ethiopia
(Ali) School of Medicine, Institute of Health, Jigjiga University, Jijiga,
Ethiopia
Publisher
John Wiley and Sons Inc
Abstract
The lungs' fissural and lobar variations are clinically and anatomically
important, with direct implications for anatomists, radiologists, and
thoracic surgeons. Although standard anatomical textbooks commonly
describe fissures as complete, numerous studies have reported substantial
variability, including incomplete, absent, and accessory fissures. These
variations may complicate surgical procedures, affect disease spread, and
lead to misinterpretation of imaging findings. Therefore, quantifying the
prevalence of fissural and lobar variations is essential for accurate
clinical planning, reliable radiologic interpretation, and effective
anatomical education. A systematic search was conducted across PubMed,
Hinari, Crossref, and Google Scholar, as well as relevant anatomical
journals, in accordance with Evidence-Based Anatomy Workgroup
recommendations and reported following PRISMA 2020 guidelines. Eligible
anatomical studies were included, and study quality was assessed using a
standardized appraisal tool. Meta-analysis was performed using MetaXL with
a random-effects model to estimate the pooled prevalence and distribution
of lung variations. Among all evaluated lungs, anatomical variations were
observed in 42%, with 63% occurring on the right side. When assessed
independently, variations were present in 55% of right lungs and 33% of
left lungs. The right horizontal fissure was complete in 54%, incomplete
in 35%, and absent in 11%, while the right oblique fissure was complete in
77%. The left oblique fissure was complete in 72%, incomplete in 26%, and
absent in 2%. Accessory fissures were present in 14% of both right and
left lungs, most commonly the inferior accessory fissure on the right (6%)
and the left minor fissure on the left (8%). Lung fissural and lobar
variations occur in nearly half of individuals, with distinct right- and
left-sided patterns and variable completeness. Awareness of these
variations is essential for accurate anatomical understanding, surgical
planning, radiological interpretation, and minimizing complications in
thoracic procedures.<br/>Copyright &#xa9; 2026 American Association of
Clinical Anatomists and British Association of Clinical Anatomists.

<71>
Accession Number
2043138873
Title
Understanding the learning curve in robotic-assisted cardiac surgery and
its application on curriculum development - systematic narrative review.
Source
Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number:
234. Date of Publication: 01 Dec 2026.
Author
EL-Gheryani M.; Sherif M.; Loubani M.
Institution
(EL-Gheryani) Clinical and Surgical Sciences Department, The University of
Edinburgh, Scotland, Edinburgh, United Kingdom
(Sherif, Loubani) Cardiothoracic Centre, Castle Hill Hospital, England,
Hull, United Kingdom
Publisher
Springer Nature
Abstract
Since robotic-assisted cardiac surgery was established, the adoption rate
was slow despite proven its efficacy and safety. Limited knowledge about
the learning curve (LC) has led to lacking recognised training programme
which in turn jeopardises patient safety and reduces the uptake rate. This
study aims to review current literature, identify any knowledge gaps and
quantify the LC. In addition, the study focuses on the application of LC
knowledge on the curriculum development which has not been covered in the
literature before. This systematic narrative review was conducted
according to PRISMA-20 guideline. Ovid MEDLINE, PubMed, EMBASE and SCOPUS
were searched from database inception to the 5th of February 2024.
Eligible articles were those assessing LC in robotic-assisted cardiac
surgery and reported in English. Among 24 studies which met the
eligibility criteria (Table 1), 12 studies are for robotic-assisted
coronary artery bypass, 9 for robotic-assisted mitral valve repair and 3
for robotic-assisted atrial septal defect repair. All studies were
observational. Reporting LC exhibited substantial heterogeneity in terms
of outcome variables and statistical analysis. None of the studies have
quantified the surgeons' previous experience. Finally, having structured
training programme is the most recommended method to mitigate the steep LC
while creating standardised reporting system has been advised to decrease
heterogeneity in the future studies. Current literature shows high
heterogeneity in defining LC which creates challenges in developing safe
curriculum. Nonetheless, adopting structured programme with good exposure
to simulation sessions are deemed effective approach to reduce LC and
improve patient safety.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag London Ltd., part of Springer Nature
2026.

<72>
Accession Number
2043152636
Title
A Review of Systemic Hypertension in the Cardiac Transplant Population:
Pathophysiology, Management, and Future Directions.
Source
Hearts. 6(4) (no pagination), 2025. Article Number: 32. Date of
Publication: 01 Dec 2025.
Author
Rashed E.R.; Sundaravel S.; Ortega-Legaspi J.M.
Institution
(Rashed) Department of Advanced Heart Failure and Transplant, Newark Beth
Israel-Robert Wood Johnson, Newark, NJ, United States
(Sundaravel) Department of Cardiovascular Medicine, Wake Forest University
School of Medicine, Winston-Salem, NC, United States
(Ortega-Legaspi) Virtua Health Heart Failure, Cherry Hill, NJ, United
States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Heart transplantation is the gold standard in patients with end stage
heart failure, offering vastly improved survival, mortality and quality of
life. However, hypertension occurring after cardiac transplantation is a
serious issue, with the incidence ranging from 50 to 80% of patients. The
pathophysiology of the hypertension encompasses a more varied and unique
set of causes than those identified in non-organ transplant patients,
particularly related to the use of calcineurin inhibitors (CNIs)
especially cyclosporine. An in-depth understanding of hypertension after
heart transplantation remains a critical issue that necessitates further
clarification, due to its deleterious long-term consequence such as
impaired graft survival, cardiac allograft vasculopathy (CAV), and overall
survival. This article provides a comprehensive review of the prevalence,
risk factors, etiology, complications, and management of hypertension
after heart transplantation.<br/>Copyright &#xa9; 2025 by the authors.

<73>
Accession Number
2043246530
Title
Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Acute Kidney Injury
Post Off-Pump Coronary Artery Bypass Grafting: A Retrospective Cohort
Study and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 27(1) (no pagination), 2026. Article
Number: 39400. Date of Publication: 2026.
Author
Zhou X.; Pan Y.; Hua K.; Yang X.
Institution
(Zhou, Pan, Hua, Yang) Department of Cardiovascular Surgery, Beijing
Anzhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Vessel Disease, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a novel
class of oral antihyperglycemic medications prescribed for type 2 diabetes
mellitus, play a beneficial role in slowing the progression of heart
failure. However, debate persists regarding the potential link of these
inhibitors to acute kidney injury (AKI) in specific clinical conditions.
<br/>Method(s): This study was a retrospective analysis of consecutive
patients receiving off-pump coronary artery bypass grafting (OPCABG) at
our institution between January 2018 and July 2023. A group of patients
who had been administered SGLT2 inhibitors was systematically compared
with non-users in a 1:3 ratio using propensity score matching. The
principal endpoint was postoperative AKI after OPCABG. In addition, we
performed a comprehensive meta-analysis of the associations between SGLT2
inhibitor therapy and AKI risk. The analytical approach combined
institutional data with aggregated findings from existing literature.
<br/>Result(s): The analysis encompassed 403 patients who administered
SGLT2 inhibitors and 1209 non-users. AKI developed in 54 cases (13.4%)
post-OPCABG among individuals who received SGLT2 inhibitors, compared to
373 cases (30.9%) in the control cohort. Statistical analysis demonstrated
significantly reduced AKI prevalence in the SGLT2 inhibitor cohort
compared to non-users (p < 0.001). The meta-analysis results confirmed a
protective association between SGLT2 inhibitor therapy and AKI risk
reduction (odds ratio (OR) = 0.525, 95% confidence interval (CI)
0.437-0.631; p < 0.001). <br/>Conclusion(s): In this study, SGLT2
inhibitor administration was associated with a decreased incidence of
postoperative AKI in OPCABG patients. Clinical Trial Registration:
NCT05888168,
https://clinicaltrials.gov/study/NCT05888168?cond=NCT05888168&rank=1.<br/>
Copyright &#xa9; 2026 The Author(s). Published by IMR Press.

<74>
Accession Number
2043152638
Title
Achilles and the Tortoise: Rethinking Evidence Generation in
Cardiovascular Surgery and Interventional Cardiology.
Source
Hearts. 6(4) (no pagination), 2025. Article Number: 28. Date of
Publication: 01 Dec 2025.
Author
Cirillo M.
Institution
(Cirillo) BresciaItaly
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Randomized controlled trials (RCTs) are the foundation of
evidence-based medicine. However, the rapid pace of technological
innovation in cardiovascular surgery and interventional cardiology
challenges the traditional RCT framework. Observational studies may hold
renewed value in fields where device evolution outpaces the time required
to validate clinical outcomes. <br/>Method(s): This analysis evaluates 270
randomized and non-randomized studies in transcatheter aortic valve
implantation (TAVI), one of the most rapidly evolving areas in
cardiovascular medicine. The investigation follows two lines: first,
mapping the timeline of major RCTs against the introduction of new
prosthetic models; second, comparing the prevalence, duration, and role of
randomized (R) versus non-randomized (NR) studies. <br/>Result(s): The
timeline reveals a persistent misalignment between innovation and
validation. New prosthetic models frequently enter the market while RCTs
for prior generations are still ongoing. For example, the Sapien 3 valve
was approved, while trials on Sapien XT were still enrolling. Similarly,
newer Evolut and Acurate models were introduced during ongoing studies of
earlier versions, often prompting new studies before existing ones
concluded. This leapfrogging effect fragments the evidence base and delays
definitive comparisons. In parallel, randomized trials have increased in
number and tend to be shorter in duration, reflecting a maturing field.
However, non-randomized studies remain crucial for early testing and
post-market surveillance. <br/>Conclusion(s): In a field with rapid
technological evolution a sort of Zeno's paradox occurs: long-term
validation cannot keep pace with fast innovation, resetting the evidence
base with each new model. To overcome this paradox, a paradigm shift in
evidence generation is desirable. Future strategies must augment adaptive
trial designs, leverage real-world data and use higher-level, advanced
analyses to incorporate subjective variables and phenotypic diversity, to
reduce confounding factors and speed up data access. Higher-level,
integrative evidence analytics could help Achilles walk alongside the
tortoise.<br/>Copyright &#xa9; 2025 by the author.

<75>
Accession Number
2043117809
Title
PROthrombin complex concentrate versus fresh frozen Plasma for bleeding in
adults undergoing HEart SurgerY (PROPHESY-2 trial): a phase III,
randomised control trial in England and Wales.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 128. Date of
Publication: 01 Dec 2026.
Author
Brown-O'Sullivan C.; Agarwal S.; Akowuah E.; Arbon E.; Gardner M.;
Hounslea E.; Hudson C.; Klein A.; Loubani M.; McCullagh J.; Murphy G.;
Murray S.; Rourke C.; Sanders J.; Simpson L.; Smith L.; Stanworth S.;
Tomini F.; Vides N.; Workman J.; Green L.
Institution
(Brown-O'Sullivan, Arbon, Gardner, Hounslea, Hudson, Rourke, Smith, Vides,
Workman) NHS Blood and Transplant Clinical Trials Unit, Cambridge, United
Kingdom
(Agarwal) Manchester University Hospital, Manchester, United Kingdom
(Akowuah) Newcastle University, Newcastle, United Kingdom
(Klein) Royal Papworth Hospital NHS Foundation Trust, Cambridge, United
Kingdom
(Loubani) Hull University Teaching Hospitals, NHS Trust, Cottingham,
United Kingdom
(McCullagh, Green) NHS Blood and Transplant and Barts Health NHS Trust,
London, United Kingdom
(McCullagh, Simpson, Tomini, Green) Queen Mary University of London,
London, United Kingdom
(McCullagh, Green) NHS Blood and Transplant and Queen Mary University of
London, London, United Kingdom
(Murphy) University of Leicester, Leicester, United Kingdom
(Murray) Patient and Public Representative, London, United Kingdom
(Sanders) King's College London, London, United Kingdom
(Stanworth) NHS Blood and Transplant, Oxford University Hospitals NHS
Trust and University of Oxford, Oxford, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Fresh frozen plasma (FFP) is the standard treatment for severe
bleeding following cardiac surgery. Despite increasing use of prothrombin
complex concentrate (PCC) for coagulopathic bleeding in preference to FFP
in the UK, the evidence comparing FFP versus PCC in this setting is
lacking. Hypothesis: In adults who develop severe bleeding, PCC is
superior to FFP in reducing a composite of mortality, organ failure, or
infection up to 90 days following cardiac surgery, and is more
cost-effective. <br/>Method(s): Phase III pragmatic, multicentre, parallel
group, superiority, non-blinded, open-label, two-stage group sequential
randomised controlled trial with internal pilot embedded. Participants
will be recruited by the research team at up to 20 hospitals in England
and Wales. Those who have provided informed consent and who develop
bleeding within 24 h of cardiac surgery (elective and urgent procedures)
will be randomised to PCC (1500 IU if <=70 kg or 2000 IU if >70 kg; a
maximum of 2 doses) or FFP (4 units if <=70 kg and 5 units if >70 kg; no
maximum dose). Randomisation will be stratified by site and will allocate
participants using minimisation, with a 1:1 ratio to receive PCC or FFP.
Age (>=70 and <70 years) and planned type of surgery (valve only, major
aortic surgery, coronary artery bypass graft + valve, and complex/combined
procedure) will be the minimisation factors. The primary outcome is a
composite of mortality or new onset of respiratory failure, myocardial
injury, renal failure, liver injury, intestinal injury, focal neurological
deficit, or infection at 90 days. Secondary outcomes will compare safety
(transfusion-related reactions, thrombosis), quality of life, healthcare
costs, and cost-effectiveness. A sample size of 496 participants will have
a 90% power (with a 5% significance level) to detect a relative risk of
0.7 between the two groups at 90 days. The date of the 1st patient
enrolled was 11th February 2025. <br/>Discussion(s): This trial will
provide evidence on the clinical/cost-effectiveness of PCC versus FFP in
cardiac surgery patients who bleed post-surgery. Its outcome will provide
high-quality evidence to inform the management of bleeding following
cardiac surgery. Trial registration: ISRCTN 92114384. Registered on
16/04/2024. ISRCTN-ISRCTN92114384: PROthrombin complex concentrate versus
fresh frozen Plasma for bleeding in adults undergoing HEart SurgerY
(PROPHESY-2 trial)<br/>Copyright &#xa9; The Author(s) 2026.

<76>
Accession Number
2043486640
Title
The impact of cardiac rehabilitation program on work ability in patients
following percutaneous coronary intervention (PCI): A retrospective cohort
study.
Source
ARYA Atherosclerosis. 21(6) (pp 69-79), 2025. Date of Publication: 01 Nov
2025.
Author
Najafloo H.; Khazaei S.; Majidi L.; Mozayani Monfared A.; Hosseini S.K.;
Ghiasvandi S.
Institution
(Najafloo) Student Research Committee, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Khazaei) Research Center for Health Sciences, Hamadan University of
Medical Sciences, Hamadan, Iran, Islamic Republic of
(Majidi) Department of Physical Medicine and Rehabilitation, School of
Medicine, Sina (Farshchian) Educational and Medical Center, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Mozayani Monfared, Hosseini) Department of Cardiology, School of
Medicine, Farshchian Cardiovascular Subspecialty Medical Center, Hamadan
University of Medical Sciences, Hamada, Iran, Islamic Republic of
(Ghiasvandi) Farshchian Hospital, Hamadan University of Medical Sciences,
Hamadan, Iran, Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
BACKGROUND: Cardiac rehabilitation (CR) is a critical intervention for
reducing complications after cardiovascular procedures such as
percutaneous coronary intervention (PCI). One of the key outcomes used to
evaluate the effectiveness of CR programs is improvement in patients' work
ability. This study aimed to assess the impact of a structured CR program
on work ability in patients undergoing PCI. <br/>METHOD(S): A
retrospective study was conducted, comparing 36 patients who participated
in a structured CR program following PCI with 36 patients who did not
receive rehabilitation. The CR program included educational and exercise
components, delivered over four weeks with three sessions per week. Work
ability was evaluated three months post-intervention using a standardized
questionnaire. Statistical analyses, including independent t-tests and
correlation assessments, were performed to examine the relationship
between CR participation and work ability. <br/>RESULT(S): The two groups
were comparable in terms of age, gender, and underlying medical conditions
(p > 0.05). Notably, 80% of patients in the CR group demonstrated good to
excellent work ability, compared with only 25% in the control group (p <
0.001). The mean work ability score was significantly higher in the CR
group than in the control group (mean difference = 7.55, p < 0.001).
<br/>CONCLUSION(S): Participation in a cardiac rehabilitation program
significantly improves work ability in patients following PCI. These
findings highlight the importance of integrating CR into post-PCI care.
Future research should focus on randomized clinical trials incorporating
diverse rehabilitation protocols and extended follow-up periods to further
validate these results.<br/>Copyright &#xa9; 2025, Isfahan University of
Medical Sciences(IUMS). All rights reserved.

<77>
Accession Number
650206732
Title
Radial versus femoral secondary access in patients undergoing TAVI -
Rationale and Design of the RADIAL-TAVI trial.
Source
The American journal of cardiology. (no pagination), 2026. Date of
Publication: 07 Feb 2026.
Author
von Ehr A.; Zeymer U.; Schneider S.; Besler C.; Valina C.; Seiffert M.;
Mahfoud F.; Sossala S.; Hilgendorf I.; Wolf D.; Moser M.; Ziegler L.;
Niehoff M.; Olivier C.B.; Westermann D.; von Zur Muhlen C.
Institution
(von Ehr, Zeymer, Besler, Valina, Wolf, Moser, Ziegler, Niehoff, Olivier,
Westermann, von Zur Muhlen) Department of Cardiology and Angiology,
University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine,
University of Freiburg, Freiburg, Germany
(Schneider) Institut fur Herzinfarktforschung, Ludwigshafen am Rhein,
Germany
(Seiffert) Department of Cardiology and Angiology, BG University Hospital
Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
(Mahfoud) Department of Cardiology, Department of Biomedical Engineering,
Department of Biomedicine, University Heart Center, University Hospital
Basel, Basel, Switzerland
(Sossala) Department of Cardiology, Campus Kerckhoff of the
Justus-Liebig-University Giessen, Kerckhoff-Klinik, Bad Nauheim, Germany;
German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main,
Bad Nauheim, Germany; Department of Cardiology and Angiology, Medical
Clinic I, University Hospital Giessen, Justus-Liebig-University Giessen,
Giessen, Germany
(Hilgendorf) Department of Cardiology and Angiology, University Heart
Center Freiburg-Bad Krozingen, Faculty of Medicine, University of
Freiburg, Freiburg, Germany; DZHK (German Centre for Cardiovascular
Research), Berlin, Germany; Department of Cardiology, Angiology and
Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus
Virchow Klinikum, Berlin, Germany
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the
standard treatment for patients with severe symptomatic aortic stenosis
across most surgical risk categories. Despite its minimally invasive
nature, transfemoral TAVI requires both a primary and a secondary arterial
access site. While the femoral artery is most commonly used for secondary
access, vascular and bleeding complications remain frequent and are
associated with adverse outcomes. Observational evidence from TAVI cohorts
suggests that radial secondary access may reduce such complications
compared to femoral access. METHODS/DESIGN: The RADIAL-TAVI trial is a
prospective, randomized, controlled, multicenter, open-label study
designed to compare radial versus femoral secondary access in patients
undergoing transfemoral TAVI. A total of 434 patients will be randomized
in a 1:1 ratio. The primary endpoint is the incidence of vascular and
bleeding complications at the secondary access site within 30 days,
adjudicated according to VARC-3 criteria. Secondary endpoints include
early safety, cardiovascular mortality, major adverse cardiovascular and
cerebrovascular events (MACCE), quality of life, and health economic
aspects up to 30 days, as well as long-term mortality up to 12 months. The
study is powered to detect a reduction in the primary endpoint from 8%
with femoral to 2% with radial access. <br/>CONCLUSION(S): The RADIAL-TAVI
trial will provide the first randomized evidence on the optimal secondary
access strategy in transfemoral TAVI. If radial access proves superior, it
has the potential to redefine standard practice, reduce complication
rates, and improve patient safety and outcomes.<br/>Copyright &#xa9; 2026.
Published by Elsevier Inc.

