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<1>
Accession Number
2037454096
Title
Colchicine for secondary prevention in patients with acute coronary
syndrome: A systematic review and meta-analysis.
Source
International Journal of Cardiology. 425 (no pagination), 2025. Article
Number: 133045. Date of Publication: 15 Apr 2025.
Author
Shaikh S.; Hamza M.; Neppala S.; Singh S.; Upreti P.; Umer A.M.; Manish
K.C.; Pandya K.; Bahar Y.; Sattar Y.; Alraies M.C.
Institution
(Shaikh) Washington University in St Louis, St Louis, MO, United States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Neppala) UT Health Science Center, Memphis, TX, United States
(Singh) Sinai Hospital, Baltimore, MD, United States
(Upreti) Sands-Constellation Heart Institute, Rochester Regional Health,
Rochester, NY, United States
(Umer) WVU Medicine Camden Clark Medical Center, Parkersburg, WV, United
States
(Manish) North Alabama Medical Center, Florence, AL, United States
(Pandya) Cleveland Clinic, Cleveland, OH, United States
(Bahar) Wayne State University, Detroit, United States
(Sattar) West Virginia University, Morgantown, WV, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Despite optimal therapy, coronary artery disease (CAD) remains
a significant public health concern worldwide. Studies have increasingly
recognized the role of inflammation in atherosclerosis. Colchicine, a
potent anti-inflammatory drug commonly used to treat gout, and
pericarditis is being evaluated in this study for its safety and efficacy
in preventing CAD following an acute coronary syndrome (ACS).
 Method(s): We searched PubMed and Embase for studies up to April 2024
comparing colchicine to standard medical treatment in ACS patients.
Primary outcomes included major adverse cardiovascular events (MACE) and
recurrent ACS, while secondary outcomes were cardiovascular death,
congestive heart failure (CHF), stroke, hospitalizations, and
gastrointestinal (GI) side effects. Data were pooled using a
random-effects model. Result(s): We included nine studies with a
pooled sample size of 7260 patients. The mean age was 60.1 (+/-11.8)
years, with 19.3 % females and a mean follow-up duration of 8.5 (+/-6)
months. Patients who received colchicine treatment demonstrated a reduced
risk of re-hospitalizations (OR 0.52 [0.34-0.81]) but had increased GI
effects (OR 2.10 [1.20-3.68]). There was no significant difference in
cardiovascular death (OR 1.17 [0.52-2.63]), MACE (OR 0.68 [0.45-1.01]),
stroke (OR 0.46 [0.18-1.18]), recurrent ACS (OR 0.55 [0.28-1.09]) and the
incidence of CHF (OR 0.90 [0.38-2.12]) between patients treated with
colchicine versus standard medical treatment. Conclusion(s): Adding
colchicine to standard medical therapy in ACS patients significantly
reduced hospitalizations but is associated with increased GI side effects.
Further prospective trials are required to validate these findings and
determine if early intervention with colchicine treatment improves
clinical outcomes in ACS patients. Copyright © 2025 Elsevier B.V.

<2>
Accession Number
2033129375
Title
Balancing the risks: continuous vs. interrupted anticoagulation during
TAVI - what does the evidence say?.
Source
Thrombosis Journal. 23(1) (no pagination), 2025. Article Number: 7. Date
of Publication: 01 Dec 2025.
Author
Patel R.; Kokori E.; Olatunji G.; Abraham I.C.; Akinboade A.; Agyemang
E.A.; Babalola A.; Aderinto N.
Institution
(Patel) Methodist Health System Dallas, Dallas, TX, United States
(Kokori, Abraham, Akinboade) Department of Medicine and Surgery,
University of Ilorin, Ilorin, Nigeria
(Olatunji) Johns Hopkins Bloomberg School of Public Health, Baltimore,
United States
(Agyemang) Newark Beth Israel Medical Center, Newark, NJ, United States
(Babalola) Kornberg School of Dentistry, Temple University, Philadelphia,
United States
(Aderinto) Department of Medicine, Ladoke Akintola University of
Technology, Ogbomoso, Nigeria
Publisher
BioMed Central Ltd
Abstract
Anticoagulation therapy is a critical component of post-transcatheter
aortic valve implantation (TAVI) management, aimed at reducing the risk of
thromboembolic events and mortality. This review examines the efficacy of
continuous versus interrupted anticoagulation strategies in TAVI patients,
focusing on mortality, stroke rates, and composite events. A literature
review was conducted, analyzing recent studies that evaluate the impact of
different anticoagulation regimens on clinical outcomes in TAVI patients.
Key outcomes assessed include all-cause mortality, thromboembolic events,
and major cardiovascular complications within 30 days and up to one year
post-procedure. The review identifies a trend favoring continuous
anticoagulation, particularly with direct-acting oral anticoagulants
(DOACs), which was associated with lower mortality rates and reduced
stroke incidence in high-risk patients. However, findings were
inconsistent across studies, with some reporting no significant
differences in outcomes between continuous and interrupted strategies.
Additionally, the review highlights the need to balance the benefits of
thromboembolic prevention with the increased risk of bleeding and vascular
complications associated with continuous therapy. The findings show the
importance of individualized anticoagulation strategies tailored to
patient risk profiles. Clinicians should weigh the potential benefits of
continuous anticoagulation against the risks, particularly in high-risk
populations. Ongoing research is essential to refine anticoagulation
protocols in TAVI patients, enhancing both safety and efficacy in clinical
practice. Copyright © The Author(s) 2025.

<3>
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Accession Number
2036724240
Title
Impact of Bifurcation Lesions on Outcomes after FFR-Guided PCI or CABG.
Source
Circulation: Cardiovascular Interventions. 18(1) (no pagination), 2025.
Article Number: e014610. Date of Publication: 01 Jan 2025.
Author
Dillen D.M.M.; Otsuki H.; Takahashi K.; Kobayashi Y.; Piroth Z.; Noiseux
N.; Nakadi B.E.; Kalinauskas G.; Szekely L.; Davidavicius G.; Teeuwen K.;
Tonino P.A.L.; Pijls N.H.J.; De Bruyne B.; Fearon W.F.; Zimmermann F.M.
Institution
(Dillen, Teeuwen, Tonino, Pijls, Zimmermann) Department of Cardiology,
Catharina Hospital, Eindhoven, Netherlands
(Otsuki, Takahashi, Fearon) Division of Cardiovascular Medicine, Stanford
University, School of Medicine, Stanford Cardiovascular Institute,
Stanford University, CA, United States
(Kobayashi) New York Presbyterian Brooklyn Methodist, Weill Cornell
Medical College, United States
(Piroth) Gottsegen National Cardiovascular Center, Budapest, Hungary
(Noiseux) Department of Cardiothoracic Surgery, Centre Hospitalier de
l'Universite de Montreal, Quebec, Canada
(Nakadi) Department of Cardiothoracic Surgery, Centre Hospitalier
Universitaire de Charleroi, Belgium
(Kalinauskas) Department of Cardiothoracic Surgery, Vilnius University
Hospital Santaros Klinikos, Lithuania
(Szekely) Department of Cardiothoracic Surgery, Gottsegen National
Cardiovascular Center, Budapest, Hungary
(Davidavicius) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Vilnius University, Lithuania
(Tonino) Department of Biomedical Engineering, Technical University,
Eindhoven, Netherlands
(De Bruyne) Cardiovascular Center Aalst, OLV Clinic, Belgium
(Zimmermann) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the era of first-generation drug-eluting stents and
angiography-guided percutaneous coronary intervention (PCI), the presence
of a bifurcation lesion was associated with adverse outcomes after PCI. In
contrast, the presence of a bifurcation lesion had no impact on outcomes
following coronary artery bypass grafting (CABG). Therefore, the presence
of a coronary bifurcation lesion requires special attention when choosing
between CABG and PCI. The aim of this study is to assess whether the
presence of a bifurcation lesion still influences clinical outcomes after
contemporary PCI using second-generation drug-eluting stent and fractional
flow reserve (FFR) guidance versus CABG. METHOD(S): The randomized
FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel
Evaluation) compared FFR-guided PCI using current drug-eluting stents with
CABG in patients with 3-vessel coronary artery disease. The prespecified
key end point at 3-year follow-up was the composite of death, myocardial
infarction, or stroke. In this substudy, the impact of bifurcation lesions
on outcomes after FFR-guided PCI and CABG was investigated.
 RESULT(S): The FAME 3 trial enrolled 1500 patients and 653 (45.2%)
patients had at least 1 true bifurcation lesion. There was no difference
in the composite of death, myocardial infarction, or stroke at the 3-year
follow-up between patients with or without at least 1 true bifurcation
lesion (11.6% versus 10.0%; hazard ratio, 1.17 [95% CI, 0.86-1.61];
P=0.32), regardless of revascularization strategy. The composite end point
was not statistically different between FFR-guided PCI and CABG in
patients with at least 1 true bifurcation lesion (hazard ratio, 1.27 [95%
CI, 0.80-2.00]) or without a true bifurcation lesion (hazard ratio, 1.36
[95% CI, 0.87-2.12]), with no significant interaction
(P<inf>interaction</inf>=0.81). CONCLUSION(S): In patients with
3-vessel coronary artery disease, the presence of a true bifurcation
lesion was not associated with a different treatment effect after
FFR-guided PCI with contemporary drug-eluting stent versus
CABG. Copyright © 2024 American Heart Association, Inc.

<4>
Accession Number
2034109771
Title
Decisional conflict and defibrillator implantation choices among Black
women and men with chronic systolic heart failure.
Source
Heart Rhythm. 22(3) (pp 627-628), 2025. Date of Publication: 01 Mar 2025.
Author
Sullivan L.T.; Maul A.J.; Young R.; Boursiquot B.C.; Khedagi A.; Alhanti
B.; Jackson L.R.; Thomas K.L.
Institution
(Sullivan, Maul, Khedagi, Jackson, Thomas) Duke University Medical Center,
Durham, North Carolina, United States
(Young, Alhanti, Jackson, Thomas) Duke Clinical Research Institute,
Durham, North Carolina, United States
(Boursiquot) Columbia University Irving Medical Center, New York, New
York, United States
Publisher
Elsevier B.V.

<5>
Accession Number
2033181675
Title
Evolution and New Perspectives of Balloon Pulmonary Angioplasty in CTEPH.
Source
Journal of Clinical Medicine. 14(3) (no pagination), 2025. Article Number:
699. Date of Publication: 01 Feb 2025.
Author
Larsen J.; Lakhter V.; Nasri A.; Bashir R.
Institution
(Larsen, Lakhter, Nasri, Bashir) Department of Cardiovascular Diseases,
Temple University Hospital, Philadelphia, PA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Chronic thromboembolic pulmonary disease (CTEPD) and chronic
thromboembolic pulmonary hypertension (CTEPH) are debilitating
complications of acute pulmonary embolism (PE) that are characterized by
fibrosis and organization of the thrombotic material within pulmonary
artery branches. This pathology leads to increased right ventricular
afterload and dead space ventilation, posing a risk of progressive
pulmonary hypertension, right-sided heart failure, and potentially death
if left untreated. Pulmonary endarterectomy (PTE) is a technically complex
open-heart surgery considered to be a first-line treatment as it is a
potentially curative therapy. Although PTE is highly successful in
proximal disease, it may not reach the very distal branches. On the other
hand, pulmonary vasodilator therapy is very effective in improving
microvasculopathy but does not address the obstructive fibrotic component
of the larger vessels. Balloon pulmonary angioplasty (BPA) is a novel
percutaneous revascularization therapy in which traditional angioplasty
techniques are used to relieve obstruction in the pulmonary arteries. This
review discusses the currently accepted indications, patient selection,
technical considerations, outcomes, and complications of contemporary BPA.
This review will address knowledge gaps and future perspectives in BPA
research. Copyright © 2025 by the authors.

<6>
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Accession Number
2037273694
Title
Economic Outcomes With Precision Diagnostic Testing Versus Usual Testing
in Stable Chest Pain: Results From the PRECISE Randomized Trial.
Source
Circulation: Cardiovascular Quality and Outcomes. (no pagination), 2025.
Article Number: 10.1161/CIRCOUTCOMES.123.011008. Date of Publication:
2025.
Author
Chew D.S.; Mark D.B.; Li Y.; Nanna M.G.; Kelsey M.D.; Daniels M.R.;
Davidson-Ray L.; Baloch K.N.; Rogers C.; Patel M.R.; Anstrom K.J.; Curzen
N.; Vemulapalli S.; Douglas P.S.
Institution
(Chew) Libin Cardiovascular Institute and O'Brien Institute for Public
Health, University of Calgary, Calgary, Canada
(Mark, Li, Kelsey, Daniels, Davidson-Ray, Baloch, Patel, Vemulapalli,
Douglas) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Mark, Kelsey, Patel, Vemulapalli, Douglas) Division of Cardiology, Duke
University Medical Center, Durham, NC, United States
(Nanna) Section of Cardiovascular Medicine, Yale University School of
Medicine, New Haven, CT, United States
(Rogers) HeartFlow, Inc, Mountain View, CA, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, United States
(Curzen) Faculty of Medicine, University of Southampton, Cardiothoracic
Unit, University Hospital Southampton, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The PRECISE (Prospective Randomized Trial of the Optimal
Evaluation of Cardiac Symptoms and Revascularization) demonstrated that a
precision diagnostic strategy reduced the primary composite of death,
nonfatal myocardial infarction, or catheterization without obstructive
coronary artery disease by 65% in patients with nonacute chest pain
compared with usual testing. Medical cost was a prespecified secondary end
point. METHOD(S): PRECISE randomized 2103 patients between December
2018 and May 2021 to usual testing or a precision strategy that used
deferred testing for the lowest risk patients (20%) and coronary computed
tomographic angiography with selective computed tomography-derived
fractional flow reserve for the remainder. Resource use consumption data
were collected from all study participants and hospital cost data from US
participants (n=1125) to estimate total medical costs. The primary and
secondary economic outcomes were total costs at 12 months and at 45 days,
respectively, from the US health care system perspective. The mean cost
differences between the 2 strategies were reported by intention-to-treat.
 RESULT(S): At 45 days, total costs were similar between the precision
strategy and usual testing (mean difference, $182 [95% CI, -$555 to
$661]). By 12 months, percutaneous coronary intervention and coronary
artery bypass surgery had been performed in 7.2% and 2.0% of precision
strategy patients and 3.5% and 1.7% of usual testing patients,
respectively. At 1 year, precision strategy costs were $5299 versus $4821
for usual testing (mean difference, $478 [95% CI, -$889 to $1437];
P=0.43). Precision care decreased mean per-patient diagnostic cost by 27%
and increased mean per-patient revascularization costs by 67%.
 CONCLUSION(S): In the PRECISE trial, the precision strategy, a
risk-based approach endorsed by current clinical practice guidelines,
improved the clinical efficiency of testing and had similar costs to usual
testing at 45 days and a nonsignificant $478 cost difference at 1
year. Copyright © 2025 The Authors.

<7>
Accession Number
2034656160
Title
Intracardiac vs transesophageal echocardiography for left atrial appendage
occlusion: An updated systematic review and meta-analysis.
Source
Heart Rhythm. 22(3) (pp 786-795), 2025. Date of Publication: 01 Mar 2025.
Author
Serpa F.; Rivera A.; Fernandes J.M.; Braga M.A.P.; Araujo B.; Ferreira
Felix I.; Ferro E.G.; Zimetbaum P.J.; d'Avila A.; Kramer D.B.
Institution
(Serpa, Ferro, Zimetbaum, Kramer) Richard A. and Susan F. Smith Center for
Outcomes Research, Beth Israel Deaconess Medical Center and Harvard
Medical School, Boston, Massachusetts, United States
(Serpa) Division of Internal Medicine, University of Texas Southwestern
Medical Center, Dallas, Texas, United States
(Rivera, Araujo) Department of Medicine, Nove de Julho University, Sao
Bernardo do Campo, Brazil
(Fernandes) Department of Medicine, Albert Einstein University, Sao Paulo,
Brazil
(Braga) Department of Medicine, Federal University of Rio de Janeiro, Rio
de Janeiro, Brazil
(Ferreira Felix) Department of Internal Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Ferro, Zimetbaum, d'Avila, Kramer) Division of Cardiology, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts,
United States
Publisher
Elsevier B.V.
Abstract
Background: Multiple studies continue to evaluate the use of intracardiac
echocardiography (ICE) and transesophageal echocardiography (TEE) for
guiding left atrial appendage occlusion (LAAO). Objective(s): The
purpose of this study was to conduct an updated meta-analysis comparing
the effectiveness and safety outcomes of both imaging modalities.
 Method(s): PubMed, Cochrane, and Embase were searched for studies
comparing ICE vs TEE to guide LAAO. Odds ratios (ORs) with 95% confidence
intervals (CIs) were pooled using a random-effects model. The primary
effectiveness endpoint was procedural success. The primary safety endpoint
included the overall complications rate. Additional safety outcomes were
assessed as secondary endpoints. Subgroup analysis of primary endpoints
was conducted according to device type (Amulet, LAmbre, Watchman, Watchman
FLX) and study region (American, Asia, Europe). R Version 4.3.1 was used
for all statistical analyses. Result(s): Our meta-analysis included
19 observational studies encompassing 42,474 patients, of whom 4415
(10.4%) underwent ICE-guided LAAO. Compared with TEE, ICE was associated
with a marginally higher procedural success (OR 1.33; 95% CI 1.01-1.76; P
= .04; I2 = 0%). There was no significant difference in the
overall complications rate (OR 1.02; 95% CI 0.77-1.36; P = .89;
I2 = 5%). However, ICE showed higher rates of pericardial
effusion (OR 2.11; 95% CI 1.47-3.03; P <.001; I2 = 0%) and
residual iatrogenic atrial septal defect (iASD) (OR 1.52; 95% CI
1.15-2.03; P <.004; I2 = 0%). Subgroup analysis revealed
variations in procedural success within the ICE group across study regions
(P = .02). Conclusion(s): In this updated meta-analysis, the
increasing adoption of ICE-guided LAAO demonstrated higher procedural
success rates compared to TEE, although with limited statistical
significance. Overall complication rates were similar; however, ICE showed
higher rates of pericardial effusion and residual iASD. Copyright
© 2024 Heart Rhythm Society

<8>
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Accession Number
2037345705
Title
Fibrinolytic activity in infants undergoing cardiac surgery on
cardiopulmonary bypass with routine tranexamic acid: A prospective cohort
substudy within the FIBrinogen CONcentrate randomised control trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 10.1097/EJA.0000000000002124. Date of Publication: 2025.
Author
Siemens K.; Parmar K.; Harris J.; Hunt B.J.; Tibby S.M.
Institution
(Siemens, Harris, Tibby) PICU Evelina London Children's Hospital, London,
United Kingdom
(Parmar, Hunt) Thrombosis and Vascular Biology Group, London, United
Kingdom
(Parmar, Hunt) Thrombosis and Haemophilia Centre and Thrombosis and
Vascular Biology Group, Guy's and St Thomas NHS Foundation Trust, London,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Fibrinolytic activity contributes to bleeding after
cardiopulmonary bypass (CPB). OBJECTIVE Our objectives were, in a group of
infants undergoing cardiac surgery with CPB: To document the extent of
peri-operative fibrinolysis using rotational thromboelastometry (ROTEM)
and standard biomarkers; to compare the agreement between these
fibrinolytic measures; to assess whether fibrinolytic activity is
associated with early postoperative mediastinal bleeding and assess
whether supplementation with fibrinogen concentrate affected fibrinolysis.
DESIGN Prospective cohort, mechanistic substudy, nested within the
FIBrinogen CONcentrate (FIBCON) randomised controlled trial. SETTING
Single centre, tertiary paediatric cardiac surgery and paediatric
intensive care units. PATIENTS Ninety infants (median age 6.3months)
undergoing cardiac surgery, who all received routine intra-operative
tranexamic acid. The infants were randomised to receive either an
individualised dose of fibrinogen concentrate (n=60) or placebo (n=30)
during CPB. MAIN OUTCOME MEASURES We measured the ROTEM variable maximum
clot lysis (ML), and fibrinolytic biomarkers including plasmin-Antiplasmin
(PAP) and tissue plasminogen activator antigen (tPA-Ag). Blood was sampled
pre-CPB, on-CPB and post-CPB, and 4h after PICU admission. RESULTS tPA-Ag,
PAP and ROTEM ML increased significantly after CPB despite the use of
tranexamic acid. The two fibrinolytic biomarkers t-PA and PAP, correlated
(P=0.001) but neither correlated with ROTEM ML. Early postoperative blood
loss was inversely associated with PAP levels. Each 100mugl-1 rise in PAP
was associated with a 7.9% reduction in mean blood loss. Fibrinogen
concentrate supplementation as expected did not affect tPA-Ag but was
temporally associated with an increase in PAP levels and a decrease in
ROTEM fibrinolytic activity. CONCLUSION Fibrinolysis is activated after
paediatric cardiac CPB surgery as indicated by increased tPA-Ag and ROTEM
ML. The substantial increase in tPA-Ag post-PICU admission is probably
accompanied by a similar rise of plasminogen activator inhibitor 1 (PAI-1)
as part of the acute phase response to surgery, thereby limiting clinical
fibrinolysis. Supplementation of fibrinogen concentrate was associated
with increased PAP activity and less clinical bleeding, consistent with
the known role for fibrinogen in being a substrate for plasmin. TRIAL
REGISTRATION ISCTRN:50553029, Eudract:2013-003532-68. Copyright ©
2025 European Society of Anaesthesiology and Intensive Care.

