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<1>
Accession Number
2032916381
Title
Effect of del Nido cardioplegia in patients with reduced left ventricular
ejection fraction: A meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Yamashita Y.; Baudo M.; Magouliotis D.E.; Cabrucci F.; Sicouri S.; Ramlawi
B.
Institution
(Yamashita, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Wynnewood, PA, United States
(Yamashita, Baudo, Magouliotis, Cabrucci, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Purpose: Research on the safety and efficacy of del Nido cardioplegia in
adult patients with reduced left ventricular ejection fraction (LVEF) is
limited. We evaluated the effect of del Nido cardioplegia on early
outcomes of cardiac surgery in this cohort. Method(s): PubMed,
Scopus, and the Cochrane Central Register of Controlled Trials were
searched through August 2024 to conduct a meta-analysis comparing del Nido
to other cardioplegia in adult patients with reduced LVEF (<=50%). Primary
endpoint was early mortality, and secondary endpoints included
morbidities, aortic cross-clamp time and postoperative LVEF before
discharge. A random-effect model was used to estimate the pooled effect
size. Result(s): Seven studies met our eligibility criteria,
including three propensity score-matched studies with a total of 1160
patients. Conventional blood cardioplegia was used exclusively as a
control solution in the included studies. The incidence of early mortality
was similar between the del Nido and control groups, with a pooled odds
ratio of 0.94 [95% confidence interval: 0.52; 1.71] (p =.822).
Postoperative stroke (p =.680), renal failure (p =.832), atrial
fibrillation (p =.412), and aortic cross-clamp time (p =.153) were also
comparable between the two groups. Postoperative LVEF was significantly
higher in the del Nido group compared to the control group, with a
standardized mean difference of 0.52 [95% confidence interval: 0.07; 0.96]
(p =.034). Conclusion(s): In adult patients with reduced LVEF
undergoing cardiac surgery, del Nido cardioplegia provides comparable
mortality and morbidity rates compared to conventional blood cardioplegic
solutions, with the potential to offer protective effects on myocardial
function. Copyright © The Author(s) 2025.

<2>
Accession Number
2036207829
Title
Clinical and microbiological characteristics of high-level
daptomycin-resistant Corynebacterium species: A systematic scoping review.
Source
Journal of Infection and Chemotherapy. 31(2) (no pagination), 2025.
Article Number: 102575. Date of Publication: 01 Feb 2025.
Author
Fukushima S.; Hagiya H.; Gotoh K.; Tsuji S.; Iio K.; Akazawa H.;
Matsushita O.; Otsuka F.
Institution
(Fukushima, Matsushita) Department of Bacteriology, Okayama University
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama, Japan
(Fukushima, Hagiya, Akazawa, Otsuka) Department of Infectious Diseases,
Okayama University Hospital, Okayama, Japan
(Fukushima, Akazawa, Otsuka) Department of General Medicine, Okayama
University Graduate School of Medicine, Dentistry and Pharmaceutical
Sciences, Okayama, Japan
(Gotoh, Tsuji) Department of Medical Laboratory Science, Okayama
University Graduate School of Health Sciences, Okayama, Japan
(Iio) Microbiology Division, Clinical Laboratory, Okayama University
Hospital, Okayama, Japan
Publisher
Elsevier B.V.
Abstract
Introduction: Corynebacterium species potentially develop high-level
daptomycin resistance (HLDR) shortly after daptomycin (DAP)
administration. We aimed to investigate the clinical and microbiological
characteristics of HLDR Corynebacterium infections. Method(s): We
first presented a clinical case accompanied by the results of a
comprehensive genetic analysis of the isolate, and then performed a
systematic scoping review. Based on the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, we
searched for articles with related keywords, including "Corynebacterium",
"Daptomycin", and "Resistance", in the MEDLINE and Web of Science
databases from the database inception to October 25, 2024. Clinical case
reports and research articles documenting the isolation of HLDR
Corynebacterium species, defined by a minimum inhibitory concentration of
DAP at >=256 mug/mL, were deemed eligible for this review. Result(s):
Of 80 articles screened, seven case reports detailing eight cases of HLDR
Corynebacterium infections, as well as five research articles, were
included. C. striatum was the most common species (7/9 cases, 77.8 %), and
prosthetic device-associated infections accounted for 66.7 % of the cases.
Duration of DAP administration before the emergence of HLDR isolates
ranged from 5 days to 3 months; three-quarters of the cases developed
within 17 days. Three HLDR isolates were genetically confirmed to have an
alteration in pgsA2. The majority of the patients were treated with either
glycopeptides or linezolid, with favorable outcomes. In vitro experiments
confirmed that C. striatum strains acquire the HLDR phenotype at higher
rates (71 %-100 %) within 24 h of incubation, compared to other
Corynebacterium strains. Conclusion(s): DAP monotherapy, especially
for prosthetic device-associated infections, can result in the development
of HLDR Corynebacterium. Additional research is warranted to investigate
the clinical implications of this potentially proliferating antimicrobial
resistant pathogen. Copyright © 2024 Japanese Society of
Chemotherapy, Japanese Association for Infectious Diseases, and Japanese
Society for Infection Prevention and Control

<3>
Accession Number
2037067260
Title
Efficacy and safety of Shexiang Baoxin Pill (MUSKARDIA) in patients with
stable coronary artery disease across different weight subgroups.
Source
Journal of Ethnopharmacology. 341 (no pagination), 2025. Article Number:
119341. Date of Publication: 11 Feb 2025.
Author
Zhou J.; Shi H.; Zhao Y.; Jin Y.; Liu Y.; Wang S.; He S.; Lu F.; Li R.;
Xiong S.; Yan J.; Liu Q.; Wang Z.; Cong H.; Han Q.; Ge J.
Institution
(Zhou) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Shi) Department of Cardiology, Huashan Hospital, Fudan University,
Shanghai, China
(Zhao) Department of Cardiology, The Second Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Jin) Department of Cardiology, The Fourth Affiliated Hospital of China
Medical University, China
(Liu) Department of Cardiology, Tianjin Third Central Hospital, Tianjin,
China
(Wang) Department of Cardiovascular Medicine, Ningbo First Hospital,
Ningbo, China
(He) Department of Cardiology, Northern Jiangsu People's Hospital,
Yangzhou, China
(Lu) Department of Cardiology, The Affiliated Hospital of Shandong
University of Traditional Chinese Medicine, Ji'nan, China
(Li) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Guangdong University of Traditional Chinese Medicine, Guangzhou, China
(Xiong) Department of Cardiovascular Medicine, Fujian Province People's
Hospital, Fuzhou, China
(Yan) Department of Cardiovascular, The First Affiliated Hospital of China
University of Science and Technology, Hefei, China
(Liu) Department of Cardiology, The Second Xiangya Hospital of Central
South University, Changsha, China
(Wang) Department of Cardiology, The Affiliated Hospital of Xuzhou Medical
University, Xuzhou, China
(Cong) Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
(Han) Department of Cardiology, The First Hospital of Shanxi Medical
University, Taiyuan, China
(Ge) Department of Cardiovascular Internal Medicine, Zhongshan Hospital,
Fudan University, Shanghai, China
Publisher
Elsevier Ireland Ltd
Abstract
Ethnopharmacological relevance: Shexiang Baoxin Pill (MUSKARDIA), a
traditional Chinese patent medicine, plays a crucial role in both
preventing and treating diverse cardiovascular diseases, including
coronary heart disease, myocardial infarction (MI), and heart failure.
Preclinical research has demonstrated that the cardioprotective effects of
MUSKARDIA are achieved through multiple pathways, such as enhancing
coronary artery dilation, fostering new blood vessel growth, reducing
inflammation and oxidative stress, improving lipid metabolism, and
protecting vascular endothelium. Aim of the study: This subgroup analysis
aimed to evaluate the efficacy and safety of Shexiang Baoxin Pill
(MUSKARDIA) plus optimal medical therapy (OMT) across different weight
categories in treating stable coronary artery disease (CAD).
 Method(s): This investigation was a subgroup analysis of a
multicenter, randomized, double-blind, placebo-controlled phase IV
clinical study. Patients receiving OMT were randomly assigned to either
MUSKARDIA or placebo group for a 24-month period. This analysis focused on
body weight as a distinguishing factor, using 65 kg as the cutoff. The
primary efficacy endpoint was the composite of major adverse
cardiovascular events (MACEs), including cardiovascular death, non-fatal
myocardial infarction (MI), and non-fatal stroke. Secondary efficacy
endpoint comprised a composite of all-cause mortality, non-fatal MI,
non-fatal stroke, hospitalizations for unstable angina or heart failure,
and coronary revascularization procedures. Result(s): A total of 2646
patients were included in the analysis, with 916 patients weighing less
than 65 kg and 1730 patients weighing 65 kg or more. The median ages were
68 (range: 35-90) years and 62 (range: 29-90) in these two subgroups,
respectively. For patients weighing less than 65 kg, the MUSKARDIA group
exhibited a significantly lower incidence of the primary efficacy endpoint
(0.65%) compared to the placebo group (2.64%) (P = 0.018), with a reduced
risk of MACEs (HR = 0.241, 95%CI: 0.068-0.856; P = 0.0168). Conversely, in
patients weighing 65 kg or more, no significant differences were observed
in the incidence rates or risks of primary or secondary efficacy endpoints
between the MUSKARDIA and placebo groups (All P > 0.05). Adverse events
were similar between two groups across both weight subgroups.
 Conclusion(s): MUSKARDIA plus OMT demonstrated promising efficacy and
acceptable safety in CAD patients weighing less than 65 kg, potentially
reducing the risk of MACEs. For patients weighing 65 kg or more, further
investigation is needed to optimize dosing strategies. Copyright
© 2025 The Authors

<4>
Accession Number
2036791379
Title
Sex Differences in Patients Undergoing FFR-Guided PCI or CABG in the FAME
3 Trial.
Source
JACC: Cardiovascular Interventions. 18(2) (pp 157-167), 2025. Date of
Publication: 27 Jan 2025.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Oldroyd K.G.; Wendler
O.; Reardon M.J.; Woo Y.J.; Yeung A.C.; Pijls N.H.J.; De Bruyne B.; Fearon
W.F.
Institution
(Takahashi, Otsuki, Ding, Yeung, Fearon) Stanford University School of
Medicine and Stanford Cardiovascular Institute, Stanford University,
Stanford, CA, United States
(Zimmermann, Pijls) Department of Cardiology, Catharina Hospital,
Eindhoven, Netherlands
(Zimmermann) St. Antonius Hospital, Nieuwegein, Netherlands
(Oldroyd) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Wendler) Cleveland Clinic London, London, United Kingdom
(Reardon) Houston Methodist Debakey Heart & Vascular Center, Houston, TX,
United States
(Woo) Department of Cardiothoracic Surgery, Division of Cardiovascular
Medicine and Stanford Cardiovascular Institute, Stanford University,
Stanford, CA, United States
(De Bruyne) Cardiovascular Center Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Outcomes in women after fractional flow reserve (FFR)-guided
percutaneous coronary intervention (PCI) using current-generation
drug-eluting stents (DES) compared with coronary artery bypass grafting
(CABG) are unknown. Objective(s): This study sought to evaluate
differences in clinical outcomes according to sex after FFR-guided PCI
with current generation DES compared with CABG. Method(s): The FAME 3
(Fractional Flow Reserve Versus Angiography for Multivessel Evaluation)
trial was an investigator-initiated, randomized controlled trial,
comparing FFR-guided PCI with current generation DES or CABG in patients
with 3-vessel coronary artery disease. This prespecified subgroup analysis
compared the incidence of major adverse cardiac and cerebrovascular events
(MACCE) according to sex, defined as the composite of all-cause death,
myocardial infarction, stroke, or repeat revascularization at 3 years.
 Result(s): Of 1,500 patients included in the FAME 3 trial, 265
(17.7%) were women. Women had a significantly higher risk of MACCE at 3
years compared with men after CABG (18.1% vs 11.7%; adjusted HR: 2.07; 95%
CI: 1.19-3.60), whereas women had a similar risk of MACCE at 3 years
compared with men after PCI (18.2% vs 19.1%; adjusted HR: 1.27; 95% CI:
0.79-2.03). Regarding treatment effects by sex, women undergoing PCI had a
similar risk of MACCE at 3 years compared with CABG (adjusted HR: 1.15;
95% CI: 0.62-2.11). By contrast, men undergoing PCI had a higher risk of
MACCE at 3 years compared with CABG (adjusted HR: 1.68; 95% CI: 1.25-2.25;
P<inf>interaction</inf> = 0.142), which was mainly driven by a higher risk
of myocardial infarction (adjusted HR: 2.11; 95% CI: 1.26-3.56;
P<inf>interaction</inf> = 0.102) and repeat revascularization (adjusted
HR: 2.26; 95% CI: 1.47-3.47; P<inf>interaction</inf> = 0.071).
 Conclusion(s): In the FAME 3 trial, at 3 years, women had similar
outcomes with FFR-guided PCI compared with CABG, whereas men had improved
outcomes with CABG. (A Comparison of Fractional Flow Reserve-Guided
Percutaneous Coronary Intervention and Coronary Artery Bypass Graft
Surgery in Patients With Multivessel Coronary Artery Disease [FAME 3];
NCT02100722) Copyright © 2025 American College of Cardiology
Foundation

<5>
Accession Number
2035488100
Title
The effects of high-intensity interval training and moderate-intensity
continuous training on patients underwent Coronary Artery Bypass Graft
surgery; a systematic review.
Source
American Journal of Cardiovascular Disease. 14(6) (pp 306-317), 2024.
Article Number: AJCD0160327. Date of Publication: 2024.
Author
Chichagi F.; Alikhani R.; Hosseini M.H.; Azadi K.; Shirsalimi N.; Ghodsi
S.; Jameie M.
Institution
(Chichagi, Jameie) Cardiac Primary Prevention Research Center, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Chichagi, Alikhani) Students' Scientific Research Center (SSRC), Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini) Students' Research Committee, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Azadi) Students' Scientific Research Center (SSRC), Alborz University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Shirsalimi) Students' Research Center, Hamadan University of Medical
Sciences, Hamedan, Iran, Islamic Republic of
(Ghodsi) Department of Cardiology, Sina Hospital, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
E-Century Publishing Corporation
Abstract
Objectives: To our knowledge, there is no clear consensus on a definitive
cardiac rehabilitation method for patients undergoing Coronary Artery
Bypass Graft (CABG). We conducted this systematic review to compare and
evaluate the effects of two of the most frequent cardiac rehabilitation
modalities, high-intensity interval training (HIIT) and moderate-intensity
continuous training (MICT), on cardiopulmonary variables. Method(s):
We carried out a systematic search of the databases PubMed, Web of
Science, Embase, Scopus, and Google Scholar. Following the removal of
duplicate results, the original search yielded 385 citations. We
identified four randomized clinical trials after reviewing titles,
abstracts, and potential full-text studies. We utilized the Cochrane Risk
of Bias Tool (RoB2) to assess the risk of bias. Result(s): We
included four randomized clinical trials involving 143 people. All trials
included individuals who had CABG and completed HIIT or MICT sessions for
at least four weeks. The findings indicated that HIIT programs may improve
functional capacity, heart rate variability indices, and blood pressure
management while lowering brain natriuretic peptide (BNP<inf>1-32</inf>)
and N-terminal pro-b-type natriuretic peptide (NT-proBNP<inf>1-76</inf>)
levels. Conclusion(s): Given the findings, it appeared that
supervised high-intensity exercise regimens could be more useful to
patients. Following the surgery, HIIT therapy improves exercise capacity,
the autonomic nervous system, volume overload, and blood pressure
regulation. Copyright © 2024, E-Century Publishing Corporation.
All rights reserved.

<6>
Accession Number
2035472810
Title
Efficacy of Ancillary Cardiopulmonary Therapeutic Regimen on Tissue
Perfusion, Post-operative Pain, and Pulmonary Functions During Acute Phase
I of Cardiopulmonary Rehabilitation Following CABG Surgery: A Pilot study.
Source
Bahrain Medical Bulletin. 46(4) (pp 2442-2450), 2024. Date of Publication:
01 Dec 2024.
Author
Palanivel O.; Al Bshabshe A.; Purushothaman S.; Theodore S.; Ramakrishnan
S.; Alshahrani M.B.; Kablan A.A.; Alwadai N.M.; Khormi K.A.A.; Saeed
A.S.S.; Sadagobane S.K.; Chinnavan E.; Subramani S.
Institution
(Palanivel, Purushothaman) Chettinad School of Physiotherapy, Chettinad
Hospital and Research Institute, Chettinad Academy of Research and
Education (CARE), Tamil Nadu, Kelambakkam, India
(Al Bshabshe) Department of Medicine, Division of Adult Critical care,
King Khalid University, Abha, Aseer Region, Saudi Arabia
(Theodore, Ramakrishnan, Subramani) Chettinad Super Specialty Hospital,
Cardio-Thoracic Vascular Surgical Department, Chettinad Health City,
Kelabakkam, Chennai, India
(Alshahrani, Kablan, Alwadai, Khormi, Saeed) Aseer Central Hospital, Abha,
Aseer Region, Saudi Arabia
(Sadagobane) University Tunku Abdul Rahman, JalanSungai long, Selangor,
Malaysia
(Chinnavan) Faculty of Allied Health Professionals, AIMST University,
Malaysia
Publisher
Bahrain Medical Bulletin
Abstract
Background: Impaired tissue perfusion, postoperative pain discomfort, and
postoperative pulmonary complications are all significant concerns that
arise immediately after coronary artery bypass grafting (CABG).
 Aim(s): This is a prospective pilot study that investigated the
effects of prophylactic Non-Invasive Positive Pressure Ventilation (NIPPV)
on tissue perfusion and the effect of Transcutaneous Electrical Nerve
Stimulation (TENS) as combined ancillary therapy on acute postoperative
pain at coughing and pulmonary functions in participants who underwent
off-pump CABG surgery with good left ventricular function or mild left
ventricular dysfunction. Method(s): This pilot study involved 40
participants, randomly divided into two groups: an intervention group (n =
20) receiving NIPPV (2 sessions) and TENS (6 sessions), and a control
group (n = 20) receiving standard routine care. We assessed the tissue
perfusion effect on each group using blood lactate and mixed central
venous oxygenation (ScvO2) levels. We measured the effect of pain on each
group using a Numerical Pain Rating Scale (NPRS) and measured lung
function using spirometry. Result(s): There are statically
significant difference in post operative pain at coughing, tissue
perfusion, pulmonary functions and length of intensive care stay
(p<0.001). Compared to the control group (mean difference of ScvO2 and
blood lactate at baseline, 1sthour, 8thhour and post 30 minutes of 8th
hour were 59.3+/-3.294, 57.4+/-2.873, 57.3+/-3.556, 57.35+/-3.453 and
2.48+/-0.2308, 2.445+/-0.2417, 2.105 +/-0.3649, 2.105+/-0,3649), NIPPV
greatly increased blood flow to tissues (mean difference of ScvO2 and
blood lactate at baseline, post 1st hour, 8th hour and post 30 minutes of
8th hour were 59.1+/-3.946, 64.1+/-5.16, 67+/-4.484, 66.9+/-4.229, p<0.001
and 2.51+/-0.3024, 2.095+/-0.2837, 1.705+/-0.2089, 1.705+/-0.2089,
p<0.001). TENS greatly decreased pain at coughing (mean difference at day
0, 1st,2nd and 5th postoperative day were 9.0500+/-.223, 6.25+/-1.25132,
4.8+/-1.15166, 4.4+/-0.50262 and enhanced the pulmonary function in the
intervention group (p<0.001). Also, the intervention group showed a lower
incidence of impaired respiratory events and shorter duration's of
postoperative ICU stays compared to the control group. Conclusion(s):
Administration of prophylactic Non-Invasive Positive Pressure Ventilation
(NIPPV) and TENS as combined ancillary therapy may improve tissue
perfusion, reduce post operative pain at coughing, pulmonary
complications, and decreases the length of intensive care stay in off-pump
coronary artery bypass graft (CABG) patients with good left ventricular
(LV) or mild left ventricular (LV) dysfunction during the acute phase I of
cardio-pulmonary rehabilitation, when compared to standard treatment
alone. Copyright © 2024, Bahrain Medical Bulletin. All rights
reserved.