<78>
Accession Number
2043110211
Title
Efficacy and Safety of Ciprofol for Sedation in Critically Ill Patients
After Cardiac Surgery: A Single-Center, Prospective, Randomized Controlled
Trial.
Source
Drug Design, Development and Therapy. 20 (no pagination), 2026. Article
Number: 12475780. Date of Publication: 2026.
Author
Guo L.; Hong M.; Li P.; Du W.; Li Y.; Li J.
Institution
(Guo, Hong, Du, Li) The Xuzhou Clinical College of Xuzhou Medical
University, Jiangsu, Xuzhou, China
(Li, Li) Xuzhou Clinical College of Xuzhou Medical University, Xuzhou
Medical University, Jiangsu, Xuzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to compare the efficacy and safety of ciprofol
and propofol for sedation in critically ill patients after cardiac
surgery. <br/>Patients and Methods: In this prospective, randomized
controlled trial, 123 patients undergoing coronary artery bypass grafting
(CABG) and/or valve surgery were randomly assigned to receive either
ciprofol (Group C) or propofol (Group P) for postoperative sedation in the
intensive care unit (ICU). Midazolam was administered if additional
sedation was required, and remifentanil was used for analgesia. Sedation
and analgesia were titrated to a target Richmond Agitation-Sedation Scale
(RASS) score of -2 to +1 and a Critical-Care Pain Observation Tool (CPOT)
score < 3. The primary endpoint was the mean sedation compliance rate,
defined as the percentage of RASS scores within the target range during
the initial 24 hours. Secondary endpoints included safety events,
extubation time, length of ICU stay, mortality, delirium incidence, and
postoperative recovery. <br/>Result(s): In the per-protocol (PP)
population, sedation compliance was 92.77% (Group C) and 94.30% (Group P).
Ciprofol showed non-inferior sedation to propofol in cardiac surgery
patients; the lower limit of the one-sided 95% confidence interval (CI)
for rate difference (RD) exceeded the -8% non-inferiority margin in both
PP and intention-to-treat (ITT) populations. The incidence of hypotension
was numerically lower in Group C (31.3% vs 40.7%; P = 0.276), with no
significant differences in other safety or secondary outcomes (all P >
0.05). <br/>Conclusion(s): In summary, ciprofol provides non-inferior
sedation efficacy and a comparable safety profile to propofol in
critically ill patients following cardiac surgery. A numerical trend
toward lower hypotension incidence was observed with ciprofol, which
warrants further validation in future studies.<br/>Copyright &#xa9; 2026
Guo et al.

<79>
Accession Number
650191771
Title
Gabapentin as an adjunct to multimodal pain regimens in surgical patients:
the GAP placebo-controlled RCT and economic evaluation.
Source
Health technology assessment (Winchester, England). 30(9) (pp 1-144),
2026. Date of Publication: 01 Feb 2026.
Author
Baos S.; Walker-Smith T.; Lui M.; A Stokes E.; Jiang J.; Pufulete M.;
Gibbison B.; A Rogers C.
Institution
(Baos, Walker-Smith, Lui, A Rogers) Bristol Trials Centre, Bristol Medical
School, University of Bristol, Bristol, United Kingdom
(A Stokes, Jiang) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, Oxford, United Kingdom
(Pufulete, Gibbison) Bristol Heart Institute, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Gibbison) University Hospitals Bristol and Weston NHS Foundation Trust,
Bristol Royal Infirmary, Bristol, United Kingdom
Abstract
Background: Gabapentin is an anticonvulsant medication with a United
Kingdom licence to treat partial seizures and neuropathic pain. It is used
off-licence for acute pain and is frequently added to multimodal analgesic
regimens after surgery to try and reduce opioid use while controlling pain
effectively. <br/>Objective(s): To test the hypothesis that gabapentin
reduces opioid use after major surgery and speeds up recovery, thereby
reducing postoperative hospital length of stay compared to standard
multimodal analgesia. Design, setting and participants: The GAP study was
a multicentre, blinded, randomised controlled trial in patients aged >= 18
years, undergoing cardiac, thoracic or abdominal surgery with an expected
postoperative stay of >= 2 days in seven National Health Service
hospitals. The trial was designed to provide 90% power to detect a
difference of 12.5% in the proportion of participants discharged by the
median length of stay in each specialty (500 participants/specialty),
which was reduced to 80% (340 participants/specialty) due to
COVID-19-related recruitment challenges. <br/>Intervention(s):
Participants were randomised 1 : 1 (stratified by surgical specialty) to
receive either gabapentin (600 mg before surgery, 300 mg twice daily for 2
days after surgery) or placebo as an adjunct to multimodal pain regimens.
<br/>Main Outcome Measure(s): Primary outcome was length of stay.
Secondary outcomes included acute and chronic (Brief Pain Inventory) pain,
total opioid use, adverse health events, health-related quality of life
(-EQ-5D-5L, Short Form questionnaire-12 items physical component score and
mental component score), resource use; cost-effectiveness (outcome measure
quality-adjusted life-years using EQ-5D, five-level version).
<br/>Result(s): One thousand one hundred and ninety-six (cardiac 500,
thoracic 346, abdominal 350) participants consented and were randomised.
Baseline characteristics were well balanced across the two groups: median
age: 68 years; male sex 796/1195 (66.4%). Of the participants, 223/1195
(18.7%) did not receive all prescribed medication or received medication
out of window. There was no difference in length of stay; median placebo
(n = 589): 6.15, gabapentin (n = 595): 5.94 days [hazard ratio for
discharge 1.07, 95% confidence interval (0.95 to 1.20), p = 0.26]. Opioid
use in-hospital differed between surgical specialties (p = 0.001); in the
abdominal specialty, it was significantly lower in the gabapentin group in
4 of the first 5 postoperative days [range -26% (-46% to 0%) to -36% (-52%
to -14%)], with no differences in the cardiac specialty nor in the
thoracic specialty beyond day 2. During follow-up, opioid use was similar
in the two groups across all specialties. Acute pain beyond 24 hours was
similar (p >= 0.15). The incidence of one or more serious adverse events
was placebo: 189/595 (31.7%); gabapentin: 195/599 (32.6%). Health-related
quality of life was similar [EQ-5D: mean difference -0.014 (-0.036 to
0.009), Short Form questionnaire-12 items physical component score: -0.87
(-1.71 to -0.04), Short Form questionnaire-12 items mental component
score: at 4 weeks 0.74 (-1.71 to 0.42) and 4 months -0.55 (-1.61 to
0.51)]. Differences in costs and quality-adjusted life-years favoured
placebo, and gabapentin was not considered cost-effective.
<br/>Limitation(s): GAP study tests the application of gabapentin to major
body cavity surgery, but not major non-body cavity surgery, or non-major
surgery. The fixed dose and limited duration of gabapentin may reduce
applicability to certain populations. Reducing the power to 80% reduced
the ability of the trial to detect a beneficial effect of gabapentin.
<br/>Conclusion(s): Among patients undergoing major cardiac, thoracic and
abdominal surgery, adding gabapentin to multimodal analgesic regimes did
not result in a change in length of stay, opiate use in two specialties,
acute pain, or health-related quality of life, nor was it cost-effective.
Future work: Trials to assess the place of gabapentin in major non-body
cavity surgery (e.g. joint replacement), or non-major (e.g. day-care)
surgery should be considered. Trial registration: This trial is registered
as Current Controlled Trials ISRCTN63614165. <br/>Funding(s): This award
was funded by the National Institute for Health and Care Research (NIHR)
Health Technology Assessment programme (NIHR award ref: 15/101/16) and is
published in full in Health Technology Assessment; Vol. 30, No. 9. See the
NIHR Funding and Awards website for further award information.

<80>
Accession Number
650179559
Title
Risk of bias in animal studies: A detailed analysis from a systematic
review in myocardial ischemia-reperfusion injury.
Source
Fundamental and Clinical Pharmacology. Conference: Annual Meeting of
French Society of Pharmacology and Therapeutics. Grenoble France.
39(Supplement 1) (no pagination), 2025. Date of Publication: 01 Jun 2025.
Author
Largeau B.; Echchih W.; Le Tilly O.; Pontois A.E.; Bejan-Angoulvant T.
Institution
(Largeau, Echchih, Le Tilly, Pontois, Bejan-Angoulvant) Inserm U1327
Ischemia "membrane Signaling and Inflammation in Reperfusion Injuries",
University of Tours & Department of Medical Pharmacology, Tours University
Hospital, Tours, France
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Animal studies (AS) are crucial to inform treatment effects
in humans, yet AS are prone to methodological and publication biases.
Systematic reviews (SR) of AS may help improve research quality by
evaluating the risk of bias (ROB). Several tools were published with no
gold standard for AS [1]. We aimed to report the ROB of AS included in a
SR evaluating the effect of monoclonal antibodies in myocardial
ischemiareperfusion injury and study the association of study conclusion
and funding with the ROB. <br/>Material(s) and Method(s): We used a
modified SYRCLE 10-items ROB tool [2] to evaluate the ROB of AS. The first
nine items evaluate selection, detection, evaluation, attrition, and
reporting biases. The 10th item evaluate the type of funding. The overall
ROB was judged first by considering all (9-item ROB) then by prioritizing
three most sensitive items (3-item ROB). We compared via Chi2 tests the
nine- and three-item ROB depending on the study conclusion
(positive/negative/mixed) and the funding (academic/industry/mixed).
<br/>Result(s): Eighty-five AS were included: 66 used a myocardial
infarction model, 17 a heart transplantation model, and 4 a
cardiopulmonary bypass model. More than 50% of AS were at high risk of
bias for 6/10 criteria, the highest being for the blinding of caregivers.
The lowest ROB was observed for random housing bias (animals being
sacrificed rapidly after intervention). Selective reporting was hardest to
evaluate (no formal outcome definition, no protocol). The funding could be
ascertained in 91% of studies: 64% academic, 9% industry funded, and 17%
mixed. The overall ROB was high, 97% and 89%, was significantly associated
with the study conclusion, P < 0.001 and <0.05, and with funding, P = 0.01
and 0.07, for the nine- and three-item ROB, respectively.
Discussion/conclusion: Our study highlights the very low quality of AS in
the field of cardiovascular research, significantly associated with study
conclusion and funding.

<81>
[Use Link to view the full text]
Accession Number
2043320738
Title
Prevalence and clinical implications of angiodysplasia in patients with
aortic stenosis: a systematic review and meta-analysis.
Source
European Journal of Gastroenterology and Hepatology. Publish Ahead of
Print (no pagination), 2025. Date of Publication: 2025.
Author
Abdel-Gawad M.; Almansoury Y.; Nagdy H.; El-Raey F.; El-Kassas M.
Institution
(Abdel-Gawad) Hepatology, Gastroenterology, and Infectious Diseases
Department, Assiut Faculty of Medicine, Al-Azhar University, Assiut
(Almansoury) Gastroenterology and Hepatology Division, Internal Medicine
Department, South Valley University, Qena
(Nagdy) Internal Medicine Department, College of Medicine, Arab Academy
for Science and Technology and Maritime Transport, Alexandria
(El-Raey) Hepatogastroenterology and Infectious Diseases Department,
Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
(El-Raey) Clinical Science Department, College of Medicine, Suliman
Alrajhi University, Al Bukayriyah, Al Qassim, Saudi Arabia
(El-Kassas) Endemic Medicine Department, Faculty of Medicine, Helwan
University, Cairo, Egypt
(El-Kassas) Applied Science Research Center. Applied Science Private
University, Amman, Jordan
Publisher
Lippincott Williams and Wilkins
Abstract
Gastrointestinal angiodysplasia is frequently observed in patients with
aortic stenosis and may present with bleeding and anemia. We conducted a
systematic review and meta-analysis to estimate its prevalence in this
population and to summarize outcomes after valve intervention. Following
PRISMA 2020, we searched PubMed, Scopus, and Web of Science and registered
the protocol in PROSPERO (CRD42024550839). Eligible observational studies
reporting angiodysplasia, von Willebrand factor abnormalities, or both in
aortic stenosis were appraised for quality and pooled using a random
effects model; heterogeneity and publication bias were assessed with I2
and Egger's test. Eleven studies were included. The pooled prevalence of
gastrointestinal angiodysplasia among patients with aortic stenosis was
6.3% (95% confidence interval: 4.51-8.38, I2 = 98.68, P < 0.0001), with no
evidence of publication bias. Across studies that reported longitudinal
outcomes, aortic valve replacement or transcatheter aortic valve
implantation was associated with a reduction in lesion burden and lower
rates of gastrointestinal bleeding, anemia, transfusion, and readmission,
although early postprocedural bleeding could occur and typically declined
over follow-up. These findings indicate that angiodysplasia is a
clinically relevant comorbidity in aortic stenosis and support proactive
gastrointestinal evaluation in patients with anemia or unexplained
bleeding. Standardized diagnostic criteria and prospective studies are
needed to clarify long-term outcomes after valve therapy and to define
screening and management pathways.<br/>Copyright &#xa9; 2026

<82>
Accession Number
650169079
Title
Study design for an emulated trial of a two arm, parallel, stratified,
adaptive, RCT of CABG versus PCI in people requiring myocardial
revascularisation at high risk (High-Risk REVASC).
Source
American heart journal. (pp 107368), 2026. Date of Publication: 02 Feb
2026.
Author
Liao W.; Rashid M.; Brookes C.L.; Barber S.; Turner R.M.; Gravel G.M.;
Petrie M.C.; Lipsic E.; Doenst T.; Fremes S.; Murphy G.J.
Institution
(Liao, Rashid) Division of Cardiovascular Sciences, School of Medical
Sciences, University of Leicester, United Kingdom
(Brookes, Barber) Leicester Clinical Trials Unit, University of Leicester,
United Kingdom
(Turner) Medical Research Council Clinical Trials Unit at UCL, United
Kingdom
(Gravel) Montreal Heart Institute, Universite de Montreal, Montreal, Qc,
Canada
(Petrie) School of Cardiovascular and Metabolic Health, University of
Glasgow, United Kingdom
(Lipsic) Department of Cardiology, University of Groningen, University
Medical Center Groningen, Groningen, Netherlands
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Fremes) University of Toronto, Toronto, Canada
(Murphy) Division of Cardiovascular Sciences, School of Medical Sciences,
University of Leicester, UK; Leicester Clinical Trials Unit, University of
Leicester, UK
Abstract
AIM: This study aims to use routinely collected health data and trial
emulation methodology to inform the design of a pragmatic randomised
controlled trial (RCT) in people requiring multivessel coronary
revascularisation with severe symptomatic multivessel disease and
high-risk characteristics, typically underrepresented in previous RCTs.
<br/>METHOD(S): Hospital Episode Statistics (HES) linked to Office for
National Statistics will be the main data source. The study population is
patients who require multivessel myocardial revascularisation with at
least one of the following high-risk characteristics: age >75 years,
female, diagnosed with acute coronary syndrome, heart failure, chronic
kidney disease, peripheral vascular disease, or intermediate frailty risk.
The intervention procedure is coronary artery bypass grafting (CABG) and
the control (reference) is percutaneous coronary intervention (PCI).
Outcomes include all-cause and cardiovascular (CV) death, CV
hospitalisation, major adverse cardiovascular events, and major vascular
complications or bleeding within 5 years of the index procedure. This
study includes three stages of statistical analyses: (1) latent class
analysis (LCA) to identify mutually exclusive patient clusters (latent
classes) representing different clinical phenotypes, (2) instrumental
variable analysis (IVA) to estimate the average treatment effect (ATE) in
the whole population and each patient cluster; and (3) repeating stage 2
in an emulated trial population obtained by matching the HES population
with individual participant data from an RCT. We will then co-design the
protocol for a definitive clinical trial in partnership with patients,
public, and stakeholders. <br/>DISCUSSION(S): This study introduces a
novel, stepwise data science framework that integrates machine learning
(unsupervised learning through LCA), causal inference, and trial emulation
methods applied in big data, to design a future stratified and adaptive
RCT of CABG versus PCI in high-risk patients. Our proposed approach
fosters new collaborations among data scientists, trial methodologists,
clinicians, and patient and public representatives in complex trial
designs for diverse, high-risk populations. This study represents a new
framework for co-production in trials of cardiovascular interventions,
which offers a scalable model and has the potential to transfer to other
disease areas. TRIAL REGISTRATION: ClinicalTrials.gov
(NCT05853536).<br/>Copyright &#xa9; 2026. Published by Elsevier Inc.

<83>
Accession Number
2042962926
Title
Bidirectional nexus between metabolic disease and aortic valve
calcification: from pathogenic mechanisms to integrated multimorbidity
management.
Source
Expert Opinion on Therapeutic Targets. (no pagination), 2026. Date of
Publication: 2026.
Author
Wang X.; Yu M.; Chen J.; Xu J.; Liu Y.; Wang Z.
Institution
(Wang, Yu, Chen, Xu, Liu, Wang) Department of Cardiology, Affiliated
Hospital of Jiangsu University, Zhenjiang, China
(Wang, Yu, Chen, Xu, Liu, Wang) Institute of Cardiovascular Diseases,
Jiangsu University, Zhenjiang, China
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Calcified aortic valve disease (CAVD) imposes a severe
global health burden, and there is currently no effective pharmacotherapy,
which urgently requires a new understanding of pathophysiology to guide
treatment. Areas covered: This review systematically evaluates the
epidemiological association and common mechanistic pathways between
metabolic diseases and aortic valve calcification (AVC) through the
proposed 'calcification-metabolic axis' framework. We conducted a
comprehensive literature search, covering the PubMed database up to
December 2025, with a focus on studies related to CAVD, metabolism,
inflammation, and calcification signaling. Expert opinion: Future
management strategies must transition toward early, multi-disease
co-governance strategies. At the same time, targeted drugs will be
developed for specific pathways on this axis, surpassing the current
treatment status of relying solely on valve replacement
surgery.<br/>Copyright &#xa9; 2026 Informa UK Limited, trading as Taylor &
Francis Group.