<9>
Accession Number
2036985791
Title
The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on
Surgical Management of Oligometastatic Non-small Cell Lung Cancer.
Source
Annals of Thoracic Surgery. 119(3) (pp 495-508), 2025. Date of
Publication: 01 Mar 2025.
Author
Antonoff M.B.; Mitchell K.G.; Kim S.S.; Salfity H.V.; Kotova S.; Ripley
R.T.; Neri A.L.; Sood P.; Gandhi S.G.; Elamin Y.Y.; Donington J.S.; Jones
D.R.; David E.A.; Swisher S.G.; Opitz I.; Hayanga J.W.A.; Rocco G.
Institution
(Antonoff, Mitchell, Swisher) Division of Surgery, Department of Thoracic
and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center,
Houston, TX, United States
(Kim) Canning Thoracic Institute, Northwestern Memorial Hospital,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Salfity) Division of Thoracic Surgery, Department of Surgery, Duke
University, Durham, NC, United States
(Kotova) Department of Pulmonary, Critical Care and Thoracic Surgery,
Peacehealth Southwest, Vancouver, WA, United States
(Kotova) Division of Thoracic Surgery, Oregon Health and Science
University School of Medicine, Portland, OR, United States
(Ripley) Division of Thoracic Surgery, Michael E. DeBakey Department of
Surgery, Baylor College of Medicine, Houston, TX, United States
(Neri, Sood) The Society of Thoracic Surgeons, Chicago, IL, United States
(Gandhi) Division of Radiation Oncology, Department of Thoracic Radiation
Oncology, University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Elamin) Department of Head and Neck/Thoracic Medical Oncology, University
of Texas MD Anderson Cancer Center, Houston, TX, United States
(Donington) Biological Sciences Division, Department of Surgery, The
University of Chicago Medicine, Chicago, IL, United States
(Jones, Rocco) Thoracic Surgery Service, Department of Surgery, Memorial
Sloan Kettering Cancer Center, New York, NY, United States
(David) Division of Cardiothoracic Surgery, University of Colorado,
Anschutz Medical Campus, Aurora, CO, United States
(Opitz) Department of Thoracic Surgery, University Hospital Zurich,
Zurich, Switzerland
(Hayanga) Department of Cardiothoracic and Vascular Surgery, West Virginia
University Medicine, Morgantown, WV, United States
Publisher
Elsevier Inc.
Abstract
Background: The use of local consolidative therapy (LCT) in patients with
oligometastatic non-small cell lung cancer (NSCLC) is rapidly evolving,
with a preponderance of data supporting the benefits of such therapeutic
approaches incorporating pulmonary resection for appropriately selected
candidates. However, practices vary widely institutionally and regionally,
and evidence-based guidelines are lacking. Method(s): The Society of
Thoracic Surgeons assembled a panel of thoracic surgical oncologists to
evaluate and synthesize the available evidence regarding the role of
pulmonary resection as LCT. Clinical and research questions of interest
were identified, and a complete literature review was conducted. Best
practice guidelines were developed accordingly. Result(s): The panel
identified 7 areas of controversy, and data were assimilated to support
the best recommended practices related to these clinical issues.
Ultimately, a number of issues in this realm were found to have a high
level of evidence to support the role for surgical therapy in patients
with stage IV lung cancer. However, the nuances of how these operations
are conducted remain in equipoise, without ample evidence to support the
extent of resection or nodal dissection. Conclusion(s): Clear data
exist to support the use of surgical resection of the primary lung tumor
as LCT in stage IV lung cancer. Evidence-based recommendations have been
provided to guide multidisciplinary teams on the implementation of
treatment plans as well as to guide researchers on areas of ongoing need
for further investigation. Copyright © 2025 The Society of
Thoracic Surgeons

<10>
Accession Number
2037383687
Title
Passing the learning curve in robotic mitral valve repair - what do we
know in 2025?.
Source
European Journal of Cardio-thoracic Surgery. 67(2) (no pagination), 2025.
Article Number: ezaf012. Date of Publication: 01 Feb 2025.
Author
Bonatti J.
Institution
(Bonatti) Department of Cardiothoracic Surgery, University of Pittsburgh
School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, PA,
United States
Publisher
European Association for Cardio-Thoracic Surgery

<11>
Accession Number
2037346925
Title
Current evidence and indications for left atrial appendage closure.
Source
Journal of Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Shinohara M.; Saji M.; Koike H.; Ohara H.; Enomoto Y.; Nakanishi R.;
Fujino T.; Ikeda T.
Institution
(Shinohara) Helmsley Electrophysiology Center, Department of Cardiology,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Shinohara, Saji, Koike, Ohara, Nakanishi, Fujino, Ikeda) Division of
Cardiovascular Medicine, Department of Internal Medicine, Toho University
Faculty of Medicine, Tokyo, Japan
(Enomoto) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Tokyo, Japan
(Enomoto) Division of Cardiology, National Center for Global Health and
Medicine Hospital, Tokyo, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Atrial fibrillation (AF) is the most common arrhythmia worldwide and its
prevalence increases with age. The main and most severe complication of AF
is ischemic stroke, yet an estimated 50 % of eligible patients cannot
tolerate or are contraindicated to receive oral anticoagulation (OAC). In
patients with AF, the left atrial appendage (LAA) is the main source of
thrombus formation. Percutaneous LAA closure (LAAC) has emerged over the
past two decades as a valuable alternative to OAC for reducing the risk of
strokes and systemic embolisms in patients with AF who cannot tolerate
long-term OAC. With newer generation devices such as the Watchman (Boston
Scientific, Natick, MA, USA) and Amulet (Abbott, Abbott Park, IL, USA)
gaining approval from the US Food and Drug Administration in recent years,
the safety and efficacy of LAAC in specific populations intolerant to OAC
have increased and more patients are being treated. This systematic review
provides the indications for LAAC and the evidence for evaluating the use
of the currently available device therapies. We also examine the current
unsolved problems with patient selection and postprocedural antithrombotic
regimens. Copyright © 2025 Elsevier Ltd

<12>
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Accession Number
2037348948
Title
Prognostic Implication of Preprocedural Pulmonary Hypertension in Patients
with Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-analysis.
Source
Cardiology in Review. 33(2) (pp 120-128), 2025. Date of Publication: 01
Mar 2025.
Author
Emami Meybodi M.; Bamarinejad A.; Bamarinejad F.; Abhari A.P.;
Fakhrolmobasheri M.; Khosravi Larijani F.; Nasiri S.; Shafie D.
Institution
(Emami Meybodi) Department of Cardiology, Afshar Hospital, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Bamarinejad, Bamarinejad, Abhari, Fakhrolmobasheri, Nasiri, Shafie) Heart
Failure Research Center, Isfahan Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Khosravi Larijani) Student Research Committee, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
Lippincott Williams and Wilkins
Abstract
Pulmonary hypertension (PH) is a common comorbidity in patients with
aortic stenosis (AS) who are candidates for transcatheter aortic valve
implantation (TAVI). Herein, we sought to elucidate the prognostic value
of preprocedural PH on the early and late mortality after TAVI. The
Cochrane Library, Scopus, PubMed, Web of Science, Embase, and ProQuest
were screened using a predefined search query. We considered odds ratios
(ORs) as the measure of effect. Meta-regression analysis was applied to
investigate the potential impact of baseline characteristics on the
outcomes. Egger's and Begg's tests were used to assess the publication
bias. Thirty-three studies comprising 34 datasets representing 68,435
patients were included in the analysis. Regardless of the definition and
severity of PH, pooled data analysis indicated that preprocedural PH was
associated with higher cardiac and overall 30-day [OR, 1.45 (1.15-1.82)
and OR, 1.75 (1.42-2.17), respectively], and 1-year mortality [OR, 1.63
(1.35-1.96) and OR, 1.59 (1.38-1.82), respectively]. Meta-regression
analysis demonstrated that older age, higher New York Heart Association
function class, history of hypertension, diabetes, and lower left
ventricular ejection fraction were predictors of higher mortality rate
following TAVI. Moreover, we found that preprocedural PH is significantly
associated with higher in-hospital mortality and 30-day acute kidney
injury. Our results demonstrated that preprocedural PH is associated with
higher early and late cardiac and overall mortality following TAVI;
however, this finding is limited regarding the considerable inconsistency
in the definition of PH and PH severity among studies. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<13>
Accession Number
2032711614
Title
Prognostic models for prediction of perioperative allogeneic red blood
cell transfusion in adult cardiac surgery: A systematic review and
meta-analysis.
Source
Transfusion. 65(2) (pp 397-409), 2025. Date of Publication: 01 Feb 2025.
Author
Van den Eynde R.; Vrancken A.; Foubert R.; Tuand K.; Vandendriessche T.;
Schrijvers A.; Verbrugghe P.; Devos T.; Van Calster B.; Rex S.
Institution
(Van den Eynde, Vrancken, Foubert, Schrijvers, Rex) Department of
Cardiovascular Sciences, Unit Anesthesiology and Algology, Biomedical
Sciences Group, University of Leuven (KU Leuven), Leuven, Belgium
(Tuand, Vandendriessche) KU Leuven Libraries - 2Bergen - Learning Centre
Desire Collen, Leuven, Belgium
(Verbrugghe) Department of Cardiovascular Sciences, Unit Cardiac surgery,
Biomedical Sciences Group, University of Leuven (KU Leuven), Leuven,
Belgium
(Devos) Department of Hematology, University Hospitals Leuven, and
Department of Microbiology and Immunology, Laboratory of Molecular
Immunology (Rega Institute), University of Leuven (KU Leuven), Leuven,
Belgium
(Van Calster) Department of Development and Regeneration, Unit Woman and
Child, University of Leuven (KU Leuven), Leuven, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Identifying cardiac surgical patients at risk of requiring red
blood cell (RBC) transfusion is crucial for optimizing their outcome. We
critically appraised prognostic models preoperatively predicting
perioperative exposure to RBC transfusion in adult cardiac surgery and
summarized model performance. Method(s): Design: Systematic review
and meta-analysis. Study eligibility criteria: Studies developing and/or
externally validating models preoperatively predicting perioperative RBC
transfusion in adult cardiac surgery. Information sources MEDLINE, CENTRAL
& CDSR, Embase, Transfusion Evidence Library, Web of Science, Scopus,
ClinicalTrials.gov, and WHO ICTRP. Risk of bias and applicability: Quality
of reporting was assessed with the Transparent Reporting of studies on
prediction models for Individual Prognosis or Diagnosis adherence form,
and risk of bias and applicability with the Prediction model Risk of Bias
ASsessment Tool. Synthesis methods: Random-effects meta-analyses of
concordance-statistics and total observed:expected ratios for models
externally validated >=5 times. Result(s): Nine model development,
and 27 external validation studies were included. The average TRIPOD
adherence score was 66.4% (range 44.1%-85.2%). All studies but 1 were
rated high risk of bias. For TRUST and TRACK, the only models externally
validated >=5 times, summary c-statistics were 0.74 (95% CI: 0.65-0.84; 6
contributing studies) and 0.72 (95% CI: 0.68-0.75; 5 contributing studies)
respectively, and summary total observed:expected ratios were 0.86 (95%
CI: 0.71-1.05; 5 contributing studies) and 0.94 (95% CI: 0.74-1.19; 5
contributing studies), respectively. Considerable heterogeneity was
observed in all meta-analyses. Discussion(s): Future high quality
external validation and model updating studies which strictly adhere to
reporting guidelines, are warranted. Copyright © 2024 The
Author(s). Transfusion published by Wiley Periodicals LLC on behalf of
AABB.

<14>
Accession Number
2037282686
Title
Five- Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER
3 Trial.
Source
Annals of Thoracic Surgery. 119(3) (pp 555-566), 2025. Date of
Publication: 01 Mar 2025.
Author
Thourani V.H.; Leon M.B.; Makkar R.; Ascione G.; Szeto W.Y.; Madhavan
M.V.; Kodali S.K.; Hahn R.T.; Pibarot P.; Malaisrie S.C.; Kapadia S.R.;
Russo M.J.; Herrmann H.C.; Babaliaros V.; Guyton R.; Genereux P.; Cohen
D.J.; Park B.; Clarke S.; Gunnarsson M.; Szerlip M.; Ternacle J.; Leipsic
J.; Blanke P.; Webb J.G.; Smith C.R.; Mack M.J.
Institution
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Leon, Madhavan, Kodali, Hahn, Cohen) Department of Medicine, Columbia
University Irving Medical Center/New York-Presbyterian Hospital, New York,
NY, United States
(Leon, Ascione, Madhavan, Hahn, Cohen) Cardiovascular Research Foundation,
New York, NY, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Szeto) Division of Cardiac Surgery, University of Pennsylvania,
Philadelphia, PA, United States
(Pibarot) Department of Medicine, Laval University, QC, Canada
(Malaisrie) Division of Cardiac Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Kapadia) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Russo) Department of Surgery, Rutgers Robert Wood Johnson Medical School,
New Brunswick, NJ, United States
(Herrmann) Cardiovascular Division, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Babaliaros, Guyton) Emory School of Medicine, Atlanta, GA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Park, Clarke, Gunnarsson) Edwards Lifesciences, Irvine, CA, United States
(Szerlip, Mack) Baylor Scott & White Healthcare, Plano, TX, United States
(Ternacle) Haut-Leveque Cardiology Hospital, CHU Bordeaux, Pessac, France
(Leipsic, Blanke, Webb) Centre for Cardiovascular Innovation, St. Paul's
Hospital, University of British Columbia, Vancouver, BC, Canada
(Smith) Department of Surgery, Columbia University Irving Medical
Center/New York-Presbyterian Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Surgery remains an important treatment for low-risk patients
with severe symptomatic aortic stenosis (AS). This study evaluated 5-year
outcomes in low-risk patients undergoing isolated surgical aortic valve
replacement (SAVR) or SAVR with concomitant procedures within the
randomized Placement of Aortic Transcatheter Valves (PARTNER) 3 trial.
 Method(s): In the PARTNER 3 trial, 454 patients underwent surgery for
severe, symptomatic, trileaflet AS and were followed up for 5 years.
Patients were stratified into those undergoing isolated SAVR (n = 334;
73.6%) vs concomitant SAVR (n = 120; 26.4%). Short- and long-term
morbidity was adjudicated by a Clinical Events Committee. Hemodynamic
valve performance was evaluated by an echocardiographic core laboratory.
Patient-reported health status was measured with the Kansas City
Cardiomyopathy Questionnaire (KCCQ). Result(s): The mean age of
participants was 73.6 +/- 6.1 years; 71.1% of these patients were male.
The median SAVR implant size was 23 mm overall. Five-year all-cause
mortality (with vital status sweep) was 9.0% for all patients (8.5%
isolated SAVR; 10.2% concomitant SAVR; P =.58), comparable to a recent
analysis of low-risk isolated SAVR-treated patients in the STS database
(overall mortality, 7.1%). The average 5-year mean gradient was 11.7 +/-
5.6 mm Hg overall. Reintervention rates were low in both groups (isolated
SAVR, 2.3% vs concomitant SAVR, 5.0%; P =.21), and most patients (isolated
SAVR, 87.9%; concomitant SAVR, 86.1%) were alive with no evidence of
bioprosthetic valve failure at 5 years. Conclusion(s): SAVR in
low-risk patients in the PARTNER 3 trial demonstrated excellent 5-year
outcomes. Five-year mortality was similar in patients undergoing isolated
SAVR vs concomitant SAVR. This result was comparable to recently published
national SAVR outcomes, thus demonstrating the generalizability of these
findings. Copyright © 2025 The Society of Thoracic Surgeons

<15>
Accession Number
2037318718
Title
Sex differences in ST-segment elevation myocardial infarction patients
treated by primary percutaneous intervention.
Source
Open Heart. 12(1) (no pagination), 2025. Article Number: e002831. Date of
Publication: 04 Jan 2025.
Author
Cook S.T.; Allemann L.; Cook M.; Arroyo D.A.; Pittet T.; Meier P.; Togni
M.; Brahim-Mathiron A.; Puricel S.; Cook S.
Institution
(Cook, Allemann, Cook, Arroyo, Pittet, Meier, Togni, Brahim-Mathiron,
Puricel, Cook) Cardiology, University Hospital Fribourg, Fribourg,
Switzerland
Publisher
BMJ Publishing Group
Abstract
Introduction The impact of sex on coronary artery disease prognosis is
debated. It has been postulated that women receive less prompt treatment
compared with men, potentially adversely affecting their prognosis by
significantly increasing the risk of morbidity and mortality. We aim to
investigate the influence of sex on the timing and clinical outcomes of
ST-segment elevation myocardial infarction (STEMI) patients using a
controlled Swiss registry. Methods and results Based on the Fribourg STEMI
Fast Track Registry, 1177 patients (288 women, 889 men) with >12 months
clinical follow-up were selected. Women had longer first medical contact
to reperfusion times (1.31 (1.14-2.00) vs 1.27 (1.09-1.54) hours, p=0.035)
but similar total ischaemic times (3.04 (2.15-4.50) vs 2.56 (2.07-4.38)
hours, p=0.064). Men had higher rates of diabetes, smoking and
dyslipidaemia, while women had higher hypertension and renal insufficiency
rates. No significant sex differences in clinical outcomes were observed
at 1-year and 5-year follow-ups. Discussion The study found sex
differences in patient profiles and minor treatment delays for women,
which did not significantly affect outcomes. Efforts to improve sex equity
in STEMI care are effective, as no significant outcome differences were
observed. Disparities are more related to patient characteristics than
sex. Conclusion Despite slight delays and different risk profiles for
women with STEMI, clinical outcomes are similar between sexes. Ongoing
efforts are needed to ensure sex equity in acute coronary syndrome
management. Trial registration number NCT04185285. Copyright ©
2025 BMJ Publishing Group. All rights reserved.

<16>
Accession Number
2033131697
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) (no pagination), 2025. Article Number: 17. Date of
Publication: 01 Dec 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, and 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, MBRU, Dubai Health, Dubai,
United Arab Emirates
Publisher
BioMed Central Ltd
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
© The Author(s) 2025.

<17>
Accession Number
2035736964
Title
Tranexamic Acid During Radical Cystectomy: A Randomized Clinical Trial.
Source
JAMA Surgery. 159(12) (pp 1355-1363), 2024. Date of Publication: 11 Dec
2024.
Author
Breau R.H.; Lavallee L.T.; Cagiannos I.; Momoli F.; Bryson G.L.; Kanji S.;
Morash C.; Turgeon A.F.; Zarychanski R.; Houston B.L.; McIsaac D.I.;
Mallick R.; Knoll G.A.; Kulkarni G.; Izawa J.; Saad F.; Kassouf W.; Fradet
V.; Rendon R.; Shayegan B.; Fairey A.; Drachenberg D.E.; Fergusson D.
Institution
(Breau, Lavallee, Kanji, McIsaac, Mallick, Fergusson) Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Cagiannos, Morash) Ottawa Hospital, Ottawa, ON, Canada
(Momoli) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Bryson, McIsaac) Departments of Anesthesiology and Pain Medicine,
University of Ottawa, Ottawa, ON, Canada
(Turgeon) Department of Anesthesiology and Critical Care Medicine,
Division of Critical Care Medicine, Universite Laval, Quebec City, QC,
Canada
(Turgeon) Population Health and Optimal Health Practices Research Unit,
Trauma-Emergency-Critical Care Medicine, CHU de Quebec - Universite Laval
Research Center, Quebec City, QC, Canada
(Zarychanski, Houston) Department of Internal Medicine, University of
Manitoba, Winnipeg, MB, Canada
(Zarychanski, Houston) Department of Medical Oncology and Haematology,
Cancercare Manitoba, Winnipeg, MB, Canada
(Knoll) Department of Medicine (Nephrology), The Ottawa Hospital, Ottawa,
ON, Canada
(Kulkarni) Division of Urology, Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Izawa) Department of Surgery & Oncology, Division of Urology, Western
University, London, ON, Canada
(Saad) University of Montreal Hospital Center (CHUM), Montreal Cancer
Institute, CRCHUM, Montreal, QC, Canada
(Kassouf) Department of Surgery (Urology), McGill University Health
Center, Montreal, QC, Canada
(Fradet) Department of Surgery (Urology), CHU de Quebec - Universite
Laval, Quebec City, QC, Canada
(Rendon) Department of Urology, Dalhousie University and Nova Scotia
Health Authority, Halifax, NS, Canada
(Shayegan) Division of Urology, McMaster University, Hamilton, ON, Canada
(Fairey) Division of Urology, University of Alberta, Edmonton, AB, Canada
(Drachenberg) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
Publisher
American Medical Association
Abstract
Importance: Among cancer surgeries, patients requiring open radical
cystectomy have the highest risk of red blood cell (RBC) transfusion.
Prophylactic tranexamic acid (TXA) reduces blood loss during cardiac and
orthopedic surgery, and it is possible that similar effects of TXA would
be observed during radical cystectomy. Objective(s): To determine
whether TXA, administered before incision and for the duration of radical
cystectomy, reduced the number of RBC transfusions received by patients up
to 30 days after surgery. Design, Setting, and Participant(s): The
Tranexamic Acid During Cystectomy Trial (TACT) was a double-blind,
placebo-controlled, randomized clinical trial with enrollment between June
2013 and January 2021. This multicenter trial was conducted in 10 academic
centers. A consecutive sample of patients was eligible if the patients had
a planned open radical cystectomy for the treatment of bladder cancer.
 Intervention(s): Before incision, patients in the intervention arm
received a loading dose of intravenous TXA, 10 mg/kg, followed by a
maintenance infusion of 5 mg/kg per hour for the duration of the surgery.
In the control arm, patients received indistinguishable matching placebo.
 Main Outcomes and Measures: The primary outcome was receipt of RBC
transfusion up to 30 days after surgery. Result(s): A total of 386
patients were assessed for eligibility, and 33 did not meet eligibility.
Of 353 randomized patients (median [IQR] age, 69 [62-75] years; 263 male
[74.5%]), 344 were included in the intention-to-treat analysis. RBC
transfusion up to 30 days occurred in 64 of 173 patients (37.0%) in the
TXA group and 64 of 171 patients (37.4%) in the placebo group (relative
risk, 0.99; 95% CI, 0.83-1.18). There were no differences in secondary
outcomes among the TXA group vs placebo group including mean (SD) number
of RBC units transfused (0.9 [1.5] U vs 1.1 [1.8] U; P =.43), estimated
blood loss (927 [733] mL vs 963 [624] mL; P =.52), intraoperative
transfusion (28.3% [49 of 173] vs 24.0% [41 of 171]; P =.08), or venous
thromboembolic events (3.5% [6 of 173] vs 2.9% [5 of 171]; P =.57).
Non-transfusion-related adverse events were similar between groups.
 Conclusions and Relevance: Results of this randomized clinical trial
reveal that TXA did not reduce blood transfusion in patients undergoing
open radical cystectomy for bladder cancer. Based on this trial, routine
use of TXA during open radical cystectomy is not
recommended. Copyright © 2024 American Medical Association. All
rights reserved.