<7>
Accession Number
2037034916
Title
Effects of postoperative glucocorticoids on mitigation of organ
dysfunction in patients with type A aortic dissection: A randomized
controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 66(6) (no pagination), 2024.
Article Number: ezae441. Date of Publication: 01 Dec 2024.
Author
Luo M.-H.; Luo J.-C.; Xu X.; He Z.-H.; Huang Y.-R.; Chen C.; Su Y.; Hou
J.-Y.; Wang C.-S.; Lai H.; Tu G.-W.; Luo Z.
Institution
(Luo, Luo, Xu, He, Huang, Su, Hou, Tu, Luo) Cardiac Intensive Care Center,
Zhongshan Hospital, Fudan University, Shanghai, China
(Luo, Huang) Shanghai Medical College, Fudan University, Shanghai, China
(Xu) Department of Critical Care Medicine, Pan Long People's Hospital,
Yunnan, Kunming, China
(He) Department of Critical Care Medicine, Dehong Prefecture People's
Hospital, Dehong Dai and Jingpo Autonomous Prefecture, Yunnan, China
(Chen) Department of Critical Care Medicine, Xiamen Branch, Zhongshan
Hospital, Fudan University, Xiamen, China
(Wang, Lai) Department of Cardiac Surgery, Zhongshan Hospital, Fudan
University, Shanghai, China
(Luo) Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai,
China
(Luo) Department of Critical Care Medicine, Shanghai Xuhui Central
Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
(Luo) Key Laboratory of Multiple Organ Failure (Zhejiang University),
Ministry of Education, Hangzhou, China
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: This study aims to evaluate the organ-protective efficacy of
postoperative glucocorticoid in patients with type A aortic dissection.
 METHOD(S): Postoperative type A aortic dissection patients were
randomly allocated to receive either postoperative glucocorticoid or
standard-of-care treatment. Intravenous methylprednisolone was
administered for 3 days. The primary outcome was the reduction of
Sequential Organ Failure Assessment score on postoperative day 4 compared
to baseline (on postoperative day 1 before methylprednisolone
administration). RESULT(S): Two hundred twelve patients were included
in the intention-to-treat analysis. The primary outcome was significantly
different between groups: 3.16 +/- 2.52 in the control group versus 4.36
+/- 2.82 in the glucocorticoid group (absolute difference 1.20 [95% CI
0.52-1.93], P = 0.001). The glucocorticoid group showed markedly lower
median high-sensitivity C-reactive protein levels compared to the control
group (91.0 mg/l vs 182.0 mg/l; absolute difference: -91 (95% CI -122 to
-57), P = 0.009) on postoperative day 4. Fewer patients in the
glucocorticoid group required continuous renal replacement therapy (8.5%
vs 19.8% in the control group; absolute difference: -10.4 [95% CI -19.1 to
-1.3], P = 0.03). CONCLUSION(S): This trial demonstrates that
postoperative glucocorticoid in patients with type A aortic dissection
significantly reduces postoperative inflammation and improves recovery of
early organ dysfunction. These findings advocate for the implementation of
glucocorticoid in the early phase after surgery for enhanced organ
protection. Copyright © 2024 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<8>
Accession Number
2037034915
Title
The effect of virtual reality on postoperative anxiety and pain in
patients following cardiac surgery: A randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 66(6) (no pagination), 2024.
Article Number: ezae440. Date of Publication: 01 Dec 2024.
Author
El Mathari S.; Shehadeh S.; Zwaan W.P.; Boulidam N.; Kuitert L.; Twisk
J.W.R.; Klautz R.J.M.; De Lind Van Wijngaarden R.; Veen K.; Kluin J.
Institution
(El Mathari, Shehadeh, Zwaan, Boulidam, Kuitert, Klautz, De Lind Van
Wijngaarden) Department of Cardiothoracic Surgery, Amsterdam University
Medical Center, Amsterdam, Netherlands
(El Mathari, Veen, Kluin) Department of Cardiothoracic Surgery, Erasmus
University Medical Center, Rotterdam, Netherlands
(Twisk) Department of Epidemiology and Data Science, Amsterdam University
Medical Center, Amsterdam, Netherlands
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The VRECOVERY investigated the impact of virtual reality (VR)
distraction therapy on postoperative pain, anxiety and quality of recovery
in patients undergoing coronary artery bypass grafting surgery.
 METHOD(S): A single-centre randomized controlled trial was conducted
involving 192 participants, allocated to either the intervention or
control group. Participants in the intervention group received VR
distraction therapy on postoperative days 1, 2 and 3, while the control
group received standard postoperative care. Primary outcomes were measured
in both groups directly following the VR sessions of the intervention
group. Outcomes included (i) postoperative pain [Numeric Rating Scale
(NRS)], (ii) postoperative anxiety [State Trait Anxiety Inventory 6
questionnaire (STAI-6)] and (iii) quality of postoperative recovery
[Quality of Recovery 15 questionnaire (QoR-15)]. RESULT(S): A total
of 100 participants completed the study, including 39 patients (mean age
69.1 +/- 7.7 years) in the intervention group and 61 patients (mean age
66.8 +/- 8.2 years) in the control group. Eighty-nine percent of
participants was male. VR-distraction therapy demonstrated a significant
difference in postoperative pain decrease between groups (NRS score;
intervention group -1.45/day vs control group -0.73/day, P = 0.007), and
an important overall difference in postoperative anxiety slopes (STAI-6
score; intervention group -0.60/day vs control group +0.09/day, P = 0.06).
There was no effect observed on postoperative quality of recovery (P =
0.11). CONCLUSION(S): The VRECOVERY trial suggests a beneficial
impact of VR distraction therapy in reducing postoperative pain. There was
no significant effect on postoperative anxiety and quality of
recovery. Copyright © 2024 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<9>
Accession Number
2037034362
Title
Editorial on incidence and outcomes of transient new onset atrial
fibrillation complicating acute coronary syndromes: Results from a
systematic review and meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(8) (pp
662-664), 2024. Date of Publication: 01 Dec 2024.
Author
Balu A.; Welters I.; Lip G.Y.H.
Institution
(Balu, Welters, Lip) Liverpool Centre for Cardiovascular Science,
University of Liverpool, Liverpool John Moores University, Liverpool Heart
& Chest Hospital, Liverpool, United Kingdom
(Welters) Liverpool University Hospitals NHS Foundation Trust, Department
of Critical Care, Royal Liverpool University Hospital, Mount Vernon
Street, Liverpool, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
Publisher
Oxford University Press

<10>
Accession Number
2036995936
Title
Association between influenza vaccination and prognosis in patients with
ischemic heart disease: A systematic review and meta-analysis of
randomized controlled trials.
Source
Travel Medicine and Infectious Disease. 64 (no pagination), 2025. Article
Number: 102793. Date of Publication: 01 Mar 2025.
Author
Liu X.; Zhang J.; Liu F.; Wu Y.; Li L.; Fan R.; Fang C.; Huang J.; Zhang
D.; Yu P.; Zhao H.
Institution
(Liu) Department of Anesthesiology, The Third Hospital of Nanchang,
Jiangxi, Nanchang, China
(Liu) Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun
Yat-sen University, Guangdong, Guangzhou, China
(Liu) Guangdong Provincial Key Laboratory of Arrhythmia and
Electrophysiology, Guangdong, Guangzhou, China
(Liu) Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics
and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA
Medicine, Sun Yat-Sen University, Guangdong, Guangzhou, China
(Zhang, Wu, Fan, Fang, Huang, Yu) Department of Endocrinology and
Metabolism, The Second Affiliated Hospital of Nanchang University,
Jiangxi, Nanchang, China
(Liu, Zhao) Department of Cardiology, The Affiliated Ganzhou Hospital of
Nanchang University, Jiangxi, China
(Li) Fujian University of Traditional Chinese Medicine, Fujian, Fuzhou,
China
(Zhang) Food and Nutritional Sciences, School of Biological Sciences, The
University of Hong Kong, Hong Kong
Publisher
Elsevier Inc.
Abstract
Background: There is substantial epidemiological evidence demonstrating
that influenza contributes to cardiovascular events in patients who
already have cardiovascular diseases. However, the efficacy of influenza
vaccination on the prognosis of patients with ischemic heart disease (IHD)
is unclear. Method(s): We conducted a systematic search for eligible
randomized controlled trials (RCTs) in PubMed, Cochrane, and Embase on
September 13, 2024, to investigate the effects of the influenza vaccine on
the prognosis of patients with IHD. The effect sizes were combined using
random-effects models, and Trial Sequential Analysis (TSA) was used to
assess the reliability and validity of the results. Result(s): Five
RCTs with a total of 5659 patients (median age ranging from 57.1 to 66
years, 67.8% male) with IHD were included. The use of influenza vaccine
reduced the risk of major adverse cardiovascular events (risk ratio [RR] =
0.67, 95% confidence interval [CI] 0.52-0.87, number-needed-to-treat [NNT]
of 37, high certainty), cardiovascular death (RR = 0.55, 95% CI 0.35-0.87,
moderate certainty), all-cause mortality (RR = 0.58, 95% CI 0.40-0.84,
high certainty) and myocardial infarction (MI) (RR = 0.66, 95% CI
0.46-0.93, high certainty) in patients with IHD compared with control. The
analysis revealed no significant benefit regarding hospitalization for
heart failure (HF) (RR = 0.91, 95% CI 0.21-3.99, moderate certainty) and
revascularization (RR = 0.59, 95% CI 0.10-3.45, moderate certainty). The
NNT to avoid 1 event was 37 for major adverse cardiovascular events, 56
for cardiovascular death, 67 for MI, and 41 for all-cause death. TSA
showed that the benefit of influenza vaccine in reducing MACE was
conclusive, no more trials were necessary. Conclusion(s): This study
suggests high level of evidence that the use of influenza vaccine may
reduce the risk of major adverse cardiovascular events in patients with
IHD. Copyright © 2025 The Authors

<11>
Accession Number
2032261497
Title
Percutaneous coronary intervention versus coronary artery bypass grafting
in left main disease according to patients' sex: A meta-analysis.
Source
European Journal of Clinical Investigation. 55(2) (no pagination), 2025.
Article Number: e14348. Date of Publication: 01 Feb 2025.
Author
Meynet P.; Improta R.; Carbone M.L.; Pecoraro M.; Pagliassotto I.; Di
Pietro G.; Demetres M.; Bruno F.; Comitini G.; Leone A.; Martinengo E.;
Siliano S.; D'Ascenzo F.; Chieffo A.; De Ferrari G.M.; Gaudino M.; Mancone
M.; Di Franco A.; De Filippo O.
Institution
(Meynet, Carbone, Pecoraro, Pagliassotto, Bruno, Martinengo, Siliano,
D'Ascenzo, De Ferrari, De Filippo) Division of Cardiology, Cardiovascular
and Thoracic Department, "Citta della Salute e della Scienza" Hospital,
Turin, Italy
(Meynet, Carbone, Pecoraro, Pagliassotto, Martinengo, Siliano, D'Ascenzo,
De Ferrari) Department of Medical Sciences, University of Turin, Turin,
Italy
(Improta, Di Pietro, Comitini, Mancone) Department of Clinical Internal,
Anaesthesiological and Cardiovascular Sciences, Sapienza University of
Rome, Rome, Italy
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Leone) Division of Cardiology, SG Moscati Hospital, Avellino, Italy
(Leone) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Chieffo) Vita Salute San Raffaele University, Milan, Italy
(Gaudino, Di Franco) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The role of sex in choosing between coronary artery bypass
grafting (CABG) and percutaneous coronary intervention (PCI) for
unprotected left main coronary artery (ULMCA) disease has gained interest.
 Method(s): Randomized controlled trials and adjusted observational
studies comparing PCI versus CABG in ULMCA patients with outcomes by sex
were included. The primary endpoint was major adverse cardiovascular
events (MACE), with secondary endpoints being all-cause mortality and
repeated revascularization. Result(s): Ten studies (3 randomized, 7
observational) involving 22,141 ULMCA disease patients (13,411 PCI, 8730
CABG) with a median 5-year follow-up were included. Among males, PCI was
associated with a higher risk of MACE (HR 1.18, 95% CI 1.01-1.38), while
no significant difference was seen in females. However, moderator analysis
showed no significant interaction between sex and revascularization
strategy for MACE (p for interaction.422). No differences in all-cause
mortality were observed between PCI and CABG for either sex. Repeated
revascularization risk was significantly higher with PCI for both sexes
(HR 3.51, 95% CI 2.21-5.59 in males and HR 4.20, 95% CI 2.57-6.87 in
females). Conclusion(s): In males with ULMCA disease, CABG was
associated with a lower risk of MACE compared to PCI, while no significant
differences were seen in females. The lack of a significant interaction
between sex and revascularization strategy suggests that these findings
may not reflect true sex-based effect modification. PCI was linked to a
higher risk of repeated revascularization in both sexes compared to CABG.
Trial registration: The protocol was registered in the PROSPERO
International Prospective Register of Systematic Reviews (ID:
CRD42024537726). Copyright © 2024 The Author(s). European Journal
of Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<12>
Accession Number
2036984295
Title
Effect of intraoperative fluid volume on postoperative pulmonary
complications in thoracic surgeries: A systematic review and
meta-Analysis.
Source
Indian Journal of Anaesthesia. 69(1) (pp 78-85), 2025. Date of
Publication: 01 Jan 2025.
Author
Adhikari S.D.; Gupta N.; Gupta M.; Nagesh S.K.; Chaudhuri S.; Garg R.
Institution
(Adhikari, Nagesh) Department of Anaesthesiology, Kasturba Medical
College, Manipal Academy of Higher Education, Karnataka, Manipal, India
(Gupta) Department of Infectious Diseases, Kasturba Medical College,
Manipal Academy of Higher Education, Karnataka, Manipal, India
(Gupta) Department of Community Medicine and Family Medicine, All India
Institute of Medical Sciences, Rajasthan, Jodhpur, India
(Chaudhuri) Department of Critical Care Medicine, Kasturba Medical
College, Manipal Academy of Higher Education, Karnataka, Manipal, India
(Garg) Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.
Institute Rotary Cancer Hospital and National Cancer Institute, All India
Institute of Medical Sciences, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: There is a lack of clear recommendations on fluid
strategies in patients undergoing thoracic surgeries. The primary
objective of this study was to compare the amount of intraoperative
intravenous fluid (IVF) infused between those who developed postoperative
pulmonary complications (PPCs) and those who did not. Method(s): All
studies comparing PPCs in intraoperative restrictive versus liberal fluid
therapies were included. Those studies where the average fluid infused was
compared between PPC and the 'no PPC' groups were also included. The
pooled mean difference in IVF between patients with and without PPC and
the pooled risk ratio of PPC in restricted versus liberal fluid arms were
calculated. Result(s): Articles from PubMed (n = 157), EMBASE (n =
724) and citation searching (n = 4) were included. After excluding
duplicates, title-Abstract screening for 759 articles and full-Text
screening for 24 articles were done. The mean fluid infused in the 11
included articles was significantly higher in those with PPC (mean
difference: 1.51 ml/kg/h, P = 0.001). The pooled proportion of PPC in
liberal fluid arms was higher than in restricted fluid arms [risk ratio =
0.58 (95% confidence interval: 0.33, 1.02), P = 0.06]. There was high
heterogeneity in both the meta-Analyses. Conclusion(s): The
meta-Analysis showed that increased intraoperative IVF is associated with
higher PPCs, and a restricted fluid strategy might be safer to reduce
PPCs. However, since most studies were observational with a high risk of
bias and high heterogeneity, well-conducted randomised controlled trials
are needed to derive recommendations. Copyright © 2025 Indian
Journal of Anaesthesia.

<13>
Accession Number
2027971342
Title
The correlation of non-invasive hemoglobin testing and lab hemoglobin in
surgical patients: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 40(1) (pp 61-68), 2025. Date of Publication:
01 Jan 2025.
Author
Kazma J.; Ebner M.; Slota J.; Berger J.S.; Farooq F.; Smith E.; Ahmadzia
H.K.
Institution
(Kazma, Slota) Department of Obstetrics and Gynecology, George Washington
University School of Medicine and Health Sciences, Washington, DC, United
States
(Ebner) School of Medicine and Health Sciences, George Washington
University School of Medicine and Health Sciences, Washington, DC, United
States
(Berger) Department of Anesthesiology and Critical Care Medicine, George
Washington University School of Medicine and Health Sciences, Washington,
DC, United States
(Farooq, Smith) Department of Global Health, The George Washington
University Milken Institute School of Public Health, Washington, DC,
United States
(Smith) Department of Exercise and Nutrition Sciences, The George
Washington University Milken Institute School of Public Health,
Washington, DC, United States
(Ahmadzia) Division of Maternal-Fetal Medicine, Department of Obstetrics
and Gynecology, George Washington University School of Medicine and Health
Sciences, Washington, DC, United States
Publisher
SAGE Publications Ltd
Abstract
Background: The decision regarding intraoperative transfusion has
traditionally been based on hemodynamic instability and estimated blood
loss. We performed a systematic review to determine the validity of the
oximetry method compared to standard of care for hemoglobin measurement.
 Method(s): A systematic literature review was conducted, and several
libraries were searched from inception to March 31,2023. The primary
outcome was comparing the mean difference between laboratory-derived
hemoglobin and non-invasive, point-of-care hemoglobin measurement.
Subgroup analysis included comparing the mean difference in the pediatric
population and among female patients. Result(s): A total of 276
studies were identified, and 37 were included. We found that the pooled
mean difference varied qualitatively between adult and pediatric
population (p value for heterogeneity <0.001). In adult populations, lab
hemoglobin measurements were on average slightly higher than non-invasive
measurements (mean difference = 0.23; 95% CI -0.13, 0.59), though there
was greater heterogeneity across studies (I2 = 97%, p value = <0.001). In
the pediatric population, most studies showed lab hemoglobin to be
slightly lower (mean difference = -0.42; 95% CI -0.87 to 0.03).
 Conclusion(s): In general, there was no clinically significant
difference in mean hemoglobin among adult and pediatric populations. The
percentage of female participants had no effect on the mean difference in
hemoglobin. Copyright © The Author(s) 2024.

<14>
Accession Number
2027208007
Title
Comparison of six percent hydroxyethyl starch 130/0.4 and ringer's lactate
as priming solutions in patients undergoing isolated open heart valve
surgery: A double-blind randomized controlled trial.
Source
Perfusion (United Kingdom). 40(1) (pp 116-124), 2025. Date of Publication:
01 Jan 2025.
Author
Sheikhi B.; Rezaei Y.; Baghaei Vaji F.; Fatahi M.; Hosseini Yazdi M.;
Totonchi Z.; Banar S.; Peighambari M.M.; Hosseini S.; Mestres C.A.
Institution
(Sheikhi, Fatahi, Hosseini Yazdi, Totonchi) Rajaie Cardiovascular Medical
and Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Rezaei, Baghaei Vaji, Totonchi, Banar, Hosseini) Heart Valve Disease
Research Center, Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Peighambari) Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mestres) Department of Cardiothoracic Surgery and the Robert WM Frater
Cardiovascular Research Centre, The University of the Free State
Bloemfontein, Bloemfontein, South Africa
Publisher
SAGE Publications Ltd
Abstract
Objectives: Colloids are added to the priming solution of the
cardiopulmonary bypass (CPB) pump to maintain colloid osmotic pressure and
prevent fluid overload. This study aimed to compare the effects of 6%
hydroxyethyl starch (HES) 130/0.4 and ringer's lactate (RL) priming
solution on patients' outcomes undergoing isolated heart valve surgery
with CPB. Method(s): This randomized clinical trial included one
hundred and 20 patients undergoing heart valve surgery, and those were
allocated into two groups. Patients in the RL group received 1500 mL of
RL, and those in the RL + HES group were given 500 mL of HES and 1000 mL
of RL. Result(s): The patients' median age was 52 (IQR 42-60) and 50
(IQR 40-61) years in the RL + HES and the RL group, respectively (p =.71).
The number of cases that required blood product transfusion in both the
operating room and intensive care unit was also significantly higher in
the RL + HES group compared to the RL group (RR 2.04, 95% CI 1.50-2.76; p
<.01 and RR 1.42, 95% CI 1.01-2.01; p =.05, respectively). Declines in
postoperative creatinine levels and platelet counts were higher in the RL
+ HES compared to the RL group (between-subjects effect p =.007 and p
=.038, respectively), while the incidence of acute kidney injury was
comparable between groups (RR 0.66, 95% CI 0.13-3.30; p =.55).
 Conclusion(s): Among patients undergoing heart valve surgery with
CPB, 6% HES added to RL for priming compared with only RL increased the
risk of the need for blood product transfusion over the hospitalization
period. Copyright © The Author(s) 2023.

<15>
Accession Number
2027129972
Title
Bivalirudin anticoagulation for cardiopulmonary bypass during cardiac
surgery.
Source
Perfusion (United Kingdom). 40(1) (pp 7-19), 2025. Date of Publication: 01
Jan 2025.
Author
Meshulami N.; Murthy R.; Meyer M.; Meyer A.D.; Kaushik S.
Institution
(Meshulami, Murthy, Meyer, Kaushik) Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Murthy) Division of Pediatric Cardiac Surgery, Department of
Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Meyer) Division of Critical Care, Department of Pediatrics, Long School
of Medicine, University of Texas Health Science Center, San Antonio, TX,
United States
(Kaushik) Pediatric Critical Care, Department of Pediatrics, Kravis
Children's Hospital at Mount Sinai, Icahn School of Medicine, New York,
NY, United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Heparin is the primary anticoagulant for cardiopulmonary
bypass (CPB) support during cardiac surgery. While widely used, ~2% of
cardiac surgery patients develop heparin-induced thrombocytopenia (HIT)
and 4-26% develop heparin resistance. Bivalirudin is an alternative
anticoagulant mainly used for percutaneous coronary interventions. Given
the challenges associated with heparin anticoagulation, we conducted a
review to explore the use of bivalirudin for CPB surgery. Method(s):
PubMed and Embase scoping review included 2 randomized controlled trials,
a retrospective comparison study, 3 pilot studies, and 30 case reports. To
provide a contemporary series, we searched for articles published from
2010 to 2023. Our review included studies from both adult and pediatric
populations. Result(s): While data is limited, bivalirudin seems to
supply similar effectiveness and safety as heparin for CPB
anticoagulation. Across the three comparative studies, the heparin cohorts
had a 0-9% mortality rate and 0-27% rate of major bleeding/reoperation
compared to a 0-3% mortality and 0-6% major bleeding/reoperation rate for
the bivalirudin cohorts. Bivalirudin was successfully used as an
anticoagulant in a wide range of CPB surgeries (e.g., heart transplants,
ventricular assisted device placements, and valve repairs). Successful
patient outcomes were reported with bivalirudin infusion of ~2 mg/kg/hour,
activated clotting time monitoring (target >400 s or 2.5x baseline), use
of cardiotomy suctions, minimization of stagnant blood, and post-bypass
modified ultrafiltration. Conclusion(s): Bivalirudin is a safe and
effective anticoagulant for CPB, especially for patients with HIT or
heparin resistance. Further comparative research is called for to optimize
bivalirudin utilization for CPB during cardiac surgery. Copyright
© The Author(s) 2023.

<16>
Accession Number
2037050065
Title
Relative perioperative analgesic efficacy of single-shot serratus anterior
plane block versus thoracic paravertebral block in breast and thoracic
surgeries - A systematic review and meta-analysis of randomised controlled
trials.
Source
Indian Journal of Anaesthesia. 69(1) (pp 54-64), 2025. Date of
Publication: 01 Jan 2025.
Author
Makkar J.K.; Singh N.P.; Khurana B.J.K.; Singh P.M.
Institution
(Makkar) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
(Khurana) Department of Anaesthesia, Punjab Institute of Liver and Biliary
Sciences, Punjab, SAS Nagar, India
(Singh) Department of Anesthesiology, Washington University School of
Medicine in St. Louis, St. Louis, MO, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Various regional analgesia techniques, such as
thoracic paravertebral (TPV) and serratus anterior plane (SAP) blocks,
have been employed to manage postoperative pain following chest wall
surgery. However, the comparative analgesic efficacy of these two
approaches remains uncertain. This systematic review and meta-analysis
aimed to assess the relative analgesic efficacy of these blocks in chest
wall surgeries, including breast and thoracic procedures. The primary
objective was the time to first rescue analgesia, and the secondary
objective encompassed opioid consumption within 24 h, pain scores at
different time intervals, opioid-related adverse effects and block-related
complications. Method(s): A systematic search for randomised
controlled trials (RCTs) was conducted in PubMed, EMBASE and Scopus
databases, covering studies from their inception to September 2023. We
included active treatment arms from RCTs comparing these analgesic
modalities. Statistical analysis was conducted in Review Manager Version
5.3, and results were analysed and reported separately for breast and
thoracic surgery subgroups. Result(s): Eighteen trials enroling 1141
patients were included. Overall, no significant difference was observed in
time to rescue analgesia, with a mean difference of 0.69 h (95% confidence
interval -1.83, 0.45; P = 0.24, I2 = 98%) between the SAP and
TPV block groups. However, the TPV block demonstrated superior results for
secondary outcomes in thoracic surgery patients. Complications related to
the TPV block included pleural puncture and haematoma at the injection
site. Conclusion(s): The evidence suggests that both blocks generally
offer comparable analgesic efficacy for chest wall surgery patients, with
the TPV block providing a slight advantage for those undergoing thoracic
surgery. Copyright © 2025 Indian Journal of Anaesthesia.

<17>
Accession Number
2032912474
Title
Strategies in Diagnosis and Therapy of External Outflow Graft Obstruction
in Patients with a Fully Magnetically Levitated Left Ventricular Assist
Device: A Meta-Analysis and Systematic Review.
Source
Journal of Clinical Medicine. 14(1) (no pagination), 2025. Article Number:
108. Date of Publication: 01 Jan 2025.
Author
Huang A.; von Mackensen J.K.R.; Zwaans V.I.T.; Schuering C.L.; Iske J.;
Stein J.; Ott S.; Heck R.; Starck C.T.; Kempfert J.; Jacobs S.; Falk V.;
Potapov E.V.; Wert L.
Institution
(Huang, von Mackensen, Zwaans, Schuering, Iske, Stein, Ott, Heck, Starck,
Kempfert, Jacobs, Falk, Potapov, Wert) Department of Cardiothoracic and
Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Huang, von Mackensen, Zwaans, Schuering, Iske, Stein, Ott, Heck, Starck,
Kempfert, Jacobs, Falk, Potapov, Wert) Department of Cardiothoracic
Surgery, Charite-Universitatsmedizin Berlin, Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Berlin, Germany
(Falk) German Center for Cardiovascular Research (DZHK), Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich, Zurich,
Switzerland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The HeartMate 3 (HM3, Abbott) left ventricular assist device
(LVAD) is the only commercially available option considered suitable for
long-term circulatory support. External compression of the outflow graft
causing obstruction (eOGO) is a serious adverse event affecting patients
on long-term support. The obstruction occurs due to the accumulation of
gelatinous substance between the bend relief and outflow graft. This
systematic review evaluated all available studies with regard to the
diagnosis and therapy of eOGOs. Method(s): A systematic literature
review and analysis of individual patient data was performed using
MEDLINE/PubMed following PRISMA guidelines. Original works dating up to 31
October 2024 were considered. Result(s): Twenty-four publications
that met the inclusion criteria were identified, providing individual data
from 113 patients with a median support time to eOGO diagnosis of 809 days
[588, 1095] and follow-up after treatment of 365 days [33, 605]. eOGO
severity classification was performed on 108 patients according to our
grading system. For treatment, most patients underwent surgery (n = 38) or
stenting (n = 29). A hazard ratio of 0.75 [0.28, 2.03] was calculated for
the surgical group versus the stenting group (p = 0.570).
 Conclusion(s): Concerning 30-day mortality, we did not find a
significant difference between the eOGO severity of survivors and
non-survivors. We found no significant differences in outcome between
patients with differing eOGO severity and treatment strategy, namely
stenting and surgery. Due to an increase in eOGO incidence after one year
of support, we propose that clinicians monitor their patients for this
complication when support time surpasses one year. Copyright ©
2024 by the authors.