<84>
Accession Number
650173621
Title
Efficacy of positive expiratory pressure in the prevention and treatment
of postoperative pulmonary complications following thoracic and abdominal
surgery. A systematic review and meta-analysis.
Source
Monaldi archives for chest disease = Archivio Monaldi per le malattie del
torace. (no pagination), 2026. Date of Publication: 04 Feb 2026.
Author
Dolic D.; Salvitti S.
Institution
(Dolic) Department of Medicine, University of Udine
(Salvitti) Department of Medicine, University of Udine; Unit of
Cardiorespiratory Physiotherapy, Azienda Sanitaria Universitaria Friuli
Centrale (ASUFC), Udine
Abstract
Postoperative pulmonary complications (PPCs), including atelectasis,
pneumonia, and respiratory failure, are common after thoracic and upper
abdominal surgery and are associated with increased morbidity, longer
hospital stays, and higher costs. This systematic review and meta-analysis
investigated whether positive expiratory pressure (PEP) devices reduce
PPCs after thoracic or upper abdominal surgery compared with continuous
positive airway pressure (CPAP), usual care/no intervention, or other
non-CPAP respiratory treatments. We searched major databases and included
randomized controlled trials. A total of 12 studies were included, and 7
contributed to the meta-analysis. Across comparator-stratified analyses,
PEP did not demonstrate a consistent reduction in PPCs. Compared with
usual care/no intervention, pooled estimates showed no significant
benefit, and results were similarly inconclusive when PEP was compared
with other non-CPAP treatments; evidence versus CPAP was limited to a
single small trial. The overall certainty of evidence was low due to
methodological limitations and heterogeneity in outcome definitions and
intervention protocols. Overall, current evidence does not support routine
use of PEP devices as a primary strategy to prevent PPCs after thoracic or
upper abdominal surgery. Further well-designed trials are needed to
clarify whether specific patient subgroups or standardized protocols may
benefit.

<85>
Accession Number
650175549
Title
Influence of Pre-emptive Haptoglobin on Postoperative Acute Kidney Injury
in Cardiac Surgical Patients: A Randomized Controlled Trial.
Source
Anesthesia and analgesia. (no pagination), 2025. Date of Publication: 21
Nov 2025.
Author
Miyazaki A.; Hokka M.; Mizobuchi S.
Institution
(Miyazaki) From the Department of Anesthesiology, Kobe University
Hospital, Hyogo, Japan
Abstract
BACKGROUND: Haptoglobin may reduce hemolysis-induced kidney injury in
patients undergoing cardiovascular surgery with cardiopulmonary bypass
(CPB). Haptoglobin may be given empirically when hemolytic urine is
observed, or pre-emptively when detected by elevated free hemoglobin
concentrations. In the present study, we investigated whether pre-emptive
haptoglobin therapy guided by serum-free hemoglobin concentrations could
prevent postoperative renal dysfunction in patients who underwent major
cardiovascular surgery using CPB. <br/>METHOD(S): This study was a
single-center, open-label, randomized controlled trial. Adult patients who
underwent major cardiovascular surgery using CPB were included. Serum-free
hemoglobin concentrations were measured in all patients who consented for
this study. Patients with free hemoglobin concentrations that reached 0.05
g/dL were randomized to either (i) pre-emptive haptoglobin therapy group
or (ii) standard of care group. Patients in the pre-emptive haptoglobin
therapy group were administered 4000 U of haptoglobin when serum-free
hemoglobin concentration reached 0.05 g/dL within 2 hours after the start
of CPB. In the standard of care group, 4000 U of haptoglobin was
administered when hemolytic urine was confirmed after the start of CPB.
The primary outcome was the difference between the preoperative creatinine
concentration and the maximum creatinine concentration within 48 hours
after surgery (DELTACr). <br/>RESULT(S): The study was terminated with the
results of interim analysis due to patients' safety concerns. Finally, 34
patients in the pre-emptive haptoglobin therapy group and 33 in the
standard of care group were included in the analysis. Median
(interquartile range) DELTACr values were 0.20 (0.05-0.44) in the
pre-emptive haptoglobin therapy group and 0.14 (0.04-0.19) in the standard
of care group (P = .05). Multiple linear regression analysis with DELTACr
as objective variable and preoperative estimated glomerular filtration
rate (eGFR), age, and randomize group as explanatory variables revealed
that pre-emptive administration of haptoglobin significantly increased
DELTACr (P = .03). <br/>CONCLUSION(S): The interim study results
demonstrated that in patients undergoing major cardiovascular surgery
using CPB, pre-emptive haptoglobin administration worsened Cr values and
independently associated with increased DELTACr.<br/>Copyright &#xa9; 2025
International Anesthesia Research Society.

<86>
[Use Link to view the full text]
Accession Number
650184145
Title
Pharmacokinetic Modeling of Ticagrelor and Ticagrelor Active Metabolite
Removal by the DrugSorb-ATR Device in a Randomized Controlled Study of
Patients Undergoing Cardiac Surgery.
Source
Journal of cardiovascular pharmacology. 87(2) (pp 105-113), 2026. Date of
Publication: 01 Feb 2026.
Author
Mould D.R.; Sweeney K.R.; Prats J.; Fan W.; Schneider D.J.; Storey R.F.;
Deliargyris E.N.
Institution
(Mould, Sweeney) Projections Research, Phoenixville, PA, United States
(Sweeney) Sweeney Consulting, East Lyme, CT, United States
(Prats) LLC, Carlisle, MA, United States
(Fan, Schneider, Deliargyris) CytoSorbents Corporation, Princeton, NJ,
United States
(Schneider, Deliargyris) Department of Medicine, Cardiovascular Research
Institute, University of Vermont, Burlington, VT; and
(Storey) Cardiovascular Research Unit, University of Sheffield, Sheffield,
United Kingdom
Abstract
ABSTRACT: Excessive surgical bleeding is a potential risk in patients
taking ticagrelor who must undergo urgent cardiothoracic (CT) surgery
before adequate washout of the drug can occur. The DrugSorb-Antithrombotic
removal (ATR) device is a polymer sorbent-filled hemoadsorption cartridge
that can remove unbound (active) fractions of ticagrelor and ticagrelor
active metabolite (TAM) from blood. STAR-T was a randomized double-blind
sham-controlled clinical trial investigating whether the intraoperative
use of the device could reduce perioperative bleeding complications in
patients undergoing CT surgery within 2 days of ticagrelor
discontinuation. Blood samples were collected during the study for total
drug level measurements because the ability to measure unbound ticagrelor
and TAM (0.2% of total levels) requires an ultra-high sensitivity assay,
which is not commercially available. A published and validated
pharmacokinetic (PK) model was used to explore the effect of the device on
unbound ticagrelor/TAM using the total drug concentrations from the study.
The model performed well for simulations of total ticagrelor and TAM,
which indicated that the unbound concentrations were also appropriate. The
model demonstrated that DrugSorb-ATR significantly reduced unbound
ticagrelor and TAM concentrations. Linear and logistic regression analyses
of summed ticagrelor and TAM concentrations showed that the DrugSorb-ATR
device reduced the probability of clinically relevant bleeding in STAR-T
because of the reduction in unbound ticagrelor and TAM.<br/>Copyright
&#xa9; 2025 Wolters Kluwer Health, Inc. All rights reserved.

<87>
Accession Number
650181229
Title
Incidence and predictors of pacemaker implantation post transcatheter
aortic valve replacement in patients with pre-existing right bundle-branch
block.
Source
The Canadian journal of cardiology. (no pagination), 2026. Date of
Publication: 05 Feb 2026.
Author
Prabhu R.; Rao K.; Ciofani J.L.; Litkouhi P.N.; Baer A.; Hansen P.; Bhindi
R.
Institution
(Prabhu) Department of Cardiology, Royal North Shore Hospital, Sydney,
Australia
(Rao, Litkouhi, Hansen, Bhindi) Department of Cardiology, Royal North
Shore Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
(Ciofani) Department of Cardiology, Royal North Shore Hospital, Sydney,
Australia; University of Sydney, Sydney, Australia; Department of
Epidemiology and Biostatistics, School of Public Health, Imperial College
London, London, United Kingdom
(Baer) Department of Cardiology, North Shore Private Hospital, Sydney,
Australia
Abstract
BACKGROUND: Pre-existing right bundle branch block (RBBB) is the leading
predictor of permanent pacemaker implantation (PPI) following
transcatheter aortic valve implantation (TAVI). The applicability of
conventional PPI predictors in this high-risk subgroup remains unclear.
This review evaluates PPI incidence and associated predictors in TAVI
patients with pre-existing RBBB. <br/>METHOD(S): A systematic review of
PubMed, Scopus, Embase, and Web of Science identified studies reporting
PPI incidence and predictors in RBBB patients undergoing TAVI. Studies not
addressing RBBB-specific factors were excluded. Pooled PPI incidence was
calculated, and a qualitative narrative synthesis of predictors was
performed. <br/>RESULT(S): Of 2,269 identified references, 22 studies with
429,342 patients met inclusion criteria. Within the RBBB cohort, the mean
age was 81.6 +/- 7.4 years, with 64.2% male, and 23.7% having atrial
fibrillation. Balloon-expandable valves were used in 69.8% of cases, and
the transfemoral approach in 88.6%. The pooled PPI incidence was 37%
across 17 studies. Substantial interstudy heterogeneity necessitated
further analysis amongst 13 studies reporting consistent 30-day follow-up,
which yielded 39% incidence. PPI predictors in the RBBB cohort encompassed
demographic, anatomical, electrophysiological, and procedural domains.
<br/>CONCLUSION(S): Patients with baseline RBBB have significantly higher
post-TAVI PPI rates. Identifying RBBB specific predictors could facilitate
individualised procedural planning and risk stratification. This review
reinforces how both traditional (e.g. implantation depth) and
non-traditional (e.g. female sex, myocardial fibrosis, calcium volume and
distribution) factors have an amplified role in predicting PPI risk,
emphasising the need for further research in this subgroup to improve risk
stratification and reduce PPI incidence.<br/>Copyright &#xa9; 2026.
Published by Elsevier Inc.

<88>
[Use Link to view the full text]
Accession Number
650175809
Title
Safety and efficacy of protamine use during transcatheter aortic valve
implantation: A systematic review and meta-analysis.
Source
Medicine. 105(6) (pp e47578), 2026. Date of Publication: 06 Feb 2026.
Author
Khan S.A.; Parajuli S.B.; Marasini A.; Shrestha A.; Khan S.; Umirkulova
F.; Anas R.; Urazbaeva D.; Bhandari B.; Kausar H.; Kauser H.
Institution
(Khan, Bhandari) Birat Medical College Teaching Hospital, Morang, Nepal
(Parajuli) Department of Community Medicine, Birat Medical College
Teaching Hospital, Morang, Nepal
(Marasini) West Virginia University Health System Princeton Community
Hospital, Princeton, WV, United States
(Shrestha) Department of Internal Medicine, Medstar Health Georgetown
University, Baltimore, MD, Liberia
(Khan) Department of Internal Medicine, Liceo de Cagayan University,
Misamis Oriental, Cagayan de Oro City, Philippines
(Umirkulova) Department of Medicine, Termez University of Economics and
Service, Uzbekistan
(Anas) Department of Internal Medicine, Sargodha Medical College,
Sargodha, Pakistan
(Urazbaeva) Department of Psychology and Medicine, Mamun University,
Uzbekistan
(Kausar) Department of Internal Medicine, Karnali Academy of Health
Sciences, Jumla, Nepal
(Kauser) Department of Pharmacology, Pokhara University, Pokhara, Nepal
Abstract
BACKGROUND: Bleeding and vascular complications are key safety concerns
during transcatheter aortic valve implantation (TAVI). Protamine is
routinely administered to reverse unfractionated heparin, yet its efficacy
and safety profile remain debated, particularly regarding its influence on
bleeding, vascular, and renal outcomes. <br/>METHOD(S): A meta-analysis of
published studies comparing protamine with placebo during TAVI was
conducted. Primary outcomes included transfusion requirements, major and
life-threatening bleeding, and major vascular complications. Secondary
outcomes were acute kidney injury, cerebrovascular events, myocardial
infarction, minor vascular complications, and 30-day mortality. Odds
ratios (ORs) with 95% confidence intervals (CIs) were calculated using
random-effects models, and heterogeneity was assessed with the I2
statistic. <br/>RESULT(S): Protamine administration significantly reduced
the need for blood transfusion (OR = 0.70; 95% CI 0.55-0.88; P = .00; I2 =
0%), major bleeding (OR = 0.54; 95% CI 0.31-0.92; P = .02; I2 = 42.6%),
life-threatening bleeding (OR = 0.33; 95% CI 0.12-0.87; P = .03; I2 =
26.8%), and major vascular complications (OR = 0.44; 95% CI 0.28-0.67; P =
.00; I2 = 0%). There were no significant differences in any bleeding (OR =
0.82; 95% CI 0.50-1.36; P = .45), acute kidney injury (OR = 0.81; 95% CI
0.61-1.07; P = .14), cerebrovascular events (OR = 0.82; 95% CI 0.43-1.59;
P = .56), myocardial infarction (OR = 0.47; 95% CI 0.08-2.90; P = .42),
minor vascular complications (OR = 0.76; 95% CI 0.51-1.15; P = .19), or
30-day mortality (OR = 1.12; 95% CI 0.68-1.85; P = .65). Heterogeneity was
minimal across most analyses (I2 < 50%). <br/>CONCLUSION(S): Protamine
reversal of heparin during TAVI appears safe and confers significant
protective effects against transfusion requirements, bleeding, and major
vascular complications, supporting its routine use in the absence of
contraindications.<br/>Copyright &#xa9; 2026 the Author(s). Published by
Wolters Kluwer Health, Inc.

<89>
Accession Number
2042967588
Title
Exercise-based cardiac rehabilitation after transcatheter aortic valve
replacement: a systematic review and meta-analysis of randomized
controlled trials.
Source
Future Cardiology. (no pagination), 2026. Date of Publication: 2026.
Author
Khan U.; Abdelgalil M.S.; Khan M.H.; Ali J.; Majeed Z.; Amin A.M.; Nawaz
A.; Younas H.M.W.; Abuelazm M.; Aamir M.
Institution
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Abdelgalil) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Ali) Department of Medicine, Saint Peter's University Hospital, New
Brunswick, NJ, United States
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Younas) Department of Medicine, Weiss Memorial Hospital, Chicago, IL,
United States
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Aamir) Department of Cardiology, Lehigh Valley Health Network, Allentown,
PA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Many patients remain functionally limited after transcatheter
aortic valve replacement (TAVR) despite successful correction of aortic
stenosis. Exercise-based cardiac rehabilitation (EBCR) is effective in
other cardiac populations, but its benefits after TAVR remain uncertain.
This study evaluated the impact of EBCR on functional capacity, cardiac
function, quality of life, and safety outcomes in post-TAVR patients.
<br/>Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) published through February 2025 was conducted
using major databases. Outcomes were pooled using mean differences or risk
ratios with 95% confidence intervals. <br/>Result(s): Six RCTs with 272
patients were included. No significant difference was found between EBCR
and usual care for peak VO<inf>2</inf> change (MD: 1.46, 95% CI: [-0.16 to
3.08], p = 0.076) and six-minute walk distance (6MWD) change (MD: 18.72,
95% CI: [-2.24 to 39.68], p = 0.08). Similarly, no significant difference
was observed between EBCR and usual care for left ventricular ejection
fraction (LVEF) change (MD: 1.31, 95% CI: [-2.06 to 4.69], p = 0.45), and
aortic valve orifice area change (AVOA) (MD: -0.03, 95% CI: [-0.24 to
0.18], p = 0.78). <br/>Conclusion(s): EBCR did not significantly improve
outcomes after TAVR; however, near-significant trends in functional
capacity warrant further large-scale investigation. <br/>Protocol
Registration: PROSPERO ID CRD420250652719.<br/>Copyright &#xa9; 2026
Informa UK Limited, trading as Taylor & Francis Group.

<90>
Accession Number
2043278240
Title
Construction of the core competencies training system for thoracic surgery
specialist nurses: A mixed-methods study.
Source
PLOS ONE. 21(2 February) (no pagination), 2026. Article Number: e0339777.
Date of Publication: 01 Feb 2026.
Author
Li Y.; Chen Y.; Chen Q.; Zhu D.; Xia P.; Mao Y.; Yin L.; Ba S.
Institution
(Li) School of Nursing, Nanjing University of Chinese Medicine, Nanjing,
China
(Chen) Department of Nursing, Nanjing Drum Tower Hospital Clinical College
of Nanjing University of Chinese Medicine, Nanjing, China
(Chen) Jiangbei Department of Nursing, Nanjing Drum Tower Hospital,
Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
(Zhu) Department of Rheumatology and Immunology, Nanjing Drum Tower
Hospital, Affiliated Hospital of Medical School, Nanjing University,
Nanjing, China
(Xia, Mao, Yin) Department of Thoracic Surgery, Nanjing Drum Tower
Hospital, Affiliated Hospital of Medical School, Nanjing University,
Nanjing, China
(Ba) Department of Surgical Day Ward, Nanjing Drum Tower Hospital,
Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
Publisher
Public Library of Science
Abstract
Objective To develop a training system for cultivating the core
competencies of thoracic surgery specialist nurses. Methods A
mixed-methods study was employed, comprising two stages: (1) A literature
review and semi-structured interviews with thoracic surgical healthcare
professionals were conducted to develop a preliminary core competencies
training system for thoracic surgery specialist nurses; (2) A two-round
Delphi expert consultation was conducted to determine the final training
system. Results Consensus was reached on the core competency framework
(training objectives) (6 first-level, 17 second-level indicators), 92
items of curriculum content along with their corresponding teaching
methods, 17 aspects of organizational management, and 8 evaluation
methods. The response rate was 100%. The authority coefficient was 0.895.
The Kendall's coefficients for the two rounds of expert inquiry were 0.141
and 0.210, respectively. Conclusion This study developed a scientific,
comprehensive specialty training system for thoracic surgery specialist
nurses, meeting practical nursing needs, and enriching the field's
evidence base. It delivers substantial clinical and practical value to
nursing administrators, practitioners, patients, and the healthcare
system. Future research should validate its practical value through
larger-scale empirical studies, continuously gather feedback on training
outcomes, refine the training system, and further enhance its adaptability
and influence.<br/>Copyright &#xa9; 2026 Li et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<91>
[Use Link to view the full text]
Accession Number
2043316424
Title
Radial artery occlusion after cardiac catheterization and impact of
anticoagulation as medical treatment: a meta-analysis.
Source
Coronary Artery Disease. 37(2) (pp 133-141), 2026. Date of Publication: 01
Mar 2026.
Author
Didagelos M.; Papazoglou A.S.; Moysidis D.V.; Pagiantza A.; Afendoulis D.;
Kakderis C.; Daios S.; Anastasiou V.; Theodoropoulos K.C.; Kouparanis A.;
Kartalis A.; Kamperidis V.; Kassimis G.; Ziakas A.
Institution
(Didagelos, Pagiantza, Kakderis, Daios, Anastasiou, Theodoropoulos,
Kouparanis, Kamperidis, Ziakas) First Cardiology Department, AHEPA
University General Hospital
(Papazoglou) Cardiology Department, Athens Naval Hospital, Athens, Greece
(Moysidis, Pagiantza) Cardiology Department, 424 General Military
Hospital, Thessaloniki, Greece
(Afendoulis, Kartalis) Cardiology Department, General Hospital of Chios
'Skylitseio'
(Kassimis) Second Department of Cardiology, Hippokration Hospital,
Thessaloniki, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Background - Radial artery occlusion (RAO) is one of the most common
complications associated with transradial access in cardiac
catheterization procedures. To date there are no standardized protocols,
and only a few studies have evaluated the use of anticoagulation for RAO
treatment. The current meta-analysis aimed to assess the impact of various
anticoagulation strategies on RAO treatment after cardiac catheterization
via the transradial route. Methods - Literature search was performed in
PubMed, Web of Science, and CENTRAL databases, from inception until
September 2024. The primary outcome of this study was the incidence of
radial artery recanalization. The secondary outcomes were the incidence of
any bleeding events and symptom resolution during patient follow-up.
Results - A total of six studies with 398 patients were included in the
analysis. Patients with RAO under anticoagulation had a sevenfold
increased chance of radial artery recanalization [pooled odds ratio (pOR)
= 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there
was no statistically significant difference between patients receiving and
not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41].
Regarding bleeding events, no pooled data could be extracted; however, no
major bleeding events were reported in any study. Conclusion - This
meta-analysis provides compelling evidence that anticoagulation therapy
significantly improves radial artery recanalization rates in patients with
RAO without increasing the risk of major bleeding events; however, its
effect on symptom resolution remains limited, suggesting the need for a
comprehensive approach to RAO management.<br/>Copyright &#xa9; 2025
Wolters Kluwer Health, Inc. All rights reserved.