<18>
Accession Number
2033040641
Title
RETRACTION: The Connotation Between Perioperative Glycemic Control
Approach and Sternal Wound Infection in Individuals With Diabetes Mellitus
Experiencing Cardiac Surgery: A Meta-Analysis(International Wound Journal,
(2023), 20, 8, (3324-3330), 10.1111/iwj.14213).
Source
International Wound Journal. 22(2) (no pagination), 2025. Article Number:
e70209. Date of Publication: 01 Feb 2025.
Author
Tan G.; Li Y.; Zhou G.
Publisher
John Wiley and Sons Inc
Abstract
RETRACTION: G. Tan, Y. Li, and G. Zhou, "The Connotation Between
Perioperative Glycemic Control Approach and Sternal Wound Infection in
Individuals With Diabetes Mellitus Experiencing Cardiac Surgery: A
Meta-Analysis," International Wound Journal 20, no. 8 (2023): 3324-3330,
https://doi.org/10.1111/iwj.14213. The above article, published online on
15 May 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/),
has been retracted by agreement between the journal Editor in Chief,
Professor Keith Harding; and John Wiley & Sons Ltd. Following an
investigation by the publisher, all parties have concluded that this
article was accepted solely on the basis of a compromised peer review
process. The editors have therefore decided to retract the article. The
authors did not respond to our notice regarding the
retraction. Copyright © 2025 The Author(s). International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<19>
Accession Number
2032504495
Title
Melatonin ameliorates inflammation and improves outcomes of
ischemia/reperfusion injury in patients undergoing coronary artery bypass
grafting surgery: a randomized placebo-controlled study.
Source
Apoptosis. 30(1) (pp 267-281), 2025. Date of Publication: 01 Feb 2025.
Author
Casper E.A.; Wakeel L.E.; Sabri N.A.; Khorshid R.; Gamal M.A.; Fahmy S.F.
Institution
(Casper, Wakeel, Sabri, Fahmy) Department of Clinical Pharmacy, Faculty of
Pharmacy, Ain Shams University, Ankara Street, Sheraton buildings, Cairo,
Egypt
(Khorshid, Gamal) Department of Cardiovascular and Thoracic Surgery, Ain
Shams University Hospital, Faculty of Medicine, Ain Shams University,
Cairo, Egypt
Publisher
Springer
Abstract
To investigate the protective role of high dose melatonin concerning
myocardial I/R injury and inflammation in patients undergoing on-pump
coronary artery bypass grafting (CABG) surgery by evaluating
IR/inflammatory biomarkers and clinical outcomes. This was a prospective;
randomized; single-blinded placebo-controlled study conducted at
cardio-thoracic surgery department of the Academy of the Cardiovascular
and Thoracic Surgery, Ain Shams University. Eligible patients were
randomly allocated to; melatonin-treated group (MTG) or placebo-treated
group (PTG). The MTG (n = 17) received 60 mg/day melatonin capsules daily
starting 5 days before surgery in addition to the standard of care. PTG (n
= 17) received placebo also 5 days before surgery plus standard of care.
The levels of nuclear factor kappa beta (NF-kappab) (primary outcome),
tumor necrosis factor (TNF-alpha), cardiac troponins I, and IL-6 levels
were all assessed for both groups at five time points: baseline before
melatonin or placebo administration (T0), before cross-clamp
application(T1), 5 min after cross-clamp removal(T2), 6 h after
cross-clamp removal(T3) and 24 h after cross-clamp removal(T4). Blood
pressure was assessed at baseline, pre-operative and 24-hours
post-operative. The Quality of recovery-40 score (QOR-40) was assessed for
both groups on day 4 after surgery. TNF-alpha levels decreased in the MTG
at T1(p = 0.034) versus PTG. At T2(p = 0.005), and T3(p = 0.04), TNF-alpha
significantly increased in PTG versus MTG. Troponins significantly
increased in PTG at T3 (p = 0.04) versus MTG. NF-kappaB levels declined at
T1 (p = 0.013) and T2 (p = 0.0001) in MTG compared to PTG. IL-6
significantly increased in PTG versus MTG at T3 (p = 0.04). The QOR-40
score significantly decreased in MTG versus PTG. MTG had statistically
significant decrease in DBP compared to the placebo group (p = 0.024). MTG
had a statistically significant shorter intubation time than did the
placebo group (p = 0.03). Melatonin 60 mg was well-tolerated without any
reported side effects. Our findings suggested that melatonin could
ameliorate myocardial I/R injury after on-pump CABG and that this outcome
was essentially correlated to its antiapoptotic and anti-inflammatory
effects. Trial registration: ClinicalTrials.gov registration number
NCT05552586, 9/2022. Copyright © The Author(s) 2024.

<20>
Accession Number
2031411326
Title
Cardiac metastasis in uterine cervical cancer: A systematic review and
case study.
Source
Strahlentherapie und Onkologie. 201(1) (pp 71-81), 2025. Date of
Publication: 01 Jan 2025.
Author
Simek I.-M.; Sturdza A.; Knoth J.; Spannbauer A.; Bergler-Klein J.;
Vogele-Kadletz M.; Widder J.; Schmid M.P.
Institution
(Simek, Sturdza, Knoth, Widder, Schmid) Department of Radiation Oncology,
Comprehensive Cancer Center, Medical University of Vienna, General
Hospital of Vienna, Wahringer Gurtel 18-20, Vienna, Austria
(Spannbauer, Bergler-Klein) Department of Cardiology, Medical University
of Vienna, General Hospital of Vienna, Vienna, Austria
(Vogele-Kadletz) Department of Cardiac Surgery, Medical University of
Vienna, General Hospital of Vienna, Vienna, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Cardiac metastasis from cervical cancer is rare and only scarcely
documented. We aim to present a new case and systematically summarize the
available literature. Material(s) and Method(s): PubMed, Scopus, Web
of Science, Central, and ClinicalTrials.gov were systematically searched
following the PRISMA (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses) criteria. Results were screened via title, abstract, and
full text. Additionally, the reference lists of all papers chosen for the
review were screened. Result(s): Eighty-one papers were identified,
describing 86 cases in total. Cardiac metastasis occurred at all stages of
cervical cancer and in all age groups. Median time from initial diagnosis
to diagnosis of cardiac metastasis was 12 months. Patients mainly
complained of dyspnea and chest pain, 60.8% had pathologic ECG
(electrocardiographic) findings. The cardiac mass was most frequently
detected by transthoracic echography. The most common tumor histology was
squamous cell carcinoma. Chemotherapy and surgical interventions were the
main treatment modalities. Median survival after diagnosis of cardiac
metastasis was 3 months. Conclusion(s): This largest review on
cardiac metastases from cervical cancer confirmed the heart as a very
infrequent site of metastasis. There are < 100 cases described in the
literature, with very poor prognosis and undefined clinical
management. Copyright © The Author(s) 2024.

<21>
Accession Number
2032702198
Title
Characterizing the antibody response to amustaline/glutathione
pathogen-reduced red blood cells.
Source
Transfusion. 65(2) (pp 344-353), 2025. Date of Publication: 01 Feb 2025.
Author
Karim C.; Panigrahi A.; Pearl R.G.; Sodha N.R.; Beaver T.M.; Pelletier
J.P.R.; Nuttall G.A.; Reece T.B.; Erickson A.; Hedrick T.; Liu K.; Bentow
S.; Corash L.; Mufti N.; Varrone J.; Benjamin R.J.
Institution
(Karim, Erickson, Hedrick, Liu, Bentow, Corash, Mufti, Varrone, Benjamin)
Cerus Corporation, Concord, CA, United States
(Panigrahi, Pearl) Stanford University, Stanford, CA, United States
(Sodha) Rhode Island Hospital, Providence, RI, United States
(Beaver, Pelletier) University of Florida, Gainesville, FL, United States
(Nuttall) Mayo Clinic, Rochester, MN, United States
(Reece) University of Colorado Hospital, Denver, CO, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The clinical significance of natural and treatment-emergent
antibodies specific for amustaline/glutathione pathogen-reduced red blood
cells (PRRBCs) is not known. Study Design and Methods: A Phase 3,
randomized clinical trial of PRRBCs (ReCePI) compared PRRBCs with
conventional RBCs in cardiac or thoracic-aorta surgery. Subjects
transfused during and for 7 days after surgery were screened for
PRRBC-specific antibodies at baseline, 28 and 75 days post-surgery.
Subjects with treatment-emergent antibodies were assessed for evidence of
hemolysis. Cryopreserved subject RBC samples were assayed by flow
cytometry for circulating PRRBCs using an acridine-specific (2S197-2M1)
monoclonal antibody, and for human IgG-coated RBCs. RBC-surface acridine
density was quantitated using a commercial calibrated phycoerythrin
(PE)-bead panel. Result(s): Five of 159 (3.1%) PRRBC and zero of 162
conventional RBC recipients developed treatment-emergent PRRBC-specific
IgG, low titer antibodies detected 26-80 days post-surgery after exposure
to 1-3 PRRBC units, without clinical evidence of hemolysis. DAT and eluate
were weak (w+) positive and PRRBC-specific in one subject. A monocyte
monolayer assay (MMA) was non-reactive in the three subjects with an
interpretable result. Flow cytometry demonstrated circulating PRRBCs in
all five subjects expressing surface acridine concentrations at the limit
of detection (approximately 150-301 PE molecules/RBC) compared with
freshly transfused PRRBCs (approximately 7500 PE molecules/RBC). In some
samples, loss of surface acridine expression could not be distinguished
from clearance of the PRRBCs. Discussion(s): Treatment-emergent
PRRBC-specific antibodies with the characteristics of nonclinically
significant antibodies were detected in five subjects transfused with
PRRBCs. Flow cytometry demonstrated persistent circulating PRRBCs with
minimal surface acridine expression. (www.ClinicalTrials.gov Identifier
NCT03459287). Copyright © 2024 The Author(s). Transfusion
published by Wiley Periodicals LLC on behalf of AABB.

<22>
[Use Link to view the full text]
Accession Number
2034298316
Title
Proton-Pump Inhibitors and Cardiovascular Adverse Events: A Meta-Analysis
of Randomized Controlled Trials.
Source
American Journal of Gastroenterology. 120(2) (pp 362-369), 2025. Date of
Publication: 01 Feb 2025.
Author
Mosholder A.D.; Hada M.; Leishear K.
Institution
(Mosholder, Leishear) Division of Epidemiology 1, US Food and Drug
Administration Center for Drug Evaluation and Research, Silver Spring, MD,
United States
(Hada) Formerly with Division of Epidemiology 1, US Food and Drug
Administration Center for Drug Evaluation and Research, Silver Spring, MD,
United States
Publisher
Wolters Kluwer Health
Abstract
INTRODUCTION: Some observational studies suggest a cardiovascular risk
from proton-pump inhibitor (PPI) treatment, but observational data may be
subject to bias. We conducted a meta-analysis of randomized controlled
trial data on cardiovascular events during PPI treatment. METHOD(S):
Manufacturers of PPIs provided data from their PPI clinical trial
programs. We included randomized trials with at least 100 subjects,
treatment duration >30 days, and a non-PPI comparator (active or placebo).
We obtained person-time of exposure per trial, to calculate summary
incidence rate ratios (primary analysis) and incident rate differences
(secondary analysis). Our primary composite outcome was major adverse
cardiovascular events-plus (MACE1), which included nonfatal myocardial
infarction, nonfatal stroke, fatal cardiovascular adverse events,
hospitalization for unstable angina, or coronary revascularization; events
were adjudicated blindly. RESULT(S): Cardiovascular outcomes were
infrequent in randomized trials of PPIs, and our primary analysis found no
overall association (summary incident rate ratio, MACE1 events,
PPI:placebo, 0.72) (95% confidence interval 0.42-1.26). There was some
heterogeneity by indication category, and by the incidence rate difference
metric, gastroesophageal reflux disorder trials had 1.04 (95% confidence
interval 0.58-1.50) excess MACE1 events per 100 person-years of treatment
vs placebo. Comparisons with active controls generally showed positive
incidence rate differences with PPI treatment. DISCUSSION(S):
Overall, we found no association of cardiovascular events with PPI
treatment. Cardiovascular events appeared more frequent with PPI treatment
in gastroesophageal reflux disorder trials, but results from this subgroup
should be interpreted with the limitations of the analysis in mind,
including sparse outcome counts and lack of individual patient
data. Copyright © 2024 by The American College of
Gastroenterology.

<23>
Accession Number
2035596408
Title
Carotid Artery Compression in Preventing Postoperative Cognitive
Dysfunction in Patients Undergoing Mitral Valve Replacement Surgery: A
Randomized Clinical Trial.
Source
Sri Lankan Journal of Anaesthesiology. 33(1) (pp 25-35), 2025. Date of
Publication: 2025.
Author
Bakry M.A.; Desouky A.A.; Soliman D.; Kaddah R.A.; Youssef M.M.I.; Mitri
R.M.
Institution
(Bakry, Desouky, Soliman, Kaddah, Youssef, Mitri) Department of
Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of
Medicine, Cairo University, Cairo, Egypt
Publisher
College of Anaesthesiologists of Sri Lanka
Abstract
Background: The efficacy of manual carotid artery compression in reducing
cerebral embolization during cardiac surgeries is a topic of debate.
 Aim(s): This study aimed to assess the safety and efficacy of carotid
artery compression in preventing postoperative cognitive dysfunction
(POCD) in patients undergoing mitral valve replacement surgery.
Methodology: This randomized, double-blind, parallel-group clinical trial
enrolled 120 adult patients scheduled for mitral valve replacement
surgery. The patients were randomly assigned to two groups of 60 patients
each. Group C underwent carotid artery compression using three fingers
(index, middle, and ring fingers) along the path of the artery for 20
seconds following aortic declamping, while group NC did not undergo
carotid artery compression. The study's primary outcome was the incidence
rate of POCD at 5-7 days and the Mini-Mental State Examination score.
Secondary outcomes included the incidence rate of POCD after 6 weeks
postoperatively and transcranial Doppler readings. Result(s): The
incidence rates of POCD at 5-7 days and after 6 weeks postoperatively were
comparable in both groups (p=0.163 and 0.364, respectively). Additionally,
the Mini-Mental State Examination score and transcranial Doppler results
were comparable between the groups before and after surgery. The incidence
of cognitive dysfunction in the NC group at 5 days postoperatively was
significantly associated with older age, shorter surgical duration, and
reduced middle cerebral artery velocity by transcranial Doppler.
 Conclusion(s): Carotid artery compression does not prevent cognitive
dysfunction after mitral valve replacement surgery. However, no additional
harm is associated with carotid compression. Copyright © 2025,
College of Anaesthesiologists of Sri Lanka. All rights reserved.

<24>
Accession Number
2037393591
Title
Integrating Quality Metrics with Enhanced Recovery Pathways in Coronary
Artery Bypass Grafting.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Phillips K.G.; Galloway A.; Grossi E.A.; Swistel D.; Smith D.E.; Mosca R.;
Zias E.
Institution
(Phillips, Galloway, Grossi, Swistel, Smith, Mosca, Zias) Department of
Cardiothoracic Surgery, Division of Cardiac Surgery, NYU Langone Health,
New York, New York, United States
Publisher
W.B. Saunders
Abstract
Quality improvement and enhanced recovery initiatives for coronarybypass
surgery have reduced complications, shortened hospital stay and recovery
times, and improved patient outcomes. Beyond the Society of Thoracic
Surgery's (STS) quality metrics, many other operative measures, such as
completeness of revascularization, and patient care measures add quality
and value for patients undergoing coronary artery bypass surgery; and
Enhanced Recovery after Surgery (ERAS) protocols have improved patient
experience and recovery, leading to better outcomes and significant
healthcare savings. Copyright © 2025 Elsevier Inc.

<25>
Accession Number
2033120686
Title
The effect of preoperative deep breathing exercise with incentive
spirometer initiated in the preoperative period on respiratory parameters
and complications in patients underwent open heart surgery: a randomized
controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 36. Date
of Publication: 01 Dec 2025.
Author
Oner Cengiz H.; Ulusan Ozkan Z.; Gani E.
Institution
(Oner Cengiz) Ankara University Faculty of Nursing, Department of Nursing,
Department of Surgical Diseases Nursing, Ankara, Turkey
(Ulusan Ozkan, Gani) Ankara Training and Research Hospital, Cardiovascular
Surgery Clinic, Ankara, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: Incentive spirometer is used in lung expansion therapy to
maintain alveolar patency and improve pulmonary volumes in postoperative
cardiac surgical patients. Deep breathing exercises with an incentive
spirometer significantly reduce the development of postoperative pulmonary
complications after open-heart cardiac surgery. Aim(s): To determine
the effect of deep breathing exercises with an incentive spirometer
initiated in the preoperative period on respiratory parameters and
complications in patients who underwent open-heart surgery.
 Method(s): This randomized controlled study was conducted with a
total of 66 participants. The participants were randomized into a deep
breathing group (n = 32) and a control group (n = 34). The control group
received hospital routine physiotherapy, and the deep breathing group
started to perform deep breathing exercises with an incentive spirometer
in the preoperative period. Data were collected with the Sociodemographic
and Medical Data Form and Patient Follow-up Form (respiratory rate, oxygen
saturation (SpO<inf>2</inf>) level, arterial blood gas parameters and
posteroanterior chest X-ray were monitored with this form prepared by the
investigators). The Medical Research Council Scale was used to determine
the severity of dyspnea in the patients included in the study. Primary
outcomes included respiratory rate, oxygen saturation, arterial blood gas
parameters, posteroanterior chest X-ray, and evaluation of postoperative
pulmonary complications development. Secondary outcomes included the
mechanical ventilation time, length of intensive care unit stay, and
length of hospital stay. Result(s): The incidence of postoperative
pulmonary complications was 3.1% and 23.5% (p < 0.05) in the deep
breathing and control groups, respectively. The mechanical ventilation
time, length of hospital stay, and length of stay in the intensive care
unit were significantly shorter in the deep breathing group (p < 0.05). In
the deep breathing group, the mean SpO<inf>2</inf> values evaluated before
surgery, on the first day in the Cardiovascular Surgery Unit, and on the
day of discharge were significantly higher than the control group (p <
0.05). Conclusion(s): Deep breathing exercises with an incentive
spirometer initiated in the preoperative period contribute to a reduction
in postoperative pulmonary complication rates, shortening of mechanical
ventilation time, length of stay in the intensive care unit, length of
hospital stay, and improvement of pre- and postoperative oxygenation.
Trial registration: The trial was registered on June 17, 2022, at
https://www.clinicaltrials.gov/, registration number
NCT05428722. Copyright © The Author(s) 2025.

<26>
Accession Number
2037281963
Title
Impact of neuromuscular block monitoring and reversal on postoperative
pulmonary complications in thoracic surgery: a Bayesian analysis of the
iPROVE-OLV trial.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Mazzinari G.; Diaz-Cambronero O.; Garutti I.; Errando C.L.; Ferrando C.
Institution
(Mazzinari, Diaz-Cambronero) Department of Anesthesiology and Pain
Medicine, Hospital Universitario y Politecnico la Fe, Valencia, Spain
(Mazzinari, Diaz-Cambronero) Perioperative Medicine Research Group,
Instituto de Investigacion Sanitaria la Fe, Valencia, Spain
(Mazzinari) Department of Statistics and Operational Research, Universidad
de Valencia, Valencia, Spain
(Garutti) Department of Anesthesiology, Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Errando) Department of Anesthesiology, Consorcio Hospital General
Universitario, Valencia, Spain
(Ferrando) Department of Anesthesia and Critical Care, Hospital Clinic i
Provincial, Barcelona, Spain
(Ferrando) CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos
III, Madrid, Spain
Publisher
Elsevier Ltd
Abstract
Background: Postoperative pulmonary complications (PPCs) are a significant
concern in thoracic surgery. A modifiable factor influencing PPCs is
postoperative residual neuromuscular block (NMB), which impairs
respiratory muscle function. Method(s): We performed a post hoc
Bayesian analysis of data from the iPROVE-OLV study, a multicentre
randomised controlled trial involving patients undergoing thoracic surgery
with one-lung ventilation. We compared participants managed with any
neuromuscular monitoring and any reversal vs those managed without either.
The primary outcome was the occurrence of a composite of PPCs within the
first 7 postoperative days. Result(s): Of the 698 patients included,
657 received any neuromuscular monitoring and any reversal, while 41 did
not. Patients managed with any neuromuscular monitoring and any reversal
had a lower incidence of PPCs (20%) compared with those without either
(34%). Bayesian random effect logistic regression indicated that the use
of any neuromuscular monitoring and any reversal reduced PPCs with an odds
ratio (OR) ranging from 0.67 (95% credibility interval, CrI, 0.39-1.11) to
0.84 (95% CrI 0.48-1.37), depending on the prior model used. The
probability of benefit (OR <1) was between 77% and 94%. Subgroup analysis
indicated that sugammadex was more effective than neostigmine in reducing
PPCs, with a high probability of benefit (97%), and both neuromuscular
monitoring and reversal reduced PCCs when evaluated separately with a high
probability of benefit. Conclusion(s): Utilising neuromuscular
monitoring and reversal agents significantly reduced the risk of PPCs in
thoracic surgery. Sugammadex was more efficacious in reducing PPCs
compared with neostigmine. These findings support the combined use of
neuromuscular monitoring and reversal drugs. Clinical trial registration:
NCT03182062. Copyright © 2024 British Journal of Anaesthesia

<27>
Accession Number
2033120700
Title
The effect of local anaesthetic agents on opioid use and recovery in
patients undergoing open heart surgery: a randomized controlled study.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
72. Date of Publication: 01 Dec 2025.
Author
Azizoglu H.; Asam M.; Gurkan Z.; Bozkurt Y.; Demir C.
Institution
(AzIZoGLu) Faculty of Health Sciences, Nursing, Van Yuzuncu Yil
University, Van, Turkey
(ASAm, Bozkurt) Van Training and Research Hospital, Van, Turkey
(GURkan) Institute of Health Sciences, Ataturk University, Erzurum, Turkey
(DemIR) Health Services Vocational High School, Van Yuzuncu Yil
University, Van, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: After open heart surgery, patients experience high levels of
pain at the sternotomy incision site and around the chest tube(s),
affecting their recovery. This study was conducted to determine the
effects of local anesthetic application around the sternotomy incision
site and chest tube(s) on the amount of opioids used and recovery after
surgery in patients undergoing open heart surgery. Method(s): This
randomized controlled experimental study was conducted with a total of 60
patients, with 30 patients in the experimental group and 30 patients in
the control group. In the experimental group, LIDOFAST 40 mg/2 ml + 0.025
mg/2 ml, a local anesthetic agent, was applied to the postoperative
sternotomy incision site and around the chest tube(s) in addition to
routine treatment. Patients in the control group received only routine
treatment. Data were collected using the "Descriptive Characteristics
Form" and the "Postoperative Recovery Index". Result(s): It was
observed that postoperative pain started later, opioid consumption
decreased, and postoperative recovery was faster in the experimental
group. As the number of chest tubes increased, recovery was delayed in all
groups, and as the number of opioids used increased, postoperative
recovery was negatively affected in the control group. Conclusion(s):
In this study, local anesthetic application to the sternotomy incision
site and around the chest tubes after open heart surgery was found to
reduce postoperative opioid consumption and positively affect recovery.
Trial registration: Current Controlled Trials NCT06642077 (Retrospectively
registered). Copyright © The Author(s) 2025.