<18>
Accession Number
645478286
Title
Does performing cardiac surgery after hours impact postoperative outcomes?
A systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. 65(6) (pp 523-532), 2024. Date of
Publication: 01 Dec 2024.
Author
O'Connell A.; El-Andari R.; Fialka N.M.; Nagendran J.; Meyer S.R.
Institution
(O'Connell, El-Andari, Fialka, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AL, Canada
(Meyer) Division of Cardiac Surgery, Department of Surgery, University of
Alberta, Edmonton, AL, Canada
Abstract
INTRODUCTION: There has been concern regarding the safety of cardiac
surgical intervention during off-hours. Sleep deprivation, resource
limitations, and an increased case urgency have been postulated to
increase off-hours surgical risk, although outcomes are inconsistent in
the existing literature. In this systematic review and meta-analysis, we
review the literature comparing patients undergoing cardiac surgery during
on and off-hours. EVIDENCE ACQUISITION: PubMed and Embase were
systematically searched for literature published from January
2000-September 2023, comparing outcomes of patients undergoing cardiac
surgery during on and off-hours. Overall, 3540 manuscript titles and
abstracts were screened and 11 articles were included. EVIDENCE SYNTHESIS:
Overall aggregate analysis indicated no significant differences in rates
of in-hospital mortality(OR 1.04; 95% CI, 0.41-2.63; P=0.93) and
perioperative morbidity, including stroke (P=0.52), reoperation (P=0.92),
major bleeding (P=0.10), and renal complications (P=0.55). Composite rates
of sternal wound infection favored on-hours surgery (P=0.01).
 CONCLUSION(S): Although inferior outcomes in patients undergoing
cardiac surgery during off-hours have been noted, aggregate analysis
largely revealed equivalent perioperative morbidity and mortality during
on and off-hours surgery, although with the exclusion of one outlier study
in-hospital mortality and reoperation favored on-hours surgery.
Heterogeneity in outcomes is likely multifactorial, with surgical staff
fatigue, patient preoperative risk, clinical setting, and resource
limitations all contributing. Further investigation is required directly
comparing emergent cardiac surgical intervention during on-hours and
off-hours controlling for baseline surgical risk to elucidate the true
impact of timing of surgery on postoperative outcomes.

<19>
Accession Number
645306979
Title
Efficacy of Sternum Guard vs. bone wax in post-cardiac surgery patients: a
randomized controlled trial.
Source
The Journal of cardiovascular surgery. 65(6) (pp 539-545), 2024. Date of
Publication: 01 Dec 2024.
Author
Hanafy D.A.; Muroso K.K.; Sugisman S.; Soetisna T.W.; Tjubandi A.; Wartono
D.A.; Herlambang B.; Busro P.W.
Institution
(Hanafy, Soetisna, Tjubandi, Wartono, Herlambang, Busro) Division of
Cardiac, Thoracic and Vascular Surgery, Faculty of Medicine, University of
Indonesia, Jakarta, Indonesia
(Hanafy, Sugisman, Soetisna, Tjubandi, Wartono, Herlambang) Division of
Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, West
Jakarta, Indonesia
(Muroso) Division of Cardiac, Thoracic and Vascular Surgery, Faculty of
Medicine, University of Indonesia, Jakarta, Indonesia
(Busro) Division of Pediatric and Congenital Heart Surgery, National
Cardiovascular Center, Jakarta, Indonesia
Abstract
BACKGROUND: Median sternotomy offers the main access during cardiac
surgery. However, a surgical site infection (SSI) of the sternum is a
distressing complication following this procedure. The incidence of
postoperative superficial and deep SSI in cardiac surgery varies from 1.3%
to 12.8%. Bone wax, a nonabsorbable substance applied as a mechanical
barrier following a median sternotomy, can increase the risk of
postoperative sternal dehiscence. Sternum Guard (Vygon, Ecouen, France), a
sternal protection device used to cover the sternum after a median
sternotomy, offers mechanical protection to prevent lesions on the
sternum. The aim of this study was to compare the effectiveness of Sternum
Guard (Vygon) and bone wax in reducing SSI and facilitating hemostasis in
post-cardiac surgery patients. METHOD(S): This single-blinded, single
center randomized controlled trial comprised 414 adult patients who
underwent cardiac surgery. The postoperative outcomes assessed were SSI
and the quantity of blood lost from the sternal edges in the Sternum Guard
(Vygon; treatment) and bone wax (control) groups. RESULT(S): The
superficial SSI prevalence in the Sternum Guard group was lower than that
in the bone wax group (2.9% vs. 8.2%, respectively; P=0.018). The
incidence of deep SSI was also lower in the Sternum Guard group (1%)
compared to the control group (2.9%) although this was not statistically
significant (P=0.284). In terms of intraoperative sternal bleeding,
Sternum Guard (Vygon) absorbed more than the sterile drapes used in the
control group (84.97+/-115.99 vs. 81.18+/-14.62, respectively; P=0.012).
 CONCLUSION(S): Sternum Guard (Vygon) had a significantly lower
incidence of postoperative infection and bleeding from the sternum
compared to bone wax.

<20>
Accession Number
2032868972
Title
Sex and gender in perioperative cardiovascular research: protocol for a
scoping review.
Source
Systematic Reviews. 14(1) (no pagination), 2025. Article Number: 6. Date
of Publication: 01 Dec 2025.
Author
Sjaus A.; Fakhory N.
Institution
(Sjaus) Department of Anesthesia, Pain Management and Perioperative
Medicine, Dalhousie University, IWK Health Centre, 5850 University Avenue,
Halifax, NS, Canada
(Sjaus) Department of Women's and Obstetric Anesthesia, IWK Health Centre,
Halifax, NS, Canada
(Fakhory) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: The inadequate inclusion of sex and gender in medical research
has resulted in biased clinical guidance and disparities in knowledge and
patient outcomes. Despite efforts by regulatory and funding agencies,
opportunities to generate sex-specific knowledge are frequently
overlooked. While certain disciplines in cardiovascular medicine have made
notable progress, these advances have yet to permeate the literature on
perioperative cardiovascular complications in non-cardiac surgery.
Prompted by the recent findings on sex-specific perioperative
cardiovascular outcomes, this review aims to scope the literature in this
field and categorize methodological approaches used to incorporate sex and
gender in studies of this patient population. Method(s): Joanna
Briggs Institute (JBI) methodology for scoping reviews will be followed in
stages elaborated by Levac (2010). A comprehensive search strategy will be
used to identify relevant primary research published since 2010. Screening
will be performed by independent reviewers using predefined inclusion and
exclusion criteria. Data will be extracted from full text and
supplementary materials of selected articles. Results will be presented as
proportions of studies reporting sex and gender, the assigned purpose of
these variables in analysis, and where they are reported in the article.
In addition, articles will be mapped to the source, country of origin, and
year of publication. Narrative summaries will be provided to outline key
findings and assess the depth of the literature within each of the major
topics (risk assessment/prediction, diagnosis, treatment, prognosis, and
outcomes). Discussion(s): Increasing recognition of the profound and
complex implications of sex and gender in medicine has fuelled calls for
greater attention to participation equity, sex-specific analysis and
reporting. Focusing on perioperative cardiovascular complications, this
review has the potential to identify knowledge gaps for future research,
as well as areas of strength that could support formal knowledge synthesis
or secondary analysis of data from past research. Scoping review
registration: Submitted on August 15th, 2023 (Web of Science
osf.io/u25sf). Copyright © The Author(s) 2025.

<21>
Accession Number
2034852565
Title
Safety and efficacy of riociguat in patients with pulmonary arterial
hypertension and cardiometabolic comorbidities: Data from interventional
clinical trials.
Source
Journal of Heart and Lung Transplantation. 44(2) (pp 135-146), 2025. Date
of Publication: 01 Feb 2025.
Author
Rosenkranz S.; Ghofrani H.-A.; Hoeper M.M.; Langleben D.; Hegab S.; Rahner
C.; Richard J.-F.; McLaughlin V.V.
Institution
(Rosenkranz) Department of Cardiology - Internal Medicine III, Heart
Center, University Hospital Cologne, Cologne, Germany
(Rosenkranz) Cologne Cardiovascular Research Center (CCRC), University of
Cologne, Cologne, Germany
(Ghofrani) University of Giessen and Marburg Lung Center, Member of the
German Center for Lung Research (DZL), Giessen, Germany
(Ghofrani) Department of Pneumology, Kerckhoff-Klinik, Bad Nauheim,
Germany
(Ghofrani) Department of Medicine, Imperial College London, London, United
Kingdom
(Hoeper) Clinic for Respiratory Medicine, Hannover Medical School, Member
of the German Center for Lung Research (DZL), Hannover, Germany
(Langleben) Division of Cardiology, Center for Pulmonary Vascular Disease,
Jewish General Hospital, McGill University, Montreal, Canada
(Hegab) Bayer U.S. LLC, Medical Affairs, Whippany, NJ, United States
(Rahner) Chrestos Concept GmbH & Co KG, Essen, Germany
(Richard) Merck & Co, Inc, Medical Affairs, Rahway, NJ, United States
(McLaughlin) Division of Cardiology, Department of Internal Medicine,
Frankel Cardiovascular Center University of Michigan Medical School, Ann
Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: There is limited evidence to support treatment recommendations
in patients with pulmonary arterial hypertension (PAH) and comorbidities.
To investigate the impact of riociguat treatment in this patient
population, we analyzed pooled data from randomized controlled trials of
riociguat. Method(s): This post hoc analysis included data from the
PATENT-1, PATENT-2, PATENT PLUS, and REPLACE studies. Safety, efficacy
(6-minute walk distance [6MWD], World Health Organization functional class
[WHO-FC], and N-terminal probrain natriuretic peptide [NT-proBNP]), and
COMPERA 2.0 risk status were assessed in patients with 0, 1 to 2, or 3 to
4 cardiometabolic comorbidities (obesity, systemic hypertension, diabetes
mellitus, coronary artery disease) in the main phase of the studies.
Safety was also assessed in the long-term extensions. Result(s): The
analysis included 686 patients (riociguat, n = 440; placebo, n = 132;
phosphodiesterase type 5 inhibitors [PDE5i], n = 114), of whom 55%, 39%,
and 6% had 0, 1 to 2, and 3 to 4 comorbidities, respectively. In the main
phase, rates and severity of adverse events (AEs) were similar in
riociguat-treated patients across comorbidity subgroups. After 2 years,
discontinuations of riociguat due to AEs were also similar across
subgroups. Compared with placebo and PDE5i, riociguat improved 6MWD and
NT-proBNP across comorbidity groups and improved WHO-FC and COMPERA 2.0
risk status in patients with 0 or 1 to 2 comorbidities.
 Conclusion(s): Riociguat had an acceptable safety profile in PAH
patients with cardiometabolic comorbidities. Efficacy and risk assessment
results suggest that riociguat can be beneficial for patients with PAH,
irrespective of the presence of comorbidities. Copyright © 2024
The Authors

<22>
Accession Number
2035283502
Title
Impact of type of mechanical circulatory support before transplant on
postorthotopic heart transplantation infections.
Source
Journal of Heart and Lung Transplantation. 44(2) (pp 215-224), 2025. Date
of Publication: 01 Feb 2025.
Author
Trottier C.A.; Martino A.; Short M.I.; Rodday A.M.; Strand A.M.; Kiernan
M.S.; Vest A.R.; Snydman D.R.; Chow J.K.
Institution
(Trottier, Strand, Snydman, Chow) Division of Geographic Medicine and
Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston,
Massachusetts, United States
(Martino) Department of Medicine, Tufts Medical Center, Boston,
Massachusetts, United States
(Short, Rodday) Clinical and Translational Sciences Institute, Tufts
University, Boston, Massachusetts, United States
(Short, Rodday) Institute for Clinical Research and Health Policy Studies,
Tufts Medical Center, Boston, Massachusetts, United States
(Kiernan) Division of Cardiology, Department of Medicine, Tufts Medical
Center, Boston, Massachusetts, United States
(Vest) Division of Cardiovascular Medicine, Heart, Vascular and Thoracic
Institute, Cleveland Clinic, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
Background: Infections after orthotopic heart transplantation (OHT) cause
significant morbidity and mortality. Concurrent with increased pre-OHT
temporary mechanical circulatory support (MCS), there have been recent
concerns of a perceived increase in infections post-OHT. We examined the
association between pre-OHT temporary versus durable MCS and post-OHT
infection. Method(s): We performed a single-center retrospective
review of patients who received OHT at Tufts Medical Center between
January 2014 and April 2022. Our composite outcome was the occurrence of
bacteremia, invasive fungal infections, opportunistic infections, or
skin/soft tissue infections of device sites within 1-year post-OHT. We
used Cox proportional hazards models to assess the relationship between
the type of pre-OHT MCS and time to the first infection, treating death
from other causes as a competing risk. We addressed confounding with 2
statistical methods: propensity score (PS) with inverse probability
weighting (IPW) and an instrumental variable (IV) analysis.
 Result(s): Of the 320 OHT recipients, 268 required MCS before OHT;
192 were managed with durable MCS and 76 with temporary MCS. Patients
receiving pre-OHT temporary MCS had no difference in time to first
infection (unadjusted hazard ratio [HR] 0.77, 95% CI 0.41-1.44) compared
to durable MCS. Results were similar in the model employing PS with IPW
(HR 0.61, 95% CI 0.29-1.27) and the IV analysis (HR 0.28, 95% CI
0.26-2.36). Conclusion(s): Pre-OHT temporary MCS was not associated
with the composite outcome of bacteremia, invasive fungal infections,
opportunistic infections, or skin/device site infections post-OHT compared
to durable MCS in this single-center cohort. Copyright © 2024
International Society for the Heart and Lung Transplantation

<23>
[Use Link to view the full text]
Accession Number
2036870096
Title
Takotsubo Syndrome Following Catheter Ablation for Atrial Fibrillation A
Systematic Review and Metasummary of Case Reports/Series.
Source
Cardiology in Review. (no pagination), 2024. Article Number:
10.1097/CRD.0000000000000845. Date of Publication: 2024.
Author
Desai R.; Gudiwada M.C.V.B.; Jasti J.R.; Jitta S.R.; Guddeti A.V.;
Vuddandam D.K.; Gujjari M.; Varala S.; Janga C.; Ganipineni V.D.P.; Merugu
B.; Bandaru R.R.; Puli S.; Venkata V.S.
Institution
(Desai) Independent Researcher, Atlanta, GA, United States
(Gudiwada) Department of Cardiology, University of Nebraska Medical
Center, Omaha, NE, United States
(Jasti) Department of Cardiology, Tower Health, Philadelphia, PA, United
States
(Jitta) Department of Internal Medicine, Mercy Hospital, Saint Louis, MO,
United States
(Guddeti) Department of Medicine, Mediciti Institute of Medical Science,
Hyderabad, India
(Vuddandam, Gujjari, Varala) Department of Medicine, Osmania General
Hospital, Hyderabad, India
(Janga) Department of Internal Medicine, Jefferson Abington Hospital,
Abington, PA, United States
(Ganipineni) Department of Internal Medicine, Thomas Hospital, Fairhope,
AL, United States
(Merugu) Department of Medicine, Vydehi Institute of Medical Sciences and
Research Center, Bengaluru, India
(Bandaru) Department of Internal Medicine, East Carolina University,
Greenville, NC, United States
(Puli, Venkata) Department of Hospital Medicine, Cheshire Medical Center,
Dartmouth Health Keene, NH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Atrial fibrillation (AF) catheter ablation is safe and effective, though
rare cases of takotsubo syndrome (TTS) have been observed without proven
causation. This review synthesizes TTS following AF ablation case reports
and series. Until October 2024, PubMed/Medline, SCOPUS, and Google Scholar
were searched for AF ablation and TTS case reports and series. This study
examines TTS incidence, clinical features, and prognosis after AF catheter
ablation. Thirteen articles detailing 18 patients were included in the
review. The study population had a mean age of 65 +/- 9.18 years and
77.77% were female. Of the 18 patients, 6 patients (33.3%) underwent
radiofrequency catheter ablation and 5 patients (27.7%) underwent
cryoablation. All the patients developed TTS within 4 days of the
procedure. Heart palpitations and breathlessness are predominant symptoms.
Eight patients had T-wave inversion. Dyskinesia was the most prevalent
echocardiography finding among the reported cases. Left ventricular
ejection fraction was moderately reduced in 5 cases (35.7%) and severely
reduced (left ventricular ejection fraction <30%) in 6 cases (42.8%). Of
the 15 patients in whom a pattern of ballooning was reported, 13 patients
had apical ballooning and 2 had atypical ballooning pattern. Of the 8
cases (44.44%) with complications, 1 had ventricular fibrillation and 2
patients had pulseless electrical activity. Left ventricular function is
completely recovered among 17 patients whereas one patient died due to
numerous cardiac electromechanical dissociation events. This systematic
investigation highlights the need for TTS vigilance after AF ablation,
especially in postmenopausal women having catheter ablation. More research
is required to fully understand the prevalence, etiology, and risk factors
of TTS after AF ablation. Copyright © 2024 Wolters Kluwer Health,
Inc. All rights reserved.

<24>
Accession Number
2032702474
Title
Incidence, Prediction, and Prevention of Fractures After Kidney
Transplantation: A Systematic Review Protocol.
Source
Canadian Journal of Kidney Health and Disease. 11 (no pagination), 2024.
Date of Publication: 01 Jan 2024.
Author
Cowan A.C.; Solo K.; Lebedeva V.; Mohammadi Kamalabadi Y.; El-Shimy M.;
Joshi A.; Olalike E.G.; Tanaka M.; Klotz A.G.R.; Elazhary H.W.; Zhu A.;
Forster A.; Veettil S.; Nair S.G.; Servin Martinez M.F.; Nayak D.; Priya
V.N.; Wellan C.; Cespedes Arcani D.M.; Roshanov P.S.
Institution
(Cowan, Elazhary, Zhu, Forster, Veettil, Roshanov) Department of Medicine,
Western University, London, ON, Canada
(Cowan, Mohammadi Kamalabadi, El-Shimy, Joshi, Olalike, Tanaka, Roshanov)
Department of Epidemiology and Biostatistics, Schulich School of Medicine
& Dentistry, Western University, London, ON, Canada
(Cowan) Victoria Hospital, London, ON, Canada
(Solo, Lebedeva) London Health Sciences Centre, London, ON, Canada
(Klotz) Faculty of Science, Western University, London, ON, Canada
(Nair) Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita
Vishwa Vidyapeetham, Coimbatore, India
(Servin Martinez) Faculty of Medicine, Autonomous University of San Luis
Potosi, Mexico
(Nayak) Precision AQ, New York, NY, United States
(Priya) Indian Institute of Public Health, Hyderabad, India
(Wellan) Independent Research Specialist, Monroe, WA, United States
(Cespedes Arcani) Department of Thoracic Surgery, The First Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Roshanov) Population Health Research Institute, Hamilton, ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Background: Kidney transplant recipients are uniquely exposed to the
disordered bone metabolism associated with chronic kidney disease
beginning before transplantation followed by chronic corticosteroid use
after transplantation. Previous efforts to synthesize the rapidly accruing
evidence regarding estimation and management of fracture risk in kidney
transplant recipients are outdated and incomplete. Objective(s): To
synthesize the evidence informing the overall incidence, patient-specific
risk prediction, and methods of prevention of fractures in patient living
with a kidney transplant. Design(s): Three systematic reviews will
address the following questions: What is the overall incidence of skeletal
fracture after kidney transplantation (review 1)? Which prediction models
and individual prognostic factors predict fracture in kidney transplant
recipients (review 2)? and How effective are different antifracture
interventions at preventing fracture or improving surrogate markers of
bone health in kidney transplant recipients (review 3)? Setting: Cohort
studies (reviews 1 and 2) and randomized trials (review 2) with a
mean/median follow-up >=12 months beginning after transplant. Review 3:
randomized trials or new-user cohort studies with concurrent controls
evaluating the effect of antifracture interventions including
bisphosphonates, calcium supplementation, cinacalcet, denosumab,
parathyroid hormone analogues, parathyroidectomy, raloxifene, romosozumab,
steroid withdrawal or minimization protocols after kidney transplant,
vitamin D (both active and nutritional), other antifracture interventions.
 Patient(s): Adult kidney transplant recipients in studies published
after the year 2000. Measurements: Review 1: incidence rate or cumulative
risk of fracture. Review 2: For prediction models, measures of
discrimination (eg, c-statistic), calibration (calibration curves,
observed:expected ratios), and net benefit (ie, from decision curve
analysis); for individual prognostic factors, relative measures of
association with fractures. Review 3: measures of treatment effect on
fractures and on surrogate markers of bone health (eg, bone mineral
density, trabecular bone score). Method(s): We searched MEDLINE,
Embase, and the Cochrane Library using subject headings and keywords
related to kidney transplant and fractures. Pairs of reviewers will screen
records independently in duplicate to identify studies relevant to one or
more of the 3 reviews and categorize each study accordingly. Single
reviewers will extract data and evaluate risk of bias for each included
study using one of the following tools as appropriate: the Quality of
Prognostic Studies tool, the Prediction model Risk Of Bias ASsessment
tool, the Risk Of Bias In Non-randomised Studies-of Interventions tool,
and the Cochrane Risk of Bias 2.0 tool. A second reviewer will
independently verify. We will synthesize study-level summary estimates by
random-effects meta-analysis for review 1, by vote counting and
random-effects meta-analysis in review 2, and by random effects pairwise
and, if feasible, network meta-analysis in review 3. We will summarize
findings according to latest guidance of the Grading of Recommendations
Assessment, Development, and Evaluation Working Group applicable to each
review. Limitation(s): Reliance on published studies is susceptible
to publication bias, particularly in studies of prediction (review 2) and
of treatment effects (review 3). Conclusion(s): This review will
provide an evidence update on 3 topics of relevance to patients,
clinicians, guideline developers, and researchers. Copyright ©
The Author(s) 2024.