<92>
Accession Number
650153225
Title
Direct oral anticoagulants versus vitamin K antagonists for postoperative
atrial fibrillation after cardiac surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
BMC cardiovascular disorders. (no pagination), 2026. Date of Publication:
04 Feb 2026.
Author
Ahmed O.A.O.; Abbas M.; Ahmed A.A.O.; Ibrahim M.A.A.; Abakar M.E.M.; Yasir
E.; Edris M.E.E.; Ahmed R.A.O.; Babkir M.; Abdulaziz M.A.M.; Sota H.A.;
Gilbert C.; Eissa A.A.
Institution
(Ahmed, Abdulaziz) Faculty of Medicine, University of Khartoum, Khartoum,
Sudan
(Abbas, Yasir, Edris, Ahmed, Ahmed) Faculty of Medicine, National Ribat
University, Khartoum, Sudan
(Ahmed) Faculty of Medicine, National Ribat University, Khartoum, Sudan
(Ibrahim, Abakar, Babkir) Faculty of Medicine, Sudan International
University, Khartoum, Sudan
(Sota, Gilbert) St. Georges University, St. Georges, Grenada
(Eissa) Ain Shams University, Cairo, Egypt

<93>
Accession Number
650155079
Title
Prognostic value of LVEF in patients undergoing TAVI: A meta-analysis of
75,085 patients.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Annual Meeting, EACVI 2025. Vienna
Austria. 27(Supplement 1) (pp i349-i350), 2026. Date of Publication: 01
Jan 2026.
Author
Nabeshima Y.; Kitano T.; Sakamoto Y.; Takeuchi M.; Node K.
Institution
(Nabeshima, Sakamoto, Node) Saga University Hospital, Department of
Cardiovascular Medicine, Saga, Japan
(Kitano) Mie University Graduate, School of Medicine, Department of
Cardiology and Nephrology, Tsu, Japan
(Takeuchi) Tobata General Hospital, Department of Cardiovascular Medicine,
Kitakyushu, Japan
Publisher
Oxford University Press
Abstract
Background: Left ventricular ejection fraction (LVEF) is widely used to
assess systolic function and predict cardiovascular outcomes, but its
prognostic role in patients undergoing transcatheter aortic valve
implantation (TAVI) remains uncertain. <br/>Purpose(s): To evaluate
whether preprocedural LVEF independently predicts clinical outcomes after
TAVI through a large-scale meta-analysis. <br/>Method(s): We performed a
systematic review and meta-analysis of studies published from 2001 to 2024
that evaluated the association between preprocedural LVEF and post-TAVI
outcomes. Eligible studies were identified via PubMed and Scopus and
included those reporting hazard ratios (HR) for preprocedural LVEF.
Random-effects models were used for univariable and multivariable
analyses. Subgroup and metaregression analyses assessed effect modifiers,
including ethnicity, LVEF classification, endpoints, and study design.
<br/>Result(s): A total of 92 studies encompassing 98 independent patient
cohorts and 75,085 individuals were included in the meta-analysis. In the
univariable analysis, each 1% decrease in baseline LVEF was significantly
associated with a higher risk of adverse clinical outcomes, with a pooled
HR of 1.02 (95% confidence interval [CI]: 1.01-1.03; p < 0.001). This
effect persisted in multivariable-adjusted analyses, with an HR of 1.03
(95% CI: 1.01-1.05; p = 0.009), confirming the independent prognostic
value of LVEF after adjusting for other clinical and echocardiographic
covariates. (Abstract Picture 1) Subgroup analyses demonstrated the
robustness of this association across diverse populations and settings,
including Asian, European, and North American cohorts, and across
preserved and mixed LVEF strata. The association remained statistically
significant for both all-cause death and major adverse cardiovascular
events (MACEs). Further, a metaregression analysis indicated a
dose-response-like relationship, in which the prognostic impact of LVEF
was more pronounced in cohorts with lower mean baseline LVEF values (p =
0.025 in multivariable models), suggesting that LVEF's predictive value
may be particularly critical in patients with more advanced myocardial
dysfunction. <br/>Conclusion(s): Reduced preprocedural LVEF is
independently associated with worse prognosis after TAVI. These results
highlight the continued importance of LVEF in risk stratification and
clinical decision-making in TAVI candidates. (Table present).

<94>
Accession Number
650151426
Title
Randomized trial of smartphone application and bed sensor for atrial
fibrillation detection in high-risk patients.
Source
Scientific reports. (no pagination), 2026. Date of Publication: 03 Feb
2026.
Author
Lehto J.; Nuotio J.; Relander A.; Jaakkola J.; Lahdenoja O.; Vasankari T.;
Anzanpour A.; Elnaggar I.; Rekola R.; Sandelin J.; Hurnanen T.; Airaksinen
J.K.; Koivisto T.; Kiviniemi T.O.
Institution
(Lehto, Nuotio, Relander, Jaakkola, Vasankari, Airaksinen) Heart Center,
Turku University Hospital and University of Turku, Turku, Finland
(Lahdenoja, Anzanpour, Elnaggar, Rekola, Sandelin, Hurnanen, Koivisto)
Department of Computing, University of Turku, Turku, Finland
(Kiviniemi) Heart Center, Turku University Hospital and University of
Turku, Turku, Finland
(Kiviniemi) Heart Center, Turku University Hospital and University of
Turku T-hospital, Hameentie 11, Turku, Finland

<95>
Accession Number
650151181
Title
Cerebral oximetry-guided anaesthesia and postoperative delirium in elderly
patients undergoing off-pump coronary artery bypass grafting: a randomized
controlled trial.
Source
BMC geriatrics. (no pagination), 2026. Date of Publication: 03 Feb 2026.
Author
Tian L.; Wang H.; Jia Y.; Guo J.; Shan J.; Zhou H.; Zhao W.; Yuan S.
Institution
(Tian, Wang, Jia, Guo, Shan) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, National Clinical Research
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, 167 Beilishi Road, Xicheng District,
Beijing, China
(Zhou) Department of Intensive Care Unit, National Center for
Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Zhao) Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Yuan) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, China

<96>
Accession Number
650154559
Title
Vasoplegic syndrome - Risk predictors and evolving treatment strategies
post coronary artery bypass graft : A systematic review.
Source
BMC Proceedings. Conference: 13th International Conference for Healthcare
and Medical Students (ICHAMS). Dublin Ireland. 19(5) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Nair A.; Vartina E.
Institution
(Nair, Vartina) Riga Stradins University, Riga, Latvia
Publisher
BioMed Central Ltd
Abstract
Introduction: The complexity of Vasoplegic Syndrome (VS), characterized by
refractory hypotension and diminished systemic vascular resistance, poses
a considerable hurdle in Coronary Artery Bypass Grafting (CABG)
procedures. This review aims to synthesize recent evidence on risk
predictors and emerging treatment modalities for VS in CABG patients
thereby improving postoperative outcomes. <br/>Method(s): A comprehensive
search across PubMed (MEDLINE and PubMed Central), Google Scholar, and the
Cochrane Library identified studies published in the last 5 years.
Inclusion criteria focused on randomized controlled trials, meta-Analyses,
prospective analyses, grey literature, observational and Cohort studies
specific to VS and CABG patients. Three independent reviewers assessed
eligibility using PRISMA methodology. <br/>Result(s): From 873 studies,
only 15 met eligibility criteria. Early risk predictors for VS include
miRNA profiles (miRNA-30d and miR-770-5p), genetic polymorphisms
(Arg389-1AR variant), endothelial glycocalyx alterations with lower
syndecan-1 levels, and the lack of an early response from CD34+ and
CD34+CD133+ hematopoietic stem cells. These markers not only reveal
dysregulation but also influence inotropic support duration, emphasizing
genetic variability's impact on post-CABG hemodynamics. Adding complexity,
preoperative variables like renal failure, history of previous cardiac
surgery, combined procedures, and prolonged aortic cross-clamp with
cardiopulmonary bypass contribute. In these scenarios, pharmacological
strategies with antioxidant potential, Terlipressin and early methylene
blue, show efficacy in patients treated with angiotensin II receptor
antagonists during CABG. Angiotensin-II usage demonstrates positive
outcomes, increasing mean arterial pressure and reducing norepinephrine
requirements. Moreover, evidence suggests Glibenclamide with Sevoflurane
anesthesia may benefit high-risk patients undergoing CABG.
<br/>Conclusion(s): This systematic review highlights the necessity of
modified techniques in maintaining stable hemodynamics and shortening
surgical duration. There is a significant demand for additional research,
to validate and establish new evidence-based guidelines. Ultimately, the
findings unfold intricate interplay of genetic and clinical factors
influencing the occurrence and management of VS during CABG procedures.

<97>
Accession Number
650156152
Title
Predictive value of global and regional speckle tracking analysis in
patients enrolled in the ECHO-FIRE study.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Annual Meeting, EACVI 2025. Vienna
Austria. 27(Supplement 1) (pp i73-i74), 2026. Date of Publication: 01 Jan
2026.
Author
Frascaro F.; Albano F.; Marchini F.; Tonet E.; Passarini G.; Campo G.;
Pavasini R.
Institution
(Frascaro, Albano, Marchini, Tonet, Passarini, Campo, Pavasini) University
Hospital of Ferrara, Ferrara, Italy
Publisher
Oxford University Press
Abstract
Background: left ventricular (LV) global longitudinal strain (GLS)
measures the longitudinal deformation of subendocardial fibers, which are
sensitive to myocardial ischemia. Regional strain reduction may indicate
coronary stenosis or predict ventricular remodelling after
revascularization. <br/>Purpose(s): the aim of the present study was to
asses the prognostic value of speckle-tracking analysis in elderly
patients with ST-elevation myocardial infarction (STEMI) and
non-ST-elevation myocardial infarction (NSTEMI) with multivessel disease
treated by percutaneous coronary intervention (PCI) at 1-year follow-up.
<br/>Method(s): this sub-analysis derives from the "Functional versus
Culprit-only Revascularization in Elderly Patients with Myocardial
Infarction and Multivessel Disease" (FIRE) trial, a multicenter,
randomized study enrolling patients >75 years with acute myocardial
infarction and multivessel disease undergoing PCI of the culprit lesion,
who were randomized to receive either physiology-guided complete
revascularization of nonculprit lesions or no further revascularization.
We included only patients with a transthoracic echocardiogram performed at
our department after the index procedure in STEMI and before
revascularization in NSTEMI patients. Speckle-tracking echocardiography
assessed layer specific GLS- epicardial, mid-myocardial, and
endocardial-and segmental strain. Regional strain was calculated based on
coronary artery territories. The primary endpoint was a composite of
all-cause death, myocardial infarction, stroke and coronary
revascularization within 1 year. Univariable and multivariable Cox
regressions were performed; p < 0.05 was significant. <br/>Result(s): a
total of 174 patients were enrolled, the median age was 80 years (IQR
75.7-85.3). Among them, 106 were admitted for NSTEMI; 42 reached the
primary endpoint. STEMI patients showed lower regional GLS values in left
anterior descending artery (LAD) (-11.4 +/- 6.8, p < 0.009) and right
coronary artery (RCA) (-11.1 +/- 4.2, p < 0.005) territories compared to
NSTEMI patients. Patients with events (EP+) were older (81.7 +/- 5.5,
p<0.04), had lower ejection fraction values (44.2 +/- 11.9 vs. 51.1 +/-
12.3, p < 0.001), and worse speckle-tracking parameters compared to those
without events (EP-). Reduced global, layer-specific, and regional GLS
predicted events in univariable analysis (HR 1.1, 95% CI 1-1.2, p < 0.01),
but only age remained significant in multivariable analysis (HR 1.1, 95%
CI 1-1.6, p < 0.01). Reduced GLS in LAD and RCA territories predicted
events at univariable analysis in both STEMI and NSTEMI patients, but not
at multivariable. <br/>Conclusion(s): in patients with STEMI, regional GLS
appear to be more severely impaired compared to NSTEMI, and lower GLS
values are associated with worse clinical outcomes. However, GLS cannot be
considered an independent predictor of outcome in elderly patients with
multivessel acute myocardial infarction. (Table present).

<98>
Accession Number
650156266
Title
Comparative study of post-procedural Doppler velocity index (DVI) and
long-term prognosis in self-expandable and balloon-expandable
transcatheter aortic valve replacement.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Annual Meeting, EACVI 2025. Vienna
Austria. 27(Supplement 1) (pp i418), 2026. Date of Publication: 01 Jan
2026.
Author
Lee S.; Jung H.; Jung M.; Chung W.
Institution
(Lee, Jung, Jung, Chung) Seoul St. Marys Hospital, Seoul, South Korea
Publisher
Oxford University Press
Abstract
Background: Little is known about the relationship between post-procedural
Doppler velocity index (DVI) and long-term clinical outcomes following
transcatheter aortic valve replacement (TAVR). This study aimed to
evaluate the association between post-procedural DVI and fiveyear outcomes
for both self-expandable and balloon-expandable transcatheter aortic
valves. <br/>Method(s): In this study, we compared outcomes based on
post-procedural Doppler velocity index (DVI) in patients who underwent
either selfexpandable (n=457) or balloon-expandable (n=455) TAVR between
June 2015 and September 2023. Patients were divided into two discharge DVI
groups (<=0.5 vs. >0.5). The relationship between discharge DVI and
five-year all-cause mortality was analyzed using Kaplan-Meier analysis.
<br/>Result(s): Among 912 patients who underwent follow-up
echocardiography within 30 days post-TAVR, 38.4% had a DVI <=0.5, with
29.3% in the self-expandable group and 47.5% in the balloon-expandable
group. Discharge DVI <=0.5 was not associated with increased five-year
all-cause mortality in either the self-expandable (67.7% vs. 59.6%,
p=0.621) or balloon-expandable (69.9% vs. 70%, p=0.703) valve groups.
Kaplan- Meier analysis showed no significant differences in five-year
all-cause mortality between the DVI groups across both valve types: Evolut
high DVI, Evolut low DVI, Sapien high DVI, and Sapien low DVI groups
(59.4% vs. 68.1% vs. 70.2% vs. 69.8%, p=0.18, Figure 1). Overall, DVI
<=0.5 was not associated with adverse outcomes following TAVR (69% vs.
65.1%, p=0.708). <br/>Conclusion(s): DVI <=0.5 was not predictive of
adverse outcomes following TAVR with either the balloon-expandable or
self-expandable valve. (Figure present).

<99>
Accession Number
2043429896
Title
Comparing the Direct Oral Anticoagulants versus Vitamin K Antagonists in
Bioprosthetic Valves: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Clinical and Applied Thrombosis/Hemostasis. 32 (no pagination), 2026. Date
of Publication: 01 Jan 2026.
Author
Waseem M.H.; Abideen Z.U.; Cheema A.H.; Farhan K.; Raja H.A.A.; Tahir
M.Z.; Saleem F.; Nadeem A.; Thada P.K.
Institution
(Waseem) Allama Iqbal Medical College, Lahore, Pakistan
(Abideen) King Edward Medical University, Lahore, Pakistan
(Cheema) University of Texas Southwestern, Dallas, TX, United States
(Farhan) Jinnah Sindh Medical University, Karachi, Pakistan
(Raja) Rawalpindi Medical University, Rawalpindi, Pakistan
(Tahir, Saleem, Nadeem) Punjab Medical College, Faisalabad, Pakistan
(Thada) Sotang Primary Hospital, Solukhumbu, Nepal
Publisher
SAGE Publications Inc.
Abstract
Background: Replacing bioprosthetic valves is common but can cause
coagulation issues. This study assesses the safety and efficacy of Direct
oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in
bioprosthetic valve procedures. <br/>Method(s): PubMed, Cochrane Central,
and ScienceDirect were searched till May 2025. The risk ratios (RRs) were
pooled with 95% confidence intervals (CIs) under the random effects model
using Review Manager software. The quality assessment was conducted using
the Cochrane risk of bias (RoB 2.0) tool. <br/>Result(s): Eight randomized
controlled trials involving 3863 patients were included in the
meta-analysis. DOACs were associated with a significant reduction in the
risk of stroke or systemic embolism compared with VKAs (RR = 0.48; 95%CI:
[0.26, 0.88]; p = .02). The rate of major bleeding was similar between the
DOACs and VKAs (RR = 0.92; 95%CI: [0.49, 1.72]; p = .79). There was no
significant difference in the incidence of any stroke between the two
groups (RR = 0.65; 95%CI: [0.32, 1.31]; p = .23). The occurrence of
clinically relevant non-major bleeding (RR = 1.17; 95%CI: [0.97, 1.40]; p
= .10), all-cause mortality (RR = 0.94; 95%CI: [0.75, 1.17]; p = .57), and
intracranial hemorrhage (ICH) (RR = 0.71; 95%CI: [0.40, 1.26]; p = .25)
were comparable between the groups. <br/>Conclusion(s): DOACs seem safe
after bioprosthetic valve implantation, lowering the risk of stroke or
systemic embolism. However, rates of major bleeding, clinically relevant
non-major bleeding, any stroke, ICH, and all-cause mortality were
comparable between DOACs and VKAs.<br/>Copyright &#xa9; 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 page
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<100>
Accession Number
2043080153
Title
Does postoperative heparin-induced thrombocytopenia worsen outcomes
following cardiac surgery? A meta-analytic review.
Source
Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 6.
Date of Publication: 01 Dec 2026.
Author
Anosike U.G.; Amador W.F.O.; de Assis T.C.C.; Maciel R.B.; Etumudon S.I.;
Montanhesi P.K.
Institution
(Anosike) Faculty of Medicine, Nnamdi Azikiwe University College of Health
Sciences, Awka, Nigeria
(Amador) Universidade Federal de Campina Grande, Cajazeiras, Paraiba,
Brazil
(de Assis) School of Medical Sciences, University of Campinas, Campinas,
Brazil
(Maciel) School of Medicine, Universidade Nove de Julho, Sao Paulo, Brazil
(Etumudon) Lagos University Teaching Hospital, Lagos, Nigeria
(Montanhesi) Division of Cardiac Surgery, St. Michael's Hospital,
University of Toronto, Toronto, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Heparin-induced thrombocytopenia (HIT) after cardiac surgery
is a life-threatening complication despite the low reported incidence. The
impact of HIT on perioperative outcomes in cardiac surgery remains
controversial, with limited and conflicting evidence regarding its effects
on cardiopulmonary bypass time, length of hospital stay, complication
rates, and mortality. Our meta-analysis aims to clarify the influence of
postoperative HIT on outcomes in cardiac surgery. <br/>Method(s): We
systematically searched PubMed, Embase, and Cochrane Library to identify
studies comparing outcomes in patients with and without postoperative HIT
after cardiac surgery. Pooled odds ratios (ORs) and mean differences (MDs)
with 95% confidence intervals (CIs) were calculated using a random effects
model. Heterogeneity was assessed with I² statistics. R
software was used for statistical analysis. <br/>Result(s): Nine studies
encompassing 266,099 cardiac surgery patients were included, among whom
1,204 patients (0.45%) were diagnosed with HIT postoperatively. The pooled
incidence of HIT was 1.68% [95% CI 0.13-4.88; Prediction Interval
0.00-20.85]. HIT was associated with higher in-hospital mortality [OR =
2.57; 95% CI 1.02-6.46; p < 0.0001], longer hospital stay [MD 10.02 days,
95% CI 3.87 to 16.17, p = 0.001], increased thromboembolic events [OR
5.13, 95% CI 2.10 to 12.53, p < 0.01], and stroke [OR 2.33, 95% CI 1.40 to
3.89, p < 0.01]. However, cardiopulmonary bypass time and postoperative
complications including 30-day mortality, acute limb ischemia, pulmonary
embolism, renal complications, renal replacement therapy, and sepsis did
not differ significantly between HIT and non-HIT groups.
<br/>Conclusion(s): HIT after cardiac surgery is associated with higher
in-hospital mortality, longer duration of hospital stay, increased
thromboembolic events, and stroke. Despite consistent signals of harm, the
very low certainty of evidence necessitates cautious interpretation and
highlights an urgent need for higher-quality prospective studies.
Systematic review registration: PROSPERO CRD420251175827<br/>Copyright
&#xa9; The Author(s) 2026.