<28>
Accession Number
2033128419
Title
Early phosphate changes as potential indicator of unreadiness for
artificial feeding: a secondary analysis of the EPaNIC RCT.
Source
Critical Care. 29(1) (no pagination), 2025. Article Number: 48. Date of
Publication: 01 Dec 2025.
Author
Lauwers C.; Langouche L.; Wouters P.J.; Wilmer A.; Van den Berghe G.;
Casaer M.P.; Gunst J.
Institution
(Lauwers, Langouche, Wouters, Van den Berghe, Casaer, Gunst) Clinical
Division and Laboratory of Intensive Care Medicine, Department of Cellular
and Molecular Medicine, KU Leuven, Leuven, Belgium
(Wilmer) Department of General Internal Medicine, University Hospitals
Leuven, Leuven, Belgium
Publisher
BioMed Central Ltd
Abstract
Background: As compared to withholding parenteral nutrition (PN) until one
week after intensive care unit (ICU) admission, Early PN prolonged ICU
dependency in the EPaNIC randomized controlled trial (RCT). The Refeeding
RCT showed improved outcome by temporary macronutrient restriction in ICU
patients developing refeeding hypophosphatemia, defined as a phosphate
decrease of > 0.16 mmol/L to levels < 0.65 mmol/L. We hypothesized that
early phosphate changes may identify critically ill patients who are
harmed by Early PN, and that dynamic phosphate changes are more
discriminative than an absolute threshold for hypophosphatemia.
 Method(s): In this secondary analysis of the EPaNIC RCT, we studied
whether absolute hypophosphatemia (AHP; < 0.65 mmol/L on the second
ICU-day), relative hypophosphatemia (RHP; > 0.16 mmol/L decrease over the
first 2 ICU-days), or a combination of both (CHP) interacted with the
randomized nutritional strategy for its impact on outcome, adjusted for
risk factors. In case of significant interaction, we studied whether the
respective change could be predicted by baseline characteristics.
 Result(s): Of 3520 patients with available phosphate measurements,
AHP developed in 9.1%, RHP in 23.7%, and CHP in 5.3% of patients. RHP, but
not AHP or CHP, interacted with the randomized intervention for its impact
on outcome (p = 0.01). In RHP patients, Early PN independently associated
with a lower likelihood of an earlier discharge alive from ICU (adjusted
HR 0.75 [0.65-0.87]). In patients without RHP, Early PN did not
significantly associate with this outcome (adjusted HR 0.93 [0.86-1.00]).
Development of RHP was only poorly predicted by admission characteristics
(adjusted pseudo R-squared = 1.7%). Conclusion(s): Development of RHP
may identify patients who are particularly harmed by early PN. Future
studies should prospectively validate the potential of including RHP in a
ready-to-feed indicator. Copyright © The Author(s) 2025.

<29>
Accession Number
2036985046
Title
Post-hoc analysis of the CARES trial suggests delayed progression of
chronic kidney disease in patients with gout during urate-lowering
therapy.
Source
Kidney International. 107(3) (pp 521-529), 2025. Date of Publication: 01
Mar 2025.
Author
Ghang B.; Park J.; Lee J.S.; Lim J.S.; Kim H.; Liew D.F.L.; Kim J.; Kang
D.-H.; Yoo B.
Institution
(Ghang, Kim) Division of Rheumatology, Department of Internal Medicine,
Jeju National University School of Medicine, Jeju National University
Hospital, Jeju, South Korea
(Park) Division of Cardiology, Department of Internal Medicine, Inje
University Haeundae Paik Hospital, Inje University College of Medicine,
Busan, South Korea
(Lee, Lim) Clinical Research Center, Asan Institute for Life Sciences,
Asan Medical Center, University of Ulsan College of Medicine, Korea,
Seoul, South Korea
(Lee) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Korea, Seoul, South Korea
(Kim) Division of Nephrology, Department of Internal Medicine, Jeju
National University School of Medicine, Jeju National University Hospital,
Jeju, South Korea
(Liew) Department of Rheumatology, Austin Health, Heidelberg, Victoria,
Australia
(Kang) Division of Nephrology, Department of Internal Medicine, Ewha
Womans University College of Medicine, Korea, Seoul, South Korea
(Yoo) Division of Rheumatology, Department of Internal Medicine, Asan
Medical Center, University of Ulsan College of Medicine, Korea, Seoul,
South Korea
Publisher
Elsevier B.V.
Abstract
Based on the hypothesis that hyperuricemia is a modifiable risk factor for
chronic kidney disease (CKD) progression, there is an expectation that
urate-lowering therapy (ULT) could delay the progression of CKD. Here, we
investigated changes in kidney function and the association of the serum
uric acid (sUA) level and kidney function during ULT in patients with
gout. To do this we conducted post-hoc analysis on patients who received
ULT with either febuxostat or allopurinol for more than six months in the
CARES trial. The estimated glomerular filtration rate (eGFR) slope (annual
rate of change in eGFR) was calculated using the CKD-EPI creatinine
equation and linear mixed modeling. Among the 5,002 patients with gout,
3,264 (65.3%) demonstrated an increased eGFR while receiving ULT over a
median follow-up of 2.5 years. Increased average sUA levels were
significantly associated with declines in eGFR slope (per 1 mg/dL
increase, (adjusted beta of -0.1912). Propensity score matched analysis
demonstrated a significant association between low average sUA levels
below 6 mg/dL during ULT and a reduced risk of eGFR decline (adjusted odds
ratio: 0.66, 95% confidence interval 0.57-0.77). Despite the
well-documented natural decline of eGFR over time in the general
population, more than half of the patients enrolled in the CARES trial did
not experience declines in eGFR while receiving ULT. Thus, our study shows
maintaining low sUA levels with ULT was significantly associated with a
decreased risk of CKD progression in patients with gout. Copyright
© 2024 International Society of Nephrology

<30>
Accession Number
2037344870
Title
Comparison of Provisional 1-Stent Strategy With Drug-Eluting Balloon
Versus Planned 2-Stent Strategy in Patients With Non-LM Coronary
True-Bifurcation Lesions (PROVISION-DEB).
Source
American Journal of Cardiology. 242 (pp 18-23), 2025. Date of Publication:
01 May 2025.
Author
Choi S.-S.; Jung J.; Kim K.; Her S.-H.; Lee K.; Jeon D.-S.; Hwang B.-H.;
Park C.S.; Lim S.; Seo S.M.; Mok J.; Han S.H.; Kwon S.U.; Hahn J.-Y.; Lee
S.-W.; Choi W.G.
Institution
(Choi, Jung, Kim, Her) Department of Cardiology, St. Vincent's Hospital,
College of Medicine, The Catholic University of Korea, Seoul, South Korea
(Lee) Department of Cardiology, Daejeon St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Jeon) Department of Cardiology, Incheon St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Hwang) Cardiovascular Center and Cardiology Division, Seoul St. Mary's
Hospital, The Catholic University of Korea, Seoul, South Korea
(Park) Cardiovascular Center and Cardiology Division, Yeouido St. Mary's
Hospital, The Catholic University of Korea, Seoul, South Korea
(Lim) Cardiovascular Center and Cardiology Division, Uijeongbu St. Mary's
Hospital, The Catholic University of Korea, Seoul, South Korea
(Seo) Department of Cardiology, Eunpyeong St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Mok) Department of Cardiology, Bucheon St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Han) Gachon University Gil Medical Center, Incheon, South Korea
(Kwon) Department of Cardiology, Ilsan-Paik Hospital, Inje University
College of Medicine, Goyang, South Korea
(Hahn) Heart Vascular Stroke Institute, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Lee) Department of Cardiology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Choi) Department of Cardiology, College of Medicine, Chungbuk National
University, Cheongju, South Korea
Publisher
Elsevier Inc.
Abstract
Percutaneous coronary intervention (PCI) for bifurcation lesions presents
several difficulties and often results in suboptimal procedural,
postprocedural clinical outcomes. While the provisional 1-stent strategy
is generally favored for its simplicity and favorable outcomes, a few
studies suggest no significant difference between 1-stent and 2-stent
techniques for true bifurcation lesions. Drug-eluting balloons (DEBs) have
demonstrated potential in small vessel disease, including bifurcation side
branches. However, no studies have compared the 2-stent strategy with the
provisional 1-stent plus DEB strategy in non-LM true bifurcation lesions.
Our study aims to address this gap by comparing these strategies, with a
focus on real-world practice and detailed endpoint analysis. The
PROVISION-DEB study is an open-label, randomized, multicenter clinical
trial designed to investigate noninferiority and compare a 1-stent
strategy with a drug-eluting balloon and a planned 2-stent strategy at
non-LM coronary true-bifurcation lesions. A total of 750 patients with de
novo non-LM coronary bifurcation lesions undergoing coronary interventions
will be randomized 1:1 to either a provisional 1-stent plus DEB strategy
or a 2-stent strategy with stratified Diabetes. The primary endpoint is a
target lesion failure, composite outcome of cardiac death, target vessel
myocardial infarction, or target lesion revascularization at the
anticipated 3 years follow-up (6, 12, and 36 months). In conclusion,
PROVISION-DEB study is a randomized, multicenter, noninferior clinical
trial and will compare a 1-setnt strategy with a drug-eluting balloon and
a planned 2-stent strategy at non-LM coronary
true-bifurcation. Copyright © 2025 The Author(s)

<31>
Accession Number
2033120683
Title
Outcome and complications in postcardiotomy cardiogenic shock treated with
extracorporeal life support - a systematic review and meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 29. Date
of Publication: 01 Dec 2025.
Author
Kienlein R.M.; Trauzeddel R.F.; Akbari N.; Avalli L.; Biancari F.; Dini
C.S.; Guenther S.; Hagl C.; Heringlake M.; Kruppa J.; Makikallio T.;
Martins R.; de Chambrun M.P.; Rastan A.J.; Rubino A.; van den Brink F.;
Nordine M.; Treskatsch S.
Institution
(Kienlein, Trauzeddel, Treskatsch) Charite - Universitatsmedizin Berlin,
corporate member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus
Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
(Akbari) Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Institute of
Biometry and Clinical Epidemiology, Chariteplatz 1, Berlin, Germany
(Avalli) Department of Cardiovascular Surgery, Centro Cardiologico
Monzino, Milan, Italy
(Biancari) Department of Cardiovascular Surgery, Centro Cardiologico
Monzino IRCCS, Milan, Italy
(Dini) Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria
Careggi, Florence, Italy
(Dini) Intensive Cardiac Care Unit, Azienda Ospedaliera-Universitaria
Senese, Siena, Italy
(Guenther, Hagl) Department of Cardiac Surgery, University Hospital
Munich, Ludwig-Maximilian-University, Munich, Germany
(Guenther, Hagl) DZHK (German Centre for Cardiovascular Research), Partner
Site Munich Heart Alliance, Munich, Germany
(Heringlake) Department of Anesthesiology and Intensive Care Medicine,
Heart- and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg
Hospital, Karlsburg, Germany
(Kruppa) Hochschule Osnabruck, University of Applied Sciences, Osnabruck,
Germany
(Makikallio) Department of Medicine, South Karelia Central Hospital,
University of Helsinki, Lappeenranta, Finland
(Martins) 1CHU Rennes, Service de Cardiologie Et Maladies Vasculaires,
Rennes, France
(de Chambrun) Sorbonne Universite, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital La Pitie-Salpetriere, Service de Medecine Intensive
Reanimation, Paris, France
(de Chambrun) Sorbonne Universite, Inserm, UMRS_1166-ICAN, Institut de
Cardiometabolisme Et Nutrition (ICAN), Paris, France
(Rastan) Department of Cardiac and Thoracic Vascular Surgery, Marburg
University Hospital, Marburg, Germany
(Rubino) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
(van den Brink) Department of Intensive Care, Leids Universitair Medisch
Centrum, Albinusdreef 2, Leiden, Netherlands
(Nordine) Department of Anesthesiology, Intensive Care Medicine, and Pain
Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is
associated with a high rate of morbidity and mortality. Beside other
therapeutic measures (e.g. intraaortic balloon pump (IABP)),
extracorporeal life support is being increasingly used in this particular
form of shock. Objectives of this meta-analysis were to determine
mortality and complications of extracorporeal life support treatment
(ECLS) in cardiac surgery patients, and if outcomes were influenced by a
preexisting cardiovascular risk profile. Method(s): MEDLINE and
EMBASE were searched for studies in English, published between January
1st 2000 and January 16th 2023, reporting mortality
and morbidity in patients aged >= 18 treated with ECLS for PCCS.
Supplementary data were requested from the respective corresponding
authors. Outcomes were weaning from extracorporeal life support, hospital
survival and complications. Result(s): Two thousand, seven hundred
seventy-four papers were screened, of which 132 full text articles were
assessed for suitability. 70 remaining studies were included for further
evaluation and data analysis. Five studies could be included in the final
analysis since the corresponding authors provided additional necessary
information. Successful weaning from extracorporeal life support was
accomplished in 52.8% (30.8%-57.4%) and 31.1% were discharged alive
(mortality of 25.0 - 56.2% after weaning). 95.1% of all treated patients
suffered from at least one complication. Diabetes mellitus and obesity
seem to be independent risk factors for poor outcome. Conclusion(s):
Extracorporeal life support for PCCS is associated with a substantial
mortality and complication rate. Diabetes mellitus and obesity seem to be
independent risk factors. Therefore, until future work has elucidated
which patients benefit at all, the risks of ECLS-treatment must be
critically weighed up against a possible benefit. Copyright © The
Author(s) 2025.

<32>
Accession Number
2035604500
Title
The Effect of Teleprehabilitation on Adverse Events After Elective Cardiac
Surgery: A Randomized Controlled Trial.
Source
Journal of the American College of Cardiology. 85(8) (pp 788-800), 2025.
Date of Publication: 04 Mar 2025.
Author
Scheenstra B.; van Susante L.; Bongers B.C.; Lenssen T.; Knols H.; van
Kuijk S.; Nieman M.; Maessen J.; van't Hof A.; Sardari Nia P.
Institution
(Scheenstra, van Susante, Maessen, Sardari Nia) Department of
Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University
Medical Center, Maastricht, Netherlands
(Scheenstra, Maessen, Sardari Nia) Department of Cardiothoracic Surgery,
Cardiovascular Research Institute Maastricht, Maastricht University,
Maastricht, Netherlands
(Bongers) Department of Nutrition and Movement Sciences, Institute of
Nutrition and Translational Research in Metabolism, Maastricht University,
Maastricht, Netherlands
(Bongers) Department of Surgery, Institute of Nutrition and Translational
Research in Metabolism, Maastricht University, Maastricht, Netherlands
(Lenssen) Department of Physical therapy, Maastricht University Medical
Center, Maastricht, Netherlands
(Knols) Department of Psychiatry and Psychology, Maastricht University
Medical Center, Maastricht, Netherlands
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Center, Maastricht, Netherlands
(Nieman) Department of Pulmonology, Maastricht University Medical Center,
Maastricht, Netherlands
(van't Hof) Department of Cardiology, Heart and Vascular Center,
Maastricht University Medical Center, Maastricht, Netherlands
(van't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Patients scheduled for cardiac surgery and procedures often
present with modifiable risk factors for adverse perioperative outcomes.
Prehabilitation has shown potential to enhance mental and physical
fitness; however, its effect on clinical cardiovascular endpoints in this
population has not been studied. Objective(s): The current trial was
designed to evaluate the effect of a personalized multimodal
teleprehabilitation on the incidence of composite endpoint on major
adverse cardiovascular events in patients scheduled for elective cardiac
surgery. Method(s): In a multicenter randomized controlled trial, 394
patients awaiting elective cardiac surgery and procedures were enrolled.
Of these, 197 patients were randomized to an online multimodal
personalized teleprehabilitation program through shared decision-making by
a multidisciplinary team, and 197 were assigned to a control group. The
primary outcome was major adverse cardiovascular events (ie,
cardiovascular death, myocardial infarction, stroke, hospitalization for
heart failure or other life-threatening cardiac events, and earlier or
repeated intervention), as measured from the randomization until 1-year
postoperatively. All events were adjudicated by a blinded event committee.
Secondary outcomes included length of hospital stay, postoperative
complications, quality of life, adherence to the program, and effect on
the incidence of modifiable risk factors. Sensitivity analyses of the
primary outcome were conducted adjusting for baseline characteristics to
evaluate the consistency of treatment effects. Result(s): From
randomization until 1 year postoperatively, the primary endpoint occurred
in 33 patients (16.8%) in the teleprehabilitation group and 50 patients
(25.5%) in the control group (difference 8.8%; 95% CI: 0.7%-16.8%; P =
0.032). This difference was primarily driven by a reduction in
hospitalizations, and the sensitivity analyses showed that treatment
effect was mainly in the patients undergoing a cardiac surgery rather than
transcatheter procedures with adjusted OR of 0.54 (95% CI: 0.30-0.96; P =
0.035). Teleprehabilitation also reduced the incidence of active smokers,
elevated pulmonary risk scores, and elevated depression scores. There was
no significant difference in postoperative length of hospital stay,
occurrence of postoperative complications, physical fitness, incidence of
obesity, or malnutrition. Conclusion(s): Multimodal personalized
teleprehabilitation resulted in a clinically relevant and statistically
significant reduction of the primary endpoint in patients undergoing
cardiac surgery. (Digital Cardiac Counseling Trial: DCC Trial [DCC];
NCT04393636) Copyright © 2025 The Authors

<33>
Accession Number
2033128425
Title
Ulinastatin treatment mitigates glycocalyx degradation and associated with
lower postoperative delirium risk in patients undergoing cardiac surgery:
a multicentre observational study.
Source
Critical Care. 29(1) (no pagination), 2025. Article Number: 52. Date of
Publication: 01 Dec 2025.
Author
Ran X.; Xu T.; Liu J.; Yang S.; Luo F.; Wu R.; Tan J.; Ruan H.; Zhang Q.
Institution
(Ran, Xu, Ruan) Department of Critical Care Medicine, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Ran, Xu, Ruan) Department of Emergency Medicine, Tongji Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Liu, Yang, Luo, Tan, Zhang) Department of Anesthesiology, Hubei Key
Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan
Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji
Medical College, Huazhong University of Science and Technology, 1095#
Jiefang Ave, Wuhan, China
(Wu) Department of Biological Sciences Division - Cardiology, University
of Chicago, Chicago, IL, United States
Publisher
BioMed Central Ltd
Abstract
Background: Ulinastatin (UTI), recognized for its anti-inflammatory
properties, holds promise for patients undergoing cardiac surgery. This
study aimed to investigate the relationship between intraoperative UTI
administration and the incidence of delirium following cardiac surgery.
 Method(s): A retrospective analysis was performed on a retrospective
cohort of 6,522 adult cardiac surgery patients to evaluate the
relationship between UTI treatment and the incident of postoperative
delirium (POD) in patients ongoing cardiac surgery. This was followed by a
prospective observational cohort study of 241 patients and an in vitro
study to explore the findings and the potential role of UTI in preventing
cardiac ischemia-reperfusion induced glycocalyx degradation.
 Result(s): Both univariate and multivariate logistic regression
analyses in retrospective cohort indicated that intraoperative
administration of UTI was associated with a significant lower risk of POD
among cardiac surgery patients, a finding confirmed through employing
propensity score matching. The subsequent prospective observational cohort
further supported these findings (adjusted Odds Ratio = 0.392, 95% CI:
0.157-0.977, P = 0.044). Furthermore, UTI mitigated glycocalyx
degradation, as demonstrated by in vitro study. Conclusion(s): UTI
administration may mitigate glycocalyx degradation, potentially lowering
the risk of POD in cardiac surgery patients, offering valuable insights
for future interventions to prevent POD and enhance patient outcomes.
Trial registration number ClinicalTrials.gov (No. NCT06268249).
Retrospectively registered 4 February 2024. Copyright © The
Author(s) 2025.