<25>
Accession Number
2032843855
Title
Valve Thrombosis Following Transcatheter Aortic Valve Replacement:
State-of-the-Art Review.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Duarte F.; Aguiar-Neves I.; Guerreiro C.E.; Silva M.; Ferreira N.D.;
Fontes-Carvalho R.
Institution
(Duarte) Cardiology Department, Hospital of Divino Espirito Santo, Ponta
Delgada, Portugal
(Aguiar-Neves, Guerreiro, Silva, Ferreira, Fontes-Carvalho) Cardiology
Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de
Gaia, Portugal
(Fontes-Carvalho) Department of Surgery and Physiology, Faculty of
Medicine of the University of Porto, UnIC@RISE, Porto, Portugal
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) is a well-established
treatment for severe aortic stenosis, especially in patients over 75 or
those at high surgical risk. While these prosthetic valves have a lower
thrombogenic profile than mechanical heart valves, leaflet thrombosis in
transcatheter aortic valves (TAV) occurs in an estimated 5%-40% of cases.
Most TAV thromboses are subclinical and can be detected via cardiac
computed tomography (CCT), which reveals hypo-attenuating leaflet
thickening and reduced leaflet motion in asymptomatic patients without
elevated transprosthetic gradients on echocardiography. The mechanisms
behind TAV thrombosis involve local mechanical triggers, patient
predisposing factors, and device and procedure-related aspects. The ideal
antithrombotic therapy post-TAVR depends on individual patient
characteristics, balancing bleeding risks with the need for oral
anticoagulants. Data on the optimal management of TAV thrombosis and the
routine use of CT post-TAVR are limited. While anticoagulation effectively
resolves clinically significant prosthesis thrombosis, its benefit in
subclinical cases is unclear. There is an ongoing debate about whether
subclinical leaflet thrombosis precedes clinical valve thrombosis, making
the ideal follow-up after valve implantation uncertain. This article aims
to provide a comprehensive review, summarizing current data on the
incidence of TAVR thrombosis, underlying mechanisms, clinical and imaging
diagnosis, management strategies, preventive measures, and long-term
follow-up. Copyright © 2025 Wiley Periodicals LLC.

<26>
Accession Number
2032846634
Title
Del Nido versus conventional blood cardioplegia in tetralogy of fallot
repair: A systematic review and meta-analysis of randomized controlled
trials.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Consoli L.N.; Koziakas I.G.; Kanakis M.
Institution
(Consoli) Federal University of Bahia, Faculty of Medicine, Bahia, Brazil
(Koziakas) Department of Anesthesiology, Onassis Cardiac Surgery Center,
Athens, Greece
(Kanakis) Department of Pediatric and Congenital Heart Surgery, Onassis
Cardiac Surgery Center, Athens, Greece
Publisher
SAGE Publications Ltd
Abstract
Objectives: Compare outcomes of Del Nido (DN) versus conventional blood
cardioplegia (BC) in the surgical repair of Tetralogy of Fallot (ToF).
 Method(s): Medical databases were searched to identify relevant
clinical trials. Meta-analysis was conducted for primary (cardiopulmonary
bypass [CPB] and aortic cross-clamp [ACC] times, hospital and intensive
care unit [ICU] length of stay [LOS], mechanical ventilation time) and
secondary (adverse events, lactate levels, volume of additional
cardioplegia) endpoints. Analysis was conducted for DN versus conventional
blood cardioplegia, and we performed sensitivity analysis with leave
one-out analysis for the primary outcome. Result(s): 4 randomized
controlled trials were included (n = 275). Mean differences (MD) with 95%
confidence intervals (CI) were calculated with a random-effects model.
Groups had similar CPB (MD -5.76 minutes; [-23.32 to 11.80]; p = 0.52) and
ACC (MD 3.06 minutes; [-13.64 to 7.52]; p = 0.57) times, ICU (MD -6.42
hours; [-25.62 to 12.78]; p = 0.51) LOS and additional cardioplegia volume
(MD -195.18 mL; [-434.19 to 43.82]; p = 0.11). The DN group had shorter
hospital LOS (MD -0.81 days; [-1.25 to -0.36]; p = 0.0003) and time under
mechanical ventilation (MD -4.57 hours; [-8.73 to -0.42]; p = 0.03). There
was no difference in mortality. Conclusion(s): DN cardioplegia has
similar clinical outcomes and operative times compared to conventional
blood cardioplegia in ToF surgery. Copyright © The Author(s)
2025.

<27>
Accession Number
2036440906
Title
Radiofrequency and Cryoablation as Energy Sources in the Cox-Maze
Procedure: A Meta-Analysis of Rhythm Outcomes.
Source
Heart Lung and Circulation. 34(1) (pp 25-33), 2025. Date of Publication:
01 Jan 2025.
Author
Baudo M.; Rosati F.; D'Alonzo M.; Benussi S.; Muneretto C.; Di Bacco L.
Institution
(Baudo, Rosati, D'Alonzo, Benussi, Muneretto, Di Bacco) Department of
Cardiac Surgery, Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
Publisher
Elsevier Ltd
Abstract
Aim: Cox-maze IV is the most effective surgical procedure for atrial
fibrillation (AF) treatment to date; however, few studies have compared
the outcomes of the different energy sources applied to achieve
transmurality. This study aimed to analyse the impact of the different
energy sources on Cox-maze IV results in terms of sinus rhythm
restoration. Method(s): A systematic review and meta-analysis was
conducted by including studies reporting rhythm outcomes on biatrial
Cox-maze AF ablation with bipolar radio-frequency (BRF), cryoenergy
(Cryo), or both (BRF+Cryo). The primary endpoints were the early and late
rhythm outcomes of AF ablation using the different energy sources. Late AF
recurrences were evaluated through timepoint analysis, and freedom from AF
from Kaplan-derived data. Sixty articles including 8,293 patients were
selected (3,364 patients Cryo, 1,937 BRF, and 2,992 BRF+Cryo).
 Result(s): At 6 months, AF incidence was significantly lower in the
Cryo group at 6.73%; it was 25.52% in the BRF and 16.79% in the BRF+Cryo
groups (p=0.0112). At the 4-year timepoint, AF incidence was lower in the
Cryo group compared with the BRF and BRF+Cryo: 6.14% vs 51.59% vs 16.09%,
respectively (p=0.0392). Freedom from AF was 76.7%+/-2.2%, 60.9%+/-2.2%,
and 66.3%+/-1.6% for Cryo, BRF, and BRF+Cryo at 4 years, respectively
(p<0.001). At meta-regression, mean left atrial diameter was positively
associated with higher AF recurrences (OR 1.04, 95% CI 1.01-1.08;
p=0.0159). Conclusion(s): When performing this procedure,
cryoablation seems to be associated with improved rhythm outcomes when
compared with bipolar radiofrequency ablation. Copyright © 2024
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<28>
Accession Number
2036902408
Title
Definitions of clinical study outcome measures for cardiovascular
diseases: The European Unified Registries for Heart Care Evaluation and
Randomized Trials (EuroHeart).
Source
European Heart Journal. 46(2) (pp 190-214), 2025. Date of Publication: 07
Jan 2025.
Author
Wilkinson C.; Bhatty A.; Batra G.; Aktaa S.; Smith A.B.; Dwight J.;
Rucinski M.; Chappell S.; Alfredsson J.; Erlinge D.; Ferreira J.;
Gudmundsdottir I.J.; Hrafnkelsdottir P.J.; Ingimarsdottir I.J.; Irs A.;
Janosi A.; Jarai Z.; Oliveira-Santos M.; Popescu B.A.; Vasko P.; Vinereanu
D.; Yap J.; Bugiardini R.; Cenko E.; Nadarajah R.; Sydes M.R.; James S.;
Maggioni A.P.; Wallentin L.; Casadei B.; Gale C.P.; Aboyans V.; Almeida
A.G.; Atar D.; Bayes-Genis A.; Biondi-Zoccai G.; Bonaca M.P.; Bonaros N.;
Brundel B.J.J.M.; Campo G.; Casado-Arroyo R.; Ceconi C.; Chioncel O.;
Ciccarelli M.; Coats L.; Collet J.-P.; Dan G.-A.; Delgado V.; Dilaveris
P.; Dobrev D.; Donal E.; Duncker D.; Elgamal S.M.; Ezekowitz J.A.; Fonarow
G.; Fraser A.G.; Giannakoulas G.; Gigante B.; Gnecchi M.;
Gollmann-Tepekoylu C.; Greene S.J.; Heijman J.; Howes J.; Iung B.; Jensen
M.T.; Kunadian V.; Lelonek M.; Leonardi S.; Grove E.L.; Liberale L.; Liga
R.; Lincoff A.M.; Lorusso R.; Mamas M.; Manfrini O.; Mangiacapra F.;
Marsan N.A.; Martin-Fernandez M.; Merino J.L.; Metra M.; Parolari A.;
Perrino C.; Raber L.; Rahmani B.; Rainer P.P.; Rosano G.M.C.; Rossi A.;
Rubboli A.; Rudolph T.; Sandner S.; Savarese G.; Siller-Matula J.;
Sossalla S.; Spadaccio C.; Stabile E.; Tanne D.; Ten Berg J.; Thielmann
M.; Treskes R.W.; Uchmanowicz I.; Udell J.A.; Van Kimmenade R.R.J.;
Zdravkovic M.
Institution
(Wilkinson) Hull York Medical School, University of York, York, United
Kingdom
(Wilkinson) Academic Cardiovascular Unit, South Tees NHS Foundation Trust,
James Cook University Hospital, Middlesbrough, United Kingdom
(Bhatty, Aktaa, Smith, Chappell, Nadarajah, Gale) Leeds Institute of
Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United
Kingdom
(Bhatty, Aktaa, Smith, Chappell, Nadarajah, Gale) Leeds Institute for Data
Analytics, University of Leeds, Leeds, United Kingdom
(Bhatty, Aktaa, Nadarajah, Gale) Department of Cardiology, Leeds Teaching
Hospitals NHS Trust, Leeds, United Kingdom
(Batra, James, Wallentin) Department of Medical Sciences, Cardiology and
Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden
(Dwight, Rucinski) European Society of Cardiology Patient Forum, Sweden
(Alfredsson, Vasko) Department of Cardiology, Linkoping University
Hospital, Linkoping, Sweden
(Erlinge) Department of Clinical Sciences, Lund University, Lund, Sweden
(Ferreira) Department of Cardiology, Hospital de Santa Cruz, Centro
Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
(Gumundsdottir, Hrafnkelsdottir, Ingimarsdottir) Department of Cardiology,
Landspitali University Hospital, Reykjavik, Iceland
(Ingimarsdottir) Department of Health Sciences, Faculty of Medicine,
University of Iceland, Reykjavik, Iceland
(Irs) Heart Clinic, Tartu University Hospital, Tartu, Estonia
(Janosi) Gyorgy Gottsegen National Cardiovascular Institute, Budapest,
Hungary
(Jarai) Department of Cardiology, South Buda Center Hospital, Szent Imre
Teaching Hospital, Budapest, Hungary
(Oliveira-Santos, Vinereanu) Cardiology Department, Unidade Local de Saude
de Coimbra, Coimbra, Portugal
(Popescu) Cardiology Clinic, University of Medicine and Pharmacy Carol
Davila, Emergency Institute for Cardiovascular Diseases Prof Dr C C
Iliescu, Bucharest, Romania
(Vinereanu) Cardiology and Cardiovascular Surgery, University and
Emergency Hospital, Bucharest, Romania
(Yap) Department of Cardiology, National Heart Centre Singapore, Singapore
(Bugiardini, Cenko) Department of Experimental, Diagnostic and Specialty
Medicine, Department of Medical and Surgical Sciences, University of
Bologna, Bologna, Italy
(Sydes) BHF Data Science Centre, HDR UK, London, United Kingdom
(Sydes) MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and
Methodology, UCL, London, United Kingdom
(Maggioni) ANMCO Research Centre, Heart Care Foundation, Florence, Italy
(Casadei) Division of Cardiovascular Medicine, NIHR Oxford Biomedical
Research Centre, University of Oxford, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Background and Aims: Standardized definitions for outcome measures in
randomized clinical trials and observational studies are essential for
robust and valid evaluation of medical products, interventions, care, and
outcomes. The European Unified Registries for Heart Care Evaluation and
Randomised Trials (EuroHeart) project of the European Society of
Cardiology aimed to create international data standards for cardiovascular
clinical study outcome measures. Method(s): The EuroHeart methods for
data standard development were used. From a Global Cardiovascular Outcomes
Consortium of 82 experts, five Working Groups were formed to identify and
define key outcome measures for: cardiovascular disease (generic
outcomes), acute coronary syndrome and percutaneous coronary intervention
(ACS/PCI), atrial fibrillation (AF), heart failure (HF) and transcatheter
aortic valve implantation (TAVI). A systematic review of the literature
informed a modified Delphi method to reach consensus on a final set of
variables. For each variable, the Working Group provided a definition and
categorized the variable as mandatory (Level 1) or optional (Level 2)
based on its clinical importance and feasibility. Result(s): Across
the five domains, 24 Level 1 (generic: 5, ACS/PCI: 8, AF: 2; HF: 5, TAVI:
4) and 48 Level 2 (generic: 18, ACS-PCI: 7, AF: 6, HF: 2, TAVI: 15)
outcome measures were defined. Conclusion(s): Internationally derived
and endorsed definitions for outcome measures for a range of common
cardiovascular diseases and interventions are presented. These may be used
for data alignment to enable high-quality observational and randomized
clinical research, audit, and quality improvement for patient
benefit. Copyright © 2024 The Author(s).

<29>
Accession Number
2036961339
Title
Comparison of percutaneous coronary intervention vs coronary artery bypass
graft for left main coronary artery disease in patients with prior
cerebrovascular disease: A systematic review, meta-analysis and
meta-regression.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
24 (no pagination), 2025. Article Number: 200370. Date of Publication: 01
Mar 2025.
Author
Shuja M.H.; Shakil F.; Ali S.H.; Uddin Q.S.; Noman A.; Iqbal J.; Ahmed M.;
Sajid F.; Ansari H.W.; Farhan S.A.; Ansari H.U.H.; Farhan S.H.; Nasir
M.M.; Qazi S.; Majid M.
Institution
(Shuja, Shakil, Ali, Uddin, Noman, Ahmed, Farhan, Ansari, Farhan, Nasir,
Qazi) Department of Internal Medicine, Dow University of Health Sciences,
Pakistan
(Iqbal) Nursing Department Communicable Diseases Centre Hamad Medical
Corporation, Doha, Qatar
(Sajid, Ansari) Department of Medicine, Liaquat National Hospital and
Medical College, Pakistan
(Majid) Department of Internal Medicine, AdventHealth Sebring, Sebring,
FL, United States
Publisher
Elsevier B.V.
Abstract
Background: Previous studies suggest similar cardiovascular (CV) benefits
for either percutaneous coronary intervention (PCI) or coronary artery
bypass graft (CABG) in patients with left main coronary artery disease
(LMCAD). However, limited data exist on the influence of prior
cerebrovascular disease (CEVD). Thus, we aim to compare the CV outcomes in
patients with LMCAD and prior CEVD, undergoing either PCI or CABG.
 Method(s): A comprehensive search from (January 2000 to August 2024)
identified three relevant studies. Outcomes analyzed included all-cause
mortality, major adverse cardiac and cerebrovascular events (MACCE),
myocardial infarction (MI), and risk of stroke in patients undergoing
either PCI or CABG for LMCAD. Data analysis employed a random effects
model and presented hazard ratios (HR) along with their 95 % confidence
intervals (CI). Result(s): Three studies involving 760 patients (361
PCI, 399 CABG) were included. PCI was associated with a significantly
higher risk of MACCE (HR = 2.56; 95 % CI = 1.23-5.37; p = 0.01;
I2 = 86 %) and MI (HR = 2.97; 95 % CI = 1.72-5.13; p < 0.0001;
I2 = 0 %) compared to CABG. No significant differences were
observed in all-cause mortality (HR = 1.35; 95 % CI = 0.92-1.98; p = 0.12;
I2 = 0 %) or recurrent stroke (HR = 0.83; 95 % CI = 0.40-1.70;
p = 0.60; I2 = 1 %). The risk of repeat revascularization was
higher in PCI, though not statistically significant (HR = 3.44; 95 % CI =
0.50-23.60; p = 0.21; I2 = 70 %). Conclusion(s): PCI
significantly elevates the risk of MACCE and MI in patients with LMCAD and
prior CEVD compared to CABG. However, risks of all-cause mortality, repeat
stroke, and revascularization were non-significant. Comorbidities may
drive the elevated risk, underscoring the need for tailored strategies in
this population. Copyright © 2025

<30>
Accession Number
2036440193
Title
Tricuspid Transcatheter Edge-to-Edge Repair for Severe Tricuspid
Regurgitation: 1-Year Outcomes From the TRILUMINATE Randomized Cohort.
Source
Journal of the American College of Cardiology. 85(3) (pp 235-246), 2025.
Date of Publication: 28 Jan 2025.
Author
Tang G.H.L.; Hahn R.T.; Whisenant B.K.; Hamid N.; Naik H.; Makkar R.R.;
Tadros P.; Price M.J.; Singh G.D.; Fam N.P.; Kar S.; Mehta S.R.; Bae R.;
Sekaran N.K.; Warner T.; Makar M.; Zorn G.; Benza R.; Jorde U.P.; McCarthy
P.M.; Thourani V.H.; Ren Q.; Trusty P.M.; Sorajja P.; Adams D.H.
Institution
(Tang, Benza, Adams) Mount Sinai Health System, New York, NY, United
States
(Hahn) NewYork-Presbyterian Columbia University Medical Center, New York,
NY, United States
(Whisenant, Sekaran) Intermountain Medical Center, Murray, UT, United
States
(Hamid, Bae, Sorajja) Allina Health Minneapolis Heart Institute at Abbott
Northwestern Hospital, Minneapolis, MN, United States
(Naik, Warner) St Joseph's Hospital and Medical Center Phoenix, AZ, United
States
(Makkar, Makar) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
(Tadros, Zorn) Kansas University Medical Center, Kansas City, KS, United
States
(Price) Scripps Clinic, La Jolla, CA, United States
(Singh) University of California-Davis Medical Center, Sacramento, CA,
United States
(Fam) St Micheal's Hospital, Toronto, ON, Canada
(Kar) Los Robles Regional Medical Center, HCA Healthcare, Thousand Oaks,
CA, United States
(Mehta) Hamilton Health Science, Hamilton, ON, Canada
(Jorde) Montefiore Medical Center, Bronx, NY, United States
(McCarthy) Northwestern University, Chicago, IL, United States
(Thourani) Marcus Valve Center, Piedmont Heart Institute, Atlanta, GA,
United States
(Ren, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Tricuspid regurgitation (TR) is a right-sided valvular disease
independently associated with morbidity and mortality. The TRILUMINATE
Pivotal (Clinical Trial to Evaluate Cardiovascular Outcomes In Patients
Treated With the Tricuspid Valve Repair System Pivotal) is the first
randomized controlled trial assessing the impact of TR reduction with
tricuspid transcatheter edge-to-edge repair (T-TEER). Objective(s):
Outcomes from the full randomized cohort of the TRILUMINATE Pivotal trial
have not been previously reported, and the additional enrollment may
further support the safety and effectiveness of T-TEER through 1 year.
 Method(s): The TRILUMINATE Pivotal trial is an international
randomized controlled trial of T-TEER with the TriClip device in patients
with symptomatic, severe TR. Adaptive trial design allowed enrollment past
the primary analysis population. The primary outcome was a hierarchical
composite of all-cause mortality or tricuspid valve surgery, heart failure
hospitalizations (HFHs), and quality-of-life improvement measured by
Kansas City Cardiomyopathy Questionnaire (KCCQ) at 1 year. Result(s):
Between August 21, 2019, and June 29, 2022, 572 subjects were randomized,
including the primary cohort (n = 350) and subsequent enrollment (n =
222). Subjects were older (78.1 +/- 7.8 years) and predominantly female
(58.9%), with atrial fibrillation (87.8%) and prior HFH (23.8%). The
primary endpoint was met for the full cohort (win ratio = 1.84; P <
0.0001). Freedom from all-cause mortality and tricuspid valve surgery
through 12 months was 90.6% and 89.9% for the device and control groups,
respectively (P = 0.82). Annualized HFH rate was comparable between device
and control subjects (0.17 vs 0.20 events/patient-year; P = 0.40). A
significant treatment effect was observed for change in quality of life
with 52.3% of device subjects achieving a >=15-point KCCQ score
improvement (compared with 23.5% of control subjects; P < 0.0001). All
secondary endpoints favored T-TEER: moderate or less TR at 30 days (88.9%
vs 5.3%; P < 0.0001), KCCQ change at 1 year (13.0 +/- 1.4 points vs -0.5
+/- 1.4 points; P < 0.0001), and 6-minute walk distance change at 1 year
(1.7 +/- 7.5 m vs -27.4 +/- 7.4 m; P < 0.0001). Freedom from major adverse
events was 98.9% for T-TEER (vs performance goal: 90%; P < 0.0001).
 Conclusion(s): TriClip was safe and effective in the full randomized
cohort of TRILUMINATE Pivotal with significant TR reduction and
improvements in 6-minute walk distance and health status. Rates of
all-cause mortality or tricuspid valve surgery and HFH through 1 year were
not reduced by T-TEER. Copyright © 2025 The Authors

<31>
Accession Number
2031711785
Title
Incidence of aortic valve reintervention in patients with aortic stenosis
undergoing transcatheter aortic valve implantation versus surgical aortic
valve replacement: a systematic review and updated meta-analysis of
randomized studies.
Source
General Thoracic and Cardiovascular Surgery. 73(1) (pp 12-22), 2025.
Article Number: n71. Date of Publication: 01 Jan 2025.
Author
Groberio J.G.; Reginato P.H.; Streit R.E.; Rocha A.V.; Udoma-Udofa O.C.;
de Mesquita C.F.; Rivera A.; Ulbrich A.Z.; Farias F.R.; Gomes W.F.
Institution
(Groberio) Faculty of Medicine, Vila Velha University, Espirito Santo,
Vila Velha, Brazil
(Reginato, Streit, Rocha, Ulbrich, Farias) Faculty of Medicine, Federal
University of Parana, Parana, Curitiba, Brazil
(Udoma-Udofa) Faculty of Medicine, Federal University of Juiz de Fora,
Minas Gerais, Juiz de Fora, Brazil
(de Mesquita) School for Medical Sciences, Federal University of
Pernambuco, Pernambuco, Recife, Brazil
(Rivera) Faculty of Medicine, Nove de Julho University, Sao Paulo, Sao
Bernardo do Campo, Brazil
(Gomes) INC Hospital, Rua Jeremias Maciel Perretto, 300, Campo Comprido,
Parana, Curitiba, Brazil
Publisher
Springer
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) and surgical
aortic valve replacement (SAVR) are established interventions for
alleviating symptoms and enhancing survival in individuals with severe
aortic stenosis (AS). However, the long-term outcomes and incidence of
reintervention associated with TAVI and SAVR remain uncertain.
 Method(s): We conducted a systematic review and meta-analysis to
compare the incidence of reintervention in TAVI versus SAVR. PubMed,
Embase, and Cochrane databases were searched for randomized controlled
trials (RCTs). Risk ratios (RR) and 95% confidence intervals (CI) were
pooled with a random-effects model. A p-value < 0.05 was considered
statistically significant. Result(s): Nine RCTs were included, with
5144 (50.9%) patients randomized to TAVI. Compared with SAVR, TAVI
increased reinterventions (RR 1.89; 95% CI 1.29-2.76; p < 0.01) and the
need for pacemakers (RR 1.91; 95% CI 1.49-2.45; p < 0.01). In addition,
TAVI significantly reduced the incidence of new-onset atrial fibrillation
(RR 0.43; 95% CI 0.32- 0.59; p < 0.01). There were no significant
differences in all-cause mortality (RR 1.04; 95% CI 0.92-1.16; p = 0.55),
cardiovascular mortality (RR 1.04; 95% CI 0.94-1.17; p = 0.44), stroke (RR
0.97; 95% CI 0.80-1.17; p = 0.76), endocarditis (RR 0.96; 95% CI
0.70-1.33; p = 0.82), and myocardial infarction (RR 1.06; 95% CI
0.79-1.41; p = 0.72) between groups. Conclusion(s): In patients with
severe AS, TAVI significantly increased the incidence of reinterventions
and the need for pacemakers as compared with SAVR. Copyright ©
The Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery 2024.