<101>
Accession Number
2043017354
Title
The impact of cerebral oxygen saturation monitoring on perioperative
neurocognitive disorders: a meta-analysis and economic analysis.
Source
Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1677218.
Date of Publication: 2026.
Author
Qin J.; Wang G.; Gu D.; Li J.; Zhang J.; Ge M.; He X.; Ma X.
Institution
(Qin, Wang, Ma) Department of Anesthesiology, Changzhi People's Hospital,
Changzhi, China
(Gu, Ge) Department of Otolaryngology, Changzhi People's Hospital,
Changzhi, China
(Li, He) Institute of Evidence-Based Medicine, Heping Hospital Affiliated
to Changzhi Medical College, Changzhi, China
(Zhang) Department of Pain Treatment, Changzhi People's Hospital,
Changzhi, China
Publisher
Frontiers Media SA
Abstract
Background: Inadequate intraoperative cerebral oxygen supply is one of the
inciting causes of postoperative cognitive disturbances. Numerous studies
have investigated the association between regional cerebral oxygen
saturation (rScO<inf>2</inf>) monitoring and postoperative cognitive
dysfunction. However, results are inconsistent, owing to differences in
surgery type, patient population, and monitoring protocols. Therefore, we
conducted a meta-analysis to comprehensively evaluate the association
between rScO<inf>2</inf> monitoring and the incidence of postoperative
neurocognitive disorders. <br/>Method(s): A comprehensive literature
search was conducted across multiple databases from their inception to
June 2025 to identify randomized controlled trials (RCTs) that compared
the impact of rScO<inf>2</inf> monitoring versus no monitoring on
cognitive function. The primary outcome was the incidence of perioperative
neurocognitive disorders (PNDs). Secondary outcomes were the incidences of
postoperative cognitive dysfunction (POCD) and postoperative delirium
(POD), as well as the economic indicators of the number needed to treat
(NNT) and cost-benefit ratio (CBR). <br/>Result(s): A total of 28 RCTs
were included. Overall, we found that intraoperative rScO<inf>2</inf>
monitoring significantly reduced the incidence risk of PND (relative risk
[RR] = 0.47, 95% confidence interval [CI]: 0.41, 0.54), POCD (RR = 0.47,
95% CI: 0.39, 0.57), and POD (RR = 0.45, 95% CI: 0.35, 0.57). Subgroup
analyses based on surgery type (cardiac, orthopedic, abdominal, and
others) demonstrated consistent protective effects of monitoring.
Sensitivity analyses using leave-one-out analysis, excluding
Chinese-language publications, low-quality studies, and studies with a
baseline rScO<inf>2</inf> < 80%, confirmed the robustness of results. The
economic evaluation showed that rScO<inf>2</inf> monitoring is both
clinically beneficial and cost-effective, as reflected in the low NNT
values and favorable CBRs, which indicated that the cost of prevention is
substantially lower than that of managing complications.
<br/>Conclusion(s): Intraoperative rScO<inf>2</inf> monitoring
significantly reduces the incidence of PND, including POCD and POD.
Consistent protective effects were observed across a wide range of surgery
types, demonstrating its broad clinical applicability. Furthermore, its
favorable cost-benefit profile demonstrated that the prevention of
neurocognitive complications has a substantially lower cost than the
estimated economic burden of managing these complications. Widespread
adoption of rScO<inf>2</inf> monitoring is recommended to improve
postoperative cognitive outcomes.<br/>Copyright &#xa9; 2026 Qin, Wang, Gu,
Li, Zhang, Ge, He and Ma.

<102>
[Use Link to view the full text]
Accession Number
2043150721
Title
Peri-Interventional Anesthesia Strategies for Transcatheter Aortic Valve
Implantation: A Multicenter, Randomized, Controlled, Noninferiority Trial.
Source
Circulation. 152(22) (pp 1526-1537), 2025. Date of Publication: 02 Dec
2025.
Author
Feistritzer H.-J.; Ender J.; Lauten P.; Rudolph T.K.; Rudolph V.; Geisler
T.; Massberg S.; Adam M.; Baldus S.; Sossalla S.; Joner M.; Mollmann H.;
Wolf A.; Kim W.-K.; Borger M.A.; Noack T.; Magunia H.; von Dossow V.;
Sander M.; Vigelius-Rauch U.; Feuerecker M.; Zakhary W.; Boening A.;
Bleiziffer S.; Hohenstein S.; Hoesler N.; Buske M.; Desch S.; Abdel-Wahab
M.; Thiele H.
Institution
(Feistritzer, Ender, Borger, Noack, Zakhary, Hoesler, Buske, Desch,
Abdel-Wahab, Thiele) Heart Center Leipzig at Leipzig University, Leipzig,
Germany
(Lauten, Baldus) Zentralklinik Bad Berka, Bad Berka, Germany
(Rudolph, Rudolph, Baldus, von Dossow) Heart and Diabetes Center NRW, Bad
Oeynhausen, Germany
(Geisler, Mollmann) University Hospital Tubingen, Tubingen, Germany
(Massberg, Feuerecker) Department of Medicine I, Ludwig Maximilian
University Munich, Munich, Germany
(Adam, Bleiziffer) Heart Center, University of Cologne, Cologne, Germany
(Sossalla, Kim, Sander, Vigelius-Rauch, Boening) University Hospital
Giessen, Giessen, Germany
(Joner) Department of Cardiology, German Heart Center Munich, Technical
University of Munich, Munich, Germany
(Magunia) Department of Cardiology, St.-Johannes Hospital Dortmund,
Dortmund, Germany
(Wolf) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(Hohenstein) Helios Health Institute, Leipzig, Germany
(Thiele) Leipzig Heart Science, Leipzig, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - Minimalist treatment strategies for transcatheter aortic
valve implantation have been widely adopted because of continued
procedural evolution, but large randomized trials are lacking. The
DOUBLE-CHOICE trial (Randomized Study Comparing Both Latest Generation
Self-Expanding Valves and a Minimalist Approach Versus Standard of Care in
Transcatheter Aortic Valve Implantation) evaluated the safety and efficacy
of a minimalist approach (MA) compared with the standard of care (SoC) for
transfemoral transcatheter aortic valve implantation. <br/>METHOD(S): - In
this investigator-initiated, 2x2 factorial, open-label, randomized,
multicenter, noninferiority trial, patients with symptomatic aortic
stenosis were included at 10 German sites. Patients were randomly assigned
to the MA, including isolated local anesthesia, versus the SoC using
conscious sedation. The primary end point was a composite of all-cause
mortality, vascular and bleeding complications, infection requiring
antibiotic therapy, and neurological events at 30 days. The noninferiority
of the MA compared with the SoC was tested in the intention-to-treat
population with an absolute noninferiority margin of -6% at an alpha level
of 0.05. <br/>RESULT(S): - Between July 11, 2022, and January 14, 2025,
752 patients were randomly assigned to the MA (n=377) and SoC (n=375). The
median age was 83 (interquartile range, 79-86) years, 439 (58.5%) patients
were women, and the median Society of Thoracic Surgeons risk score was
4.6% (interquartile range, 2.9-8.0). The primary end point occurred in 80
(22.9%) of 350 patients in the MA group and in 91 (25.8%) of 353 patients
in the SoC group (rate difference, 2.9%; lower boundary of the 1-sided 95%
CI, -2.4%; P for noninferiority=0.003; 2-sided 95% CI, -3.4 to 9.3; P for
difference=0.37). Patient-reported anxiety and stress levels during the
procedure were higher in the MA group. <br/>CONCLUSION(S): - The MA
including isolated local anesthesia was noninferior to the SoC with
conscious sedation, highlighting the safety and efficacy of the MA for
transcatheter aortic valve implantation. The burden of intraprocedural
pain and discomfort is potentially higher in the MA group. REGISTRATION: -
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT05036018.<br/>Copyright &#xa9; 2025 American Heart Association, Inc.

<103>
Accession Number
650167757
Title
Left atrial appendage occlusion versus NOACs in patients with atrial
fibrillation: Rationale and design of the CATALYST Trial.
Source
American heart journal. (pp 107367), 2026. Date of Publication: 02 Feb
2026.
Author
Reddy V.Y.; Hylek E.; Camm A.J.; Halperin J.L.; Diener H.-C.; Thaler D.;
Schmidt B.; Hara H.; Huisman M.V.; Price M.J.; Lakkireddy D.; Gage R.;
Zhao H.; Jensen T.P.; Quintana M.; Windecker S.
Institution
(Reddy, Halperin) Mount Sinai Fuster Heart Hospital, Icahn School of
Medicine at Mount Sinai, New York, NY
(Hylek) Boston University School of Medicine, Boston, MA, United States
(Camm) City St. George's University of London, London, United Kingdom
(Diener) University Duisburg-Essen, Essen, Germany
(Thaler) Tufts Medical Center, Boston, MA, United States
(Schmidt) Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
(Hara) Toho University Ohashi Medical Center, Tokyo, Japan
(Huisman) Leiden University Medical Center, Leiden, Netherlands
(Price) Scripps Clinic, La Jolla, CA, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Gage, Zhao) St. Paul, Abbott, MN, United States
(Jensen, Quintana) Berry Consultants, Austin, TX, United States
(Windecker) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
Abstract
BACKGROUND: Both percutaneous left atrial appendage occlusion (LAAO) and
non-vitamin K antagonist oral anticoagulants (NOACs) are noninferior to
warfarin for stroke prevention in high-risk patients with atrial
fibrillation (AF). However, there is limited data comparing LAAO with
NOACs. The CATALYST trial compares a dual-seal LAAO device (AmplatzerTM
AmuletTM) to NOACs in AF patients indicated for thromboprophylaxis. STUDY
DESIGN: CATALYST is a prospective, multicenter, randomized controlled,
open-label trial with an adaptive statistical design. Up to 2,650 AF
patients with CHA2DS2-VASc score >=2 (men) or >=3 (women) will be randomly
assigned to LAAO or NOAC at 123 global sites. Patients randomized to NOACs
take the appropriate labeled dose with compliance monitored at each visit,
while LAAO patients receive dual antiplatelet therapy followed by aspirin
monotherapy for >=12 months post-implant. Patients are followed through 5
years, with post-implant cardiac imaging at 3- and 12-months. There are
three co-primary endpoints: (1) ischemic stroke, systemic embolism, or
cardiovascular death through 2 years, tested for noninferiority; (2) major
or clinically relevant non-major bleeding through 2 years, tested for
superiority; and (3) ischemic stroke or systemic embolism through 3 years,
tested for noninferiority. The following secondary endpoints will be
tested if the primary endpoints are met: (1) all-bleeding, tested for
noninferiority; (2) followed by testing for superiority; (3) disabling or
fatal strokes, tested for superiority; all through 2 years.
<br/>CONCLUSION(S): CATALYST is evaluating the safety and effectiveness of
a dual seal LAAO device compared to NOACs in patients with AF at increased
risk of stroke. CLINICAL TRIAL REGISTRATION: URL
https://clinicaltrials.gov; Unique Identifier NCT04226547.<br/>Copyright
&#xa9; 2026. Published by Elsevier Inc.

<104>
Accession Number
2037676518
Title
Regional analgesia for postoperative pain control after thoracic surgery:
a narrative review.
Source
Journal of Yeungnam Medical Science. 42 (no pagination), 2025. Article
Number: 80. Date of Publication: 2025.
Author
Park S.-J.; Choi E.K.
Institution
(Park, Choi) Department of Anesthesiology and Pain Medicine, Yeungnam
University College of Medicine, Daegu, South Korea
Publisher
Yeungnam University School of Medicine and College of Medicine
Abstract
Effective management of post-thoracotomy pain is essential to prevent
pulmonary complications and reduce the risk of developing chronic pain
syndrome. Although systemic opioids remain a common option, their use is
limited by significant adverse effects, making regional analgesia the
cornerstone of postoperative pain management. Thoracic epidural analgesia,
historically regarded as the gold standard, provides potent postoperative
pain relief but carries risks of hypotension and, in rare cases, severe
neurological events. Thoracic paravertebral block (PVB) has emerged as the
primary alternative, offering comparable analgesic efficacy and an
improved safety profile, particularly in maintaining hemodynamic
stability. However, PVB is technically demanding and associated with a
higher failure rate and localized procedural complications such as
pneumothorax. Fascial plane blocks have recently been developed to
prioritize safety. The erector spinae plane block is technically simpler,
using the transverse process as a "bony backstop" to minimize the risk of
pleural injury; however, its analgesic potency may be lower than that of
PVB. The intertransverse process block seeks to combine the efficacy of
PVB with enhanced safety; however, supporting evidence remains limited.
Alternative regional techniques, such as serratus anterior plane block,
intercostal nerve block, and continuous wound instillation, typically
provide insufficient analgesia for the comprehensive pain associated with
open thoracotomy. No regional analgesic technique has demonstrated
universal superiority. The optimal approach should be individualized,
balancing the distinct risk-benefit profile of each block with patient
comorbidities, surgical factors, and institutional
expertise.<br/>Copyright &#xa9; 2025 Yeungnam University College of
Medicine, Yeungnam University Institute of Medical Science.

<105>
Accession Number
2043024225
Title
Optimizing preoperative CTA protocols for TAVR: enhanced image quality and
reduced radiation and contrast doses with dual-source Turbo Flash mode.
Source
Chinese Journal of Academic Radiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Liu W.; Zheng Y.; Chen J.; Li J.; Du M.; Zeng J.; Chen X.; Chen W.; Li L.
Institution
(Liu, Zheng, Chen, Li, Du, Zeng, Chen, Li) First Affiliated Hospital of
Army Medical University, Chongqing, China
(Chen) University of Birmingham, Birmingham, United Kingdom
Publisher
Springer
Abstract
Purpose: This study aimed to investigate the feasibility of using the
Turbo Flash mode for transcatheter aortic valve replacement (TAVR)
computed tomography (CT) with a single contrast agent injection, aiming to
reduce contrast agent volume and radiation dose while maintaining image
quality. <br/>Method(s): Ninety patients were randomly assigned to either
the Turbo Flash group, which received a single contrast agent injection
and underwent the Turbo Flash scan without electrocardiogram
synchronization, or the conventional group, which received two contrast
agent bolus injections and underwent a standard scan. <br/>Result(s):
Compared with the conventional group (110 mL contrast agent), the Turbo
Flash group showed a 30% reduction in iodine usage (80 mL contrast agent).
All examination image qualities met diagnostic requirements. No
significant differences were noted between the two groups in terms of
subjective and objective aortic root computed tomography angiography (CTA)
scores. However, the Turbo Flash group had a significantly higher
subjective score for aorta-femoral artery CTA compared with the
conventional group (P < 0.001). The Turbo Flash group demonstrated lower
radiation doses for aorto-femoral artery scanning (474.73 +/- 127.48 mGy
cm) compared to the conventional group (661.97 +/- 172.91 mGy cm), a 28.3%
reduction (P < 0.05). No significant difference in the radiation dose for
aortic root scanning was observed between the two groups.
<br/>Conclusion(s): Performing pre-TAVR CT with a single segmented
contrast agent injection is feasible and effective. These images can meet
clinical diagnostic needs while reducing contrast agent volume and
radiation dose.<br/>Copyright &#xa9; The Author(s) 2026.

<106>
[Use Link to view the full text]
Accession Number
650151146
Title
Balloon-expandable versus self-expanding valves in severe aortic stenosis
with small aortic annulus: an updated meta-analysis.
Source
Coronary artery disease. (no pagination), 2026. Date of Publication: 04
Feb 2026.
Author
Narciso I.A.T.; Krishna M.M.; Joseph M.; Puglla Sanchez L.R.; Ezenna C.;
Ayesha A.; Pereira V.; Lajczak P.; Mendes B.S.; Schincariol M.
Institution
(Narciso, Mendes) University Center UNIFIPMOC, Montes Claros, Brazil
(Krishna, Joseph) Department of Medicine, Medical College
Thiruvananthapuram, Kerala, India
(Puglla Sanchez) Clinico Lozano Blesa University Hospital, Zaragoza, Spain
(Ezenna) Department of Medicine, University of Massachusetts, Baystate
Medical Center, Springfield, United States
(Ayesha) Shifa College of Medicine, Islamabad, Pakistan
(Pereira) Faculty of Biomedical Sciences Austral University, Pilar,
Argentina
(Lajczak) Medical University of Silesia, Katowice, Poland
(Schincariol) Klinikum Furth, Academic Teaching Hospital of
Friedrich-Alexander-Universitat Erlangen-Nurnberg, Furth, Germany
Abstract
BACKGROUND: Balloon-expandable valve (BEV) and self-expanding valve (SEV)
are used in transcatheter aortic valve replacement (TAVR). Patients with a
small aortic annulus (SAA) make up to one-third of the cases and face
higher risks of prosthesis-patient mismatch and high valvular gradients.
<br/>OBJECTIVE(S): This meta-analysis aimed to compare balloon-expandable
and self-expanding valves used in TAVR in patients with a SAA, focusing on
hemodynamic and clinical outcomes. <br/>METHOD(S): We systematically
searched Cochrane Central, PubMed, and EMBASE for studies comparing
balloon-expandable and self-expanding valves in patients with SAA
undergoing TAVR. Random effects models were applied to generate odds
ratios (ORs) and mean differences with 95% confidence interval (CI).
<br/>RESULT(S): Fifteen studies (two randomized controlled trials and 13
propensity-matched studies) with 5149 patients (48.4% balloon-expandable
valves) were identified. BEVs were associated with a lower indexed
effective orifice area (mean difference: -0.18, 95% CI: -0.25 to -0.10; P
< 0.00001) and higher transvalvular mean pressure gradient (mean
difference: 4.32, 95% CI: 3.39-5.24; P < 0.00001) and peak pressure
gradients (mean difference: 4.87, 95% CI: 1.23-8.51; P = 0.009). Permanent
pacemaker implantation (OR: 0.57, 95% CI: 0.44-0.73; P < 0.0001) and major
bleeding (OR: 0.67, 95% CI: 0.47-0.96; P = 0.03) were lower in
balloon-expandable valves. BEVs increased the odds of any
prosthesis-patient mismatch (OR: 2.28, 95% CI: 1.61-3.22; P < 0.00001) and
severe prosthesis-patient mismatch (OR: 3.16, 95% CI: 2.19-4.58; P <
0.00001). <br/>CONCLUSION(S): In patients with SAA undergoing TAVR, SEVs
offer superior hemodynamic performance, whereas BEVs are associated with
fewer conduction disturbances and bleeding events. Both valve platforms
yielded similar clinical outcomes, underscoring the need for
individualized device selection.<br/>Copyright &#xa9; 2026 Wolters Kluwer
Health, Inc. All rights reserved.