<34>
Accession Number
2033120664
Title
The C-MAC video laryngoscope helps presbyopic anesthetists to overcome
difficulty in neonatal and infantile intubation: a randomized controlled
trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 24. Date
of Publication: 01 Dec 2025.
Author
Abdalla A.E.; Eissa M.M.; Elbasyouny M.R.; Zomra M.R.; Elnaggar A.M.;
Elsayed M.M.
Institution
(Abdalla, Eissa, Elbasyouny, Zomra, Elnaggar, Elsayed) Department of
Anesthesia, ICU & Pain, Faculty of Medicine (Boys), Al-Azhar University,
Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Endotracheal intubation (ETI) is a life-saving procedure that
must be accurately carried on to guard against complications. Presbyopia
leads to difficulty in viewing close objects and may obstacle proper
intubation even with the best hands. Purpose(s): This study supposed
that the use of video-laryngoscope (VL) may provide better intubation
conditions for presbyopic anesthetists and targets to evaluate the
neonates and infants' intubation success rates (ISR) by anesthetists aged
>= 45 years using the C-MAC VL compared to the standard laryngoscope (SL).
 Method(s): Thirty-one neonates with an age of 18.2 +/- 5.2 days and a
body weight of 4.5 +/- 0.3 kg and 103 infants aged 8.6 +/- 1 months and
weighing 9.4 +/- 1.5 kg were randomly categorized into the SL group that
received ETI using the SL and the VL group had intubated using the
C-MAC (Karl Storz, Germany) VL with the standard Miller blade
and flexible Stylet (2 mm PORTEX stylet; Smiths Medical
International Ltd., UK) to strengthen the endotracheal tube (ETT) and
adjust its curvature as C-shaped. The study outcomes included the
frequency of successful intubation and the number of intubation attempts.
 Result(s): The ISR was significantly (P < 0.001) higher with
significantly (P = 0.0037) lower frequency of using assistance maneuvers
with VL. The mean score of the anesthetist's difficulty rating was
significantly (P < 0.001) higher with SL (2.7 +/- 2) than with VL (1.27
+/- 1.27). Times for the full intubation process were significantly (P <
0.001) shorter with VL than SL. The 1st attempt success rate was
significantly (P = 0.0195) higher with VL than SL (86.6% vs. 67.2%). The
frequency of maneuver-related complications was insignificantly (P =
0.116) reduced with the use of VL (4.5%) than with SL (12%). The ISR
showed a negative significant correlation (r=-0.973, P = 0.005) with the
anesthetist's age. Conclusion(s): Neonatal and infantile intubation
using VL is feasible and easy to handle by aged anesthetists and allows
higher ISR and 1st attempt rate with minimal need for external assistant
maneuvers and maneuver-related complications. VL might be more appropriate
for the presbyopic pediatric anesthetists than the SL. Limitation(s):
The limitations of the study are the small sample size of anesthetists and
the use of one type of VLs. Copyright © The Author(s) 2025.

<35>
Accession Number
2027733144
Title
ST Elevation Myocardial Infarction Complicated by Cardiogenic Shock:
Systematic Review of Survival Predictors.
Source
American Journal of Medicine Open. 10 (no pagination), 2023. Article
Number: 100057. Date of Publication: 01 Dec 2023.
Author
Khoo J.K.; Trewin B.P.; Adji A.; Wong Y.W.; Hungerford S.
Institution
(Khoo) Department of Cardiology, Liverpool Hospital, Sydney, Australia
(Trewin) The Children's Hospital at Westmead, Sydney, Australia; The
University of Sydney, Australia
(Adji) Victor Chang Cardiac Research Institute, Sydney, Australia; St
Vincent's Hospital Clinical School, The University of New South Wales,
Sydney, Australia; Macquarie University, Sydney, Australia
(Wong) Department of Cardiology, The Prince Charles Hospital, Brisbane,
Australia, University of Queensland, Brisbane, Australia
(Hungerford) St Vincent's Hospital Clinical School, The University of New
South Wales, Sydney Australia, Department of Cardiology, Royal North Shore
Hospital, Sydney, Australia; The CardioVascular Center, Tufts, Boston,
Mass, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiogenic shock complicating acute myocardial infarction is
associated with reduced survival despite advancements in the treatment of
acute coronary syndromes. Characterizing predictors of morbidity and
mortality in this setting is crucial to improving risk stratification and
management. Notwithstanding, the interplay of factors determining survival
in this condition remains poorly studied. Method(s): Embase, MEDLINE,
and CINAHL databases were searched for original studies evaluating
predictors of short-term (30-day or in-hospital) survival in ST elevation
myocardial infarction with cardiogenic shock (STEMI-CS). Included studies
were analyzed by way of vote counting, identifying variables that
predicted mortality or survival. Result(s): Twenty-four studies,
consisting of 14,735 patients (5649 nonsurvivors and 9086 survivors) were
included. All studies were observational by design (17 retrospective and 7
prospective) with clinical and statistical heterogeneity. Unsuccessful
revascularization, reduced left ventricular ejection fraction, renal
impairment, and other variables were identified as key independent
predictors of mortality. Conclusion(s): Several key variables have
been shown to independently increase mortality in STEMI-CS populations.
Future prospective studies examining the prognostic role of multivariate
scoring systems incorporating these domains are required. Copyright
© 2023 The Author(s)

<36>
Accession Number
2037271818
Title
The risk of malnutrition as a predictor of arrhythmia recurrence after
catheter ablation in patients with paroxysmal non-valvular atrial
Fibrillation and heart failure with preserved ejection fraction.
Source
PLoS ONE. 20(1 January) (no pagination), 2025. Article Number: e0317721.
Date of Publication: 01 Jan 2025.
Author
Wang C.; Liu Q.; Xiao Y.; Zhou J.; Wu K.; Huang Y.; Zhang Z.; Liu S.; Lin
Q.
Institution
(Zhang, Wang, Liu, Xiao, Zhou, Wu, Huang, Zhang, Liu, Lin) Department of
Nutritional Sciences, The Second Xiangya Hospital, Central South
University, Hunan Province, Changsha City, China
Publisher
Public Library of Science
Abstract
Background Malnutrition presents a significant challenge in managing
patients with atrial fibrillation (AF) and heart failure with preserved
ejection fraction (HFpEF), yet its impact on AF recurrence after catheter
ablation in this population remains unclear. Methods We conducted a
retrospective analysis of 204 patients with paroxysmal non-valvular AF and
HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of
malnutrition as assessed using three screening tools: the Controlling
Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and
Nutritional Risk Index (NRI)]. We examined the relationship between risk
of malnutrition and AF recurrence post-ablation. Results After a mean
follow-up period of 11.2 +/- 1.8 months, 43 patients (21.1%) experienced
AF recurrence. Despite being classified as overweight or obese based on
body mass index, many patients were at risk of malnutrition according to
the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT
scores (HR: 10.132; 95% CI: 2.545-40.336; P = 0.001), lower NRI (HR:
22.734; 95% CI: 6.399-80.776; P < 0.001), or lower PNI (HR: 9.469; 95% CI:
3.232-27.739; P < 0.001) were significantly associated with increased risk
of AF recurrence. Restricted cubic spline regression revealed an inverted
U-shaped relationship between the CONUT score and AF recurrence, and
L-shaped relationships for both NRI and PNI with AF recurrence.
Conclusions Systematic nutritional assessment is crucial in patients with
paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low
PNI serve as independent predictors for AF recurrence. Further large-scale
randomized controlled trials are required to validate these
findings. Copyright © 2025 Zhang et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<37>
Accession Number
2036864683
Title
Optimum diagnostic pathway and pathologic confirmation rate of early stage
lung cancer: Results from the VIOLET randomised controlled trial.
Source
Lung Cancer. 199 (no pagination), 2025. Article Number: 108070. Date of
Publication: 01 Jan 2025.
Author
Harris R.A.; Stokes E.A.; Batchelor T.J.P.; Internullo E.; West D.; Jordan
S.; Nicholson A.G.; Paul I.; Jacobs C.; Shackcloth M.; Feeney S.; Anikin
V.; McGonigle N.; Steyn R.; Kalkat M.; Stavroulias D.; Havinden Williams
M.; Qadri S.; Dobbs K.; Zamvar V.; Macdonald L.; Kaur S.; Rogers C.A.; Lim
E.
Institution
(Harris, Kaur, Rogers) Bristol Trials Centre, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Stokes) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, Oxford, United Kingdom
(Batchelor) Thoracic Surgery, St Bartholomew's Hospital, Barts Health NHS
Trust, West Smithfield, London, United Kingdom
(Internullo, West, Jordan) Thoracic Surgery, Bristol Royal Infirmary,
University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
(Nicholson, Anikin, Lim) Thoracic Surgery, Royal Brompton and Harefield
Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, London,
United Kingdom
(Paul, Jacobs) Cardiothoracic Surgery, The James Cook University Hospital,
Middlesbrough, United Kingdom
(Shackcloth, Feeney) Thoracic Surgery, Liverpool Heart and Chest Hospital,
Liverpool, United Kingdom
(McGonigle) Thoracic Services, Belfast City Hospital, Belfast Trust
Hospitals, Belfast, United Kingdom
(Steyn, Kalkat) Thoracic Surgery, Heartlands Hospital, University
Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(Stavroulias, Havinden Williams) Cardiothoracic Surgery, John Radcliffe
Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Qadri, Dobbs) Cardiothoracic Surgery, Castle Hill Hospital, Hull, United
Kingdom
(Zamvar, Macdonald) Cardiothoracic Surgery, Edinburgh Royal Infirmary,
Edinburgh, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Pathologic confirmation of lung cancer influences treatment
selection for suspected early-stage lung cancer. High pre-treatment tissue
confirmation rates are recommended. We sought to define management and
outcomes of patients undergoing surgery for primary lung cancer in a UK
multi-centre clinical trial. Method(s): VIOLET compared minimally
invasive video-assisted thoracic surgery versus open surgery for known or
suspected lung cancer. Diagnostic patient pathways were identified and
methods of tissue confirmation were documented. The outcome of
inappropriate lobectomy for benign disease or inappropriate wedge
resection for primary lung cancer was compared with respect to the
pathologic diagnosis. Finding(s): From July 2015 to February 2019,
502 patients were randomised and underwent surgery; 262 (52%) had a
pre-operative pathologic confirmed diagnosis of primary lung cancer, 205
did not have a pre-operative biopsy and 35 had a non-diagnostic
pre-operative biopsy. Of the 240 participants without pre-operative
pathologic confirmation of primary lung cancer, intraoperative biopsy and
frozen section analysis was undertaken in 144 (60%). The remaining 96
underwent direct surgical resection without tissue confirmation (19% of
the entire cohort). Confirmation of histologic diagnosis before surgery
was less costly than diagnosis in the operating theatre. The inappropriate
surgery rate was 3.6% (18/502 participants, 7 lobectomy for benign
disease, 11 wedge resection for lung cancer). Interpretation(s): Low
levels of inappropriate resection can be achieved at pre-operative tissue
confirmation rates of 50% through a combination of intra-operative
confirmatory biopsy and correct risk estimation of lung cancer. Practice
needs to be monitored to ensure acceptable levels are consistently
achieved. Copyright © 2025 The Authors

<38>
Accession Number
2037346943
Title
Efficacy of surgical ablation and left atrial appendage occlusion in
patients with AF undergoing coronary artery bypass grafting: A network
meta-analysis.
Source
Journal of Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Awad A.K.; Elbahloul M.A.; Gamal A.; Attia A.N.; Hamed S.M.; Elsekhary
A.I.; Sa M.P.
Institution
(Awad) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Awad) Department of Cardiothoracic Surgery, Ain-Shams University
Hospitals, Cairo, Egypt
(Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Kafr
El-Shaikh, Egypt
(Gamal) Clinical Pharmacy Department, Faculty of Pharmacy, Deraya
University, Minia, Egypt
(Attia, Elsekhary) Kasr Alainy School of Medicine, Cairo University,
Cairo, Egypt
(Hamed) Faculty of Medicine, Mansura University, Dakahlia, Egypt
(Sa) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia
that greatly elevates the risk of stroke. This risk increases both during
and after cardiac procedures, such as coronary artery bypass grafting
(CABG). There is an increasing interest in non-pharmacological treatments
such as left atrial appendage occlusion (LAAO) and surgical ablation,
intending to enhance both immediate and long-term postoperative results.
 Objective(s): To investigate the efficacy of surgical ablation (SA),
LAAO, or both in patients with AF undergoing CABG. Method(s): We
searched four electronic databases: PubMed, Scopus, Cochrane Library, and
WOS. We analyzed data using R language and "netmeta" and "netrank"
packages of meta-insight software. Pooled outcomes were reported as mean
difference or risk ratio (RR) with 95 % confidence interval (CI) in a
random effect method. Result(s): A total of 16 studies were included
with 594,312 patients included. The 30-day mortality showed a
non-statistically significant difference between CABG-LAAO compared to
CABG alone and CABG-SA with RR of 1.70 (95%CI 0.38-7.61) and 0.62 (95%CI
0.10-3.94). However, compared to CABG alone, CABG-SA + LAAO, CABG-LAAO,
and CABG-SA had significantly lower risk of long-term mortality with RR
0.75 (95%CI 0.57-0.98), 0.78 (95%CI 0.65-0.94), and 0.73 (95%CI
0.61-0.88), respectively. CABG-SA + LAAO, CABG-LAAO, and CABG-SA reduced
the risk of short-term stroke compared to CABG alone with RR of 0.73
(95%CI 0.43-1.24), 0.93 (95%CI 0.78-1.11), and 1.01 (95%CI 0.75-1.36),
respectively. Moreover, only CABG-SA + LAAO and CABG-LAAO showed a
statistically significant reduction in long term stroke and
hospitalization due to heart failure while CABG-SA showed no statistically
significant difference. Furthermore, there was no statistically
significant difference between our interventions in terms of 30-day
rehospitalization, intra-aortic balloon pump support, and risk of
hemorrhage. Conclusion(s): Among patients with AF undergoing CABG,
whether undergoing SA alone or LAAO alone or both showed significant
clinical outcomes such as reduced risk of both short- and long-term
mortality and short-term stroke. Copyright © 2025 Elsevier Ltd

<39>
[Use Link to view the full text]
Accession Number
2035473749
Title
Amino acids and the kidney; friends or foes?.
Source
Current Opinion in Clinical Nutrition and Metabolic Care. 28(2) (pp
156-159), 2025. Date of Publication: 01 Mar 2025.
Author
Redaelli M.B.; Landoni G.; Monti G.; Bellomo R.
Institution
(Redaelli, Landoni, Monti) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Italy
(Landoni, Monti) Vita-Salute San Raffaele University, Milan, Italy
(Bellomo) Department of Critical Care, University of Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Acute kidney injury (AKI) is common in hospitalized
patients and is independently associated with morbidity and mortality.
Moreover, AKI increases the risk of chronic kidney disease, which is a
major healthcare problem. Currently, no single therapy has been proven to
be effective in preventing AKI. The role of amino acids in the context of
kidney function and AKI prevention has been controversial and most of the
evidence is available from nutritional studies. However, knowledge of
amino acids in recruiting renal functional reserve and their potential
role to protect renal function under stress has recently expanded. Recent
findings The nephroprotective effects of amino acids were first postulated
in 1973. Recently, this strategy gained renewed interest and has been more
extensively studied, reintroducing their use in clinical situations
characterized by a high incidence of AKI. Intravenous amino acids
administration for kidney protection is now supported by a large
multinational randomized double-blind controlled trial in cardiac surgery
and by experimental and observational data. All such data support the
rationale for a biologically and clinically important nephroprotective
effect. Summary The infusion of amino acids was recently found to reduce
the incidence of AKI in cardiac surgery patients and surgical patients.
This strategy for the protection of renal function is supported by a
multicenter, international, double-blind randomized trial, with a huge
potential for additional application in several clinical fields. Several
mechanisms of action support the robustness of these findings and are
summarized in this manuscript. Copyright © 2025 Wolters Kluwer
Health, Inc. All rights reserved.

<40>
Accession Number
2026517076
Title
Pathophysiology and Treatment of Intraseptal-Course Left Coronary Anomaly:
Surgery for All?.
Source
Pediatric Cardiology. 46(1) (pp 4-13), 2025. Article Number: e008375. Date
of Publication: 01 Jan 2025.
Author
Angelini P.; Uribe C.; Corno A.F.
Institution
(Angelini, Uribe) The Texas Heart Institute Center for Cardiovascular
Care, Houston, TX, United States
(Corno) School of Engineering, University of Leicester, University Road,
Leicester, United Kingdom
Publisher
Springer
Abstract
Intraseptal-course, ectopic coronary anomalies are not well characterized
as to anatomy, function, prognosis, and treatment. Recently, a
revolutionary but unsupported new theory is claiming that most patients
with a Left Anomalous Coronary Artery originating from the Opposite Sinus
with anomalous Intra-Septal course (L-ACAOS-IS)-even small children-have
significant stenoses and require open-heart surgery to prevent acute
myocardial infarction and death. This surprising view has spurred ongoing
discussions among adult and pediatric cardiologists and cardiac surgeons,
compelling us (the conservative party in the discussion) to offer an
in-depth and comprehensive review of this anomaly, based on objective but
opposite data. We and other adult cardiologists have followed numerous
L-ACAOS-IS patients for many years and have observed none of the claimed
catastrophes. Rather, we have consistently found that L-ACAOS-IS generally
has a benign clinical prognosis. We present the general principle of
coronary artery dysfunction in anatomical congenital anomalies (that only
significant luminal coronary stenosis can have clinical repercussions). We
then review anatomical and functional details of L-ACAOS-IS related to
prognosis and treatment indications, which could explain many of the
clinical presentations recently mentioned. Finally, we encourage our more
liberal colleagues to recognize that, compared with normal coronary
arteries, those with anomalies of origin and course are associated with
frequent coronary spasm. In particular, we underscore that some of the
ischemic manifestations and other results might actually be caused by
pressure wire-induced artifacts (rigid wires tend to cause coronary spasm
when advanced into tortuous coronary arteries). Copyright © The
Author(s) 2023.

<41>
Accession Number
2023225726
Title
The connotation between perioperative glycemic control approach and
sternal wound infection in individuals with diabetes mellitus experiencing
cardiac surgery: A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3324-3330), 2023. Date of
Publication: 01 Oct 2023.
Author
Tan G.; Li Y.; Zhou G.
Institution
(Tan) Department of Cardiovascular Medicine, Sichuan Academy of Medical
Sciences & Sichuan Provincial People's Hospital, Sichuan, China
(Li) Department of Endoscopy, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
(Zhou) Department of Endocrinology, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation to measure the connotation between
perioperative glycemic control (GC) approach and sternal wound infection
(SWI) in individuals with diabetes mellitus (DM) experiencing cardiac
surgery (CS). A comprehensive literature inspection till February 2023 was
applied and 2654 interrelated investigations were reviewed. The 12 chosen
investigations enclosed 1564 individuals with DM and CS in the chosen
investigations' starting point, 790 of them were using strict GC, and 774
were using moderate GC. Odds ratio (OR) in addition to 95% confidence
intervals (CIs) were used to compute the value of the Connotation between
the perioperative GC approach and SWI in individuals with DM experiencing
CS by the dichotomous and continuous approaches and a fixed or random
model. Strict GC had significantly lower SWI (OR, 0.33; 95% CI,
-0.22-0.50, P <.001) compared with those with moderate GC in individuals
with DM and CS. Strict GC had significantly lower SWI compared with those
with moderate GC in individuals with DM and CS. However, caused of the
small sample sizes of several chosen investigations for this
meta-analysis, care must be exercised when dealing with its
values. Copyright © 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<42>
Accession Number
2026931798
Title
The Role of Prone Position Combined With Nasal CPAP in Preventing
Extubation Failure in Infants After Cardiac Surgery.
Source
Respiratory Care. 68(2) (pp 241-246), 2023. Date of Publication: 01 Feb
2023.
Author
Wu H.-L.; Chen Y.-K.; Lin S.-H.; Chen Q.; Zheng Y.-R.
Institution
(Wu, Chen, Lin, Chen, Zheng) Department of Cardiac Surgery, Fujian
Children's Hospital, (Fujian Branch of Shanghai Children's Medical
Center), College of Clinical Medicine for Obstetrics and Gynecology and
Pediatrics, Fujian Medical University, Fuzhou, China
Publisher
American Association for Respiratory Care
Abstract
BACKGROUND: Previous studies suggest that prone position could improve
oxygenation and prevent lung injury. Whether prone position can improve
post-extubation clinical outcomes in infants undergoing cardiac surgery is
unknown. The aim of our study was to investigate the effects of prone
position in preventing extubation failure in noninvasively ventilated
infants after cardiac surgery. METHOD(S): Ninety-six infants who were
weaned to nasal CPAP after congenital cardiac surgery were randomly
divided into 2 groups: the prone position group (n 5 48) and the supine
position group (n 5 48). Primary outcomes measured were extubation failure
rate within 48 h of extubation and arterial blood gas values within 6 h of
a mandatory prone positioning session. Secondary outcomes included nasal
trauma, pressure ulcers, pneumothorax, gastroesophageal reflux, abdominal
distention, in-hospital mortality, postoperative nasal CPAP duration, and
hospital length of stay. RESULT(S): Compared with the supine position
group, the prone position group had fewer extubation failure infants (2.0%
vs 14.5%, P 5.02). Arterial blood gas values after 6 h after a mandatory
prone positioning session showed that the P<inf>aO2</inf> and
P<inf>aO2</inf>/F<inf>IO2</inf> in the prone position group were
significantly higher than those in the supine position group
(P<inf>aO2</inf> 93.3 6 8.5 vs 82.5 6 9.1, P <.05;
P<inf>aO2</inf>/F<inf>IO2</inf> 255.8 6 23.6 vs 235.8 6 20.7, P <.05).
Moreover, nasal CPAP duration and total hospital length of stay in the
prone position group were significantly shorter than those in the supine
position group (P <.05). CONCLUSION(S): In infants supported with
nasal CPAP following cardiac surgery, prone positioning improved
postextubation oxygenation, helped reduced extubation failure, and reduced
the duration of nasal CPAP ventilation and total hospital length of
stay. Copyright © 2023, American Association for Respiratory
Care. All rights reserved.