<32>
Accession Number
2036876019
Title
A Randomized, Controlled Trial of In-Hospital Use of Virtual Reality to
Reduce Preoperative Anxiety Prior to Cardiac Surgery.
Source
Mayo Clinic Proceedings. (no pagination), 2025. Date of Publication:
2025.
Author
Subramaniam T.; Dearani J.A.; Stulak J.M.; Lahr B.; Lee A.; Miller J.D.
Institution
(Subramaniam, Dearani, Stulak, Miller) Departments of Cardiovascular
Surgery, Mayo Clinic, Rochester, MN, United States
(Lahr, Lee) Quantitative Health Sciences, Mayo Clinic, Rochester, MN,
United States
(Miller) Physiology and Biomedical Engineering, Mayo Clinic, Rochester,
MN, United States
(Miller) Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester,
MN, United States
Publisher
Elsevier Ltd
Abstract
Objective: To study the effectiveness of virtual reality (VR) in reducing
anxiety levels in patients undergoing first-time sternotomy for cardiac
surgery. Patients and Methods: A total of 100 adult patients
scheduled for cardiac surgery at Mayo Clinic in Rochester, Minnesota, USA,
was recruited from April 19, 2022, to October 12, 2022. Before surgery,
patients wore a physiological monitor to record vital signs. On the day of
surgery, patients completed the State-Trait Anxiety Inventory (STAI) and
were randomized into two groups: one receiving a tablet-based intervention
(control) and the other an immersive VR experience in the preoperative
holding area. After the interventions, patients repeated the state anxiety
component of the STAI. Result(s): The results showed that overall
state anxiety scores decreased an average of 2.0 points with tablet
treatment, but this change failed to reach statistical significance.
However, 6 of 20 specific state anxiety features significantly improved
with tablet treatment whereas 1 feature significantly worsened. With the
VR experience, overall state anxiety scores were significantly reduced by
an average of 2.9 points, with improvement in seven state anxiety features
(three of which did not overlap with the tablet intervention). Despite a
greater reduction in the STAI score with the VR experience, there were no
significant differences in the anxiolytic responses between groups.
Physiologically, both tablet and VR treatments slightly but significantly
reduced pulse rate, with no difference between the groups.
 Conclusion(s): Overall, the findings suggest that treatment of older
adults with an immersive VR experience before cardiac surgery can
significantly reduce overall anxiety. Further investigation determining
how such interventions can be optimally implemented in surgical practices
and whether such interventions reduce the need for anxiolytic medications
and improve the overall patient experience is needed. Copyright ©
2024

<33>
Accession Number
2035416229
Title
Levosimendan in Patients with Low Cardiac Output Syndrome After Cardiac
Surgery: A Substudy of the Multicenter Randomized CHEETAH Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(1) (pp 151-161),
2025. Date of Publication: 01 Jan 2025.
Author
Boboshko V.; Lomivorotov V.; Ruzankin P.; Khrushchev S.; Lomivorotova L.;
Monaco F.; Calabro M.G.; Comis M.; Bove T.; Pisano A.; Belletti A.
Institution
(Boboshko, Lomivorotova) Department of Anesthesiology and Intensive Care,
E. Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State College of Medicine, Penn State Milton S. Hershey Medical
Center, Hershey, PA
(Ruzankin) Department of Mathematics and Mechanics, Novosibirsk State
University, Novosibirsk, Russian Federation
(Ruzankin, Khrushchev) Sobolev Institute of Mathematics, Novosibirsk,
Russian Federation
(Monaco, Calabro, Belletti) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Comis) Cardiac and Vascular Department, Ospedale Mauriziano Umberto I,
Torino, Italy
(Bove) Department of Medicine (DMED), University of Udine, Italy
(Bove) Department of Emergency "Santa Maria della Misericordia", Azienda
Sanitaria Universitaria Friuli Centrale (ASUFC), Udine University
Hospital, Udine, Italy
(Pisano) Cardiac Anesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
Publisher
W.B. Saunders
Abstract
Objective: To test the hypothesis that levosimendan administration in
patients with low cardiac output syndrome after cardiac surgery is
associated with improved long-term (5-year follow-up) outcomes.
 Design(s): Single-center subanalysis of the multicenter randomized
CHEETAH trial. Setting(s): Cardiac surgery department of a tertiary
hospital. Participant(s): A total of 134 adult patients requiring
hemodynamic support for a cardiac index <2.5 L/min/m2 after
cardiac surgery with cardiopulmonary bypass (CPB). Intervention(s):
Patients were randomized (1:1 ratio) to receive levosimendan (continuous
infusion with a starting dose of 0.05 mug/kg/min) or placebo, in addition
to standard inotropic care. Measurements and Main Results: The
primary endpoint was long-term mortality (1-5 years) after randomization.
Secondary outcomes were hemodynamic parameters, need for inotropic
support, acute kidney injury (AKI), need for renal replacement therapy,
duration of mechanical ventilation, intensive care unit (ICU) and hospital
stay, and 30-day mortality. No significant between-group difference in
long-term mortality (5 years) was observed (hazard ratio, 1.59; 95%
confidence interval, 0.81 to 3.11; p = 0.17). There were no significant
differences in secondary outcomes, except for the difference in the mean
pulmonary artery pressure at 4 to 6 hours after randomization, which was
lower in the levosimendan group compared to the placebo group (median, 24
[interquartile range (IQR), 21.8-28] mmHg vs 26 [IQR, 22.2-33] mmHg; p =
0.019). Conclusion(s): Among patients requiring hemodynamic support
after cardiac surgery with CPB, perioperative levosimendan infusion did
not affect long-term survival (1-5 years) compared with placebo.
Levosimendan also had no effect on major clinical outcomes such as AKI,
ICU stay, hospital stay, and 30-day mortality. Copyright © 2024
Elsevier Inc.

<34>
Accession Number
2036949009
Title
Change in frailty status in the 12 months following solid organ
transplantation: a systematic review and meta-analysis.
Source
Age and Ageing. 54(1) (no pagination), 2025. Article Number: afae283. Date
of Publication: 01 Jan 2025.
Author
Bevan A.; Avery J.; Cheah H.L.; Carter B.; Hewitt J.
Institution
(Bevan, Avery, Cheah) Centre for Medical Education, Heath Park, Cardiff
University, United Kingdom
(Carter) Department of Biostatistics and Health Informatics, Institute of
Psychiatry, Psychology and Neuroscience, King's College London, De
Crespigny Park, London, United Kingdom
(Hewitt) Department of Population Medicine, Heath Park, Cardiff
University, United Kingdom
Publisher
Oxford University Press
Abstract
Objectives: To investigate if frailty status alters following solid organ
transplantation (lung, liver, kidney and heart) without rehabilitation
intervention. Research design and methods: Studies published between 1
January 2000 and 30 May 2023 were searched across five databases. Studies
measuring frailty, using a validated or established frailty measure, pre-
and post-transplant were included. Narrative synthesis was used to
describe the included studies according to the time post-transplant and
according to solid organ group. Where data allowed a meta-analysis was
conducted to compare frailty prevalence pre- and 6-12 months
post-transplant across studies. Result(s): Twelve studies were
included in this review (6 kidney transplant, 2 liver transplant, 3 lung
transplant and 1 heart transplant), with a total of 3065 transplant
recipients with 62% being male. The mean age across studies was 51.35
years old. When narratively synthesised after an initial worsening of
frailty immediately post-transplant, there appears to be a significant
improvement in frailty by 3 months post-transplant that is sustained by 6
to 12 months following solid organ transplantation. Five studies were
included in the meta-analysis which demonstrated an odds ratio = 0.27 (95%
CI, 0.12, 0.59, P =. 001, = 82%) for frailty prevalence post-solid organ
transplantation (SOT) compared to frailty prevalence pre-SOT. When the
single paper deemed to be of poor quality was removed the remaining four
studies demonstrated a reduced odds ratio of being frail at 6-12 months
post-transplant (OR 0.45 (95% CI, 0.32, 0.65, P =. 001, I2=
13%). Conclusion(s): Transplant may be associated with a reversal in
frailty, although heterogeneity was demonstrated across
studies. Copyright © 2025 The Author(s). Published by Oxford
University Press on behalf of the British Geriatrics Society.

<35>
Accession Number
2035079803
Title
Granulocyte colony-stimulating factor for stem cell mobilisation in acute
myocardial infarction: a randomised controlled trial.
Source
Heart. 110(22) (pp 1316-1326), 2024. Date of Publication: 28 Oct 2024.
Author
Achilli F.; Maggiolini S.; Madotto F.; Bassetti B.; Gentile F.; Maggioni
A.P.; Colombo G.I.; Pompilio G.; Bovenzi F.M.; Caico S.I.; Campana C.;
Castelli C.; Casu G.; De Servi S.; Di Pasquale G.; Gaita F.; Iliceto S.;
Klugmann S.; Landolina M.E.; Limido A.; Lombardi F.; Macchi A.; Mafrici
A.; Malafronte C.; Marenzi G.; Marzilli M.; Mascelli G.; Mauro C.;
Nassiacos D.; Olivari Z.; Pagnotta A.; Pantaleoni M.; Parati G.; Perna
G.P.; Pes R.M.; Piovaccari G.; Pirelli S.; Planca E.; Politi A.; Rigo F.;
Sante Bongo A.; Savonitto S.; Severi S.; Sinagra G.; Sommariva L.; Tespili
M.; Tonelli C.; Trimarco B.; Verzoni A.; Viecca M.; Villani G.Q.
Institution
(Achilli) Department of Cardiology, ASST Brianza, Desio, Italy
(Maggiolini) Department of Cardiology, San L Mandic Hospital, Merate,
Italy
(Madotto) Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda
Ospedale Maggiore Policlinico, Milano, Italy
(Bassetti, Pompilio) Unit of Vascular Biology and Regenerative Medicine,
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere
Scientifico, Milano, Italy
(Gentile) Department of Cardiology, Hospital Bassini, Cinisello Balsamo,
Italy
(Maggioni) ANMCO Research Center, Heart Care Foundation, Firenze, Italy
(Colombo) Unit of Immunology and Functional Genomics, Centro Cardiologico
Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy
(Pompilio) Department of Biomedical, Surgical and Dental Sciences,
Universita degli Studi di Milano, Milano, Italy
Publisher
BMJ Publishing Group
Abstract
Background To determine whether granulocyte colony-stimulating factor
(G-CSF) improves clinical outcomes after large ST-elevation myocardial
infarction (STEMI) when administered early in patients with left
ventricular (LV) dysfunction after successful percutaneous coronary
intervention (PCI). Methods STEM-AMI OUTCOME was designed as a
prospective, multicentre, nationwide, randomised, open-label, phase III
trial (ClinicalTrials.gov ID: NCT01969890) to demonstrate the efficacy and
safety of early G-CSF administration in reducing 2-year cardiac mortality
and morbidity in patients with STEMI with LV ejection fraction <=45% after
PCI. The primary outcome was a composite of all-cause death, recurrence of
myocardial infarction and hospitalisation for heart failure. Due to low
recruitment and event rates, the study was discontinued and did not
achieve adequate statistical power to verify the hypothesis. Results
Patients were randomly allocated to G-CSF (n=260) or standard of care
(SOC; n=261). No difference was found in the composite primary outcome
between study groups (HR 1.20; 95% CI 0.63 to 2.28). The 2-year mortality
was 2.31% in the G-CSF and 2.68% in the control group (HR 0.88; 95% CI
0.29 to 2.60). Adverse events did not differ between the G-CSF (n=65) and
SOC groups (n=58; OR 1.17; 95% CI 0.78 to 1.75). In post hoc analyses on
the intervention group, we observed a trend towards fewer composite
primary outcomes in patients with low bone marrow (BM) cell mobilisation
(n=108) versus those with high mobilisation (n=152, with peak leucocyte
count >50x109/L; HR 2.86; 95% CI 0.96 to 8.56). Primary
outcomes were lower in patients with severe LV systolic dysfunction at
discharge treated with G-CSF than in controls (interaction beta+/-SE,
-0.08+/-0.04; p=0.034). Conclusions Although inconclusive, this is the
largest trial in the field of cell-based cardiac repair after STEMI
providing evidence of the tolerability and long-term safety of G-CSF
treatment. The results prompt further studies to understand which patient
can benefit most from BM cell mobilisation. Copyright © Author(s)
(or their employer(s)) 2024.

<36>
Accession Number
2034613916
Title
Long-term prognostic value of contemporary stress echocardiography in
patients with suspected or known coronary artery disease: Systematic
review and meta-analysis.
Source
Heart. 110(23) (pp 1349-1356), 2024. Date of Publication: 19 Nov 2024.
Author
Ihekwaba U.; Johnson N.; Choi J.S.; Savarese G.; Orsini N.; Khoo J.;
Squire I.; Kardos A.
Institution
(Ihekwaba, Johnson, Choi, Kardos) Department of Cardiology, Translational
Cardiovascular Research Group, Milton Keynes University Hospital NHS
Foundation Trust, Milton Keynes, United Kingdom
(Ihekwaba, Squire) NIHR Cardiovascular Research Centre, Glenfield
Hospital, Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Savarese) Department of Medicine, Karolinska Institute, Stockholm, Sweden
(Orsini) Department of Global Public Health, Karolinska Institutet,
Stockholm, Sweden
(Khoo) Department of Cardiology, Leicester University Hospital, Leicester,
United Kingdom
(Kardos) Faculty of Medicine and Health Sciences, University of
Buckingham, Buckingham, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background Long-term outcome of contemporary stress echocardiography has
not been systematically assessed. Objective To evaluate the association
between results of stress echocardiography and patients' outcomes with
suspected coronary artery disease using randomised controlled trials.
Methods Multiple electronic databases were searched for studies evaluating
long-term outcome (>12 months) of stress echocardiography in patients
suspected of coronary artery disease since year 2000. A common-effect
model was used to derive pooled estimates. The primary outcome was a
composite of all-cause mortality or cardiovascular death and non-fatal
myocardial infarction, depending on the definition applied in individual
trials, termed as major adverse cardiovascular event (MACE). Secondary
outcome was all-cause mortality. Positive stress echocardiography result
was defined as inducible ischaemia in at least one of the 17 left
ventricular segments and negative stress echocardiography with no
inducible ischaemia. Results Among a total of six trials, 16 581 subjects
underwent either pharmacological or treadmill stress echocardiography, a
median follow-up of 31 months (range 21-101). The annual event rate was
1.76% for the composite MACE and 1.35% for all-cause mortality. Compared
with negative stress echocardiography, positive stress echocardiography
was associated with an increased risk of the MACE and all-cause mortality
with an annual event rate of 1.99% vs 1.54% (OR 2.04, 95% CI 1.79 to 2.33)
and 1.68% vs 1.02% (OR 2.06, 95% CI 1.80 to 2.35), respectively.
Conclusion Positive stress echocardiography results were associated with
poorer long-term MACE and all-cause mortality. Stress echocardiography
results may provide a useful long-term guidance in intensifying
preventative treatment in patients with suspected coronary artery disease.
PROSPERO registration number CRD42023416766. Copyright © 2024 BMJ
Publishing Group. All rights reserved.

<37>
Accession Number
646262525
Title
Erratum: Correction: Using artificial intelligence to predict
post-operative outcomes in congenital heart surgeries: a systematic review
(BMC cardiovascular disorders (2024) 24 1 DOI:
10.1186/s12872-024-04336-6).
Source
BMC cardiovascular disorders. 25(1) (pp 14), 2025. Date of Publication: 10
Jan 2025.
Author
Mohammadi I.; Firouzabadi S.R.; Hosseinpour M.; Akhlaghpasand M.;
Hajikarimloo B.; Zeraatian-Nejad S.; Sardari Nia P.
Institution
(Mohammadi, Firouzabadi, Hosseinpour, Akhlaghpasand, Hajikarimloo,
Zeraatian-Nejad) Cardiovascular Surgery Research and Development
Committee, Iran University of Medical Sciences (IUMS), PO box 14665-354,
Tehran, Iran, Islamic Republic of
(Firouzabadi) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Iran, Islamic Republic of
(Akhlaghpasand, Zeraatian-Nejad) Department of Surgery, Surgery Research
Center, School of Medicine, Rasool-E Akram Hospital, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Sardari Nia) Department of Cardiothoracic Surgery, Maastrich University
Medical Centre, Maastricht, Netherlands
(Sardari Nia) Foundation Heart Team Academy, Maastricht, Netherlands

<38>
Accession Number
646262349
Title
Combined effects of reflexology massage and respiratory relaxation on pain
following chest tube removal in heart surgery patients.
Source
Journal of cardiothoracic surgery. 20(1) (pp 55), 2025. Date of
Publication: 10 Jan 2025.
Author
Bahramian Z.; Kazemi M.; Vazirinejad R.; Hasani H.
Institution
(Bahramian) Department of Medical Surgical Nursing, Faculty of Nursing and
Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,
Islamic Republic of
(Kazemi) Department of Medical Surgical Nursing, Faculty of Nursing and
Midwifery, Non- Communicable Disease Research Center, Rafsanjan University
of Medical Sciences, Rafsanjan, Iran, Islamic Republic of
(Kazemi) Faculty of Nursing, Nurse Street, Rafsanjan, Iran, Islamic
Republic of
(Vazirinejad) Department of Epidemiology and Biostatistics, School of
Health, Social Determinants of Health Research Center, Rafsanjan
University of Medical Sciences, Rafsanjan, Iran, Islamic Republic of
(Hasani) Department of Nursing, School of Nursing and Midwifery, Shahroud
University of Medical Sciences, Iran, Islamic Republic of
Abstract
BACKGROUND AND AIM: Removing the chest tube in cardiac patients after
surgery is one of the worst experiences of hospitalization in the
intensive care units. Various pharmacological and non-pharmacological
methods are available to control pain in these patients. This study aimed
to investigate the combined effect of reflexology massage and respiratory
relaxation on pain following chest tube removal in cardiac surgery
patients of Shahid Beheshti Hospital in Shiraz, Iran, in 2023.
 METHOD(S): This was a double-blind randomized clinical trial
performed on 140 patients who underwent heart surgery and had a chest tube
in Shiraz, Iran. The samples were randomly divided into four groups: 1-
control group, 2- respiratory relaxation group, 3- foot reflex massage
group, and 4- a combination of respiratory relaxation and reflexology
massage. To collect data, two demographic questionnaires, and a visual
analog scale were used. RESULT(S): The participants of the four
groups were not meaningfully different in terms of age, BMI, duration of
surgical operation, gender, job, education, place of residency, number of
chest tubes, history of operation (P = 0.99, 0.31, 0.06, 0.81, 0.97, 0.96,
0.17, 0.10, 0.89 respectively). The mean scores of pain intensity during
chest tube removal, and 15 min after chest tube removal were not
statistically different among the four groups of study (P = 0.15, 0.54
respectively); However, just after chest tube removal, the mean scores of
pain intensity differed meaningfully among four groups (P = 0.008).
 CONCLUSION(S): The results showed that reflexology massage and
respiratory relaxation both reduce pain immediately after chest tube
removal in heart surgery patients. Also, the combination of these two
techniques was more effective in reducing patients' average
pain. Copyright © 2024. The Author(s).

<39>
Accession Number
2032930320
Title
Comparisons of Risk Scores for Infective Endocarditis Surgery: A
Meta-Analysis.
Source
Angiology. (no pagination), 2025. Date of Publication: 2025.
Author
Agrawal A.; Arockiam A.D.; Dahdah J.E.; Honnekeri B.; Schleicher M.;
Shekhar S.; Haroun E.; Witten J.; Majid M.; Pettersson G.; Griffin B.;
Unai S.; Wang T.K.M.
Institution
(Agrawal, Arockiam, Dahdah, Honnekeri, Shekhar, Haroun, Majid, Griffin,
Wang) Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
OH, United States
(Witten, Pettersson, Unai) Department of Thoracic and Cardiovascular
Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
Publisher
SAGE Publications Inc.
Abstract
While multiple scoring systems exist to predict mortality in cardiac
surgery, their utility in infective endocarditis (IE) remains uncertain,
prompting this study to compare their prognostic accuracy. We conducted a
comprehensive review using Ovid Medline, Embase, and Cochrane Central
Register of Controlled Trials. Data were pooled using Open-Meta[Analyst]
software, and calibration analysis was performed with Review Manager 5.4.
Among 620 articles identified, 570 were screened, leading to 15 included
studies. Twelve risk scores were analyzed for operative mortality
discrimination in IE surgery, with the area under the curve (AUC) ranging
from 0.64 to 0.83. Among the IE-specific risk scores, AUCs (95% confidence
interval) were highest for ANCLA (Anemia, NYHA class IV, critical state,
large intracardiac destruction, surgery on thoracic aorta) 0.838
(0.803-0.873), AEPEI (Association pour l'Etude et la Prevention de
l'Endocadite Infectieuse) 0.764 (0.726-0.802), RISK-E (Risk Endocarditis)
(0.752 (0.662-0.842) and APORTEI (Analisis de los factores PROnosticos en
el Tratamiento quirurgico de la Endocarditis Infecciosa) 0.750
(0.726-0.774) scores. Regarding traditional risk scores, EuroSCORE II
performed at 0.750 (0.725-0.775) but underestimated mortality compared
with EuroSCORE I in calibration analysis. In conclusion, EuroSCORE II and
several endocarditis-specific scores had moderate discrimination (AUC >
0.75) in predicting mortality after IE surgery. Copyright ©
©The Author(s) 2025.

<40>
Accession Number
646265115
Title
Effect of acute kidney injury care bundle on kidney outcomes in cardiac
patients receiving critical care: a systematic review and meta-analysis.
Source
BMC nephrology. 26(1) (pp 17), 2025. Date of Publication: 10 Jan 2025.
Author
Ahmed F.R.; Al-Yateem N.; Nejadghaderi S.A.; Gamil R.; AbuRuz M.E.
Institution
(Ahmed, Al-Yateem) College of Health Sciences, Department of Nursing,
University of Sharjah, Sharjah, United Arab Emirates
(Ahmed, Gamil) Critical Care and Emergency Nursing Department, Faculty of
Nursing, Alexandria University, Alexandria, Egypt
(Nejadghaderi) HIV/STI Surveillance Research Center, WHO Collaborating
Center for HIV Surveillance, Institute for Futures Studies in Health,
Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Nejadghaderi) Systematic Review and Meta-analysis Expert Group (SRMEG),
Universal Scientific Education and Research Network (USERN), Tehran, Iran,
Islamic Republic of
(AbuRuz) College of Nursing and Midwifery, Dubai Health, Dubai, United
Arab Emirates
Abstract
BACKGROUND: Cardiac surgery is a major contributor to acute kidney injury
(AKI); approximately 22% of patients who undergo cardiac surgery develop
AKI, and among them, 2% will require renal replacement therapy (RRT). AKI
is also associated with heightened risks of mortality and morbidity,
longer intensive care stays, and increased treatment costs. Due to the
challenges of treating AKI, prevention through the use of care bundles is
suggested as an effective approach. This review aimed to assess the impact
of care bundles on kidney outcomes, mortality, and hospital stay for
cardiac patients in critical care. METHOD(S): PubMed, Scopus, Web of
Science, and EMBASE were searched up to November 2024. Inclusion criteria
were studies on individuals with cardiac diseases receiving critical care,
that used AKI care bundle as the intervention, and reported outcomes
related to AKI, mortality, and other kidney-related events. We used the
Cochrane Collaboration's risk of bias tool 2 and the Newcastle-Ottawa
scale for quality assessment. Pooled odds ratios (ORs) or risk ratios
(RRs) with 95% confidence intervals (CIs) were calculated. RESULT(S):
Seven studies on total 5045 subjects, including five observational and two
randomized controlled trials (RCTs) were included. The implementation of
care bundles significantly reduced the incidence of all-stage AKI (OR:
0.78; 95%CI: 0.61-0.99) and moderate-severe AKI (OR: 0.56; 95%CI:
0.43-0.72). Also, the implementation of care bundle increased the
incidence of persistent renal dysfunction after 30 days by 2.39 times.
However, there were no significant changes in RRT, major adverse kidney
events, or mortality between the groups. The mean quality assessment score
for observational studies was 7.2 out of ten, while there were noted
concerns in the risk of bias assessment of the RCTs. CONCLUSION(S):
The application of care bundles in patients, including those undergoing
cardiac surgeries as well as non-cardiac critical illness, appears to be
effective in reducing AKI, particularly in moderate and severe stages.
However, given the inclusion of non-cardiac patients in some studies, the
observed effect may not be solely attributable to cardiac surgery cases.
Future large-scale RCTs focusing specifically on cardiac surgery patients
are recommended to clarify the impact of care bundles within this
subgroup. REGISTRATION ID IN PROSPERO: CRD42024498972. Copyright
© 2025. The Author(s).