<107>
Accession Number
650152276
Title
The Society of Thoracic Surgeons (2025) Expert Consensus Document on
Interventions for Screen-Detected Lung Nodules.
Source
The Annals of thoracic surgery. (no pagination), 2026. Date of
Publication: 01 Feb 2026.
Author
Servais E.; Hayanga J.W.A.; Linden P.; Sood P.; Raymond D.P.; Antonoff
M.B.; Chudgar N.P.; Keshava H.B.; Velotta J.B.; Crabtree T.; Jeffrey Yang
C.-F.; Raz D.; Tong B.; Cooke D.T.; Erkmen C.P.; Shaller B.; Kent M.S.;
McKee A.; Phan C.T.; Daly M.E.; Onaitis M.W.; Edwards J.P.; Yang S.C.;
Merritt R.E.; Shrager J.
Institution
(Servais) Department of Thoracic Surgery, Lahey Hospital and Medical
Center, Burlington, MA, United States; Department of Surgery, UMass Chan
Medical School, Worcester, MA, United States
(Hayanga) Department of Cardiovascular and Thoracic Surgery, Heart and
Vascular Institute West Virginia University Medicine, Morgantown, VA,
United States
(Linden) Division of Thoracic and Esophageal Surgery, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
(Sood) Society of Thoracic Surgeons, Chicago, IL, United States
(Raymond) Department of Thoracic & Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Antonoff) Division of Surgery, Department of Thoracic and Cardiovascular
Surgery, University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Chudgar) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center/Albert Einstein College of Medicine, New York, NY, United
States
(Keshava) Division of Thoracic Surgery, Department of Surgery, University
of California, Irvine, CA, United States
(Velotta) Divison of Thoracic Surgery, Kaiser Permanente, Oakland, CA,
United States; Department of Surgery, University of California, San
Francisco (UCSF) School of Medicine, San Francisco, CA, United States;
Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School
of Medicine, Pasadena, CA, United States
(Crabtree) Division of Cardiothoracic Surgery, Southern Illinois
University Medical Center, Springfield, IL, United States
(Jeffrey Yang) Department of Surgery, Division of Thoracic Surgery,
Massachusetts General Hospital, Boston, MA, United States
(Raz) Division of Thoracic Surgery, City of Hope, Duarte, CA, United
States
(Tong) Department of Surgery, Division of Thoracic Surgery, Duke
University Medical Center, Durham, NC, United States
(Cooke) Division of General Thoracic Surgery, University of California,
Davis Health, Sacramento, CA, United States
(Erkmen) Division of Surgery, Lewis Katz School of Medicine at Temple
University, Philadelphia, PA, United States
(Shaller) Division of Pulmonary, Allergy & Critical Care Medicine,
Stanford University School of Medicine, Stanford, CA, United States
(Kent) Division of Thoracic Surgery and Interventional Pulmonology, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(McKee) Department of Radiation Oncology, Lahey Hospital and Medical
Center, Burlington, MA, United States
(Phan) Division of Pulmonary, Critical Care & Sleep Medicine, University
of California, Davis Health, Sacramento, CA, United States
(Daly) Department of Radiation Oncology, University of California, Davis
Comprehensive Cancer Center, Sacramento, CA, United States
(Onaitis) Department of Surgery, University of California, San Diego, CA,
United States
(Edwards) Department of Surgery, Section of Thoracic Surgery, University
of Calgary, Calgary, AB, Canada
(Yang) Department of Surgery, Division of Thoracic Surgery, Johns Hopkins
Medical Institutions, Baltimore, MD, United States
(Merritt) Division of Thoracic Surgery, Ohio State Wexner Medical Center,
Columbus, OH, United States
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, CA, United
States; Veterans Affairs Palo Alto Health Care Center, Palo Alto, CA,
United States
Abstract
BACKGROUND: Computed tomographic (CT) lung cancer screening (LCS) reduces
lung cancer-specific mortality and improves survival. We reviewed
contemporary literature to develop consensus recommendations on
perioperative quality standards for LCS programs to optimize outcomes.
<br/>METHOD(S): The Society of Thoracic Surgeons (STS) Task Force on Lung
Cancer Screening and STS Workforce on Evidence Based Surgery convened a
multidisciplinary panel of thoracic surgeons, radiation oncologists, and
interventional pulmonologists. A comprehensive literature review was
conducted using the Population-Intervention-Comparisons-Outcome framework.
Consensus statements were developed through a modified Delphi process
addressing: 1) preoperative biopsy and diagnostic surgical procedures, 2)
acceptable rates of complications from diagnostic and therapeutic
procedures, and 3) timing of intervention following a suspicious LCS
finding and the role of the multidisciplinary team in patient management.
Consensus required >=75% agreement. <br/>RESULT(S): Twenty-three consensus
statements were developed after three Delphi rounds; 20 achieved consensus
in the first round. Surgery without tissue diagnosis was acceptable for
carefully selected patients, favoring minimally invasive,
parenchymal-sparing approaches. Pneumonectomy without diagnosis was
unanimously rejected. Programs should track benign resection rates.
Acceptable complication benchmarks included pneumothorax <5%, hemoptysis
<2%, and mortality <1% for bronchoscopic biopsy; and surgical morbidity
<10%, 30-day mortality <1%, per STS database standards. Definitive
resection should occur within 12 weeks of the inciting imaging study.
Multidisciplinary teams should include thoracic surgery, oncology,
pulmonology, and radiology. Preoperative pulmonary rehabilitation and
smoking cessation were emphasized. <br/>CONCLUSION(S): This STS consensus
defines perioperative quality standards for CT LCS programs, supporting
shared decision-making, multidisciplinary care, and quality
improvement.<br/>Copyright &#xa9; 2026. Published by Elsevier Inc.

<108>
Accession Number
650155400
Title
Revascularization strategies for left main coronary lesions: A
meta-analysis of ultrasound-guided and angiography-directed PCI outcomes.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Annual Meeting, EACVI 2025. Vienna
Austria. 27(Supplement 1) (pp i898-i899), 2026. Date of Publication: 01
Jan 2026.
Author
Hassan E.M.A.N.; Ahmed M.; Ahmed R.
Institution
(Hassan) Sheikh Shakhbout Medical City Ssmc, Abu Dhabi, United Arab
Emirates
(Ahmed) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ahmed) Imperial College London, London, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Unprotected left main coronary artery (ULMCA) disease
represents the most prognostically significant manifestation of coronary
artery disease, carrying substantial risks of cardiovascular mortality and
morbidity. While coronary artery bypass grafting (CABG) has traditionally
been the gold standard, percutaneous coronary intervention (PCI) with
drug-eluting stents has emerged as a viable alternative for select
patients, as demonstrated in contemporary clinical trials. However,
conventional angiographic guidance presents inherent limitations in
complex lesion assessment. <br/>Method(s): We conducted a systematic
evidence synthesis comparing intravascular ultrasound (IVUS)-guided versus
angiography-guided PCI for ULMCA disease, incorporating randomized
controlled trials and propensity score-matched observational studies.
Following PRISMA guidelines, we comprehensively searched multiple
databases through March 2024. Study quality was assessed using Cochrane
ROB 2.0 and ROBINS-I tools. Primary and secondary outcomes were analyzed
using random-effects models in R software. <br/>Result(s): Our analysis
included 12 studies (3 RCTs, 9 PSM studies) encompassing 15,370 patients.
IVUS guidance demonstrated superior outcomes across multiple endpoints:
significant reductions in major adverse cardiovascular events (RR 0.60,
95% CI 0.49-0.74), all-cause mortality (RR 0.65, 0.59-0.72), cardiac
mortality (RR 0.44, 0.30-0.63), myocardial infarction (RR 0.70,
0.57-0.85), stent thrombosis (RR 0.38, 0.21-0.70), and revascularization
endpoints (TLR RR 0.55, 0.33-0.91; TVR RR 0.64, 0.46-0.91). Heterogeneity
was generally low (I<50%) across analyses. <br/>Conclusion(s): This
comprehensive meta-analysis establishes IVUS guidance as superior to
conventional angiography for ULMCA PCI, demonstrating significant
improvements in both safety and efficacy outcomes. The tomographic
visualization provided by IVUS enables precise lesion assessment and stent
optimization, addressing key limitations of two-dimensional angiography.
(Table present).

<109>
Accession Number
650152165
Title
Tuning in To Recovery: Music's Role in Pain Reduction After Cardiothoracic
Surgery.
Source
Mayo Clinic proceedings. (no pagination), 2026. Date of Publication: 02
Feb 2026.
Author
Trinchet L.P.; Chen K.Y.; Lopez-Ruiz A.A.; Millstine D.M.; Misra L.
Institution
(Trinchet, Lopez-Ruiz) Mayo Clinic Alix School of Medicine, Mayo Clinic,
Scottsdale, AZ, United States
(Chen, Misra) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Scottsdale, AZ, United States
(Millstine) Division of Women's Health Internal Medicine, Department of
Medicine, Mayo Clinic, Scottsdale, AZ, United States
Abstract
Cardiothoracic surgery can be a physically and emotionally challenging
experience for patients, often involving significant pain, anxiety, and a
reliance on opioid-based analgesia. As health care moves toward more
holistic and patient-centered approaches, there is growing interest in
complementary therapies like music. Music interventions represent a safe,
noninvasive, and cost-effective strategy to support recovery in
cardiothoracic surgery patients. This review explores how music
interventions can support recovery in patients undergoing cardiothoracic
procedures, focusing on pain reduction, anxiety alleviation, and
physiological responses. A search of PubMed, CINAHL, and PsychInfo
identified 19 studies, primarily randomized controlled trials,
investigating music interventions during the perioperative period in adult
cardiothoracic surgery patients. Across the studies reviewed, music
interventions significantly reduced postoperative pain and anxiety
compared with control groups. Several trials also reported reductions in
analgesic use, heart rate, and blood pressure, although findings on
physiological measures were mixed. Although further research is still
warranted to optimize implementation and assess long-term benefits, the
current evidence suggests that music can positively impact surgical
recovery. Incorporating music into multimodal recovery protocols may
improve patient experiences and reduce reliance on pharmacological
interventions.<br/>Copyright &#xa9; 2025 Mayo Foundation for Medical
Education and Research. Published by Elsevier Inc. All rights reserved.

<110>
Accession Number
650155911
Title
Effect of pre-reperfusion SGLT2 Inhibitors on infarct size and ventricular
function in patients with acute myocardial infarction.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Annual Meeting, EACVI 2025. Vienna
Austria. 27(Supplement 1) (pp i643-i644), 2026. Date of Publication: 01
Jan 2026.
Author
Noparatkailas N.; Suwannasom P.; Leemasawat K.; Saengsin K.; Chattipakorn
S.; Chattipakorn N.; Phrommintikul A.
Institution
(Noparatkailas, Suwannasom, Leemasawat, Phrommintikul) Chiang Mai
University, Division of Cardiology, Department of Internal Medicine,
Chiang Mai, Thailand
(Saengsin) Chiang Mai University, Department of Pediatrics, Chiang Mai,
Thailand
(Chattipakorn, Chattipakorn) Chiang Mai University, Cardiac
Electrophysiology Research and Training Center, Chiang Mai, Thailand
Publisher
Oxford University Press
Abstract
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown
cardioprotective benefits in both diabetic and non-diabetic patients.
Preclinical studies suggest that early SGLT2i administration may limit
myocardial ischemia/reperfusion injury. However, its effect on infarct
size and ventricular remodeling during the acute phase of myocardial
infarction in humans is not well established. Cardiac magnetic resonance
imaging (CMR) offers a reliable method to quantify infarct size,
ventricular function, and microvascular obstruction (MVO).
<br/>Objective(s): To assess the impact of pre-reperfusion dapagliflozin
on infarct size and left ventricular remodeling using CMR in patients with
anterior ST-elevation myocardial infarction (STEMI). <br/>Method(s): This
is a randomized, double-blind, placebo-controlled study. Patients with
anterior wall STEMI were randomized 1:1 to receive dapagliflozin (20 mg
loading, then 10 mg daily) or placebo before coronary reperfusion. CMR was
performed at early days and 3 months post- PCI to evaluate left
ventricular volumes, ejection fraction (LVEF), infarct size (%LV mass),
and MVO. Imaging was interpreted blinded to treatment allocation.
<br/>Result(s): Twenty patients with anterior wall STEMI were enrolled: 11
(55%) received dapagliflozin, while 9 (45%) received a placebo. The mean
age was 67.2 +/- 7.0 years, and 70% were male. Baseline infarct size was
not significantly different between the two groups (36.1% vs. 31.2%, p =
0.176). MVO was present in 73% of patients receiving dapagliflozin
compared to 75% of those receiving placebo (p = 0.912). At the 3-month
follow-up, dapagliflozin did not result in significant reverse remodeling
compared to the placebo. Median change in left ventricular end-diastolic
volume index was -2.3 mL/m2 (IQR: -3.3 to 16.9) in the dapagliflozin group
vs. -1.6 mL/m2 (IQR: -14.4 to 4.2) in the placebo group (p = 0.261).
Median change in left ventricular end-diastolic volume index was -1.3
mL/m2 (IQR -3.3 to 3.7) vs. -2.3 mL/m2 (IQR -15.4 to 0.6), respectively (p
= 0.331). <br/>Conclusion(s): Early dapagliflozin administration before
reperfusion was feasible, however, it did not significantly reduce infarct
size or MVO. Further studies with larger sample sizes, longer
dapagliflozin duration and follow-up are warranted to clarify its role in
myocardial protection during acute myocardial infarction. (Table present).

<111>
Accession Number
2043331614
Title
The effect of transcutaneous electrical nerve stimulation (TENS) on pain
and vital signs during chest tube removal.
Source
Pakistan Journal of Medical Sciences. 42(2) (pp 345-351), 2026. Date of
Publication: 01 Feb 2026.
Author
Turkmen A.; Avci A.; Tura I.; Erden S.
Institution
(Turkmen, Tura, Erden) Department of Nursing, Faculty of Health Sciences,
Cukurova University, Adana, Turkey
(Avci) Department of Thoracic Surgery, Faculty of Medicine, Cukurova
University, Adana, Turkey
Publisher
Professional Medical Publications
Abstract
Objective: The aim of the study was to determine the effects of
transcutaneous electrical nerve stimulation (TENS) on pain and vital signs
during chest tube removal (CTR). Methodology: This randomized controlled
study was conducted with a group of patients treated in the thoracic
surgery unit of a university hospital between May 2023 to September 2023.
Participants were equally allocated using simple randomization. This
randomized-controlled study collected data 60 thoracic surgery patients
using Patient Information Form (PIF) and the Numerical Rating Scale (NRS).
TENS was applied for a total of one hour, 2-3 cm from the chest tube site.
The pain level and vital signs of the patients were assessed at
immediately before (T1), during (T2) and immediately after (T3) the CTR in
all groups. <br/>Result(s): Pain levels were significantly lower in the
TENS group compared to the control group (p < 0.05). In addition, a
significance was found between the groups at T2 for Heart Rate (HR), T2-T3
for Systolic Blood Pressure (SBP) and T2-T3 for Respiratory Rate (RR). HR,
SBP and RR were statistically significant at T2 time (p<0.05) in this
group. <br/>Conclusion(s): TENS effectively reduces acute procedural pain
and provide maintain stable vital signs as a safe complementary method in
multimodal pain management.<br/>Copyright &#xa9; 2026, Professional
Medical Publications. All rights reserved.

<112>
Accession Number
2043474495
Title
General principles of antibiotic therapy in infective endocarditis.
Source
Cirugia Cardiovascular. (no pagination), 2025. Date of Publication: 2025.
Author
Calderon-Parra J.; Diego-Yague I.; Ramos-Martinez A.
Institution
(Calderon-Parra) Unidad de Enfermedades Infecciosas (Medicina Interna),
Hospital Universitario Puerta de Hierro, Universidad Autonoma de Madrid,
Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia de Arana
(IDIPHISA), Madrid, Spain
(Diego-Yague, Ramos-Martinez) Unidad de Enfermedades Infecciosas (Medicina
Interna), Hospital Universitario Puerta de Hierro, Instituto de
Investigacion Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA),
Madrid, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Treatment of infective endocarditis (IE) requires prolonged use of
antimicrobials, frequently bactericidal, with debridement/valvular
replacement surgery in a high percentage of cases. The distinction between
empirical (initial) and targeted therapy (based on blood cultures) is key.
In recent years, cases of IE on prosthetic material are increasing. Recent
strategies aim to reduce hospitalization: outpatient parenteral antibiotic
therapy using infusion pumps, switching to oral antibiotics in stable
patients (validated by the POET trial), and the use of long-acting
antibiotics such as dalbavancin/oritavancin). Blood culture-negative IE is
a considerable challenge and requires further investigation (serology,
PCR). For inoperable patients with surgical indication, chronic
suppressive therapy may control symptoms and improve prognosis, although
evidence is limited and based on observational studies/expert opinion, as
are many treatment guidelines due to the paucity of randomized clinical
trials. Management should be individualized and often
multidisciplinar.<br/>Copyright &#xa9; 2025 Published by Elsevier Espana,
S.L.U. on behalf of Sociedad Espanola de Cirugia Cardiovascular y
Endovascular. This is an open access article under the CC BY-NC-ND
license. http://creativecommons.org/licenses/by-nc-nd/4.0/

<113>
Accession Number
2042956900
Title
Combined assessment of pulmonary artery pulsatility index and pulmonary
arterial capacitance for risk stratification following transcatheter
aortic valve implantation.
Source
Acta Cardiologica. (no pagination), 2026. Date of Publication: 2026.
Author
Ozaki Y.; Uemura Y.; Kondo T.; Kazama S.; Yamaguchi S.; Okajima T.;
Mitsuda T.; Ishikawa S.; Takemoto K.; Okumura T.; Murohara T.; Watarai M.
Institution
(Ozaki, Uemura, Yamaguchi, Okajima, Mitsuda, Ishikawa, Takemoto, Watarai)
Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan
(Kondo, Kazama, Okumura, Murohara) Department of Cardiology, Nagoya
University Graduate School of Medicine, Nagoya, Japan
Publisher
Taylor and Francis Ltd.
Abstract
Background: Right heart haemodynamics, including right ventricular
function and pulmonary arterial capacitance (PAC), are important
prognostic determinants in cardiovascular disease. However, their combined
role in patients undergoing transcatheter aortic valve implantation (TAVI)
remains unclear. This study aimed to determine whether the combined
assessment using pulmonary artery pulsatility index (PAPi) and PAC can
stratify clinical outcomes in patients with aortic stenosis (AS)
undergoing TAVI. <br/>Method(s): This retrospective single-centre study
included 77 patients with severe AS who underwent right heart
catheterisation within 3 months before TAVI. Patients were stratified into
four groups based on the median values of PAPi and PAC. The primary
endpoint was a composite of all-cause death or heart failure-related
hospitalisation. <br/>Result(s): During a median follow-up of 3.60 years
(interquartile range: 1.89-4.62), 15 patients experienced the primary
endpoint. Kaplan-Meier's analysis showed significant stratification by
PAPi-PAC groups (log-rank p = 0.040). In Cox regression models, the low
PAPi/low PAC group was independently associated with adverse outcomes
compared with the other groups (hazard ratio (HR): 3.65, 95% confidence
interval (CI): 1.28-10.40, p = 0.015 adjusted for age and sex; HR: 3.61,
95% CI: 1.27-10.26, p = 0.016 adjusted for natriuretic peptide levels; HR:
3.07, 95% CI: 1.07-8.81, p = 0.038 adjusted for the Meta-analysis Global
Group in Chronic Heart Failure score). <br/>Conclusion(s): Combined
PAPi-PAC assessment identified distinct haemodynamic phenotypes with
prognostic significance following TAVI. This approach offers a simple,
physiologically grounded framework for postprocedural risk stratification
and individualised management.<br/>Copyright &#xa9; 2026 Belgian Society
of Cardiology.