<43>
Accession Number
646475166
Title
Effect of use of Entropy Monitoring on Consumption of Sevoflurane
Inhalational Agent in patients undergoing off-Pump Coronary Artery Bypass
Graft Surgery.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S75), 2022. Date of Publication: 2022.
Author
Trivedi V.
Institution
(Trivedi) SMS Medical College and Hospital, Jaipur, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Assessing depth of anaesthesia using entropy is
resourceful as it allows for accurate hypnotic drug administration and
decreased anaesthetic drug consumption. This study was performed to
evaluate the effect of entropy monitoring on sevoflurane consumption in
patients undergoing off-pump coronary artery bypass graft (OPCABG)
Surgery. Method(s): 60 patients of American Society of
Anesthesthesiologists grade II and III between 40-70 years of age, of
either sex planned for OPCABG surgery were randomly allocated to two
groups. In the control group B, sevoflurane was titrated according to
changes in clinical parameters and in the study group A, sevoflurane was
titrated to maintain state entropy values between 40-60 accordingly.
Response entropy and state entropy values were continuously recorded in
both the groups but were displayed on the monitor only in the study group.
The entropy values, sevoflurane consumption andrecovery times were
compared. Result(s): Sevoflurane consumption and recovery time were
significantly reduced in the study group A than the control group B
(p-value <0.001); Sevoflurane consumption was 7.03+/-0.67 ml/h vs
12.42+/-0.68 ml/h; recovery time 6.47+/-0.65 h vs 12.05+/-1.11 h).
Response and state entropy values were lower in the control group than the
study group (p < 0.001). Systolic blood pressure during skin incision,
sternotomy and at the time of completion of all grafts were significantly
lower in study group. Conclusion(s): Monitoring the depth of
anaesthesia using entropy monitoring leads to significant reduction in
sevoflurane consumption. Significantly faster recovery rate from surgery
could be associated with more accurate hypnotic and analgesic drug
administration. .

<44>
Accession Number
646475223
Title
Comparison study of routine coagulation tests and thromboelastography for
detection of hypocoagulable state in patients undergoing cardiac surgery
on cardiopulmonary bypass.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S86), 2022. Date of Publication: 2022.
Author
Garg P.
Institution
(Garg) SMS Medical College, Jaipur, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aim: Hypocoagulability after cardiac surgeries on
cardiopulmonary bypass (CPB) is a major concern. Conventionally routine
coagulation tests (RCT) were used for this but recently
thromboelastography (TEG) is being used. We compared whether RCT and TEG
had any correlation with blood loss. Method(s): This prospective
study was done on patients undergoing cardiac surgery on CPB to determine
the correlation between different RCT (PT/INR, aPTT, fibrinogen level,
platelet count) and TEG parameters (r-time, k-time, alpha angle and MA)
before heparinisation and after reversal with protamine. Their correlation
with chest-tube output at 24 hours after surgery was also determined.
 Result(s): Most RCT parameters changed significantly after CPB.
Prebypass platelet count and postbypass PT and fibrinogen level correlated
significantly with the postoperative blood loss at 24h. Of the TEG
parameters, only MA changed significantly after bypass. Alpha angle and
K-time after bypass correlated significantly with postoperative blood
loss. RCT and TEG parameters correlation was found in both prebypass and
postbypass samples. In few pairs (prebypass: APTT/ K-time, platelet count/
MA and postbypass; aPTT/ R-time, Fibrinogen/ alpha angle, fibrinogen/ MA)
correlation was not significant. Conclusion(s): In our study, RCT and
TEG parameters correlated among themselves and PT, fibrinogen levels after
bypass. Their corresponding part in TEG, K-time and alpha angle correlated
significantly with amount of blood loss. TEG can be used to guide blood
component therapy postoperatively in ICU rather than empirically.

<45>
Accession Number
646475089
Title
Comparison of erector spinae block versus epidural catheter infusion for
analgesia in thoracic surgery.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S6-S7), 2022. Date of Publication: 2022.
Author
Sayed M.R.
Institution
(Sayed) Aster Medcity., India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Theprimary objective was to compare the efficacy of
analgesia provided by epidural catheter and erector spinae blockin the
postoperative period based onnumerical rating scale. Rescue analgesia,
time of mobilisation, any complications associated were assessed as
secondary objectives. Method(s): This Prospective randomised
single-blinded comparative study included 76 patients of American Society
of Anesthesiologists grade I, II and III. Haemodynamicdata including heart
rate, blood pressre and oxygen saturation were recorded preoperatively, 5
minutes after induction, 5 minutes after nerveblock/epidural, at skin
incision, 20 minutes after incision. Local anaesthetic infusion of 0.125%
bupivacaine + 2 mug/mlfentanyl was given @ 6-8 ml/h at 1 h after block/
epidural.Postoperative pain assessment was done for pain at rest
anddynamic pain with Numerical rating scale (NRS) and sedation level based
on the Ramsay sedation scale was noted. The need for rescueanalgesia and
complications was documented. Result(s): NRS score at rest was
statistically significant in the period between 12 to 24 h, while
thedynamic score was found to be statistically significant from 4 to 24 h.
The epidural group required more rescue analgesic and total amount of
intraoperative fentanyl doses compared to the erector spinaegroup with a
P-value of 0.02. Conclusion(s): Ultrasound-guided ESP block is
comparable with thoracic epidural technique in patientsundergoing elective
thoracotomy with regards to post operative analgesia, less opioid
requirement, patient satisfaction, and fewer complications.

<46>
Accession Number
2037332003
Title
Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis
and Myocardial Fibrosis: The EVOLVED Randomized Clinical Trial.
Source
JAMA. 333(3) (pp 213-221), 2025. Date of Publication: 21 Jan 2025.
Author
Loganath K.; Craig N.J.; Everett R.J.; Bing R.; Tsampasian V.; Molek P.;
Botezatu S.; Aslam S.; Lewis S.; Graham C.; White A.C.; Macgillivray T.;
Tuck C.E.; Rayson P.; Cranley D.; Irvine S.; Armstrong R.; Milne L.; Chin
C.W.L.; Hillis G.S.; Fairbairn T.; Greenwood J.P.; Steeds R.; Leslie S.J.;
Lang C.C.; Bucciarelli-Ducci C.; Joshi N.V.; Kunadian V.; Vassiliou V.S.;
Dungu J.N.; Hothi S.S.; Boon N.; Prasad S.K.; Keenan N.G.; Dawson D.;
Treibel T.A.; Motwani M.; Miller C.A.; Mills N.L.; Rajani R.; Ripley D.P.;
Mccann G.P.; Prendergast B.; Singh A.; Newby D.E.; Dweck M.R.
Institution
(Loganath, Craig, White, Tuck, Mills, Newby, Dweck) British Heart
Foundation Centre of Research Excellence, University of Edinburgh,
Edinburgh, United Kingdom
(Craig, Everett, Bing, White, Mills, Newby, Dweck) Edinburgh Heart Centre,
Royal Infirmary of Edinburgh, Scotland, Edinburgh, United Kingdom
(Tsampasian, Vassiliou) Norwich Medical School, University of East Anglia,
United Kingdom, Norwich, United Kingdom
(Tsampasian, Vassiliou) Department of Cardiology, Norfolk and Norwich
University Hospital, Norwich, United Kingdom
(Molek) Department of Coronary Disease and Heart Failure, Jagiellonian
University Medical College, Krakow, Poland
(Botezatu) University of Medicine and Pharmacy Carol Davila, Cardiology
Department, Euroecholab, Bucharest, Romania
(Aslam, Mccann, Singh) Department of Cardiovascular Sciences, University
of Leicester, The NIHR Leicester Biomedical Research Centre, Glenfield
Hospital, Leicester, United Kingdom
(Lewis, Rayson, Cranley, Irvine, Armstrong, Milne) Edinburgh Clinical
Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh,
United Kingdom
(Graham) Edinburgh Clinical Research Facility, The University of
Edinburgh, Edinburgh, United Kingdom
(Macgillivray) Edinburgh Imaging, The University of Edinburgh, Edinburgh,
United Kingdom
(Chin) Department of Cardiology, National Heart Centre Singapore,
Singapore
(Chin) Cardiovascular Medicine ACP Duke NUS Medical School, Singapore
(Hillis) Medical School, University of Western Australia, Perth, WA,
Australia
(Hillis) Department of Cardiology, Royal Perth Hospital, Perth, WA,
Australia
(Fairbairn) Department of Cardiology, Liverpool Centre for Cardiovascular
Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Greenwood) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Greenwood) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
(Steeds) Department of Cardiology, Queen Elizabeth Hospital Birmingham,
University Hospitals of Birmingham NHS Foundation Trust, Birmingham,
United Kingdom
(Leslie) Cardiac Unit, Raigmore Hospital, Inverness, United Kingdom
(Lang) Division of Molecular and Clinical Medicine, School of Medicine,
University of Dundee, Scotland, Dundee, United Kingdom
(Lang) Tuanku Muhriz Chair, National University of Malaysia, Malaysia
(Bucciarelli-Ducci, Joshi) Bristol Heart Institute, University Hospitals
Bristol NHS Foundation Trust, Bristol, United Kingdom
(Bucciarelli-Ducci, Prasad) Royal Brompton and Harefield Hospitals, Guys'
and St Thomas NHS Foundation Trust, London, United Kingdom
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle, United Kingdom
(Kunadian) University and Cardiothoracic Centre, Freeman Hospital,
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne,
United Kingdom
(Dungu) Essex Cardiothoracic Centre, Nethermaynem, Essex, Basildon, United
Kingdom
(Dungu) Anglia Ruskin University, Essex, Chelmsford, United Kingdom
(Hothi) Department of Cardiology, Royal Wolverhampton NHS Trust,
Wolverhampton, UK, Institute of Cardiovascular Sciences, University of
Birmingham, United Kingdom
(Boon) HertfordshireUnited Kingdom
(Keenan) Department of Cardiology, West Hertfordshire Hospitals NHS Trust,
Watford, United Kingdom
(Keenan) Imperial College, London, United Kingdom
(Dawson) Aberdeen Cardiovascular and Diabetes Centre, University of
Aberdeen, Aberdeen, United Kingdom
(Treibel) Institute of Cardiovascular Sciences, University College London,
St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield,
London, United Kingdom
(Motwani) Department of Cardiology, Manchester Heart Institute, Manchester
Royal Infirmary, Manchester University NHS Foundation Trust, Manchester,
United Kingdom
(Miller) Division of Cardiovascular Sciences, School of Medical Sciences,
Faculty of Biology, Medicine and Health, Manchester Academic Health
Science Centre, The University of Manchester, Manchester, United Kingdom
(Mills) Usher Institute, The University of Edinburgh, Edinburgh, United
Kingdom
(Rajani) Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
(Ripley) Cardiology, Northumbria Healthcare NHS Foundation Trust,
Newcastle upon Tyne, United Kingdom
(Prendergast) Cleveland Clinic London and St Thomas' Hospital, London,
United Kingdom
Publisher
American Medical Association
Abstract
Importance: Development of myocardial fibrosis in patients with aortic
stenosis precedes left ventricular decompensation and is associated with
an adverse long-term prognosis. Objective(s): To investigate whether
early valve intervention reduced the incidence of all-cause death or
unplanned aortic stenosis-related hospitalization in asymptomatic patients
with severe aortic stenosis and myocardial fibrosis. Design, Setting,
and Participant(s): This prospective, randomized, open-label, masked end
point trial was conducted between August 2017 and October 2022 at 24
cardiac centers across the UK and Australia. Asymptomatic patients with
severe aortic stenosis and myocardial fibrosis were included. The final
date of follow-up was July 26, 2024 Intervention: Early valve intervention
with transcatheter or surgical aortic valve replacement or
guideline-directed conservative management. Main Outcomes and
Measures: The primary outcome was a composite of all-cause death or
unplanned aortic stenosis-related hospitalization in a time-to-first-event
intention-to-treat analysis. There were 9 secondary outcomes, including
the components of the primary outcome and symptom status at 12 months.
 Result(s): The trial enrolled 224 eligible patients (mean [SD] age,
73 [9] years; 63 women [28%]; mean [SD] aortic valve peak velocity of 4.3
[0.5] m/s) of the originally planned sample size of 356 patients. The
primary end point occurred in 20 of 113 patients (18%) in the early
intervention group and 25 of 111 patients (23%) in the guideline-directed
conservative management group (hazard ratio, 0.79 [95% CI, 0.44-1.43]; P
=.44; between-group difference, -4.82% [95% CI, -15.31% to 5.66%]). Of 9
prespecified secondary end points, 7 showed no significant difference.
All-cause death occurred in 16 of 113 patients (14%) in the early
intervention group and 14 of 111 (13%) in the guideline-directed group
(hazard ratio, 1.22 [95% CI, 0.59-2.51]) and unplanned aortic stenosis
hospitalization occurred in 7 of 113 patients (6%) and 19 of 111 patients
(17%), respectively (hazard ratio, 0.37 [95% CI, 0.16-0.88]). Early
intervention was associated with a lower 12-month rate of New York Heart
Association class II-IV symptoms than guideline-directed conservative
management (21 [19.7%] vs 39 [37.9%]; odds ratio, 0.37 [95% CI,
0.20-0.70]). Conclusions and Relevance: In asymptomatic patients with
severe aortic stenosis and myocardial fibrosis, early aortic valve
intervention had no demonstrable effect on all-cause death or unplanned
aortic stenosis-related hospitalization. The trial had a wide 95% CI
around the primary end point, with further research needed to confirm
these findings. Trial Registration: ClinicalTrials.gov Identifier:
NCT03094143. Copyright © 2024 American Medical Association. All
rights reserved.

<47>
Accession Number
2037089618
Title
Coronary Events After Transcatheter Aortic Valve Replacement: Insights
From the France TAVI Registry.
Source
JACC: Cardiovascular Interventions. 18(2) (pp 229-243), 2025. Date of
Publication: 27 Jan 2025.
Author
Zendjebil S.; Akodad M.; Dumonteil N.; Cuisset T.; Beurtheret S.; du
Chayla F.; Leclere M.; Sanguineti F.; Hovasse T.; Chevalier B.; Neylon A.;
Eltchaninoff H.; Garot P.; Benamer H.; Adjedj J.; Albat B.; Aubert S.;
Azmoun A.; Bach V.; Bar O.; Belle L.; Bellien J.; Bertrand B.; Bessou
J.-P.; Beygui F.; Beziau-Gasnier D.; Bischoff N.; Bonnet J.-L.; Bonnet N.;
Brakenhielm E.; Braunberger E.; Caligiuri G.; Carrie D.; Caus T.;
Champagnac D.; Chatel D.; Chavanis N.; Chevreul K.; Chocron S.; Choplain
J.-N.; Christiaens L.-P.; Christophe C.; Claudel J.-P.; Collart F.; Collet
F.; Collet J.-P.; Corbi P.; Curtil A.; Darodes N.; Darremont O.;
Debroucker F.; Delepine S.; Delomez M.; Derieux T.; Diab C.; Dibie A.;
Doisy V.; Durand E.; Durrleman N.; Durand de Gevigney G.; Fabre O.; Farge
A.; Favereau X.; Folliguet T.; Fraschini C.; Ghostine S.; Gilard M.;
Gommeaux A.; Grimaud J.-P.; Guyon P.; Hepp A.; Himbert D.; Houel R.;
Innorta A.; Isaaz K.; Iung B.; Ivascau C.; Jacquemin L.; Jazayeri S.;
Jegaden O.; Joly P.; Juthier F.; Kamel S.; Kindo M.; Labrousse L.;
Laghzaoui A.; Laschet J.; Le Breton H.; Leclercq F.; Lefevre T.; Lemoine
S.; Leprince P.; Leroux L.; Levy G.; Lorgis L.; Makowski S.; Manigold T.;
Manrique A.; Marcheix B.; Maupas E.; Messas E.; Messika-Zeitoun D.; Metz
D.; Mirode A.; Mirza A.; Mohsinaly F.; Monassier F.; Morelle J.-F.; Munos
E.; Nataf P.; Ohlmann P.; Pinaud F.; Pinelli G.; Pinet F.; Portocarrero
E.; Pouzet B.; Quilliet L.; Richard V.; Robert G.; Roussel J.-C.; Saade
Y.; Saloux E.; Schiele F.; Souteyrand G.; Spaulding C.; Tchetche D.;
Teboul J.; Teiger E.; Thoenes M.; Tribouilloy C.; Vahdat O.; Van Belle E.;
Verhoye J.-P.; Vezier C.; Vilat J.; Yassine M.; Zannis K.; Zegdi R.
Institution
(Zendjebil, Akodad, Sanguineti, Hovasse, Chevalier, Neylon, Garot,
Benamer, Lefevre) Institut Cardiovasculaire Paris-Sud, Hopital Prive
Jacques Cartier, Ramsay-Sante, Massy, France
(Iung) Service de Cardiologie, CHU Bichat Claude Bernard, APHP, LVTS
INSERM 1148, Universite Paris-Cite, Paris, France
(Dumonteil) Service de Cardiologie Interventionnelle, Clinique Pasteur,
Toulouse, France
(Cuisset) Service de Cardiologie CHU de la Timone, Marseille, France
(le Breton) Service de Cardiologie CHU de Rennes, Rennes, France
(Beurtheret) Service de Chirurgie Cardiaque, Hopital St Joseph, Marseille,
France
(du Chayla, Leclere) Clinityx, Boulogne-Billancourt, France
(Eltchaninoff) Service de Cardiologie, CHU de Rouen, Rouen, France
(Gilard) Service de Cardiologie, CHU de Brest, Brest, France
Publisher
Elsevier Inc.
Abstract
Background: The prevalence of coronary artery disease in patients
undergoing transcatheter aortic valve replacement (TAVR) is high.
Treatment of a coronary events (CE) after TAVR can be technically
challenging. Objective(s): The authors sought to assess the incidence
and prognostic impact of CE after TAVR. Method(s): Patients
undergoing TAVR for native aortic stenosis, with balloon-expandable valves
(BEV) or self-expandable valves (SEV), included in the France-TAVI
registry (Registry of Aortic Valve Bioprostheses Established by Catheter)
were studied. The primary endpoint was the rate of first hospitalization
for CE at maximal follow-up. The main secondary endpoint was the composite
of all-cause mortality or hospitalization for heart failure following CE.
 Result(s): Between 2013 and 2021, 64,660 patients were included (BEV
63.8%, SEV 36.2%). CE occurred in 11.6% of cases (1.5%/y). Previous
coronary artery disease and known coronary artery stenosis >50% before
TAVR were the main predictors of CE. After CE, the composite endpoint was
lower in patients who underwent percutaneous coronary intervention (PCI)
compared with those who had only coronary angiography or no intervention
(79.6%, 85.2%, and 86.5%, respectively; P = 0.002) and higher in SEV than
in BEV patients (85.8% vs 83.8%; P = 0.01). Patients admitted to a TAVR
center were more likely to have PCI (OR: 1.20 [95% CI: 1.01-1.42]; P =
0.04), even more so if they had a BEV (OR: 1.42 [95% CI: 1.18-1.71]; P =
0.002). Conclusion(s): The yearly incidence of CE after TAVR is low.
In the event of CE, patients who have not undergone PCI have a worse
outcome. SEV patients have a higher rate of unfavorable outcomes and are
less likely to undergo PCI, especially when admitted to non-TAVR
centers. Copyright © 2025 American College of Cardiology
Foundation

<48>
Accession Number
2036264450
Title
Practice Changing Updates in Perioperative Medicine Literature 2023. A
Systematic Review.
Source
American Journal of Medicine. 138(3) (pp 419-427.e1), 2025. Date of
Publication: 01 Mar 2025.
Author
Silbert R.E.; Khambaty M.; Devalapalli A.P.; Kashiwagi D.T.; Stephenson
C.R.; Bartlett M.A.; Regan D.W.; Sundsted K.K.; Mauck K.F.
Institution
(Silbert, Stephenson, Bartlett, Mauck) Division of General Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, Minn
(Khambaty, Devalapalli, Kashiwagi, Regan, Sundsted) Division of Hospital
Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic
College of Medicine, Rochester, Minn
Publisher
Elsevier Inc.
Abstract
Perioperative medicine is an evolving field, with important publications
each year across multiple disciplines. Staying up to date in the field is
complicated due to the wide range of journals that publish relevant
articles. This review summarizes the most noteworthy perioperative
publications in 2023. We conducted a multi-database search of the
literature from January to December 2023 and included all original
research articles, meta-analyses, systematic reviews, and guidelines.
Abstracts, case reports, letters, protocols, pediatric and obstetric
articles, and cardiac surgery publications were excluded. Two authors
reviewed each reference using the Distiller SR systematic review software
(Evidence Partners Inc., Ottawa, Ont, Canada). A modified Delphi technique
was used to identify 8 practice-changing articles as well as another 8
articles for table-based summary. Copyright © 2024 Elsevier Inc.