<41>
Accession Number
2037097840
Title
Characteristics and outcomes of cardiac amyloid disease after heart
transplantation: A systematic review and meta-analysis.
Source
Transplantation Reviews. 39(2) (no pagination), 2025. Article Number:
100908. Date of Publication: 01 Apr 2025.
Author
Rahimov D.; Yan V.Z.; Ahmad D.; Nasher N.; Tatum R.; Im M.; Storozynsky
E.; Rame J.E.; Rajagopal K.; Entwistle J.W.; Massey H.T.;
Tchantchaleishvili V.
Institution
(Rahimov, Yan, Ahmad, Nasher, Tatum, Im, Rajagopal, Entwistle, Massey,
Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Storozynsky, Rame) Division of Cardiology, Department of Medicine, Thomas
Jefferson University, Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Patients with systemic amyloidosis with cardiac involvement
require careful selection for heart transplantation (HTx) due to the
associated poor outcomes. Large databases do not provide sufficient
granularity to allow for differentiation between its major subtypes
[light-chain (AL) and transthyretin (ATTR) amyloidosis]. We sought to pool
the existing data on amyloidosis patients undergoing HTx, and perform
stratified analysis based on its major subtypes. Method(s):
Electronic search identified adult patients with amyloidosis undergoing
HTx. Cohort-level data for 340 patients from 19 studies were extracted and
analyzed. Patients were categorized based on amyloid subtype into AL and
ATTR groups. Result(s): AL amyloidosis was diagnosed at an earlier
age compared to ATTR [53 (95 % CI 48; 57) years vs. 63 (55; 71) years, p =
0.03], with greater incidence in the Caucasian population [75 % (60; 87)
vs. 39 % (21; 59), p <=0.01]. Females comprised 33 % (25; 41) of the
patients with greater preponderance in AL group [41 % (33; 48) vs. 21 %
(8; 36), p = 0.02]. AL patients also had higher involvement of >=two
organs [50 % (29; 70) vs. 15 % (3; 32), p = 0.01]. GI involvement [25 %
(6; 50) vs. 0 % (0; 8), p = 0.02], and renal involvement [20 % (8; 34) vs.
0 % (0; 2), p < 0.01] were virtually limited to AL, while ATTR patients
had more implantable cardioverter defibrillators placed [64 % (34; 90) vs.
15 % (6; 28), p < 0.01] and trended towards greater incidence of
neuropathy [24 % (9; 42) vs. 9 % (2; 19), p = 0.07]. The AL group had a
significantly higher incidence of recurrent amyloidosis [16 % (7; 27) vs.
0 % (0; 0), p <=0.01]. Pooled Kaplan-Meier survival analysis showed worse
long-term survival in the AL group (p = 0.02). Conclusion(s):
Patients with AL amyloidosis showed more widespread systemic involvement
and worse long-term survival after HTx compared to patients with ATTR
amyloidosis. Protocols for mitigating the recurrence of AL amyloidosis are
needed to improve survival in this high-risk subtype. Copyright ©
2025 Elsevier Inc.

<42>
Accession Number
2032954686
Title
Evolving perspectives on aortic stenosis: the increasing importance of
evaluating the right ventricle before aortic valve intervention.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1506993. Date of Publication: 2024.
Author
Androshchuk V.; Chehab O.; Wilcox J.; McDonaugh B.; Montarello N.; Rajani
R.; Prendergast B.; Patterson T.; Redwood S.
Institution
(Androshchuk, Chehab, Redwood) School of Cardiovascular Medicine &
Sciences, Faculty of Life Sciences & Medicine, King's College London,
London, United Kingdom
(Wilcox, McDonaugh, Montarello, Patterson) Cardiovascular Directorate, St
Thomas' Hospital, London, United Kingdom
(Rajani) School of Biomedical Engineering and Imaging Sciences, Faculty of
Life Sciences & Medicine, King's College London, London, United Kingdom
(Prendergast) Heart, Vascular & Thoracic Institute, Cleveland Clinic
London, London, United Kingdom
Publisher
Frontiers Media SA
Abstract
Aortic stenosis (AS) was historically considered a disease of the left
side of the heart, with the main pathophysiological impact being
predominantly on the left ventricle (LV). However, progressive pressure
overload in AS can initiate a cascade of extra-valvular myocardial
remodeling that could also precipitate maladaptive alterations in the
structure and function of the right ventricle (RV). The haemodynamic and
clinical importance of these changes in patients with AS have been largely
underappreciated in the past. Contemporary data indicates that RV
dilatation or impairment identifies the AS patients who are at increased
risk of adverse clinical outcomes after aortic valve replacement (AVR). It
is now increasingly recognised that effective quantitative assessment of
the RV plays a key role in delineating the late clinical stage of AS,
which could improve patient risk stratification. Despite the increasing
emphasis on the pathological significance of RV changes in AS, it remains
to be established if earlier detection of these changes can improve the
timing for intervention. This review will summarise the features of normal
RV physiology and the mechanisms responsible for RV impairment in AS. In
addition, we will discuss the multimodality approach to the comprehensive
assessment of RV size, function and mechanics in AS patients. Finally, we
will review the emerging evidence reinforcing the negative impact of RV
dysfunction on clinical outcomes in AS patients treated with
AVR. Copyright 2025 Androshchuk, Chehab, Wilcox, McDonaugh,
Montarello, Rajani, Prendergast, Patterson and Redwood.

<43>
Accession Number
2035487983
Title
The impact of threshold-loaded inspiratory muscle training and respiratory
biofeedback on preserving inspiratory muscle strength and vital capacity
after CABG: a randomized clinical trial.
Source
American Journal of Cardiovascular Disease. 14(6) (pp 375-383), 2024. Date
of Publication: 2024.
Author
Mehregan-Far B.; Naimi S.S.; Abedi M.; Salemi P.; Raeis-Sadat S.A.;
Beheshti-Monfared M.
Institution
(Mehregan-Far, Salemi) Student Research Committee, Department of
Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Naimi) Department of Physiotherapy, School of Rehabilitation, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Abedi) Department of Physiotherapy, Chronic Respiratory Diseases Research
Center, Dr. Masih Daneshvari Hospital, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Raeis-Sadat) Department of Physical Medicine and Rehabilitation Research
Center, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Beheshti-Monfared) Department of Cardiovascular Surgery, School of
Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
E-Century Publishing Corporation
Abstract
Objectives: Postoperative pulmonary complications (POPC) are common after
cardiac surgeries such as coronary artery bypass grafting (CABG) and are
influenced by factors including anesthesia and surgical trauma.
Inspiratory muscle training (IMT) with visual biofeedback may mitigate
these complications. This study investigates the impact of threshold
loading inspiratory muscle training (TL-IMT) combined with respiratory
biofeedback on the dynamic strength of inspiratory muscles (S-index) in
patients undergoing CABG surgery during their hospitalization phase.
 Method(s): A single-blind study was conducted with 38 CABG candidates
at Shahid Modares Hospital, Tehran. Participants were randomized into two
groups: the TL-IMT with biofeedback group and the placebo IMT group. TLIMT
exercises were performed at 30% of maximum dynamic inspiratory strength
using the Power Breath K5 device, with visual biofeedback displayed on the
screen. The placebo group performed the same exercises at minimal load
without biofeedback. Both groups received standard respiratory
physiotherapy. Measurements of S-index, peak inspiratory flow (PIF), and
vital capacity (VC) were taken before surgery (T1), one day after surgery
(T2), and at discharge (T3). Result(s): Both groups showed
significant changes, with a decrease from T1 to T2 and an increase from T2
to T3. In the study group, T3 values remained the same as at T1, while the
placebo IMT group experienced a significant decrease. After surgery, both
groups had a drop in the S-index. However, the study group saw more
pronounced changes between T3-T2 and T3-T1 compared to the control group,
although no significant difference was found between T2-T1. By the time of
discharge, the TL-IMT group had higher S-index values than the placebo
group, returning to preoperative levels. Additionally, the TL-IMT group
showed improvements in PIF and VC. Conclusion(s): TL-IMT with visual
biofeedback effectively maintains dynamic inspiratory muscle strength and
improves key pulmonary parameters in cardiac surgery patients. These
findings suggest that integrating TL-IMT with biofeedback can enhance
postoperative recovery and reduce the incidence of POPC. Copyright
© 2024, E-Century Publishing Corporation. All rights reserved.

<44>
Accession Number
2037042953
Title
Transcatheter Aortic Valve Replacement in Heart Failure, Reduced Ejection
Fraction, and Moderate Aortic Stenosis.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 2025.
Author
O'Gara P.T.
Institution
(O'Gara) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.

<45>
Accession Number
646251093
Title
Aspirin and Hemocompatibility After LVAD Implantation in Patients With
Atherosclerotic Vascular Disease: A Secondary Analysis From the ARIES-HM3
Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2025. Date of Publication: 08 Jan 2025.
Author
Gustafsson F.; Uriel N.; Netuka I.; Katz J.N.; Pagani F.D.; Connors J.M.;
Jorde U.P.; Zimpfer D.; Pya Y.; Conway J.; Anyanwu A.; Scandroglio A.M.;
Sulemanjee N.; Atluri P.; Keebler M.; Selzman C.H.; Alexis J.D.; Hayward
C.; Henderson J.; Dirckx N.; Gazzola C.; Mehra M.R.
Institution
(Gustafsson) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Uriel) Columbia University College of Physicians and Surgeons and New
York Presbyterian Hospital, NY, United States
(Netuka) Insitute for Clinical and Experimental Medicine, Prague, Czechia
(Katz) NYU Grossman School of Medicine and Bellevue Hospital, NY, United
States
(Pagani) University of Michigan, Ann Arbor, United States
(Connors) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
(Jorde) Montefiore Einstein Center for Heart and Vascular Care, NY, United
States
(Zimpfer) Medical University of Vienna, Vienna, Austria
(Pya) University Medical Center, Astana, Kazakhstan
(Conway) University of Alberta Hospital, Edmonton, AB, Canada
(Anyanwu) Mount Sinai Medical Center, NY, United States
(Scandroglio) Ospedale San Raffaele, Milan, Italy
(Sulemanjee) Aurora St Luke's Medical Center, Milwaukee, WI, United States
(Atluri) Hospital of the University of Pennsylvania, Philadelphia, United
States
(Keebler) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Selzman) University of Utah Hospital, Salt Lake City, United States
(Alexis) University of Rochester Medical Center, Rochester, NY, United
States
(Hayward) St Vincent's Hospital, Sydney, NSW, Australia
(Henderson, Dirckx, Gazzola) Abbott, Chicago, Illinois
(Mehra) Brigham and Women's Hospital Heart and Vascular Center, Center for
Advanced Heart Disease, Harvard Medical School, Boston, MA, United States
Abstract
Importance: The Aspirin and Hemocompatibility Events With a Left
Ventricular Assist Device in Advanced Heart Failure (ARIES-HM3) study
demonstrated that aspirin may be safely eliminated from the antithrombotic
regimen after HeartMate 3 (HM3 [Abbott Cardiovascular]) left ventricular
assist device (LVAD) implantation. This prespecified analysis explored
whether conditions requiring aspirin (prior percutaneous coronary
intervention [PCI], coronary artery bypass grafting [CABG], stroke, or
peripheral vascular disease [PVD]) would influence outcomes differentially
with aspirin avoidance. Objective(s): To analyze aspirin avoidance on
hemocompatibility-related adverse events (HRAEs) at 1 year after implant
in patients with a history of CABG, PCI, stroke, or PVD. Design,
Setting, and Participant(s): This was an international, multicenter,
prospective, double-blind, placebo-controlled, randomized clinical trial
including patients implanted with a de novo HM3 LVAD across 51 centers.
Data analysis was conducted from April to July 2024. Intervention(s):
Patients were randomized in a 1:1 ratio to receive aspirin (100 mg per
day) or placebo, in addition to a vitamin K antagonist (VKA) targeted to
an international normalized ratio of 2 to 3 in both groups. Main
Outcomes and Measures: Primary end point (assessed for noninferiority) was
a composite of survival free of any nonsurgical (>14 days after implant)
HRAEs including stroke, pump thrombosis, bleeding, and arterial peripheral
thromboembolism at 12 months. Secondary end points included nonsurgical
bleeding, stroke, and pump thrombosis events. Result(s): Among 589 of
628 patients (mean [SD] age, 57.1 [13.7] years; 456 male [77.4%]) who
contributed to the primary end point analysis, a history of PCI, CABG,
stroke, or PVD was present in 41% (240 of 589 patients). There was no
interaction between the presence of an atherosclerotic vascular condition
and effect of aspirin compared with placebo (P for interaction= .23). The
preset 10% noninferiority margin was not crossed for the studied subgroup
of patients. Thrombotic events were rare, with no differences between
aspirin and placebo in patients with and without vascular disease (P for
interaction = .77). Aspirin treatment was associated with a higher rate of
nonsurgical major bleeding events in the group with prior vascular
condition history compared with those without aspirin (rate ratio for
placebo compared with aspirin, 0.52; 95% CI, 0.35-0.79). Conclusions
and Relevance: Results of this prespecified analysis of the ARIES-HM3
randomized clinical trial demonstrate that in patients with advanced heart
failure who have classical indications for antiplatelet therapy use at the
time of LVAD implantation, aspirin avoidance was safe and not associated
with increased thrombosis risk. Importantly, elimination of aspirin was
associated with no increased thrombosis but a reduction in nonsurgical
bleeding events in patients with a history of PCI, CABG, stroke, or PVD.
Trial registration: ClinicalTrials.gov Identifier: NCT04069156.

<46>
Accession Number
646250477
Title
Clinical Benefits of Parasternal Block with Multihole Catheters when
Inserted before Sternotomy.
Source
Annals of cardiac anaesthesia. (no pagination), 2024. Date of
Publication: 19 Nov 2024.
Author
Eljezi V.; Jallas C.; Pereira B.; Chasteloux M.; Duale C.; Camilleri L.
Institution
(Eljezi, Chasteloux) Department of Perioperative Medicine, CHU
Gabriel-Montpied, Rue Montalembert ,BP 69, France
(Jallas) Departement of Anaesthesia, Hospital Femme Mere Enfant, 59
Boulevard Pinel, Bron, France
(Pereira) Biostatistics Unit, CHU Gabriel Montpied, Rue Montalembert ,BP
69, France
(Duale) Centre d'Investigation Clinique (INSERM CIC 501), CHU de
Clermont-Ferrand, Clermont-Ferrand, Rue Montalembert ,BP 69, France
(Camilleri) Department of Cardiovascular Surgery, CHU Gabriel Montpied,
Rue Montalembert ,BP 69, France
Abstract
BACKGROUND: The aim of this study was to assess whether parasternal block
with multihole catheters inserted before surgical incision enables to
alleviate postoperative analgesia and opioid reduction in cardiac surgery
patients with sternotomy. METHOD(S): Twenty-six adult patients
scheduled for cardiac surgery with sternotomy aged between 18 and 84 olds
were included in this prospective, monocentric, open, single-group trial.
Two parasternal multihole catheters were inserted on each side of the
sternum before the surgical skin incision for cardiac surgery and 10 mL of
ropivacaine 7.5 mg mL-1 was initially administered in each catheter. Local
anesthetic administration followed by continued infusion at 3 mL hr-1 of
ropivacaine 2 mg mL-1 per catheter for 48 h postoperatively upon patient
arrival in the intensive care unit. The efficacy of the parasternal block
was assessed according to a composite endpoint including pain score at
rest, pain score during movements (dynamic pain), and morphine consumption
over 48 hours. RESULT(S): The treatment failed in 11 patients and was
considered effective in 15 patients. Sixteen patients out of 26 had a
sternal pain score <=3/10 on more than 75% of observations, and the
treatment was considered successful. In 23/26 patients (88%), the mean
pain score at cough was <=3.5/10 and the treatment was considered
successful. Morphine consumption over 48 h was significantly lower in the
intervention group compared to the control group 7 mg [6; 21] versus 142
mg [116; 176] (P < 0.001). CONCLUSION(S): Parasternal block with
multihole catheters inserted before the surgical incision is an effective
technique for postoperative analgesia and opioid reduction. Copyright
© 2024 Annals of Cardiac Anaesthesia.

<47>
Accession Number
646241626
Title
Application of low-intensity anticoagulation after On-X mechanical aortic
valve replacement.
Source
Journal of cardiothoracic surgery. 20(1) (pp 49), 2025. Date of
Publication: 09 Jan 2025.
Author
Zou K.; Wei D.; Xiang B.; Yu T.; Huang K.; Liu S.
Institution
(Zou) NHC Key Laboratory of Nuclear Technology Medical
Transformation(MIANYANG CENTRAL HOSPITAL), Sichuan Province, Mianyang,
China
(Wei, Xiang, Yu, Huang, Liu) Cardiac Surgery Center, Sichuan Academy of
Medical Sciences & Sichuan Provincial People's Hospital, Affiliated
Hospital of University of Electronic Science and Technology, Sichuan
Province, Chengdu, China
Abstract
OBJECTIVE: To explore the safety and efficacy of low-intensity
anticoagulation in patients after On-X mechanical aortic valve
replacement. METHOD(S): A total of 104 patients undergoing aortic
valve replacement in Cardiac Surgery Department of Sichuan Provincial
People's Hospital from December 2018 to December 2021 were randomly
divided into low-intensity anticoagulant (INR:1.5-2.0) and high-intensity
anticoagulant (INR:2.0-2.5) to compare the incidence of adverse events
related to postoperative anticoagulation between the two groups.
 RESULT(S): Fifty-three patients were included in the low-intensity
anticoagulation group (INR 1.5-2.0), and 51 patients were included in the
high-intensity group (2.0-2.5). There was no significant difference in
baseline data and surgical index between the two groups (P > 0.05); there
were statistically significant differences in PT, INR and bleeding events
(P < 0.05), but no significant difference in embolic events (P > 0.05).
 CONCLUSION(S): For patients requiring On-X mechanical aortic valve
replacement who have no risk factors for thromboembolism, it is
appropriate to control the INR in the target range 1.5-2.0, which can
reduce the incidence of bleeding adverse events and significantly improve
the quality of life, without increasing the risk of thromboembolic adverse
events. Copyright © 2024. The Author(s).

<48>
Accession Number
2037024639
Title
IMPACT OF AMINO ACID/PROTEIN THERAPY ON RENAL OUTCOMES AND RECOVERY IN
CARDIAC SURGERY PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S48-S49), 2025. Date of
Publication: 01 Feb 2025.
Author
Lucena L.; Cavalcante D.; Zamora F.; Pimenta N.; Santos A.C.; Galvao L.;
Biavatti B.; Medeiros A.; Oliveira A.L.; Duarte I.; Borges R.; Carvalho
N.; Leite V.; Nobrega T.; de Oliveira R.
Institution
(Lucena, Medeiros, Oliveira, Duarte, Borges, Carvalho, Leite, Nobrega)
Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
(Cavalcante) Department of Biology, Federal University of Maranhao, Sao
Luis, Brazil, Brazil
(Zamora, Galvao) Faculty of Medicine, Federal University of Minas Gerais,
Belo Horizonte, Brazil, Brazil
(Pimenta) Faculty of Medicine, Federal University of the State of do Rio
de Janeiro, Rio De Janeiro, Brazil, Brazil
(Santos) School of Pharmacy, City University of Sao Paulo, Sao Paulo,
Brazil, Brazil
(Biavatti) Faculty of Medical Sciences, State University of Campinas,
Campinas, Brazil
(de Oliveira) Integrated Medicine Department, Federal University of Rio
Grande do Norte, Natal, Brazil
Publisher
Elsevier Inc.
Abstract
Introduction: Intravenous amino acid therapy is being investigated for
kidney protection in high-risk cardiac surgery patients with acute kidney
injury (AKI), which leads to higher morbidity and mortality. Although
amino acids might improve certain renal outcomes, their impact on the
duration of renal dysfunction remains uncertain. This study aimed to
clarify the effects of amino acid/protein therapy compared to control on
renal outcomes in patients undergoing cardiac surgery. Method(s): We
conducted a systematic search of PubMed, Embase, and Cochrane databases
for randomized controlled trials (RCTs) and propensity-matched cohorts
(PMC) to evaluate the efficacy of amino acids and/or proteins in reducing
the occurrence of AKI after cardiac surgery. The primary outcomes included
the incidence of AKI stages 2 and 3, necessity of postoperative kidney
replacement therapy (KRT), mortality, ICU stay, and hospital length of
stay. Relative risk (RR) was calculated for binary outcomes and
standardized mean difference (MD) was calculated for continuous variables,
with 95% confidence intervals (CIs). Heterogeneity was assessed using
I2 statistics. Result(s): A total of 6 RCTs and 1 PMC,
involving 5,615 patients (2,751 received protein/amino acids), were
included in the analysis. The results showed no significant differences
between the groups in terms of AKI stage 2 and 3 (RR 0.95; 95% CI
0.39-2.31; p=0.914; Figure 1A), kidney replacement therapy (RR 0.72; 95%
CI 0.45-1.15; p=0.34; Figure 1B), mortality (RR 1.03; 95% CI 0.76-1.29;
p=0.863; Figure 1C), or ICU length of stay (SMD -0.05; 95% CI -0.10-0.01;
p=0.108; Figure 2A). However, the length of hospital stay was
significantly shorter in the amino/protein group (SMD -0.62; 95% CI -1.08-
-0.15; p=0.009; Figure 2B). [Formula presented] [Formula presented]
 Conclusion(s): Our study suggests that the use of amino acids/protein
was associated with a significantly shorter hospitalization time, with no
differences in reduction of AKI incidence, KRT or mortality in patients
undergoing cardiac surgery. Therefore, the use of amino acids/protein can
be considered a viable tool for patients in this context. I have no
potential conflict of interest to disclose. I did not use generative AI
and AI-assisted technologies in the writing process. Copyright ©
2024