<114>
Accession Number
2043360600
Title
Comparison of intravenous dexmedetomidine and intravenous dexamethasone
for prolongation of analgesia in supraclavicular brachial plexus block: A
prospective comparative study.
Source
International Journal of Clinical Obstetrics and Gynaecology. 10(1) (pp
569-575), 2026. Date of Publication: 01 Jan 2026.
Author
Hassan S.; Bashir R.; Abbas C.Z.
Publisher
Integrated Publishers
Abstract
Background: Supraclavicular brachial plexus block provides effective
anesthesia and postoperative analgesia for upper limb surgeries. Various
intravenous adjuvants have been evaluated to enhance the quality and
duration of analgesia. Dexmedetomidine and dexamethasone, when
administered intravenously, have shown promising analgesic effects;
however, comparative evidence remains limited. <br/>Method(s): This
prospective comparative study was conducted on 80 patients (ASA physical
status I-II), aged 18-60 years, undergoing elective unilateral upper limb
surgeries under ultrasound-guided supraclavicular brachial plexus block.
Patients were randomized into two equal groups (n = 40 each). Group DEXA
received intravenous dexamethasone 0.1 mg/kg, Group DEXMED received
intravenous dexmedetomidine 1 microg/kg. All patients received 20 mL of
0.5% ropivacaine for the block. The primary outcome was time to first
rescue analgesia. Secondary outcomes included onset and duration of
sensory and motor block, postoperative VAS scores, intra-operative
hemodynamic parameters, and adverse effects. <br/>Result(s): Demographic
variables and baseline characteristics were comparable between groups. The
onset of sensory block was 10.02+/-1.16 minutes in Group DEXA and
10.45+/-1.26 minutes in Group DEXMED (p = 0.121), while onset of motor
block was 15.35+/-1.21 minutes and 15.40+/-1.24 minutes, respectively (p =
0.855). The duration of sensory block was 443.12+/-53.73 minutes in Group
DEXA and 433.62+/-51.09 minutes in Group DEXMED (p = 0.422). Motor block
duration was 392.25+/-57.45 minutes and 378.62+/-52.99 minutes,
respectively (p = 0.274). The time to first rescue analgesia was
significantly longer in Group DEXA (504.12+/-55.81 minutes) compared to
Group DEXMED (496.25+/-47.78 minutes, p = 0.046). Postoperative VAS scores
were comparable between groups, with no pain reported up to 4 hours, mild
pain at 6 hours in all patients, and severe pain at 12 hours in 10.0%
(DEXA) and 12.5% (DEXMED) of patients. Intra-operative heart rate showed a
statistically significant reduction in the DEXMED group at 5, 15, and 20
minutes; however, systolic blood pressure, diastolic blood pressure, and
SpO2 remained comparable between groups. Adverse effects were minimal,
with bradycardia and hypotension observed only in the DEXMED group,
without statistical significance. <br/>Conclusion(s): Both intravenous
dexamethasone and dexmedetomidine are effective adjuvants for
supraclavicular brachial plexus block. Intravenous dexamethasone provided
a significantly longer duration of postoperative analgesia, while
dexmedetomidine was associated with greater intra-operative heart rate
reduction but maintained overall hemodynamic stability.<br/>Copyright
&#xa9; Gynaecology Journal.

<115>
Accession Number
2043363907
Title
Expert consensus on three-dimensional visualization-guided precision
surgery for rectal tumors (2025 edition).
Source
Chinese Journal of Digestive Surgery. 24(12) (pp 1528-1538), 2025. Date of
Publication: 20 Dec 2025.
Author
Xiao W.; Li X.; Du X.; Yao H.; Chen M.
Institution
(Xiao) Department of General Surgery, The Second Affiliated Hospital
(Xinqiao Hospital) of Army Medical University, Chongqing Municipal Higher
Education Key Laboratory for Precision Digestive Surgery and Homeostasis,
Chongqing, China
(Li) Department of Colorectal Surgery, Fudan University Shanghai Cancer
Center, Shanghai, China
(Du) Department of General Surgery, First Medical Center, Chinese People's
Liberation Army General Hospital, Beijing, China
(Yao) Department of General Surgery, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
(Chen) Department of Hepatobiliary Surgery, Editorial Board, Chinese
Journal of Digestive Surgery, The First Affiliated Hospital (Southwest
Hospital) of Army Medical University, Chongqing, China
Publisher
Chinese Medical Journals Publishing House Co.Ltd
Abstract
With the advancement of digital surgery, computer-assisted imaging
analysis techniques have gained increasing attention in surgical
treatment. While three-dimensional recons-truction technology based on
CT/MRI has been widely adopted in hepatobiliary and thoracic surgery, its
application in rectal surgery remains in the early stage. The Colorectal
Surgery Group, Branch of Surgery, Chinese Medical Association, the Tumor
Minimally Invasive Surgery Expert Committee, Chinese Society of Clinical
Oncology, and the Editorial Board of the Chinese Journal of Digestive
Surgery have organized domestic gastrointestinal surgery experts to
develop the Expert consensus on three-dimen-sional visualization-guided
precision surgery for rectal tumors (2025 edition). This consensus is
estab-lished based on evidence-based medicine and clinical practice,
addressing the indications, acquisition standards, and reporting paradigms
for the application of CT/MRI three-dimensional reconstruction technology
in radical resection of rectal cancer. It aims to standardize the
application of CT/MRI three-dimensional reconstruction technology in the
treatment of rectal cancer, promote the digitiza-tion and precision of
surgical procedures, enhance surgical safety and efficacy, and provide
scientific guidance for clinical practice.<br/>Copyright 2026, Chinese
Medical Association

<116>
Accession Number
650132832
Title
Five-Year Quality of Life Outcome from a Randomized Controlled Trial
Comparing Aortic Valve Replacement through Upper Hemisternotomy and Full
Median Sternotomy.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2026.
Date of Publication: 02 Feb 2026.
Author
van Putten S.E.; Klop I.D.G.; Nieuwkerk P.T.; Friguech B.; Kloppenburg
G.T.L.; Klautz R.J.M.; van Putte B.P.; Klein P.
Institution
(van Putten, Klop, Friguech, Kloppenburg, van Putte, Klein) Department of
Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands
(van Putten, Klautz, van Putte, Klein) Department of Cardiothoracic
Surgery, Amsterdam University Medical Centre, Amsterdam, Netherlands
(Nieuwkerk) Department of Medical Psychology, Amsterdam University Medical
Centre, Amsterdam, Netherlands
(Nieuwkerk) Amsterdam Public Health, Amsterdam University Medical Centre,
Amsterdam, Netherlands
(Nieuwkerk) Amsterdam institute for Immunology and Infectious diseases
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
Abstract
OBJECTIVES: The impact of minimally invasive surgical aortic valve
replacement on long-term quality of life is uncertain. This randomized
controlled trial compared quality of life five years after surgical aortic
valve replacement through upper hemisternotomy or full median sternotomy.
<br/>METHOD(S): Patients undergoing surgical aortic valve replacement were
randomized to upper hemisternotomy or full median sternotomy. The primary
outcome was postoperative cardiac-specific quality of life during five
years, assessed by the Kansas City Cardiomyopathy Questionnaire physical
limitations domain. Secondary outcomes include survival, other quality of
life domains, and factors associated with declined quality of life between
one and five years. <br/>RESULT(S): Surgical aortic valve replacement via
upper hemisternotomy resulted in better quality of life as indicated by
more favourable physical limitation and total symptoms scores (estimated
mean difference (95% confidence interval) respectively -1.89 (-2.93 to
-0.85; p-value = <0.001) and 2.96 (-4.71 to -1.22; p-value = 0.016).
Quality of life improvement persisted for five years, despite a decline
after one year postoperative. Age and valve size smaller than or equal to
21 were independent predictors of decline in physical functioning, while
full median sternotomy independently predicted declined total symptoms
score. Five-year survival was 91.9% and similar between approaches
(p-value = 0.417). <br/>CONCLUSION(S): Minimally invasive surgical aortic
valve replacement was associated with a modest but statistically
significant improvement in cardiac-specific quality of life over five
years compared to median sternotomy, driven by earlier recovery, with
comparable outcomes at five years. Full median sternotomy independently
predicted decline in quality of life demonstrated by decreased total
symptom scores.<br/>Copyright &#xa9; The Author(s) 2026. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<117>
Accession Number
2042872311
Title
Reconstructed Patient-Level Meta-analysis of Prophylactic Left Atrial
Appendage Closure During Cardiac Surgery.
Source
Canadian Journal of Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Dong A.; Lee G.; Krishna V.; Whitlock R.; Kiankhooy A.; Bowdish M.; Chikwe
J.; Tam D.Y.
Institution
(Dong, Krishna, Kiankhooy, Bowdish, Chikwe, Tam) Department of Cardiac
Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Lee, Tam) Temerty Faculty of Medicine, University of Toronto, Toronto,
ON, Canada
(Whitlock) Population Health Research Institute, Division of Cardiac
Surgery, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background The benefit of prophylactic concomitant left atrial appendage
closure (LAAC) in cardiac surgery patients without preoperative atrial
fibrillation is unclear. We aim to evaluate whether LAAC reduces the risk
of late stroke in patients without preoperative atrial fibrillation.
Methods A systematic search was conducted through July 2025 for studies
investigating LAAC vs no LAAC in cardiac surgery patients without atrial
fibrillation. Random-effects meta-analysis was performed, and Kaplan-Meier
curves were digitized to reconstruct individual patient data. Primary
outcome was stroke at 5 years. Median follow-up time was 3.8 years
(interquartile range 2.1-4.6 years). Results One randomised controlled
trial and 6 observational studies were included with 4306 LAAC and 4129
no-LAAC patients. LAAC vs no-LAAC patients were similar in preoperative
characteristics including age (66 vs 65 years; P = 0.8), sex (30% vs 29%
female,- P = 0.8), and CHA<inf>2</inf>DS<inf>2</inf>-VASc scores (2.7 vs
2.6; P = 0.9). There was no difference in 30-day mortality (1.2% vs 1.1%,
relative risk [RR] 1.04, 95% confidence interval [CI] 0.64-1.69; P = 0.42;
I ² = 0%). Postoperative atrial fibrillation was significantly
higher after LAAC (31.1% vs 26.1%, RR 1.20, 95% CI 1.03-1.39; P < 0.01; I
² = 72%). Using reconstructed patient level data, 5-year
freedom from stroke improved after prophylactic LAAC (95.9% vs 94.4%,
hazard ratio 0.66, 95% CI 0.52-0.83; P = 0.0004). The number needed to
treat was 67 to prevent 1 stroke. Conclusions In patients without atrial
fibrillation undergoing cardiac surgery, prophylactic LAAC was associated
with a lower observed risk of stroke. These exploratory findings warrant
confirmation in ongoing large multicentre randomised clinical
trials.<br/>Copyright &#xa9; 2025 Canadian Cardiovascular Society.

<118>
Accession Number
650124963
Title
STRATEGY OPTIMIZATION FOR THE COMBINED PROCEDURE OF LEFT ATRIAL APPENDAGE
OCCLUSION PLUS CATHETER ABLATION IN PATIENTS WITH ATRIAL FIBRILLATION
(COMBINATION): A MULTI-CENTER, RANDOMIZED STUDY.
Source
Journal of Arrhythmia. Conference: 17th Asia Pacific Heart Rhythm Society
(APHRS). Sydney Australia. 41(2) (no pagination), 2025. Date of
Publication: 01 Mar 2025.
Author
Du X.; Chu H.
Institution
(Du, Chu) The First Affiliated Hospital of Ningbo University, Ningbo,
China
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The long-term efficacy and safety of the atrial fibrillation
(AF) combined procedure have been established. However, the optimal
combining strategy has not been well elucidated. We aimed to determine the
impact of different combining strategies on long-term clinical outcomes.
<br/>Method(s): AF patients referred for the combined procedure were
randomly assigned to the ablation-first or occlusion-first groups at a 1:1
ratio. Long-term outcomes of LAAC with a Watchman device and AF catheter
ablation were evaluated. <br/>Result(s): A total of 194 randomized
patients from 14 centers were analyzed. Baseline characteristics were
comparable between groups. All procedures were accomplished with acute
successful LAAC and restoration of sinus rhythm. Incidences of
periprocedural complications were similar. Higher incidences of chronic
peri-device leak (PDL, 15.5% vs 5.2%, P=0.031) and device-related thrombus
(DRT, 8.2% vs 1.0%, P=0.035) were observed in the ablation-first group.
The event-free survival rate of the primary endpoint (composite of
thromboembolic events including stroke/transient ischemic attack, DRT,
clinically-relevant bleeding, cardiovascular rehospitalization/ death) was
significantly higher in the occlusion-first group (83.5% vs 71.1%,
log-rank P=0.036, HR 0.53, 95%CI 0.29-0.95) during a median 2.5-year
follow-up. Patients with male gender and higher CHA2DS2-VASc score were at
lower risk in the subgroup analysis. Long-term freedoms from AF (77.3% vs
63.5%, log-rank P=0.039) and atrial tachyarrhythmias (70.1% vs 55.7%,
log-rank P=0.044) were higher in the occlusion-first group, respectively.
<br/>Conclusion(s): The occlusion-first approach is recommended for
patients with atrial fibrillation in combined procedures with catheter
ablation and left atrial appendage closure with a plug-like device
implanted due to the superior long-term clinical benefits.

<119>
[Use Link to view the full text]
Accession Number
2043177294
Title
Research trends in cardiac rehabilitation following COVID-19: A
cross-sectional bibliometric study.
Source
Medicine (United States). 104(47) (pp e46028), 2025. Date of Publication:
21 Nov 2025.
Author
Abdelwahab S.I.; Taha M.M.E.; Bakhsh H.R.; Aldhahi M.I.
Institution
(Abdelwahab, Taha) Health Research Centre, Jazan University, Jazan, Saudi
Arabia
(Bakhsh, Aldhahi) Department of Rehabilitation Sciences, College of Health
and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University,
Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
This bibliometric analysis assesses scientific progress, spatial
distribution, keyword trends, thematic evolution, and research gaps in
cardiac rehabilitation research (CRR), with a focused appraisal of the
post-COVID-19 era (2020-2023). Scopus-indexed publications from 1948 to
2023 and 2020 to 2023 were analyzed using VOSviewer (v1.6.19) and
Biblioshiny (v2.0.2). The study was strengthening the reporting of
observational studies in epidemiology-compliant. A total of 9173 CRR
documents were identified, showing sustained exponential growth over time.
The Journal of Cardiopulmonary Rehabilitation and Prevention emerged as
the leading source. The United State, Canada, and the United Kingdom led
global output and collaboration networks. Core keywords included "cardiac
rehabilitation, " "coronary artery disease, " "myocardial infarction, "
"exercise, " and "rehabilitation." Post-COVID-19 analyses revealed a
discernible thematic shift, with emerging clusters and hot themes centered
on "age, " "primary care, " "heart transplant, " and "exercise". This
first comprehensive bibliometric overview of CRR maps long-term growth,
geographic leaders, evolving themes, and research gaps, and highlights a
reorientation of priorities in the post-COVID-19 era to inform future
research directions.<br/>Copyright &#xa9; 2025

<120>
[Use Link to view the full text]
Accession Number
2043203948
Title
Does Language Matter? The Impact of English Proficiency on Healthcare
Outcomes After Cardiac Surgery: A Scoping Review.
Source
Anesthesia and Analgesia. Publish Ahead of Print (no pagination), 2026.
Date of Publication: 01 Jan 2026.
Author
Rios-Monterrosa J.; Castro S.; Aguiar C.; Tanvir A.; Woodward A.; Sun
L.Y.; Milam A.J.
Institution
(Rios-Monterrosa, Castro, Sun) From the Department of Anesthesiology and
Perioperative Medicine, Stanford University School of Medicine, Stanford,
CA, United States
(Aguiar) Department of Clinical Science, California Northstate University
College of Medicine, Elk Grove, CA, United States
(Tanvir) Department of Anesthesiology, Mayo Hospital, Lahore, Pakistan
(Woodward) Lane Medical Library, Stanford University School of Medicine,
Stanford, CA, United States
(Milam) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Phoenix, AZ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Health care disparities, particularly among minoritized groups, pose
significant challenges within health care systems, including the field of
cardiac surgery. Limited English proficiency (LEP) is an often-overlooked
factor contributing to these disparities. As key members of the
preoperative evaluation, intraoperative management, and postoperative care
of cardiac surgery patients, anesthesiologists have both ethical and
economic responsibilities to understand, recognize, and address
disparities to ensure equitable care for all patients. The objective of
this scoping review is to summarize the literature on how LEP impacts the
utilization of health services and outcomes after cardiac surgery. More
specifically, the review will map how LEP is defined in the literature,
summarize the patient populations that have been studied, and describe the
health care outcomes in patients with LEP after cardiac surgery. A
comprehensive literature search strategy was developed in collaboration
with a medical librarian and was registered before conducting the search.
Studies were eligible for inclusion in our current study if (i) the
patient population was composed of adults (>or = 18), (ii) the study
reported health care outcomes before or after cardiac surgery, and (iii)
results were stratified by a patient's English proficiency. All randomized
control trials, systematic reviews, observational studies, and
cross-sectional studies published in English were included in our study.
If conference abstracts met the inclusion criteria, they were included for
full-text review. Opinion articles and case reports were excluded. The
search produced 2401 articles with 13 articles meeting the inclusion
criteria. All studies were conducted in either North America or
Australia/New Zealand. The number of patients included in each study
ranged from 204 to 21, 789, with 4 studies having less than 1500 patients
and 2 studies having greater than 10, 000 patients. Through a systematic
review of the literature on this topic, we identified 3 overarching themes
that were inferred from the collective body of studies. First, a
significant barrier to studying this topic is the absence of a universal
definition of LEP. Second, the heterogeneity in several aspects of the
available studies makes it difficult to draw conclusions from the results.
Finally, there is a general scarcity of research done on the impact of LEP
on cardiac surgery outcomes. Ultimately, our scoping review reveals an
area of health disparity research that requires more attention. If
disparities are found, then health care leaders may begin investigating
which interventions can help mitigate these disparities.<br/>Copyright
&#xa9; 2026 International Anesthesia Research Society