<49>
Accession Number
2037231062
Title
Regional Analgesia in Pediatric Cardiothoracic Surgery: A Bayesian Network
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ren Y.; Li L.; Gao J.; Hua L.; Zheng T.; Wang F.; Zhang J.
Institution
(Ren, Li, Hua, Zheng, Wang, Zhang) Department of Anesthesiology, Beijing
Children's Hospital, Capital Medical University, National Center for
Children's Health, China
(Gao) Department of Orthopedics, Beijing Children's Hospital, Capital
Medical University, National Center for Children's Health, China
Publisher
W.B. Saunders
Abstract
Various regional analgesia techniques are used to reduce postoperative
pain in pediatric patients undergoing cardiothoracic surgeries. This study
aimed to determine the relative efficacy of regional analgesic
interventions. PubMed, EMBASE, Web of Science, and Cochrane databases were
searched to identify all randomized controlled studies evaluating the
effects of regional block after cardiothoracic surgery. The primary
endpoint was opioid consumption within 24 hours postoperatively, Pain
scores, the time to first rescue analgesic, and the incidence of
postoperative nausea and vomiting were also collected. A Bayesian NMA was
performed to compare the outcomes of interest. A total of 24 studies
involving 1602 patients and 13 regional blocks were included. All
techniques reduced opioid consumption within 24 hours postoperatively. The
largest decrease was in the thoracic retrolaminar block group, with a WMD
of -0.97 (95% CrI -1.1, -0.84) mg/kg morphine equivalent. In terms of pain
scores, there was no significant difference between any block and the
control at any time point except for the thoracic retrolaminar block group
at 0 hours postoperatively. In addition, all regional blocks prolonged the
time to first rescue analgesic, which was the longest in the pectoral
nerve block group. The incidence of postoperative nausea and vomiting was
the lowest in the epidural anesthesia group, followed by the transversus
thoracis muscle plane block group. Regional anesthesia revealed
significant opioid-sparing effects following pediatric cardiothoracic
surgery. However, indirect comparisons are limited because of the
heterogeneity of previous studies, and direct comparisons are needed to
establish the relative efficacies of different blocks. Copyright
© 2024

<50>
Accession Number
2035578091
Title
Peculiarities of in-Stent Thrombosis and Restenosis in Coronary Arteries
Post-COVID-19: A Systematic Review of Clinical Cases and Case Series.
Source
Open Access Emergency Medicine. 17 (pp 15-30), 2025. Date of Publication:
2025.
Author
Pivina L.; Batenova G.; Omarov N.; Ygiyeva D.; Messova A.; Alibayeva G.;
Jamedinova U.; Kurumbayev R.; Pivin M.
Institution
(Pivina, Batenova, Omarov, Ygiyeva, Messova, Jamedinova, Kurumbayev)
Department of Emergency Medicine, Semey Medical University, Abay Region,
Semey, Kazakhstan
(Alibayeva) Semey Emergency Hospital, Abay Region, Semey, Kazakhstan
(Pivin) Nuclear Medicine Department, Center of Nuclear Medicine and
Oncology, Abay Region, Semey, Kazakhstan
Publisher
Dove Medical Press Ltd
Abstract
Background: One of the most serious complications of coronary artery
stenting is restenosis and in-stent thrombosis; their prevalence can reach
20-25%. Stent thrombosis can be acute (up to 24 hours), subacute (24 hours
to 30 days), late (30 days to 1 year), and very late (> 1 year after
previous stenting). In the patients with COVID-19 in intensive care units,
the proportion of those with elevated troponin levels reached 25%.
 Objective(s): Evaluation of the association between COVID-19 and the
development of in-stent thrombosis and restenosis of the coronary arteries
based on the analysis of clinical cases and case series. Material(s)
and Method(s): We searched the PubMed and Scopus databases for relevant
case reports and case series of stent restenosis and in-stent thrombosis
associated with coronavirus infection (CVI) published between 2020 and the
present. Thirty-eight full-text publications were screened and manually
checked for analysis. We found 10 publications describing cases of
thrombosis and restenosis of stents associated with coronavirus infection,
of which only 2 were case series. In total, we analyzed 22 cases.
 Result(s): In the structure of in-stent restenosis and thrombosis,
59.1% were very late, 9.1% were late; 18.2% were considered subacute
events, and 13.6% were acute events. All cases were angiographically
confirmed. The main location of restenosis or thrombosis was the left
coronary artery (LAD) (51.1%), thrombosis of the right coronary artery
(RCA) occurred in 27.3%, and location in circumflex artery was in 22.7%.
All patients had COVID-19 confirmed by a PCR test or the presence of
immunoglobulins G and M. In fourteen patients (54.5%), an X-ray
examination showed the presence of bilateral polysegmental infiltration.
 Conclusion(s): Analysis of publications demonstrates the association
between restenosis and in-stent thrombosis in patients with coronary
arteries disease (CAD) and coronavirus infection. Copyright ©
2025 Pivina et al.

<51>
Accession Number
2034580994
Title
Liraglutide effects on epicardial adipose tissue micro-RNAs and
intra-operative glucose control.
Source
Nutrition, Metabolism and Cardiovascular Diseases. 35(2) (no pagination),
2025. Article Number: 103726. Date of Publication: 01 Feb 2025.
Author
Iacobellis G.; Goldberger J.J.; Lamelas J.; Martinez C.A.; Sterling C.M.;
Bodenstab M.; Frasca D.
Institution
(Iacobellis, Bodenstab) Division of Endocrinology, Diabetes and
Metabolism, Department of Medicine, University of Miami Miller School of
Medicine, Miami, FL, United States
(Goldberger, Martinez, Sterling) Division of Cardiology, Department of
Medicine, University of Miami Miller School of Medicine, Miami, FL, United
States
(Lamelas) Division of Cardiothoracic Surgery, DeWitt Daughtry Department
of Surgery, University of Miami Miller School of Medicine, Miami, FL,
United States
(Frasca) Department of Microbiology and Immunology, University of Miami
Miller School of Medicine, Miami, FL, United States
(Frasca) Sylvester Comprehensive Cancer Center, University of Miami Miller
School of Medicine, Miami, FL, United States
Publisher
Elsevier B.V.
Abstract
Background and aim: Epicardial adipose tissue (EAT) plays a role in
coronary artery disease (CAD). EAT has regional distribution throughout
the heart and each location may have a different genetic profile and
function. Glucagon like peptide-1 receptor analogs (GLP-1RAs) reduce
cardiovascular risk. However, the short-term effects of GLP-1RA on
microRNA (miRNA) profile of each EAT location is unknown. Objective was to
evaluate if EAT miRNAs were different between coronary (CORO-EAT), left
atrial EAT (LA-EAT) and subcutaneous fat (SAT), and liraglutide can
modulate EAT miRNAs expression. Methods and Results: This was a
12-week randomized, double-blind, placebo-controlled study in 38 patients
with type 2 diabetes (T2DM) and coronary artery disease (CAD) who were
started on either liraglutide or placebo for a minimum of 4 up to 12 weeks
prior to coronary artery by-pass grafting (CABG). Fat samples were
collected during CABG. miR16, miR155 and miR181a were significantly higher
in CORO-EAT and in LA-EAT than SAT (p < 0.01 and p < 0.05) in overall
patients. miR16 and miR181-a were significantly higher in CORO-EAT than
SAT (p < 0.01), and miR155 and miR181a were higher in LA-EAT than SAT (p <
0.05) in the liraglutide group. Liraglutide-treated patients had better
intra-op glucose control than placebo (146 +/- 21 vs 160 +/- 21 mg/dl, p <
0.01). Conclusion(s): Our study shows that CORO- and LA-miRNAs
profiles were significantly different than SAT miRNAs in overall patients
and miRNAs were significantly higher in CORO-EAT and LA-EAT than SAT in
the liraglutide group. Pre-op liraglutide was also associated with better
intra operative glucose control than placebo independently of weight
loss. Copyright © 2024 The Italian Diabetes Society, the Italian
Society for the Study of Atherosclerosis, the Italian Society of Human
Nutrition and the Department of Clinical Medicine and Surgery, Federico II
University

<52>
[Use Link to view the full text]
Accession Number
2035652499
Title
Stent thrombosis in the setting of ST-segment elevation acute myocardial
infarction in the contemporary practice: results from the TOTAL randomized
trial.
Source
Coronary Artery Disease. 36(2) (pp 126-138), 2025. Date of Publication: 01
Mar 2025.
Author
Moreno R.; Dzavik V.; Cairns J.; Balasubramanian K.; Martinez R.; Cantor
W.J.; Kedev S.; Stankovic G.; Bertrand O.; Pinilla N.; Sibbald M.; Akl E.;
Jolly S.S.
Institution
(Moreno, Martinez) Department of Cardiology, University Hospital La Paz,
Spain
(Moreno, Martinez) Cardiology Department, IdiPAZ, Universidad Autonoma de
Madrid, Madrid, Spain
(Dzavik, Cairns) Cardiology Department, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Balasubramanian) Cardiology Department, University of British Columbia,
Vancouver, BC, Canada
(Pinilla, Sibbald, Akl, Jolly) Cardiology Department, Population Health
Research Institute, Hamilton, ON, Canada
(Cantor) Cardiology Department, Southlake Regional Health Centre,
Newmarket, ON, Canada
(Kedev) Cardiology Department, University Clinic of Cardiology, Saints
Cyril and Methodius University, Skopje, North Macedonia
(Stankovic) Cardiology Department, University of Belgrade, Belgrade,
Serbia
(Bertrand) Cardiology Department, Quebec Heart-Lung Institute, Laval
University, Quebec, QC, Canada
(Pinilla, Sibbald, Akl, Jolly) Department of Medicine, McMaster
University, Hamilton, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
The aim was to know the risk and predictive factors of stent thrombosis
(ST) in patients with ST-elevation myocardial infarction (STEMI) treated
with primary percutaneous coronary intervention (PCI) in the contemporary
practice. The TOTAL [ThrOmbecTomy with percutaneous coronary intervention
(PCI) versus PCI ALone] randomized trial, being the largest trial
performed in the setting of STEMI with a general application of the recent
recommendations, represents a unique opportunity to know the current
real-world incidence of ST as well as its associated factors. A total of
10 064 patients that received >=1 coronary stent in the TOTAL trial
comprise the study population. The risk, predictive factors, and clinical
implications of ST was studied. During 1-year follow-up, 155 patients
(1.54%) suffered definitive or probable ST (59 acute, 67 subacute, and 29
late). Previous infarction, the number of stents, the previous use of
clopidogrel, and the use of diuretics at discharge were independent
predictors for ST, whereas the use of upfront glycoprotein IIb/IIIa
inhibitors, radial access, and treatment with statins at discharge were
independent protective factors. The number of stents, stent diameter,
upfront treatment with IIb/IIIa inhibitors, previous treatment with
clopidogrel, and treatment with statins at discharge were independently
associated with the risk of early ST. Only previous infarction was
associated with the risk of late ST. In the contemporary practice, ST
still constitutes a frequent complication of primary PCI for STEMI,
occurring in 1.5% of patients. Independent predictors are different
depending on the time of ST. Copyright © 2024 Wolters Kluwer
Health, Inc. All rights reserved.

<53>
Accession Number
2036565510
Title
Fate of Abstracts Presented at Annual Meetings of The Society of Thoracic
Surgeons From 2015 to 2019.
Source
Annals of Thoracic Surgery. 119(3) (pp 677-686), 2025. Date of
Publication: 01 Mar 2025.
Author
Valdes C.A.; Bilgili A.; Stinson G.; Sharaf R.M.; Sharaf O.M.; Brennan Z.;
Jimenez-Contreras F.; Peek G.J.; Bleiweis M.S.; Beaver T.M.; Jacobs J.P.
Institution
(Valdes, Bilgili, Stinson, Sharaf, Sharaf, Brennan, Jimenez-Contreras,
Peek, Bleiweis, Beaver, Jacobs) Department of Surgery, University of
Florida College of Medicine, Gainesville, FL, United States
(Brennan) Department of Cardiac Surgery, Smidt Heart Institute, Cedars
Sinai Medical Center, Los Angeles, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Society of Thoracic Surgeons (STS) Annual Meetings provide
opportunities to disseminate cardiothoracic research. We assessed rates of
publication of STS abstracts as manuscripts in peer reviewed journals over
5 years and determined factors associated with successful publication.
 Method(s): The STS "Annual Meeting Archive" was searched online for
abstract books from STS Annual Meetings from 2015 to 2019. Abstract books
were reviewed for information about presented abstracts. PubMed and Google
were then searched to identify corresponding peer reviewed journal
publications. Result(s): There were 1451 abstracts presented at STS
Annual Meetings from 2015 to 2019. The overall publication rate of
accepted abstracts as manuscripts in peer reviewed journals was 1097 of
1451 (75.60%). Most published manuscripts were published in The Annals of
Thoracic Surgery (750 of 1097 [68.37%]). Median duration between abstract
presentation and peer reviewed journal publication was 313 days
(interquartile range [IQR], 212.5-458 days). Only 29 of 1451 abstracts
(2.00%) won an award, and all 29 of these award-winning abstracts were
published as a manuscript. Oral presentation was associated with increased
odds of publication compared with a poster presentation (odds ratio, 1.28;
95% CI, 1.04-1.71; P =.021). Median 5-year impact factor of peer reviewed
journals containing these manuscripts was 5.04 (IQR, 5.04-5.04), and
corresponding manuscripts were cited a median of 4 times (IQR, 1-9 times).
Overall, 836 of 1097 (76.20%) of manuscripts published in peer reviewed
scientific journals had a corresponding North American author.
 Conclusion(s): STS Annual Meetings are a forum for the presentation
of high-quality research. The rate of publication of accepted STS
abstracts as manuscripts in peer reviewed journals is >75%, comparing
favorably with national meetings of other surgical societies, and more
than two-thirds of published manuscripts are published in STS's official
journal. Copyright © 2025 The Society of Thoracic Surgeons

<54>
Accession Number
2037218551
Title
Safety Interventions in Cardiac Anesthesia: A Systematic Review.
Source
Joint Commission Journal on Quality and Patient Safety. (no pagination),
2025. Date of Publication: 2025.
Author
O'Callaghan L.; Ahern S.; Doyle A.
Publisher
Joint Commission Resources, Inc.
Abstract
Background: The cardiac operating room is a complex, high-risk,
sociotechnical system. Risks in cardiac surgery and anesthesiology have
been extensively categorized, but less is known about effective risk
reduction strategies. A comprehensive understanding of effective,
evidence-based risk reduction strategies is necessary to improve patient
safety in cardiac anesthesia. Method(s): An advanced literature
search of MEDLINE, CINAHL, Embase, and Web of Science databases was
conducted to identify studies involving the introduction of a tool or
intervention to improve patient safety and human factors in cardiac
anesthesia. Studies were screened independently by two authors applying
prespecified inclusion and exclusion criteria. Risk reduction strategies
and safety initiatives identified were classified according to the Systems
Engineering Initiative for Patient Safety model. Data were extracted using
a standardized form and were narratively synthesized. Result(s): A
total of 18 studies were identified for inclusion using preoperative
briefing tools, intraoperative checklists, and postoperative handover
tools. Preoperative briefing tools were associated with a significant
reduction in patient mortality and length of hospital stay and also led to
adaptations to planned operation. Intraoperative checklists demonstrated
decreased bleeding, mortality, and blood transfusion requirements.
Postoperative handover tools were associated with improved information
transfer and teamwork. Conclusion(s): This review identified three
categories of tools that may be used to improve patient and organizational
outcomes. Many of these tools are simple to introduce and sustainable in
the long term and can be readily adapted to different
centers. Copyright © 2024 The Joint Commission

<55>
Accession Number
2033038619
Title
Advances in understanding the effects of cardiopulmonary bypass on gut
microbiota during cardiac surgery.
Source
International Journal of Artificial Organs. (no pagination), 2025. Date
of Publication: 2025.
Author
Zhang Y.; Luo W.; Zhao M.; Li Y.; Wu X.
Institution
(Zhang, Luo, Li, Wu) Department of Cardiac surgery, The Second Hospital &
Clinical Medical School, Lanzhou University, Lanzhou, China
(Zhao) Department of Cardiology, First Hospital of Lanzhou University,
Lanzhou University, Lanzhou, China
Publisher
SAGE Publications Ltd
Abstract
Cardiopulmonary bypass (CPB) is an indispensable technique in cardiac
surgery; however, its impact on gut microbiota and metabolites remains
insufficiently studied. CPB may disrupt the intestinal mucosal barrier,
altering the composition and function of gut microbiota, thereby
triggering local immune responses and systemic inflammation, which may
lead to postoperative complications. This narrative review examines
relevant literature from PubMed, Web of Science, Google Scholar, and CNKI
databases over the past decade. Keywords such as "gut microbiota,"
"cardiopulmonary bypass," "cardiac surgery," and "postoperative
complications" were employed, with Boolean operators used to refine the
search results. The review examines changes in gut microbiota before and
after CPB, their role in postoperative complications, and potential
strategies for modulation to improve outcomes. Copyright © The
Author(s) 2025.

<56>
Accession Number
2033097075
Title
Effect of aspirin dosage on oxidative stress and platelet reactivity in
patients undergoing coronary artery bypass grafting (APRICOT): randomized
controlled trial.
Source
Platelets. 36(1) (no pagination), 2025. Article Number: 2457415. Date of
Publication: 2025.
Author
Gasecka A.; Kaczorowski R.; Pomykala K.; Kucharski T.; Gajewska M.; Siwik
D.; Karon K.; Malyszko M.; Hunia J.; Zimodro J.M.; Kowalczyk P.;
Zagrocka-Stendel O.; Dutkiewicz M.; Koziak K.; Eyileten C.; Postula M.;
Wondolkowski M.; Grabowski M.; Kusmierczyk M.; Wilimski R.
Institution
(Gasecka, Kaczorowski, Pomykala, Kucharski, Gajewska, Hunia, Zimodro,
Grabowski) Department of Cardiology, Medical University of Warsaw, Warsaw,
Poland
(Siwik) Department of Psychiatry, Medical University of Warsaw, Warsaw,
Poland
(Karon) Department of Internal Medicine with the Diabetology, Metabolic
Disorders Unit and the Endocrine Diagnostics Unit, Bielanski Hospital,
Warsaw, Poland
(Malyszko) Department of Gastroenterology and Internal Medicine, Medical
University of Warsaw, Warsaw, Poland
(Kowalczyk) Department of Animal Nutrition, The Kielanowski Institute of
Animal Physiology and Nutrition, Polish Academy of Sciences, Jablonna,
Poland
(Zagrocka-Stendel, Dutkiewicz, Koziak) Department of Immunology,
Biochemistry and Nutrition, Medical University of Warsaw, Warsaw, Poland
(Eyileten, Postula) Department of Experimental and Clinical Pharmacology,
Medical University of Warsaw, Warsaw, Poland
(Eyileten, Postula) Center for Preclinical Research and Technology,
Medical University of Warsaw, Warsaw, Poland
(Wondolkowski, Kusmierczyk, Wilimski) Department of Cardio-Thoracic
Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland
Publisher
Taylor and Francis Ltd.
Abstract
Coronary artery bypass grafting (CABG) triggers oxidative stress and
platelet activation. High acetylsalicylic acid (ASA) dose might mitigate
the transient proinflammatory state. We compared the effect of three ASA
dosages on post-CABG platelet reactivity, oxidative stress, and serum CD39
and CD73 levels. Thirty-six consecutive patients undergoing elective
off-pump CABG, pre-treated with ASA 1 x 75 mg for >=7 days, were
randomized to continue the prior treatment regimen, switch to ASA 1 x 150
mg, or ASA 2 x 75 mg. Blood was collected on admission, 7 days, 1 month,
and 3 months after CABG. Platelet reactivity was assessed using impedance
aggregometry. Platelet oxidative stress was measured as platelet
mitochondria extracellular oxygen consumption rate and oxidatively damaged
whole-blood DNA cleavage. Serum CD39 and CD73 levels were determined using
ELISA. Platelet reactivity and oxidative stress parameters were comparable
in all groups. Patients treated with ASA 2 x 75 mg had higher CD39 levels
at 7 days and 1 month (p =.049, p =.033), compared to the control group.
ASA 2 x 75 mg was associated a beneficial effect on serum CD39 levels
after off-pump CABG, without a significant effect on oxidative stress
parameters. Copyright © 2025 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<57>
Accession Number
2032105186
Title
Meta-Analysis of Randomised Controlled Trials Comparing Bypass and
Endovascular Revascularisation for Peripheral Artery Disease.
Source
Vascular and Endovascular Surgery. 59(3) (pp 277-287), 2025. Date of
Publication: 01 Apr 2025.
Author
Pegler A.H.; Thanigaimani S.; Pai S.S.; Morris D.; Golledge J.
Institution
(Pegler, Thanigaimani, Pai, Morris, Golledge) Queensland Research Centre
for Peripheral Vascular Disease, College of Medicine and Dentistry, James
Cook University, Townsville, QLD, Australia
(Thanigaimani, Golledge) The Australian Institute of Tropical Health and
Medicine, James Cook University, Townsville, QLD, Australia
(Morris, Golledge) The Department of Vascular and Endovascular Surgery,
The Townsville University Hospital, Townsville, QLD, Australia
Publisher
SAGE Publications Inc.
Abstract
Objective: Peripheral artery disease affects approximately 250 million
people globally. Multiple randomised controlled trials have compared
bypass and endovascular interventions but the optimum revascularisation
approach remains unclear. The recently published BEST-CLI and BASIL-2
trials provide current and robust data addressing this question, however
their findings are not concordant. This systematic review and
meta-analysis provides an overview of the worldwide randomised evidence
comparing bypass surgery and endovascular revascularisation in lower limb
peripheral artery disease. Method(s): A comprehensive literature
search of MEDLINE, Embase and CENTRAL databases was performed of all time
periods up to 7 May 2023 to identify randomised controlled trials
comparing bypass and endovascular revascularisation for treating lower
limb peripheral artery disease. The primary outcome was major amputation.
Secondary outcomes were mortality, re-intervention, 30-day adverse events
and 30-day mortality. Odds ratios were calculated and pooled using the
random-effects model. Risk of bias was assessed using the Cochrane risk of
bias 2 tool. Result(s): Fourteen cohorts were identified across
thirteen studies, enrolling 3840 patients. There was no significant
difference in major amputation (OR 1.12; 95% CI 0.80-1.57) or mortality
(OR 0.96; 95% CI 0.79-1.17) between the bypass and endovascular groups.
Bypass was associated with a significant reduction in re-intervention
compared with endovascular treatment (OR 0.57, 95% CI 0.40-0.82).
 Conclusion(s): These findings suggest that rates of major amputation
and mortality are similar following bypass and endovascular interventions.
Patients who undergo bypass surgery have a significantly lower
re-intervention rate post-operatively. Copyright © The Author(s)
2024.