<49>
Accession Number
2037024791
Title
Steroid avoidance with low-dose tacrolimus is safe and effective for
kidney transplant recipients with low immunologic risk in the long-term:
SAILOR II follow-up study.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S534-S535), 2025. Date
of Publication: 01 Feb 2025.
Author
Baid-Agrawal S.; Ekberg J.; Enevoldsen A.-E.; Wallquist C.; Skov K.;
Jespersen B.; Lindner P.
Institution
(Baid-Agrawal, Ekberg, Lindner) Transplant Institute, Sahlgrenska
University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy
at University of Gothenburg, Gothenburg, Sweden
(Enevoldsen, Skov, Jespersen) Department of Nephrology, Aarhus University
Hospital, Aarhus, Denmark
(Wallquist) Department of Transplantation, Skane University Hospital,
Malmoe, Sweden
Publisher
Elsevier Inc.
Abstract
Introduction: In our previous randomized controlled open-label multicenter
trial, the SAILOR study, we reported good feasibility, safety, and
efficacy of steroid avoidance at 2-years in immunologically low-risk
kidney transplant recipients. A total of 222 participants were randomized
to the following two treatment arms: Steroid avoidance arm with ATG
induction + low-dose tacrolimus + mycophenolate mofetil (MMF) or the
standard of care steroid maintenance arm with basiliximab induction +
low-dose tacrolimus + MMF + prednisolone. Long-term results are needed to
prove the safety and efficacy of the steroid avoidance protocol.
 Method(s): In SAILOR II, a non-interventional observational study, we
collected clinical data of all original SAILOR study participants at 1-,
2-, 5-years and the last follow-up, unless they withdrew the consent for
participation. Efficacy endpoints were: 1) patient survival, 2)
death-censored graft survival, 3) overall graft survival, 4) incidence of
biopsy-proven rejection, 5) incidence of post-transplantation diabetes
mellitus (PTDM), and 6) estimated glomerular filtration rate (eGFR).
Safety endpoints were incidence of: 1) severe infection (including
opportunistic infections) requiring hospitalization, 2) opportunistic
infections not requiring hospitalization, 3) malignancies (including
non-melanoma skin cancer), 4) MACE (myocardial infarction, percutaneous
coronary intervention, coronary artery bypass graft surgery, stroke, heart
failure requiring hospitalization or cardiovascular death), and 5)
donor-specific antibodies (DSA). Result(s): A total of 111 patients
were included in the steroid avoidance arm and 104 in the steroid
maintenance arm (Figure 1). The mean follow-up time post-randomization was
7.3 +/- 1.8 years. Death-censored graft survival (91.8 vs. 93.1%, p=0.88),
patient survival (88 vs. 93%, p=0.32), cumulative incidence of
biopsy-proven rejection (19.8% vs. 16.3% (p=0.6), kidney function (50.8
vs. 54 ml/min/1.73m2, p=0.27), and donor-specific antibodies (13.5 vs.
15,4%, p=0.70), respectively, were similar in both arms (Table 1, Figures
2 and 3). Incidence of PTDM, serious infections requiring hospitalization,
malignancies and chronic rejection did not differ significantly. Two
thirds of participants in steroid avoidance arm remained steroid-free at
the end of follow-up. Table 1: Efficacy endpoints [Formula presented]
Results presented as mean +/-SD; survival (CI); n (%) Figure 1. Flow-chart
of patient population [Formula presented] Figure 2: Death-censored graft
survival [Formula presented] Figure 3. Rejection-free survival [Formula
presented] Conclusion(s): Steroid avoidance in patients with low
immunological risk was safe and effective at 7 years after kidney
transplantation. Two-thirds of the patients could be maintained
steroid-free. This study provides further evidence for long-term safety of
the steroid-free protocol after kidney transplantation even with the
current regimen using low-dose tacrolimus + MMF with antibody induction..
I have no potential conflict of interest to disclose. I did not use
generative AI and AI-assisted technologies in the writing
process. Copyright © 2024

<50>
Accession Number
2037022762
Title
IMPACT OF DEXMEDETOMIDINE ON REDUCING ACUTE KIDNEY INJURY RISK FOLLOWING
CORONARY ARTERY BYPASS GRAFTING: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S57), 2025. Date of
Publication: 01 Feb 2025.
Author
Elkoumi O.; Elkoumi A.; Elbairy M.K.; Habib O.K.; Abdulgadir A.
Institution
(Elkoumi, Elbairy) Faculty of Medicine, Suez University, Suez, Egypt
(Elkoumi) Faculty of Oral and Dental Medicine, Egyptian Russian
University, Cairo, Egypt
(Habib) Faculty of Medicine, PortSaid University, PortSaid, Egypt
(Abdulgadir) Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Publisher
Elsevier Inc.
Abstract
Introduction: Acute kidney injury (AKI) is a serious complication that
increases morbidity and mortality rates after coronary artery bypass
grafting (CABG). Dexmedetomidine (DEX) is a selective alpha2-adrenergic
agonist that has proven its efficacy as a cardioprotective agent. However,
its impact on the kidneys is not yet well-established. This systematic
review and meta-analysis aims to assess the impact of dexmedetomidine on
reducing AKI risk in patients undergoing CABG. Method(s): We
conducted a systematic search in PubMed, Embase, and Scopus from inception
until August 28th, 2024. We searched for all clinical trials and
observational studies assessing the postoperative incidence of AKI or
other adverse events in patients receiving DEX following CABG. Statistical
analysis was performed using Review Manager 5.4, with a fixed-effects
model applied unless significant heterogeneity was detected, in which case
a random-effects model was used. Result(s): Eight studies involving a
total of 1,133 patients were included in the meta-analysis. DEX was
associated with a statistically significant reduction in postoperative AKI
incidence (RR: 0.54, 95% CI [0.36, 0.81], p = 0.003). Moreover, a
statistically significant difference was observed for the length of
intensive care unit (ICU) stay (MD: -2.07, 95% CI [-3.33, -0.81], p =
0.001), hospital stay (MD: -0.59, 95% CI [-0.92, -0.25], p = 0.0006), and
mechanical ventilation duration (MD: -1.74, 95% CI [-1.99, -1.49], p <
0.00001). However, no statistically significant difference was found for
intra/post-operative hemorrhage (MD: -10.87, 95% CI [-29.87, 8.14], p =
0.26), or bradycardia (RR: 0.99, 95% CI [0.53, 1.84], p = 0.97).
 Conclusion(s): Dexmedetomidine appears to significantly reduce the
incidence of AKI, ICU stay time, hospital stay, and mechanical ventilation
duration in patients undergoing CABG. However, it does not significantly
affect the rates of intra/post-operative hemorrhage or bradycardia.
Further randomized controlled trials are recommended to assess the effects
of different DEX doses on renal outcomes following CABG. I have no
potential conflict of interest to disclose. I did not use generative AI
and AI-assisted technologies in the writing process. Copyright ©
2024

<51>
Accession Number
646242526
Title
A novel technique of blindly positioning bronchial blockers for one-lung
ventilation: a prospective, randomized, crossover study.
Source
Journal of cardiothoracic surgery. 20(1) (pp 50), 2025. Date of
Publication: 09 Jan 2025.
Author
Min S.; Yoon S.; Han J.; Seo J.-H.; Bahk J.-H.
Institution
(Min, Han) Department of Anesthesiology and Pain Medicine, Chung-Ang
University Gwangmyeong Hospital, Chung-Ang University College of Medicine,
Gyeonggi-do, South Korea
(Yoon, Seo, Bahk) Department of Anesthesiology and Pain Medicine, Seoul
National University Hospital, Seoul National University College of
Medicine, 101 Daehak-ro ,Jongno-gu, Seoul, South Korea
Abstract
BACKGROUND: Several methods for blindly positioning bronchial blockers
(BBs) for one-lung ventilation (OLV) have been proposed. However, these
methods do not reliably ensure accurate positioning and proper direction.
Here, we developed a clinically applicable two-stage maneuver by modifying
a previously reported one-stage maneuver for successful insertion of a BB
at the appropriate depth and direction in patients requiring lung
isolation where a flexible bronchoscope (FOB) is not applicable.
 METHOD(S): This prospective, randomized, crossover study was
conducted at a tertiary university hospital and included 94 patients
requiring OLV for elective thoracic surgery under general anesthesia. The
patients underwent the one-stage maneuver followed by the two-stage
maneuver and vice versa, and the success rates of the two methods were
compared. After tracheal intubation, the deflated rigid-angle BB was
inserted into the endotracheal tube (ET) until a pre-marked point
indicating that the BB was just protruding from the ET tip. To identify
the carinal depth without FOB, the BB balloon was inflated and advanced
toward the intended side whilst monitoring abrupt changes in peak
inspiratory pressure and expiratory tidal volume to indicate placement at
the carina. In one-stage maneuver, the BB balloon was deflated and
advanced 3 cm further from the estimated carinal depth. During the
two-stage maneuver, the same procedure was performed to determine the
carinal depth, and the deflated BB was withdrawn and reinserted to a
predetermined depth with its tip directed 90 degree toward the target
bronchus. The accuracy of BB positioning for both maneuvers was evaluated
by a 4-point scale, with grades 1 and 2 considered acceptable for
providing OLV. RESULT(S): BB placement was more accurate in the
two-stage maneuver than in the one-stage maneuver [88.0% (81/92) vs. 73.9%
(68/92), relative risk (95% confidence interval [CI]), 0.45 (0.23-0.88), P
< 0.001]. This improvement was particularly significant when targeting the
left main bronchus [84.8% (39/46) vs. 58.7% (27/46), relative risk (95%
CI), 0.36 (0.17-0.79), P < 0.001)]. CONCLUSION(S): The novel
two-stage maneuver significantly improved the success rate of blindly
positioning the BB. TRIAL REGISTRATION: This study was registered in
ClinicalTrials.gov (NCT02981537) on December 05, 2016. Copyright
© 2024. The Author(s).

<52>
Accession Number
2037010854
Title
Robotic mitral valve surgery: evolving history, techniques, and training
paths.
Source
Current Opinion in Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Hasan I.; Amabile A.; Tam D.Y.
Institution
(Hasan, Amabile) Division of Cardiac Surgery, Department of Cardiothoracic
Surgery, University of Pittsburgh, United States
(Hasan) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Tam) Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Over the past 25years, robotic-assisted mitral valve
surgery has gained significant recognition because of its potential to
minimize patient trauma and improve clinical outcomes. This field has
evolved from early efforts in minimally invasive mitral procedures to more
refined and technically sophisticated approaches, driven by the need for
smaller incisions and reduced recovery times. Recent findings This review
will delve into the historical evolution of robotic-assisted mitral valve
surgery, detailing the technical advancements that have shaped current
practices and outlining the essential training pathways for a career as
robotic mitral valve surgeon. Summary The development of robotic systems
has marked a turning point, offering surgeons greater precision and
dexterity, crucial adjuncts in complex mitral valve repairs. Copyright
© 2025 Wolters Kluwer Health, Inc. All rights reserved.

<53>
Accession Number
646245796
Title
Treatment of Pleural Mesothelioma: ASCO Guideline Update.
Source
Journal of clinical oncology : official journal of the American Society of
Clinical Oncology. (pp JCO2402425), 2025. Date of Publication: 08 Jan
2025.
Author
Kindler H.L.; Ismaila N.; Bazhenova L.; Chu Q.; Churpek J.E.; Dagogo-Jack
I.; Bryan D.S.; Drazer M.W.; Forde P.; Husain A.N.; Sauter J.L.; Rusch V.;
Bradbury P.A.; Cho B.C.J.; de Perrot M.; Ghafoor A.; Graham D.L.; Khorshid
O.; Lebensohn A.; White J.; Hassan R.
Institution
(Kindler, Bryan, Drazer, Husain) University of Chicago Medicine, Chicago,
IL, United States
(Ismaila) American Society of Clinical Oncology, Alexandria, VA
(Bazhenova) University of California San Diego Moores Cancer Center, La
Jolla, CA, United States
(Chu) Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
(Churpek) University of Wisconsin-Madison and Carbone Cancer Center,
Madison, WI, United States
(Dagogo-Jack) Massachusetts General Hospital Cancer Center, Boston, MA,
United States
(Forde) Johns Hopkins University, Baltimore, MD, Liberia
(Sauter, Rusch) Memorial Sloan Kettering Cancer Center, New York, NY
(Bradbury, Cho) Princess Margaret Cancer Centre, Toronto, ON, Canada
(de Perrot) Toronto General Hospital, Toronto, ON, Canada
(Ghafoor, Lebensohn, Hassan) Center for Cancer Research, National Cancer
Institute, Bethesda, MD, Liberia
(Graham) Levine Cancer Institute, Charlotte, NC
(Khorshid) National Cancer Institute, Cairo University, Cairo, Egypt
(White) Mesothelioma Foundation, WA, United States
Abstract
PURPOSE: To provide evidence-based recommendations to practicing
physicians and others on the management of pleural mesothelioma (PM).
 METHOD(S): ASCO convened an Expert Panel of medical oncology,
thoracic surgery, radiation oncology, pathology, cancer genetics, and
advocacy experts to conduct an updated literature search, which included
systematic reviews, meta-analyses, randomized controlled trials, and
prospective and retrospective comparative observational studies published
from 2016 through 2024. Outcomes of interest included survival,
disease-free or recurrence-free survival, and quality of life. Expert
Panel members used available evidence and informal consensus to develop
evidence-based guideline recommendations. RESULT(S): The literature
search identified 110 additional relevant studies to inform the evidence
base for this guideline. RECOMMENDATIONS: Evidence-based recommendations
were developed for surgical cytoreduction, immunotherapy, chemotherapy,
pathology, and germline testing in patients with PM.Additional information
is available at www.asco.org/thoracic-cancer-guidelines.

<54>
Accession Number
2037025814
Title
Effectiveness of Amino Acid Supplementation in Preventing Acute Kidney
Injury Following Cardiac Surgery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S30-S31), 2025. Date of
Publication: 01 Feb 2025.
Author
Majeed M.W.; Ruelas M.G.; Finnegan E.; Lopes L.M.; Righetto B.; Salha I.;
Delgado D.; Tomo A.
Institution
(Majeed) Medicine, Government Medical college Anantnag, Srinagar, India
(Ruelas) Nutrition, Instituto de Investigacion Nutricional (IIN), Lima,
Peru
(Finnegan) Medical Student, Trinity College Dublin, Dublin, Ireland
(Lopes) Public Health, Johns Hopkins Bloomberg School of Public Health,
Baltimore, United States
(Righetto) Medicine, Universidade Positivo, Parana, Brazil
(Salha) Medicine, Trinity College Dublin, Dublin, Ireland
(Delgado) Medical Student, Universidad Peruana de Ciencias Aplicadas,
Lima, Peru
(Tomo) Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
Publisher
Elsevier Inc.
Abstract
Introduction: Acute kidney injury (AKI) is a common complication after
cardiac surgery, associated with increased morbidity, prolonged
hospitalization, and higher mortality rates. Previous studies have
suggested that amino acid supplementation may reduce the incidence of AKI
by enhancing renal blood flow and glomerular filtration rate (GFR).
However, evidence remains inconclusive regarding the overall benefit and
impact on secondary outcomes. Hence, we aimed to assess the effectiveness
of perioperative amino acid supplementation in preventing AKI and other
related complications following cardiac surgery. Method(s): PubMed,
Embase, and Cochrane databases were systematically searched for randomized
controlled trials (RCTs) comparing amino acids versus standard care in
preventing cardiac surgery-associated acute kidney injury. We used the
Mantel-Haenszel (MH) model of random effects to calculate pooled risk
ratios (RRs) for binary endpoints with 95% confidence intervals (CIs). The
primary outcome was the risk of AKI, defined by the Kidney Disease
Improving Global Outcomes (KDIGO) criteria. Secondary outcomes included
30-day mortality, renal replacement therapy (RRT) requirement,
postoperative stroke, and atrial and ventricular fibrillation.
Heterogeneity was assessed using the I2 statistic. Statistical
analyses were performed using R version 4.4.2, with significance
determined at a p-value < 0.05. Result(s): This meta-analysis
included five randomized controlled trials (RCTs) comprising 4,501
patients who underwent cardiac surgery. Amino acid supplementation
significantly reduced the risk of AKI compared to the control group (RR =
0.80; 95% CI 0.66-0.97; p = 0.026; I2 = 28%). However, there
were no significant differences in 30-day mortality (RR = 1.03; 95% CI
0.36-2.93; p = 0.959; I2 = 42%), RRT requirement (RR = 0.78;
95% CI 0.36-1.71; p = 0.537; I2 = 22%), postoperative stroke
(RR = 1.05; 95% CI 0.40-2.78; p = 0.918; I2 = 34%), or
postoperative atrial (RR = 1.00; 95% CI 0.88-1.15; p = 0.961;
I2 = 38%) and ventricular fibrillation (RR = 1.81; 95% CI
0.84-3.90; p = 0.132; I2 = 0%). [Formula presented] [Formula
presented] [Formula presented] [Formula presented] [Formula presented]
[Formula presented] Conclusion(s): Amino acid supplementation reduces
AKI risk in cardiac surgery patients but does not significantly impact
mortality, RRT, or other postoperative complications. More extensive
trials are needed to confirm these findings. I have no potential conflict
of interest to disclose. I did not use generative AI and AI-assisted
technologies in the writing process. Copyright © 2024

<55>
Accession Number
646245602
Title
Clinical efficacy and hemodynamic effects of levosimendan in cardiac
surgery patients after surgery.
Source
Journal of cardiothoracic surgery. 20(1) (pp 43), 2025. Date of
Publication: 07 Jan 2025.
Author
Zhao M.; Hou Y.; Yuan M.; Ma S.; Yue Y.
Institution
(Zhao, Yuan, Ma) Department of Critical Care Medicine, Zibo Central
Hospital, Zibo, China
(Hou) Department of Critical Care Medicine, First Affiliated Hospital of
Shandong First Medical University, JiNan, China
(Yue) Department of Anesthesiology, Zibo Central Hospital, Shandong
Province, No.10 Shanghai Road, China
Abstract
OBJECTIVE: To investigate the therapeutic effect of levosimendan on
hemodynamics in patients undergoing major cardiac surgery and presenting
with acute postoperative heart failure. METHOD(S): The subjects of
the study were 160 patients with severe cardiac conditions who underwent
surgery and had acute heart failure. Eighty cases each were assigned to
the research and control groups using a random number table. Document the
general patient data for each of the two groups; compare the clinical
outcomes of the two groups. The hemodynamic states of the two groups were
compared both before and after therapy. 48 h after surgery,
echocardiography was performed in both groups to determine cardiac
function. 48 h after surgery, N-terminal pro-brain B-type natriuretic
peptide (NT-Pro-BNP) levels were compared between the two groups.
 RESULT(S): The overall effective rate was significantly higher in the
research group (92.5%) compared to the control group (76.25%, P < 0.05).
Post-treatment, the research group demonstrated a significant reduction in
CVP (9.25 +/- 2.11 cmH2O vs. 11.36 +/- 3.08 cmH2O, P < 0.001), heart rate
(100.30 +/- 8.69 bpm vs. 105.74 +/- 7.69 bpm, P < 0.001), and lactic acid
levels (1.68 +/- 0.59 mmol/L vs. 2.69 +/- 0.55 mmol/L, P < 0.001). The
research group also showed improvements in SBP (117.23 +/- 8.74 mmHg vs.
113.25 +/- 7.55 mmHg, P = 0.002) and urine output (4.21 +/- 1.76 mL/kg/h
vs. 3.65 +/- 1.23 mL/kg/h, P = 0.021). Cardiac function indicators 48 h
after surgery indicated a higher LVEF (55.21 +/- 8.04% vs. 47.18 +/-
6.60%, P < 0.001) and lower LVEDVi and LVESVi in the research group (P <
0.001 for both). NT-Pro-BNP levels were significantly lower in the
research group (6010.19 +/- 1208.52 pg/mL vs. 9663.21 +/- 2391.34 pg/mL, P
< 0.001). The incidence of complications was lower in the research group
(5% vs. 22.5%, P = 0.001). CONCLUSION(S): Cardiac surgery patients
are prone to complications with acute heart failure after surgery.
Treatment with levosimendan can significantly improve clinical efficacy
and reduce complications. It can also effectively improve patients'
cardiac function and promote hemodynamic stability. Copyright ©
2025. The Author(s).

<56>
Accession Number
2037023874
Title
Survival Outcomes Following Cardiopulmonary Resuscitation in Adults
Receiving Kidney Replacement Therapy.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S288), 2025. Date of
Publication: 01 Feb 2025.
Author
Brown A.; Tuharska Z.; Cameron E.J.; Hole B.; Pippias M.
Institution
(Brown, Tuharska) Nephrology Department, North Bristol NHS Trust, Bristol,
United Kingdom
(Cameron) Intensive Care Department, North Bristol NHS Trust, Bristol,
United Kingdom
(Hole, Pippias) Renal Unit, North Bristol NHS Trust., Population Health
Sciences, Bristol Medical School, University of Bristol, Bristol, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Introduction: All patients receiving kidney replacement therapy (KRT)
should have a documented cardiopulmonary resuscitation (CPR) decision.
However, the literature on CPR outcomes in this cohort has not yet been
formally assessed. Addressing this disparity could improve
andsupportindividualised, patient-centred decision making. We conducted a
systematic review of survival and neurological outcomes of CPR in patients
undergoing KRT. Method(s): A comprehensive literature search
identified studies including in hospital or in dialysis unit CPR in adults
(>18 years) receiving chronic KRT (i.e., haemodialysis, peritoneal
dialysis, and kidney transplantation). Cardiac arrests or CPR occurring
outside of a hospital or dialysis unit setting were excluded. Due to
population heterogeneity, lack of standardised outcomes and inconsistent
use of control groups, a narrative review was conducted. Result(s):
After screening 1,301 studies, eleven studies were included. No study
included kidney transplant recipients. Six studies investigated CPR during
inpatient admission (n=125,125), five were conducted in North America and
one in Taiwan. Mean age ranged from 64-76 years. Comorbidities included
ischaemic heart disease (17-51%), cardiac failure (23-73%) and chronic
respiratory disease (5-37%). Five studies (all North American)
investigated CPR in the outpatient setting (n= 1,661), defined as remote
dialysis facilities without access to external automated defibrillation
and facilities within acute hospitals. Two studies reported the aetiology
of cardiac arrest, 34-51% arrests were cardiac in origin. Three of the
four studies reporting initial cardiac rhythm suggested most patients were
in a 'non-shockable' rhythm (66-81%). Inpatient rates of return of
spontaneous circulation (ROSC) were 69-72%, and survival to discharge
18-30%. 30-day and 1-year survival were not reported. Median length of
survival post-discharge was 3-11 months. Outpatient rates of ROSC were
49-76%, survival to discharge 24-75%, 30-day survival 16-75% and 1-year
survival 8-15% (Figure 1). Generally, certainty of evidence was 'low' for
survival outcomes, except for survival to discharge for the inpatient
cohort ('high'). A single inpatient study reported 17% of survivors
experienced 'good' neurological outcome, and three inpatient studies
reported 36-44% were discharged to their own home. Conclusion(s):
Between a fifth and a third of patients undergoing dialysis who experience
inpatient CPR survive to discharge, 36-44% of these survivors will be
discharged to their own home. Outcomes are similar to those of the general
population. The literature base is centred on North America and does not
represent other high-, middle- or low-income countries. Kidney transplant
recipients are not represented and reliable survival or neurological
outcome data following outpatient CPR is lacking. A more holistic measure
of neurological function with acknowledgement of personal, societal and
cultural expectation would increase applicability to the individual.
Further work should assess outcomes and experiences of advanced
resuscitation decisions more globally. Specific cardiac arrest aetiology
(e.g., intra-dialysis, intra-operative or traumatic cardiac arrest) should
be explored, these factors may account for variance in survival outcomes.
I have no potential conflict of interest to disclose. I did not use
generative AI and AI-assisted technologies in the writing
process. Copyright © 2024