<121>
Accession Number
650123913
Title
Prevalence of postoperative neurocognitive disorders in older non-cardiac
surgical patients: a systematic review and meta-analysis.
Source
Alzheimer's and Dementia. Conference: Alzheimer's Association
International Conference, AAIC 2025. Toronto, ON Canada. 21(Supplement 6)
(no pagination), 2025. Date of Publication: 01 Dec 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Munster,
Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li) TorontoWestern Hospital, University Health Network, University of
Toronto, Toronto, ON, Canada
(Thangavelu, Yan, Chung) Temerty Faculty of Medicine, University of
Toronto, Toronto, ON, Canada
(Saripella, Yan, Chung) TorontoWestern Hospital, University Health
Network, Toronto, ON, Canada
(Englesakis) University Health Network, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: The growing number of older persons undergoing surgery are at
a higher risk of neurocognitive disorder due to multimorbidity and
age-related changes. The prevalence of postoperative neurocognitive
disorder in this population requires further investigation. This
systematic review and meta-analysis aims to estimate the pooled prevalence
of perioperative neurocognitive disorder in older non-cardiac surgical
patients. <br/>Method(s): A comprehensive search of multiple databases was
conducted from inception to January 24, 2024. This review included studies
of non-cardiac surgical inpatients aged >60 years old who underwent
perioperative cognitive assessments. The primary outcome was the
prevalence of postoperative neurocognitive disorder or cognitive
dysfunction (POCD). Data were analyzed using a random-effects model to
calculate pooled prevalence rates. Quality assessment employed the
Newcastle-Ottawa Scale and MOOSE guidelines. Meta-regression was performed
with OpenMeta Analyst and RStudio 4.3.3. <br/>Result(s): Thirty-nine
studies (n = 12,921) were included with mean age of 70.0 +/- 8.9 years and
44.3% women. The overall prevalence of POCD was 23% (95% CI: 20%, 27%) at
day 7,16%(95% CI: 7%, 25%) at 1 month,10%(95% CI: 8%, 13%) at 3 months and
3% (95% CI: 2%, 4%) at 1 year (Figure 1). Our meta-regression showed a
higher prevalence of POCD in abdominal surgery at day 7 (beta = 0.13, 95%
CI: 0.03-0.22, p = 0.01) and 3 months (beta = 0.49, 95% CI: 0.40-0.58, p <
0.001), versus orthopedic surgeries. <br/>Conclusion(s): The overall
prevalence of POCD in older non-cardiac surgical populations was 23%, 16%,
10%, and 3% at day 7, 1 month, 3 months, and 1 year, respectively.
Abdominal surgery had a higher prevalence of POCD than orthopedic surgery.
The significant risk of POCD calls for cognitive screening, risk
mitigation and intervention to provide better perioperative care and
improve surgical outcomes.

<122>
Accession Number
650124431
Title
17th Asia Pacific Heart Rhythm Society (APHRS).
Source
Journal of Arrhythmia. Conference: 17th Asia Pacific Heart Rhythm Society
(APHRS). Sydney Australia. 41(2) (no pagination), 2025. Date of
Publication: 01 Mar 2025.
Author
Anonymous
Publisher
John Wiley and Sons Inc
Abstract
The proceedings contain 940 papers. The topics discussed include: pulsed
field ablation for AF in patients with cardiac implantable electronic
devices; P-Wave-PR segment duration ratio and occurrence of atrial
fibrillation; hypertrophic cardiomyopathy in Oman; value of diagnosis of
left septal fascicular block to predict NLBBB and AVB post-TAVR; cardiac
sympathetic nervous excitation monitoring during pulmonary vein isolation
by using skin potential response; preliminary evidence on EV-ICD with
concomitant micra; performance of sleep apnea detection algorithm using
insertable cardiac monitor in patients with healthy and unhealthy heart
rate variability indices; electrocardiographic manifestations of
hospitalized adult patients with coronavirus disease 19 (COVID-19): UP
DCVM ECG study; and the prognostic significance of exercise- induced right
bundle branch block: a systematic review.

<123>
Accession Number
2042985142
Title
Comparison of a mean arterial pressure alarm to the hypotension prediction
index in preventing intraoperative hypotension in elective moderate- to
high-risk non-cardiac surgical patients: a study protocol for a blinded,
parallel, randomized controlled trial with a non-inferiority framework.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 104. Date of
Publication: 01 Dec 2026.
Author
Mulder M.P.; Florax A.A.; Harmannij-Markusse M.; Fresiello L.; Donker
D.W.; Potters J.-W.
Institution
(Mulder, Florax, Fresiello, Donker, Potters) Cardiovascular and
Respiratory Physiology, TechMed Centre, University of Twente, Enschede,
Netherlands
(Florax, Potters) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(Harmannij-Markusse) Technical Medicine, University of Twente, Enschede,
Netherlands
(Donker) Intensive Care Center, University Medical Center Utrecht,
Utrecht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension is common in surgical patients and
associated with an increased risk for acute kidney injury, myocardial
injury, and 30-day mortality. To predict hypotension and thereby promote
proactive blood pressure management, a machine learning algorithm was
developed: the Hypotension Prediction Index (HPI). In clinical trials, it
proved to prevent hypotension. However, a recent observational study found
that the performance of the HPI in predicting hypotension up to 15 min in
advance was virtually identical to that of the concurrent mean arterial
pressure (MAP). This indicates that the added value of the HPI above
continuous MAP monitoring may be limited. It is hypothesized that the
effect of preventing intraoperative hypotension triggered by a MAP
threshold of 70-75 mmHg is comparable to clinical care triggered by an HPI
alarm. <br/>Method(s): This is a monocentral, blinded, randomized
controlled clinical trial, conducted in the Netherlands. Adult patients
undergoing moderate- or high-risk elective non-cardiac surgery requiring
continuous blood pressure monitoring aiming for a MAP of >=65 mmHg are
eligible for inclusion. A total of 142 participants is randomized into two
groups: in the HPI group, the monitor alarms when the HPI value exceeds
85, whereas in the MAP group, it alarms when the MAP value drops below 72
mmHg. The monitor screen is partly covered to blind treating clinicians
for the study group allocation. The primary outcome measure is the area
under the threshold of hypotension (defined as MAP < 65 mmHg for at least
1 min) during surgery. Secondary objectives are the incidence and severity
of intraoperative hypotension and hypertension, cumulative doses of
administered medication and fluids, incidence of acute kidney injury and
myocardial injury, length of hospital stay, and 30-day mortality after
surgery. <br/>Discussion(s): The decision to initiate treatment upon an
alarm is left at the discretion of the attending clinicians; if deemed
appropriate, they can also choose to ignore the alarms. Consequently,
clinical interventions could vary between participants and groups.
Contrarily, early treatment could lead to overtreatment. Trial
registration: Overview of Medical research in the Netherlands (OMON),
NL-OMON53215, registered on 20-09-2023, last updated on 30-01-2025,
https://onderzoekmetmensen.nl/nl/trial/53215.<br/>Copyright &#xa9; The
Author(s) 2025.

<124>
Accession Number
650122853
Title
CLINICAL IMPACT OF NEW-ONSET RIGHT BUNDLE BRANCH BLOCK AFTER TRANSCATHETER
AORTIC VALVEIMPLANTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of Arrhythmia. Conference: 17th Asia Pacific Heart Rhythm Society
(APHRS). Sydney Australia. 41(2) (no pagination), 2025. Date of
Publication: 01 Mar 2025.
Author
Ahmed M.; Rao K.; Bhindi R.
Institution
(Ahmed, Rao, Bhindi) University of Sydney, Sydney, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is an
effective treatment for symptomatic severe aortic stenosis, however, is
often complicated by new permanent pacemaker implantation (PPI) in 9-26%
cases. Pre-existing right bundle branch block (RBBB) and new-onset left
bundle branch block (LBBB) are well published predictors of PPI after
TAVI, however the impact of new-onset RBBB is not well understood.
<br/>Method(s): We comprehensively searched the following databases,
MEDLINE, Embase, Web of Science and PubMed, from the date of establishment
until May 2024 to screen for studies on new-onset RBBB after TAVI. Our
primary outcome was the association between new-onset RBBB and PPI at 1
year, while all-cause mortality was the secondary outcome. <br/>Result(s):
We identified and screened 102 potential eligible studies. After abstract
and full-text screening, a total of 3 retrospective cohort studies were
included with 2,812 patients for analysis. New-onset RBBB was found in
1.7% of cases and increased the risk of PPI at 1 year (RR: 6.08; 95% CI:
4.39-8.41, p < 0.001). New-onset RBBB was not associated with the risk of
all-cause mortality at 1 year (RR: 1.74; 95% CI: 0.88-3.46, p = 0.11).
Figure 1: Forest plot of PPI rates in patients with and without new-onset
RBBB after TAVI. Figure 2: Forest plot of all-cause mortality rates in
patients with and without new-onset RBBB after TAVI. <br/>Conclusion(s):
This meta-analysis of 3 retrospective cohort studies suggests that
new-onset RBBB is uncommon after TAVI but significantly increases the risk
of PPI but not all-cause mortality at 1 year. Only 3 studies with
moderate-to-high degree of heterogeneity were available for analysis.
Future dedicated prospective studies with longer-term follow ups are
required to further understand this area.

<125>
Accession Number
650125450
Title
Optimising albumin usage in cardiothoracic surgery at University Hospitals
of North Midlands (UHNM) NHS Trust.
Source
British Journal of Haematology. Conference: 65th Annual Scientific Meeting
of the British Society for Haematology. Glasgow . 206(Supplement 1) (pp
273-274), 2025. Date of Publication: 01 Apr 2025.
Author
Hasan S.A.; Sanghavi V.; Graham J.
Institution
(Hasan, Graham) University Hospitals Of North Midlands NHS Trust,
Stoke-on-Trent, United Kingdom
(Sanghavi, Graham) Keele University School of Medicine,
Newcastle-under-Lyme, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Use of intravenous human albumin solution (HAS) by
cardiothoracic surgery is high, despite multiple randomised controlled
clinical trials failing to show improvement in patient outcome, and a
significant side effect profile. In 2024, availability of HAS has been
difficult, with both local (January) and national (July) shortages. At
UHNM, measures have been implemented to support appropriate HAS use,
including laboratory screening of HAS requests against evidence-based
practice. <br/>Objective(s): This quality improvement project (QIP)
explores the efficacy of implemented measures to limit HAS usage within
cardiothoracic surgery at UHNM. <br/>Method(s): Trust-wide measures to
guide appropriate HAS use were implemented in February 2024 and reinforced
in August 2024. Anonymised cardiothoracic surgery usage data and HAS
literature review was presented to the cardiothoracic department
(September 2024) with responsibility for HAS usage handed over. Efficacy
of QIP measures was evaluated using retrospective trust-wide HAS usage
reports (Clinisys WinPath) combined with individual surgeon activity data
(IntellectWeb), to include incidence of HAS use, volume and cost.
<br/>Result(s): Pre-implementation (May 2023-January 2024): 511 surgeries
were performed by 5 surgeons, with 232 patients receiving HAS (incidence
45%). HAS was ordered 469 times (mean 2 order episodes/patient receiving
HAS) tallying to 1593g/month. HAS usage varied significantly across
surgeons. Surgeon A used 625g/month transfusing 56% of his patients
(mainly 20% HAS), whilst surgeon D used only 110g/month transfusing 27%.
Surgeon B used 215g/month of 5% HAS but ranked high in transfusing 58% of
his patients. Departmental spend was 3711/month. Post-trust-wide
QIP-implementation period (February 24-July 24): Cardiothoracic HAS usage
reduced to 593g/month (62% reduction), transfusing only 23% of patients
undergoing cardiothoracic surgery (49% reduction), averaging at 2.7 order
episodes/patient. Departmental spend decreased to 1389/month (62%
reduction). Post Cardiothoracic measures (October 24-December 24): HAS
transfusion in patients undergoing cardiothoracic surgery decreased by a
further 35% (67% overall reduction from baseline) with 50- 83% reductions
across all surgeons. HAS usage was 385g/month (76% reduction from
baseline), although order episodes were slightly increased (mean 2.4 order
episodes/patient receiving HAS, range 1-27). Departmental spend was
897/month (76% reduction from baseline), thus a saving of 2814/month.
<br/>Conclusion(s): HAS use in cardiothoracic surgery is high despite
limited evidence of benefit. Guideline updates and 'HAS request challenge'
by laboratory staff helps reduce HAS usage but has challenges/limitations.
Specifically highlighting large differences in individual HAS usage and
placing increased emphasis of responsibility with the cardiothoracic
surgeons themselves, has further reduced HAS usage in cardiothoracic
surgery. Long-term monitoring is required.

<126>
[Use Link to view the full text]
Accession Number
2043177382
Title
Comparative Outcomes of Balloon-Expandable and Self-Expandable Valves in
Transcatheter Aortic Valve Replacement for Bicuspid Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date
of Publication: 2025.
Author
Bacha Z.; Rath S.; Qadri M.; Alam U.; Ali M.A.; Ahmad O.; Sajjad F.; Khan
K.; Noor H.; Javed J.; Henna F.; Tariq M.D.; Ghanim Al-Badri S.; Ahmed R.;
Ahmad H.; Fakhar M.; Mattumpuram J.
Institution
(Bacha, Alam, Ali, Ahmad, Sajjad, Khan, Noor) From the Department of
Medicine, Khyber Medical College, Peshawar, Pakistan
(Rath) Department of Medicine, All India Institute of Medical Sciences,
Bhubaneswar, Odisha, India
(Qadri, Javed) Department of Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Henna) Department of Medicine, Dubai Medical College for Girls, Dubai,
United Arab Emirates
(Tariq, Fakhar) Department of Medicine, Mary Washington Healthcare,
Fredericksburg, VA
(Ghanim Al-Badri) Department of Medicine, College of Medicine, University
of Warith Al-Anbiyaa, Karbala, Iraq
(Ahmed, Ahmad) Department of Cardiology, National Heart and Lung
Institute, Imperial College London, London, United Kingdom
(Mattumpuram) Department of Cardiology, University of Louisville School of
Medicine, Louisville, KY
Publisher
Lippincott Williams and Wilkins
Abstract
The comparative efficacy and safety of balloon-expandable valves (BEVs)
and self-expandable valves (SEVs) in transcatheter aortic valve
replacement for bicuspid aortic stenosis remain a topic of debate. This
systematic review and meta-analysis aim to synthesize available evidence
to guide clinical decision-making. A systematic search of PubMed, Embase,
and Web of Science was conducted. Risk ratios (RRs) and mean differences
were pooled using a random-effects model. Thirteen studies comprising 2174
patients were included. BEVs were associated with a significantly higher
risk of annulus rupture (RR = 3.00, 95% CI, 1.13-7.94, P = 0.03), while
procedural and 30-day mortality rates were comparable between BEVs and
SEVs. The need for new pacemaker implantation at 30 days was significantly
lower in the BEV group (RR = 0.64, 95% CI, 0.49-0.83, P = 0.0009).
Postdilation was reduced considerably with BEVs following sensitivity
analysis (RR = 0.35, 95% CI, 0.24-0.52, P < 0.0001). In summary, both BEVs
and SEVs demonstrated acceptable safety profiles, with BEVs carrying a
higher risk of annular rupture but potential advantages in device success
and postdilation rates. Large-scale randomized trials remain essential to
refine patient selection and procedural strategies.<br/>Copyright &#xa9;
2025

<127>
[Use Link to view the full text]
Accession Number
2043177378
Title
Long-Term Outcomes of Synchronous Versus Staged Carotid Endarterectomy and
Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date
of Publication: 2025.
Author
Moawad M.H.E.D.; Alkhawaldeh I.M.; Karawya M.; Abushanap M.M.; Abualnadi
M.; Alkabi A.; Alhamouz L.H.A.; Alkhalili H.B.A.; Zaki M.S.A.; Alattar A.;
Serag I.; Abdul-Hafez H.A.; Gadelmawla A.F.; Abouzid M.; Bisht O.
Institution
(Moawad, Karawya) From the Alexandria Main University Hospital,
Alexandria, Egypt
(Moawad) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Alkhawaldeh, Alkabi, Alhamouz) Faculty of Medicine, Mutah University,
Al-Karak, Jordan
(Abushanap, Abualnadi) Faculty of Medicine, Hashemite University, Zarqa,
Jordan
(Alkhalili) Prince Hamza Hospital, Hashemite University, Zarqa, Jordan
(Zaki) Department of Anatomy, College of Medicine, King Khalid University,
Abha, Saudi Arabia
(Alattar) King Abdullah Medical City, Makkah, Saudi Arabia
(Serag) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Abdul-Hafez) Department of Medicine, An-Najah National University, West
Bank, Nablus, Palestine
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Gadelmawla) Medical Research Group of Egypt (MRGE), Negida Academy,
Arlington, MA
(Abouzid) Department of Physical Pharmacy and Pharmacokinetics, Faculty of
Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
(Bisht) Evangelisches Herzzentrum Coswig, Coswig (Anhalt), Germany
Publisher
Lippincott Williams and Wilkins
Abstract
The management of patients with concomitant coronary artery disease and
carotid artery stenosis undergoing coronary artery bypass grafting (CABG)
remains controversial. While synchronous carotid endarterectomy (CEA) with
CABG may reduce perioperative stroke, its long-term benefit compared with
staged procedures is unclear. This study systematically reviewed and
meta-analyzed long-term outcomes of synchronous versus staged CEA with
CABG. Following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines, was searched up to July 2025. Eligible studies
included randomized controlled trials and cohort studies reporting
long-term outcomes after synchronous or staged CEA/CABG. Pooled risk ratio
(RR) with 95% confidence intervals (CIs) was calculated using a
random-effects model. Twenty-five studies, including 35, 781 patients,
were analyzed, of whom 6828 underwent synchronous and 28, 953 staged
procedures. Long-term mortality was significantly lower with staged
surgery (RR: 1.26, 95% CI: 1.15-1.37, P < 0.00001, I2 = 0%). No
significant differences were observed between synchronous and staged
approaches for stroke (RR: 1.16, 95% CI: 0.75-1.77), myocardial infarction
(MI) (RR: 0.83, 95% CI: 0.54-1.28), or major adverse cardiovascular events
(MACE) (RR: 0.99, 95% CI: 0.85-1.16). Among patients undergoing
synchronous CEA/CABG, pooled long-term incidences were 14.6% for
mortality, 6.2% for stroke, 5.0% for MI, and 17.5% for MACE. Long-term
stroke, MI, and MACE rates are broadly comparable between synchronous and
staged CEA with CABG. However, staged procedures appear to provide a
survival advantage, with significantly reduced long-term mortality.
Further multicenter randomized trials are warranted to confirm these
findings and optimize patient selection.<br/>Copyright &#xa9; 2025