<57>
Accession Number
2037024661
Title
A Prospective, Multi-Centric, Randomized, Double Blind, Placebo-Controlled
Study to Evaluate the Effectiveness of Supplementation of
N-Acetylcysteine& Taurine in Preventing Progression of Chronic Kidney
Disease.
Source
Kidney International Reports. Conference: ISN World Congress of Nephrology
(WCN) 2025. New Delhi India. 10(2 Supplement) (pp S269-S270), 2025. Date
of Publication: 01 Feb 2025.
Author
Verma H.; Bhalla A.K.; Kumar S.; Sheth G.; Kumar B.; Mondal R.
Institution
(Verma) Nephrology, Vardhman Mahavir Medical College and Safdarjung
Hospital, New delhi, India
(Bhalla) Nephrology, Sir Ganga Ram Hospital, New delhi, India
(Kumar) Nephrology, Meenakshi Mission Hospital & Research Centre, Madurai,
India
(Sheth) Nephrology, Grant Government Medical College and Sir J.J Group of
Hospitals, Mumbai, India
(Kumar) Nephrology, Kumar Hypertension and Kidney Clinic, Howrah, India
(Mondal) Nephrology, BMRC Hospital, Kolkata, India
Publisher
Elsevier Inc.
Abstract
Introduction: Chronic kidney disease is a slow and progressive loss of
kidney function over a period of several years eventually leading to
permanent kidney failure. CKD is known to be a risk factor for
cardiovascular disease which inturn worsens CKD, making it a vicious
cycle. The association of CKD with oxidative stress is a contributing
factor to cardiovascular burden and is also proven to increase markers of
inflammation like interlukins (IL's), tumor necrosis factor (TNF-alpha)
and C- Reactive Proteins (CRP) leading to progression of renal injury. The
anti-oxidant effect of N-acetylcysteine (NAC) is seen to reduce the
production of free radicals, inflammatory cytokines and serum creatinine.
This study aims at evaluating the effect of Nefrosave on the markers of
CKD and compare the time of event of interest with placebo.
 Method(s): Adult Patients between 18 - 65 years of age, of both
gender with a diagnosis of chronic kidney disease (including type 2
diabetes mellitus associated chronic kidney disease) stage 1, stage 2 and
stage 3 A (Stage 1 with normal or high GFR (GFR > 90 mL/min) Stage 2 Mild
CKD (GFR = 60-89 mL/min Stage 3 Moderate CKD (GFR = 43-59 mL/min) as per
National Kidney Foundation-Kidney Disease Outcomes Quality Initiative
(NKF-KDOQI) were included. Serum creatinine < 3.0 mg/dL, Subjects who are
willing to give written informed consent were included in the study.
Patients with Type 1 DM, severe CKD, history of MI, CABG/
PTCA/angioplasty/stent, Cerebrovascular event, Cardiac failure as per New
York Heart Association Functional, allergies or intolerance to N-
acetylcysteine or taurine, Untreated UTI/ medical condition impacting
urine protein values, patients maintained on dialysis, BMI 30 kg/m2 or any
other systemic disease/abnormal laboratory values that may interfere in
the study were excluded. The objective of the study is to evaluate the
delay in progression of chronic kidney disease by supplementing with
Nefrosave and compare with an identical placebo. Result(s): An 18.6%
overall reduction in uACR was seen in Nefrosave group compared to placebo
with 34.09% reduction in micro albuminuria and 17.55% reduction in macro
albuminuria Overall Cystatin C reduced by 21.89% in Nefrosave group which
is 36.9% more than Placebo group. 9.74% competitive reduction of serum
Creatinine was shown in Nefrosave group compared to Placebo. A competitive
reduction was also noted by 27.43% in CKD 1 & 2, 64.8% in CKD 3
respectively. [Fig 1 and 2] [Formula presented] [Formula presented]
 Conclusion(s): The combination of N-Acetylcysteine & Taurine
(Nefrosave of Fourrts India Laboratories Pvt Ltd, Chennai) with low
protein diet is an effective therapy to slow down the progression of CKD
as it shows significant reduction in Micro albuminuria, Cystatin C and
Serum Creatinine. I have potential conflict of interest to disclose. This
study wasfundedby Nefrosave of Fourrts India Laboratories Pvt Ltd,
Chennai, India I did not use generative AI and AI-assisted technologies in
the writing process. Copyright © 2024

<58>
Accession Number
2037017490
Title
Surgery versus thrombolytic therapy for the management of left-sided
prosthetic valve thrombosis without hemodynamic compromise: A systematic
review and meta-analysis.
Source
Archives of Cardiovascular Diseases. Conference: JESFC 2025. Paris France.
118(1 Supplement) (pp S69), 2025. Date of Publication: 01 Jan 2025.
Author
Chopard R.; Vidoni C.; Besutti M.; Ismail M.; Ecarnot F.; Favoulet B.;
Badoz M.; Schiele F.; Perrotti A.; Meneveau N.
Institution
(Chopard, Vidoni, Besutti, Favoulet, Schiele, Meneveau) Cardiologie,
centre hospitalier universitaire de Besancon, Besancon, France
(Ismail, Perrotti) Chirurgie cardiaque, centre hospitalier universitaire
de Besancon, Besancon, France
(Ecarnot, Badoz) Cardiologie, CHU de Besancon, Besancon, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: The optimal strategy in prosthetic heart valve thrombosis
(PVT) remains controversial, with no randomized trials and conflicting
observational data. Objective(s): To perform a systematic review and
meta-analysis of evidence comparing systemic thrombolysis and cardiac
surgery in PVT. Method(s): We searched for studies on treatment
strategies in patients with left-sided PVT since 2000 in PubMed, Cochrane
and Embase. Primary outcome was mortality, secondary outcomes were major
bleeding, and thrombo-embolism during follow-up (PROSPERO no
CRD42022384092). Result(s): We identified 2298 studies, of which 16
were included, comprising 1389 patients with PVT (mean age, 50.4 +/- 9.3
years, 60.0% were women). Among them, 67.2% were New York Heart
Association Stage III/IV at admission. Overall, 48.1% were treated with
systemic thrombolysis, and 51.9% with cardiac surgery. Mortality was 10.8%
in the thrombolysis group, and 15.3% in the surgery group. The pooled OR
for mortality with systemic thrombolysis was 0.66 (95% CI, 0.46-0.96; I2 =
36.6%; tau2, 0.428; P = 0.03) versus cardiac surgery. Rates of both
transient ischemic attack and non-central nervous system embolism were
higher in the thrombolysis group (P = 0.002 and P = 0.02, respectively).
Treatment success, major bleeding and stroke were similar between groups.
Sensitivity analysis including studies that used low dose and/or slow
infusion thrombolysis showed that mortality was lower, and treatment
success was higher inpatients referred to systemic thrombolysis, with
similar rates of other secondary outcomes. Conclusion(s):
Thrombolysis seems to be the preferred option for the management of PVT
without cardiogenic shock, pending future RCTs or larger observational
studies. Copyright © 2024

<59>
Accession Number
646227185
Title
Risk of Atherosclerotic Cardiovascular Disease After Chronic Obstructive
Pulmonary Disease Hospitalization among Primary and Secondary Prevention
Older Adults.
Source
Journal of the American Heart Association. (pp e035010), 2025. Date of
Publication: 10 Jan 2025.
Author
Mosher C.L.; Osazuwa-Peters O.L.; Nanna M.G.; MacIntyre N.R.; Que L.G.;
Palmer S.M.; Jones W.S.; O'Brien E.C.
Institution
(Mosher, MacIntyre, Que, Palmer) Division of Pulmonary, Allergy, Critical
Care Medicine Duke University School of Medicine Durham NC USA
(Mosher, Palmer, Jones, O'Brien) Duke Clinical Research Institute Durham
NC USA
(Osazuwa-Peters, Palmer, Jones, O'Brien) Department of Population Health
Sciences Duke University School of Medicine Durham NC USA
(Nanna) Section of Cardiovascular Medicine Yale School of Medicine New
Haven CT USA
(Jones) Division of Cardiovascular Disease Duke University School of
Medicine Durham NC USA
Abstract
BACKGROUND: Meta-analyses have suggested that the risk of cardiovascular
disease events is significantly higher after a chronic obstructive
pulmonary disease (COPD) exacerbation, but the populations at highest risk
have not been well characterized to date. METHODS AND RESULTS: The authors
analyzed the risk of atherosclerotic cardiovascular disease (ASCVD)
hospitalizations after COPD hospitalization compared with before COPD
hospitalization and patient factors associated with ASCVD hospitalizations
after COPD hospitalization among 2 high-risk patient cohorts. The primary
outcome was risk of an ASCVD hospitalization composite outcome (myocardial
infarction, coronary artery bypass graft, percutaneous coronary
intervention, stroke, transient ischemic accident) after COPD
hospitalization relative to before COPD hospitalization. Additional
analyses evaluated for risk factors associated with the composite ASCVD
hospitalization outcome. In the high-risk primary prevention cohort, the
hazard ratio (HR) estimate following adjustment for the composite ASCVD
hospitalization outcome after COPD hospitalization versus before COPD
hospitalization for 30 days was 0.74 (95% CI, 0.66-0.82; P<=0.0001); for
90 days, 0.69 (95% CI, 0.64-0.75; P<=0.0001); and for 1 year, 0.78 (95%
CI, 0.73-0.82; P<=0.0001). In the secondary prevention cohort, the HR for
30-day hospitalization was 1.15 (95% CI, 1.05-1.26; P=0.0036); 90-day
hospitalization, 1.08 (95% CI, 1.01-1.15; P=0.0178); and 1-year
hospitalization, 1.07 (95% CI, 1.02-1.11; P=0.0026). Among the 19
characteristics evaluated, hyperlipidemia and history of acute ASCVD event
were associated with the highest risk of ASCVD events 1 year after COPD
hospitalization in the high-risk primary and secondary prevention cohorts.
 CONCLUSION(S): The risk of ASCVD hospitalization was higher in
patients with established ASCVD and lower among high-risk patients without
established ASCVD after-COPD hospitalization relative to before
hospitalization. We identified multiple risk factors for ASCVD
hospitalization after COPD hospitalization.

<60>
Accession Number
2037017422
Title
Two-year follow-up of myocardial revascularization after anatomical and
functional screening for myocardial ischemia: Insights from the "Nancy
Ischemia Registry".
Source
Archives of Cardiovascular Diseases. Conference: JESFC 2025. Paris France.
118(1 Supplement) (pp S9), 2025. Date of Publication: 01 Jan 2025.
Author
Chati Z.; Tissier S.; Balaj C.; Lafitte M.; Benzaghou N.; Amor M.; Emoine
J.; Angioi M.; Maigrat C.-H.; Farah G.; Belhadj K.; Schwartz J.; Olivier
A.; Breton C.; Simon J.-P.
Institution
(Chati, Emoine, Angioi, Maigrat, Belhadj, Schwartz, Olivier, Breton,
Simon) Cardio-vasculaire, clinique Louis Pasteur, Essey-les-Nancy, France
(Tissier, Balaj, Benzaghou) Radiologie, clinique Louis Pasteur,
Essey-les-Nancy, France
(Lafitte) Radiolgie clinique louis pasteur, clinique Louis Pasteur,
Essey-les-Nancy, France
(Amor) Cardio-Vasculaire, clinique Louis Pasteur, Essey-les-Nancy, France
(Farah) Cardiologie, clinique Louis Pasteur, Essey-les-Nancy, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Myocardial revascularization after screening for myocardial
ischemia is one of the main Major Adverse Cardiovascular Events (MACE)
observed. Careful monitoring of patients could play an important role.
 Objective(s): Systematic monitoring of patients after a myocardial
revascularization procedure is known from randomized clinical trials. A
real follow-up outside of this context is not really known. In a real
world, Nancy Ischemia Registry aims to prospectively study the
consequences of screening for myocardial ischemia on subsequent myocardial
revascularization. Method(s): After prospectively including 2977
patients as part of screening for myocardial ischemia by anatomical
(Coronary Calcium-Scores, CT-Coronary Angiograms) and functional imaging
(Stress Echo, Stress CMR) between May 2021 and the end of December 2022,
we observed the occurrence of a myocardial revascularization procedure in
these patients. After a positive screening for myocardial ischemia, a
coronary angiography was performed. A first myocardial revascularization
procedure was decided if the patient presented at least one significant
coronary lesion (>= 70% or FFR <= 0.80). Result(s): In 2,375
patients, screening did not reveal significant myocardial ischemia
(ISCHEMIA -). We noted 602 examinations (20% of all examinations) with
suspicion of myocardial ischemia (ISCHEMIA +). 324 patients (11% of all
examinations) (REAVASC +) benefited from a first myocardial
revascularization in the following weeks. All patients in the three groups
had usual follow-up. At the end of 2023, in the ISCHEMIA - group, we had
recorded two cases of myocardial revascularization. In the ISCHEMIA +
group, 97 new revascularization interventions were recorded. However, at
least one other myocardial revascularization procedure was observed in 73
patients in the REVASC + group. Conclusion(s): Far from the context
of randomized clinical trials, non-systematic, but regular, monitoring of
patients with suspected myocardial ischemia and/or revascularization shows
the interest of anatomical and functional imaging to probably avoid a more
significant evolution of MACE and allows for better stratification of
patients. Copyright © 2024

<61>
Accession Number
646226547
Title
Coronary revascularization in randomized clinical trials comparing
transcatheter and surgical aortic valve replacement: is it time to bridge
the gap?.
Source
European heart journal. (no pagination), 2025. Date of Publication: 09
Jan 2025.
Author
Aarts H.M.; Voskuil M.; Delewi R.
Institution
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Heidelberglaan 100, CX Utrecht, Netherlands
(Aarts, Delewi) Department of Cardiology, Amsterdam University Medical
Center, Amsterdam, Netherlands

<62>
Accession Number
646225647
Title
Prognostic Value of Myocardial CT-ECV in Severe Aortic Stenosis Requiring
Aortic Valve Replacement: A Systematic Review and Meta-analysis.
Source
European heart journal. Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 10 Jan 2025.
Author
Faggiano A.; Gherbesi E.; Carugo S.; Brusamolino M.; Cozac D.A.; Cozza E.;
Savo M.T.; Cannata F.; Guglielmo M.; La Mura L.; Fazzari F.; Carrabba N.;
Conte E.; Mushtaq S.; Baggiano A.; Guaricci A.I.; Pedrinelli R.; Indolfi
C.; Sinagra G.; Perrone Filardi P.; Pergola V.; Pontone G.
Institution
(Faggiano, Gherbesi, Carugo) Department of Cardio-Thoracic-Vascular
Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico,
Milan, Italy
(Faggiano, Carugo, Brusamolino) Department of Clinical Sciences and
Community Health, University of Milan, Milan, Italy
(Brusamolino, Cannata, Fazzari, Mushtaq, Baggiano, Pontone) Department of
Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico
Monzino IRCCS, Milan, Italy
(Cozac, Cozza, Savo, Pergola) Cardiology Clinic, Department of Cardiac,
Thoracic, Vascular Sciences and Public Health, University of Padova,
Padova, Italy
(Cozac) Department of Physiology, University of Medicine, Pharmacy,
Science and Technology "George Emil Palade" of Targu Mures, Romania
(Guglielmo) Department of Cardiology, Division of Heart and Lungs, Utrecht
University, Utrecht University Medical Center, Utrecht, Netherlands
(Guglielmo) Department of Cardiology, Haga Teaching Hospital, The Hague,
Netherlands
(La Mura, Perrone Filardi) Department of Advanced Biomedical Sciences,
University Federico II of Naples. Naples, Italy
(Carrabba) Department of Cardiothoracovascular Medicine, Azienda
Ospedaliero-Universitaria Careggi, Florence, United States
(Conte) Department of Clinical Cardiology and Cardiovascular Imaging,
Galeazzi-Sant'Ambrogio Hospital IRCCS, Milan, Italy
(Guaricci) University Cardiology Unit, Interdisciplinary Department of
Medicine, University of Bari Aldo Moro, Bari, Italy
(Pedrinelli) Cardiac, Thoracic and Vascular Department, University of
Pisa, Pisa, Italy
(Indolfi) Istituto di Cardiologia, Dipartimento di Scienze Mediche e
Chirurgiche, Universita degli Studi "Magna Graecia", Catanzaro, Italy
(Sinagra) Cardiology Specialty School, University of Trieste, Trieste,
Italy
(Sinagra) Center for Diagnosis and Treatment of Cardiomyopathies,
Cardiovascular Department, Azienda Sanitaria Universitaria
Giuliano-Isontina (ASUGI), Trieste, Italy
(Pontone) Department of Biomedical, Surgical and Dental Sciences,
University of Milan, Milan, Italy
Abstract
AIM: Computed tomography (CT)-derived extracellular volume fraction (ECV)
is a non-invasive method to quantify myocardial fibrosis. Evaluating
CT-ECV during aortic valve replacement (AVR) planning CT in severe aortic
stenosis (AS) may aid prognostic stratification. This meta-analysis
evaluated the prognostic significance of CT-ECV in severe AS necessitating
AVR. METHODS AND RESULTS: Electronic database searches of PubMed,
OVID-MEDLINE, and Cochrane Library were performed. The primary outcome was
to compare the occurrence of a composite of cardiovascular outcomes in
patients with severe AS undergoing AVR with elevated myocardial CT-ECV
values versus patients with normal values. Secondary outcomes included
all-cause mortality and heart failure (HF) related hospitalization. A
total of 1223 patients undergoing AVR for severe AS were included in 10
studies: 524 patients with high values of CT-ECV and 699 with normal
values of CT-ECV. The pooled CT-ECV cut-off to define elevated values and
predict prognosis was 30.7% (95% CI: 28.5-33.7%). At a mean follow-up of
17.9+/-2.3 months after AVR, patients with elevated CT-ECV experienced a
significantly higher number of cardiovascular events (43.4% vs 14.0%;
OR:4.3, 95% CI:3.192/5.764, p <0.001). Regarding secondary outcomes,
all-cause mortality occurred in 29.3% of patients with elevated CT-ECV vs
11.6% with CT-ECV below the cut-off (OR3.5, 95% CI:2.276/5.311, p<0.001),
whereas HF hospitalization was observed in 25.5% vs 5.9% (OR 4.9, 95% CI:
2.283/10.376, p<0.001). Graphical Abstract. CONCLUSION(S): Patients
undergoing AVR for severe AS with elevated CT-ECV values experience a
worse post-intervention prognosis. The implementation of CT-ECV evaluation
in routine AVR planning protocols should be considered. Copyright
© The Author(s) 2025. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<63>
Accession Number
2032920306
Title
Human leukocyte antigen alloimmunization in a randomized trial of
amustaline/glutathione pathogen-reduced red cells in complex cardiac
surgery patients.
Source
Transfusion. (no pagination), 2025. Date of Publication: 2025.
Author
Norris P.J.; Stone M.; Di Germanio C.; Balasko B.; Kaidarova Z.; Friend
H.; Varrone J.; Corash L.; Mufti N.; Benjamin R.J.
Institution
(Norris, Stone, Di Germanio, Balasko, Kaidarova) Vitalant Research
Institute, San Francisco, CA, United States
(Norris, Stone, Di Germanio) Department of Laboratory Medicine, University
of California, San Francisco, San Francisco, CA, United States
(Norris) Department of Medicine, University of California, San Francisco,
San Francisco, CA, United States
(Friend, Varrone, Corash, Mufti, Benjamin) Cerus Corporation, Concord, CA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Although alloimmunization risk of pathogen-reduced (PR)
platelets has been studied, the risk has not been reported with PR red
blood cells (RBCs). Study Design and Methods: In a Phase III, randomized,
controlled trial (Red Cell Pathogen Inactivation), cardiac or
thoracic-aorta surgery patients were randomized to transfusion with
amustaline/glutathione PR versus conventional RBCs. Pre-transfusion and
Day 28 samples were evaluated for Human leukocyte antigen (HLA) Class I
and Class II antibodies at low, medium, and high cutoff values.
 Result(s): The HLA alloimmunization analysis included 114
participants (53% female) in the PR and 113 (51% female) in the
conventional RBC arms. In a modified intention-to-treat analysis, 13.7% (N
= 29) and 7.2% (N = 15) developed new high-level HLA Class I or Class II
antibodies, respectively; however, there was no signal that PR-RBCs
affected the rate of HLA Class I (odds ratio (OR) 1.3 [95% confidence
interval (CI) 0.62-2.9]) or Class II antibody formation (OR 0.99 [95% CI
0.35-2.8]). Female transfusion recipients had higher risk of developing
new high-level HLA Class I antibodies (OR 12.0 [95% CI 3.5-40.9]) and
Class II antibodies (OR 5.0 [95% CI 1.4-17]). The mean number of RBC (5.5
vs. 3.6 units, p = 0.018) and platelet (1.8 vs. 1.1 units, p = 0.043)
transfusions was higher in subjects with new high-level HLA Class II
antibodies. Discussion(s): Receipt of amustaline/glutathione PR-RBC
units did not affect HLA alloimmunization risk. Female sex and number of
RBC and platelet transfusions were risk factors for the development of new
high-level HLA Class I and Class II antibodies. Copyright © 2025
AABB.

<64>
Accession Number
2037012100
Title
Surgeon-led Point-of-care Ultrasound-guided Thoracic Biopsy: A new
paradigm in efficient diagnosis and resource-sparing care.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Gupta V.; Gowing S.D.; Pandya R.; Tan L.; Liu R.Y.; Srinathan S.K.; Kidane
B.
Institution
(Gupta, Pandya) Division of Thoracic Surgery, Department of Surgery,
Western University, London, Canada
(Gowing, Tan, Liu, Srinathan, Kidane) Section of Thoracic Surgery, Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
(Kidane) CancerCare Manitoba Research Institute, Winnipeg, Canada
(Kidane) Department of Physiology and Pathophysiology, University of
Manitoba, Winnipeg, Canada
(Kidane) Department of Biomedical Engineering, University of Manitoba,
Winnipeg, Canada
(Kidane) Children's Hospital Research Institute of Manitoba, Winnipeg,
Canada
Publisher
Elsevier Inc.
Abstract
Objective: Tissue diagnosis through a variety of interventional approaches
guides thoracic cancer management, but often introduces delay to
definitive treatment and can be resource intensive. We introduced a
thoracic surgeon-led, point-of-care ultrasound-guided biopsy program to
provide rapid diagnosis for patients with thoracic cancers. We assessed
the diagnostic yield and adverse events with this approach.
 Method(s): A prospective cohort study was performed of consecutive
patients undergoing ultrasound-guided biopsies performed by 5 thoracic
surgeons from June 2021 to April 2024 at a tertiary Canadian thoracic
surgery institution. By using a bedside ultrasound, 20-gauge tissue cores
were obtained using multiple passes with a standard spinal needle.
Descriptive univariable statistics were used. Result(s): A total of
160 patients underwent bedside biopsy for lung (n = 101), liver (n = 20),
chest wall/pleural (n = 20), mediastinal (n = 18), or other (n = 1)
lesions. Tissue diagnosis was obtained in 86.3% of patients (n = 138), and
diagnostic yield was similar for high- and low-volume providers and over
time. All liver biopsies were diagnostic. Nondiagnostic biopsies were more
likely to occur with benign pathology, chest wall/pleural lesions, or
extensive necrosis; diagnosis was achieved with other modalities in most
cases. There was 1 postprocedure pneumothorax (adverse event rate 0.6%).
 Conclusion(s): Thoracic surgeon-led ultrasound-guided biopsies are
safe in an outpatient clinic setting and have high diagnostic accuracy.
This results in reduced time to diagnosis by an estimated 28 to 35 days
and frees up endoscopic and radiology resources for other patients. This
low-cost procedure can be adopted as part of comprehensive thoracic
malignancy assessment and can accelerate patient access to cancer
treatment. Copyright © 2024 The Authors

<65>
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. (no pagination), 2024. Date of
Publication: 2024.
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) Anesthesiology, Chiang
Mai University Faculty of Medicine, Chiang Mai, Thailand
(Phothikun) Surgery, Chiang Mai University Faculty of Medicine, 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. Method(s): 70 cardiac patients undergoing median
sternotomy were randomly assigned to receive either single or double
injections of superficial parasternal blocks bilaterally. Each patient
received 40 mL of 0.25% bupivacaine with epinephrine 5 mug/mL and
dexamethasone 10 mg. The single-injection group received 20 mL/side at the
third costal cartilage, while the double-injection group received 10
mL/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.
 Result(s): 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.
 Conclusion(s): 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. Trial registration number:
TCTR20230408004. Copyright © American Society of Regional
Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and
permissions. Published by BMJ.

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