<58>
Accession Number
2037362637
Title
The effect of Neurokinin-1 receptor antagonists on postoperative pain: A
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Anesthesia. 102 (no pagination), 2025. Article Number:
111772. Date of Publication: 01 Mar 2025.
Author
D'Amico F.; Kelleher E.; D'Andria Ursoleo J.; Yavorovskiy A.G.; Turi S.;
Zaffaroni S.; Agosta V.T.; Ajello S.; Landoni G.
Institution
(D'Amico, D'Andria Ursoleo, Turi, Zaffaroni, Agosta, Ajello, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Kelleher) Nuffield Department of Clinical Neurosciences, University of
Oxford, Oxford, United Kingdom
(Yavorovskiy) Sechenov First Moscow State Medical University of the
Ministry of Health of the Russian, Moscow, Russian Federation
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
Publisher
Elsevier Inc.
Abstract
Study objective: Substance P is a neuropeptide with a pivotal role in pain
transmission and modulation. Preclinical studies suggest that targeting
substance P and inhibiting its receptor, neurokinin 1 (NK-1), is a
potential avenue for pain relief. When translated into clinical settings,
these preliminary findings yielded mixed results. This meta-analysis of
randomized controlled trials (RCTs) aims to investigate whether a
preemptive administration of NK-1 antagonists may reduce postoperative
pain. Design(s): We searched PubMed, Cochrane and EMBASE from
inception to January 3, 2025, for studies comparing NK-1 antagonists
versus placebo or standard care that reported data on postoperative pain.
The primary outcome was pain at two hours after surgery measured through a
0-10 numeric scale. Secondary outcomes were postoperative pain at 24 and
at 48 h and postoperative morphine equivalent consumption.
 Setting(s): Hospitals. Main Result(s): The search strategies
identified 13 RCTs with a total of 1959 patients. All studies reported a
single preoperative administration of NK-1 antagonists. NK-1 antagonists
reduced postoperative pain two hours (n = 8; MD -0.62; 95 % CI: -0.91,
-0.32; P < 0.001; I2 = 0 %) and at 24 h (n = 9; MD -0.65; 95 % CI: -1.22,
-0.09; P = 0.02; I2 = 86 %) but not 48 h after surgery. Morphine
equivalent consumption was similar in the two groups. Conclusion(s):
Preoperative single-administration of NK-1 antagonists reduces
postoperative pain. The observed pain reduction pattern is consistent with
the pharmacokinetics (half-life 9-12 h) of these inhibitors and with data
from preclinical studies. Copyright © 2025 Elsevier Inc.

<59>
Accession Number
2035615179
Title
Nitrogen single and multiple breath washout test and lung imaging to
detect treatment-related pulmonary toxicity in paediatric cancer patients
and survivors: a systematic review.
Source
European Respiratory Review. 34(175) (no pagination), 2025. Article
Number: 240178. Date of Publication: 01 Jan 2025.
Author
Schneider C.; Koenig C.; Zarkovic M.; Stranzinger E.; Rivero T.M.; Rossler
J.; Kuehni C.E.; Latzin P.; Schindera C.; Usemann J.
Institution
(Schneider, Koenig, Rossler) Division of Paediatric Haematology and
Oncology, Department of Paediatrics, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Schneider, Schindera, Usemann) University Children's Hospital Basel
(UKBB), Basel, Switzerland
(Schneider, Latzin, Usemann) Division of Paediatric Respiratory Medicine
and Allergology, Department of Paediatrics, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Schneider) Graduate School for Cellular and Biomedical Sciences,
University of Bern, Bern, Switzerland
(Zarkovic, Kuehni, Schindera) Institute of Social and Preventive Medicine,
University of Bern, Bern, Switzerland
(Zarkovic) Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
(Stranzinger) Department of Diagnostic, Interventional and Paediatric
Radiology, Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
(Rivero) Medical Library, University Library, University of Bern, Bern,
Switzerland
(Usemann) Division of Respiratory Medicine, University Children's Hospital
Zurich and Childhood Research Centre, Zurich, Switzerland
Publisher
European Respiratory Society
Abstract
Background Spirometry-based assessment of pulmonary function has
limitations in detecting pulmonary toxicity following cancer treatment
with chemotherapy, haematopoietic stem cell transplantation, radiotherapy
or thoracic surgery. Nitrogen single and multiple breath washout tests are
sensitive in assessing peripheral airway function, and lung imaging
detects structural abnormalities, but little is known about their use in
paediatric cancer patients and survivors. We aimed to 1) identify studies
using nitrogen single or multiple breath washout tests and/or lung imaging
to assess pulmonary toxicity in paediatric cancer patients and survivors,
and 2) describe reported abnormalities. Method We systematically searched
MEDLINE, Embase and the Cochrane Library for studies published in
1995-2023. Eligible studies included paediatric cancer patients and
survivors under 22 years of age receiving haematopoietic stem cell
transplantation, chemotherapy, radiotherapy and/or thoracic surgery who
underwent nitrogen single or multiple breath washout tests or lung imaging
for detecting pulmonary toxicity. Two independent reviewers identified the
studies, performed data extraction and assessed risk of bias. Results We
included 12 of 6544 publications. Three studies used nitrogen single or
multiple breath washout tests, seven conducted lung imaging using computed
tomography and two used both nitrogen single or multiple breath washout
tests and lung imaging. Abnormal test results for nitrogen single and
multiple breath washout tests and lung imaging were mainly reported
following haematopoietic stem cell transplantation (67%). All studies
performing lung imaging reported structural abnormalities. Study results
were heterogeneous due to varying patient and methodological
characteristics. Conclusion We identified a limited number of studies,
mainly after haematopoietic stem cell transplantation, reporting
functional and structural lung abnormalities in paediatric cancer patients
and survivors. Longitudinal studies with standardised assessments using
nitrogen single or multiple breath washout tests and lung imaging are
needed to improve our understanding of treatment-related pulmonary
toxicity. Copyright © The authors 2025.

<60>
Accession Number
2037304040
Title
Assessing stable chest pain: the plain case for coronary CT angiography
over stress testing.
Source
European Heart Journal. 46(5) (pp 484-486), 2025. Date of Publication: 01
Feb 2025.
Author
Matuck B.R.S.; Arbab-Zadeh A.
Institution
(Matuck, Arbab-Zadeh) Department of Medicine, Division of Cardiology,
Johns Hopkins University, School of Medicine, 600 N. Wolfe St, Halsted
559, Baltimore, MD, United States
Publisher
Oxford University Press

<61>
Accession Number
2037313457
Title
Early diagnosis to avoid invasive treatment in cardiac migration of a
ventriculoperitoneal catheter: a qualitative systematic review and Weibull
analysis of case reports.
Source
Journal of Neurosurgery. 142(2) (pp 353-362), 2025. Date of Publication:
01 Feb 2025.
Author
Nakae T.; Hojo M.; Arakawa Y.
Institution
(Nakae, Arakawa) Department of Neurosurgery, Kyoto University Graduate
School of Medicine, Kyoto, Kyoto City, Japan
(Nakae, Hojo) Department of Neurosurgery, Shiga General Hospital, Shiga,
Moriyama, Japan
Publisher
American Association of Neurological Surgeons
Abstract
OBJECTIVE The migration of distal catheter after ventriculoperitoneal
shunt placement is a rare but significant complication. Especially in a
case of cardiac migration, open-heart surgery or catheter intervention may
be required. The authors encountered a case of cardiac migration that
fortunately could be treated by withdrawal. A systematic review of cardiac
migration was performed to clarify when and how migration was diagnosed
and why invasive treatments were required. Based on the collected cases, a
Weibull analysis of the latency until diagnosis was performed to examine
whether cardiac migration is caused by an initial factor and to compare
the result with the other migration sites such as gastrointestinal tract
or urinary tract. METHODS A qualitative systematic review was performed
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analysis (PRISMA) guidelines. A database of case reports was created
by searching PubMed and Scopus with the keywords "ventriculoperitoneal AND
shunt AND migration"(last search date: April 2022). Whether the occurrence
rate of migration is constant over time was examined by fitting a Weibull
distribution. RESULTS A total of 339 articles of all migration sites were
identified. Among them, 36 articles reporting 38 cases of cardiac
migration were considered eligible. A total of 39 cases including the
authors' case were reviewed qualitatively. When classifying the cases by
their latency to diagnosis, the rates of pulmonary thrombosis and of
cardiac adhesion were higher in the delayed group (>= 1 year) than in the
early group (<= 1 month). The rate of open chest surgery was higher in the
delayed, intermediate, and early groups, in that order. In the Weibull
analysis, the shape parameter (beta) was less than 1, indicating that the
occurrence rate of cardiac migration was initially high, followed by a
decline. The finding supports the hypothesis that migration results from
an intraoperative vascular injury. Note that these findings are subject to
bias given that they are derived from case reports. CONCLUSIONS In light
of the previous reports, the latency until diagnosis of cardiac migration
was associated with the rate of thrombosis and adhesion, which resulted in
escalation to invasive treatment. Early diagnosis will prevent invasive
treatment because most cases are caused by initial factors, as the Weibull
analysis showed. Copyright © AANS 2025.

<62>
[Use Link to view the full text]
Accession Number
2037328674
Title
Role of Renin-Angiotensin System Inhibitors After Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000001897. Date of Publication: 2025.
Author
Burhan M.; Noor S.; Ahmed M.; Shafiq S.; Ahmed R.; Shahid F.
Institution
(Burhan, Noor, Ahmed, Shafiq) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
Publisher
Lippincott Williams and Wilkins

<63>
Accession Number
2032545323
Title
Trends in safety of catheter-based electrophysiology procedures in the
last 2 decades: A meta-analysis.
Source
Heart Rhythm. 21(9) (pp 1718-1726), 2024. Date of Publication: 01 Sep
2024.
Author
Oates C.P.; Basyal B.; Whang W.; Reddy V.Y.; Koruth J.S.
Institution
(Oates, Basyal) MedStar Heart and Vascular Institute, Georgetown
University-Washington Hospital Center, Washington, DC, United States
(Oates, Whang, Reddy, Koruth) Helmsley Center for Cardiac
Electrophysiology, Icahn School of Medicine at Mount Sinai, New York, New
York, United States
Publisher
Elsevier B.V.
Abstract
Background: Rapid technologic development and expansion of procedural
expertise have led to widespread proliferation of catheter-based
electrophysiology procedures. It is unclear whether these advances come at
cost to patient safety. Objective(s): This meta-analysis aimed to
assess complication rates after modern electrophysiology procedures during
the lifetime of the procedures. Method(s): A comprehensive search was
performed to identify relevant data published before May 30, 2023. Studies
were included if they met the following inclusion criteria: prospective
trials or registries, including comprehensive complications data; and
patients undergoing atrial fibrillation ablation, ventricular
tachyarrhythmia ablation, leadless cardiac pacemaker implantation, and
percutaneous left atrial appendage occlusion. Pooled incidences of
procedure-related complications were individually assessed by random
effects models to account for heterogeneity. Temporal trends in
complications were investigated by clustering trials by publication year
(2000-2018 vs 2019-2023). Result(s): A total of 174 studies (43,914
patients) met criteria for analysis: 126 studies of atrial fibrillation
ablation (n = 24,057), 25 studies of ventricular tachyarrhythmia ablation
(n = 1781), 21 studies of leadless cardiac pacemaker (n = 8896), and 18
studies of left atrial appendage occlusion (n = 9180). The pooled
incidences of serious procedure-related complications (3.49% [2000-2018]
vs 3.05% [2019-2023]; P < .001), procedure-related stroke (0.46% vs 0.28%;
P = .002), pericardial effusion requiring intervention (1.02% vs 0.83%; P
= .037), and procedure-related death (0.15% vs 0.06%; P = .003)
significantly decreased over time. However, there was no significant
difference in the incidence of vascular complications over time (1.86% vs
1.88%; P = .888). Conclusion(s): Despite an increase in cardiac
electrophysiology procedures, procedural safety has improved over
time. Copyright © 2024 Heart Rhythm Society

<64>
Accession Number
2037502350
Title
100.35 An Updated Meta-Analysis of Clinical Outcomes, Interventions, and
Treatment Approaches in SMuRF vs. SMuRF-Less: Evidence From 2.6 Million
ACS Patients.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S1), 2025. Date of Publication: 24 Feb 2025.
Author
Bin Abdul Malik M.H.; Hamza A.; Arham M.; Bin Abdul Malik M.A.; Shahid S.;
Ihsan A.; Tahir T.
Institution
(Bin Abdul Malik) Nassau University Medical Center, East Meadow, NY,
United States
(Hamza) Sheikh Zayed Medical College / Hopsital, Rahim Yar Khan, Pakistan
(Arham, Bin Abdul Malik) Sheikh Zayed Medical College/Hospital, Rahim Yar
Khan, Pakistan
(Shahid) Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
(Ihsan) University Medical and Dental College, Faisalabad, Pakistan
(Tahir) Mercy One North Lowa Medical Center, Mason City, IA, United States
Publisher
Elsevier Inc.
Abstract
Background: SMuRF-less ACS patients lack the traditional modifiable
cardiovascular risk factors (dyslipidemia, hypertension, diabetes,
smoking), raising concerns about poorer clinical outcomes. Method(s):
We searched PubMed, EMBASE, and ScienceDirect databases to find studies
comparing SMuRF-less ACS patients with SMuRFs. A single-arm meta-analysis
was conducted to estimate the proportion of SMuRF-less patients, while a
double-arm meta-analysis was performed to assess relative risks,
confidence intervals (CIs), and I2 statistics for heterogeneity
across various clinical outcomes, interventions, and discharge
medications. Due to significant heterogeneity among studies, a
random-effects model was applied for pooling the data. Result(s):
This updated meta-analysis included 2,650,310 ACS patients, with 356,716
(13.4%) SMuRF-less, having a mean age of 65.2 years compared to 63.2 years
for SMuRF patients. SMuRF-less patients were associated with an increased
risk of in-hospital mortality (RR:1.47, 95%CI:1.12-1.92), Cardiogenic
shock (RR:1.46, 95%CI:1.24-1.70), and cardiac death (RR:1.61,
95%CI:1.03-2.50). SMuRF-less patients were less likely to undergo CABG
(RR: 0.78, 95% CI: 0.61-0.98), albeit with non-significant PCI rates (RR:
1.03, 95% CI: 0.90-1.18). Although adverse events were higher in
SMuRF-less patients, there was underutilization of ACEi/ARBs (RR:0.87,
95%CI:0.79-0.96) in this group, beta-blockers, and statins showed trends
toward higher utilization in SMuRFs with borderline significance.
 Conclusion(s): MuRF-less ACS patients experienced worse outcomes, yet
received less optimal GDMT, specifically ACEi/ARBs. Beta-blockers and
statins showed an inclination toward higher utilization in SMuRFs,
underscoring disparities in care [Formula presented] Copyright ©
2025

<65>
Accession Number
2037442936
Title
Perioperative goal-directed therapy with artificial intelligence to reduce
the incidence of intraoperative hypotension and renal failure in patients
undergoing lung surgery: A pilot study.
Source
Journal of Clinical Anesthesia. 102 (no pagination), 2025. Article Number:
111777. Date of Publication: 01 Mar 2025.
Author
Habicher M.; Denn S.M.; Schneck E.; Akbari A.A.; Schmidt G.; Markmann M.;
Alkoudmani I.; Koch C.; Sander M.
Institution
(Habicher, Denn, Schneck, Akbari, Schmidt, Markmann, Koch, Sander)
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy,
Justus Liebig University of Giessen, Rudolf-Buchheim-Street 7, Giessen,
Germany
(Alkoudmani) Department of General, Visceral, Thoracic, Transplant and
Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim Street
7, Giessen, Germany
Publisher
Elsevier Inc.
Abstract
Study objective: The aim of this study was to investigate whether
goal-directed treatment using artificial intelligence, compared to
standard care, can reduce the frequency, duration, and severity of
intraoperative hypotension in patients undergoing single lung ventilation,
with a potential reduction of postoperative acute kidney injury (AKI).
 Design(s): single center, single-blinded randomized controlled trial.
 Setting(s): University hospital operating room. Patient(s): 150
patients undergoing lung surgery with single lung ventilation were
included. Intervention(s): Patients were randomly assigned to two
groups: the Intervention group, where a goal-directed therapy based on the
Hypotension Prediction Index (HPI) was implemented; the Control group,
without a specific hemodynamic protocol. Measurements: The primary outcome
measures include the frequency, duration of intraoperative hypotension,
furthermore the Area under MAP 65 and the time-weighted average (TWA) of
MAP of 65. Other outcome parameters are the incidence of AKI and
myocardial injury after non-cardiac surgery (MINS). Main Result(s):
The number of hypotensive episodes was lower in the intervention group
compared to the control group (0 [0-1] vs. 1 [0-2]; p = 0.01), the
duration of hypotension was shorter in the intervention group (0 min
[0-3.17] vs. 2.33 min [0-7.42]; p = 0.01). The area under the MAP of 65 (0
mmHg * min [0-12] vs. 10.67 mmHg * min [0-44.16]; p < 0.01) and the TWA of
MAP of 65 (0 mmHg [0-0.08] vs. 0.07 mmHg [0-0.25]; p < 0.01) were lower in
the intervention group. The incidence of postoperative AKI showed no
differences between the groups (6.7 % vs.4.2 %; p = 0.72). There was a
trend to lower incidence of MINS in the intervention group (17.1 % vs.
31.8 %; p = 0.07). A tendency towards reduced postoperative infection was
seen in the intervention group (16.0 % vs. 26.8 %; p = 0.16).
 Conclusion(s): The implementation of a treatment algorithm based on
HPI allowed us to decrease the duration and severity of hypotension in
patients undergoing lung surgery. It did not result in a significant
reduction in the incidence of AKI, however we observed a tendency towards
lower incidence of MINS in the intervention group, along with a slight
reduction in postoperative infections. Copyright © 2025

<66>
Accession Number
2037500520
Title
100.09 Elderly Patients Undergoing PCI or CABG for Left Main Disease -
Individual Patient Data Meta-Analysis of Four Randomized Controlled
Trials.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S22), 2025. Date of Publication: 24 Feb 2025.
Author
Haller P.M.; Bellavia A.; Kappetein P.; Stone G.; Christiansen E.H.;
Murphy S.; Park D.-W.; O'Gara P.T.; Smith P.; Serruys P.W.; Sabik J.; Holm
N.; Sabatine M.S.; Bermark B.A.
Institution
(Haller, Bellavia, Murphy, O'Gara, Sabatine, Bermark) Brigham and Women's
Hospital, Boston, MA, United States
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York City, NY, United States
(Christiansen) Aarhus University Hospial, Aarhus, Denmark
(Park) Asan Medical Center, Seoul, South Korea
(Smith) Duke University School of Medicine, Duke Clinical Research
Institute, Durham, NC, United States
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom, United Kingdom
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Holm) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
Publisher
Elsevier Inc.
Abstract
Background: Age is a key factor in revascularization decisions for
patients with left main (LM) coronary artery disease (CAD). The long-term
outcomes of PCI versus CABG for older patients with LM CAD remain unclear.
 Method(s): Individual patient data were analyzed from four randomized
controlled trials (SYNTAX, PRECOMBAT, NOBLE, EXCEL) comparing PCI vs CABG
in patients with LM CAD considered suitable for either strategy. Adjusted
risks of all-cause and CV death over 5 years were compared for patients <
vs >=75 years. Age-related heterogeneity in treatment effect (PCI vs CABG)
was assessed for absolute and relative risks. Result(s): Among 4,394
patients, 811 (18.5%) were aged >=75 yrs. Compared with patients <75
years, older patients were more frequently female (29% vs 22%), with a
greater proportion with eGFR<60ml/min (28% vs 9%), and higher median
SYNTAX score (27 vs 24) and EuroSCORE (6 vs 2). Older patients had
significantly higher 5-yr rates of all-cause (22% vs 8%) and CV (14% vs
4%, Fig A) death than younger patients (p<0.001 for both). The 5-year
risks of all-cause death and CV death were similar for patients undergoing
PCI vs CABG regardless of age (Fig B). There was no significant
interaction between treatment and age regarding primary and secondary
endpoints (Fig B). Conclusion(s): In patients with LM CAD eligible
for either PCI or CABG, advanced age was associated with an approximately
3-fold higher rate of all-cause and CV death. However, the risks for both
were similar after PCI vs CABG in both age groups. This suggests that in
carefully selected patients, both treatment strategies are reasonable
options with respect to all-cause and CV death. [Formula
presented] Copyright © 2025

<67>
Accession Number
2033204427
Title
Prognostic Value of Perioperative Near-Infrared Spectroscopy Monitoring
for Postoperative Acute Kidney Injury in Pediatric Cardiac Surgery: A
Systematic Review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Niezen C.K.; Modestini M.; Massari D.; Bos A.F.; Scheeren T.W.L.; Struys
M.M.R.F.; Vos J.J.
Institution
(Niezen, Modestini, Massari, Scheeren, Struys, Vos) Department of
Anesthesiology, University Medical Center Groningen, University of
Groningen, Groningen, Netherlands
(Niezen) Department of Anesthesiology, Isala Hospital, Zwolle, Netherlands
(Bos) Department of Neonatology, Beatrix Children's Hospital, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Struys) Department of Basic and Applied Medical Sciences, Ghent
University, Gent, Belgium
Publisher
SAGE Publications Inc.
Abstract
Introduction: Postoperative acute kidney injury (AKI) is a common
postoperative complication in cardiac surgery, with varying reported
incidences and prognostic factors. Renal hypoperfusion is believed to be a
key factor contributing to postoperative AKI. Near-infrared spectroscopy
(NIRS) monitoring, which assesses regional tissue saturation
(RSO<inf>2</inf>), has been suggested as a tool to predict postoperative
AKI. The aim of this systematic review was to examine the prognostic value
of perioperative NIRS monitoring in predicting postoperative AKI in
pediatric patients. Methods and Results: After a systematic search in
PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were
included. The inter-rater agreement on study quality was strong, yet a
high risk of bias was identified. Conclusion(s): The heterogeneity of
the results-in part attributable to several potential confounding factors
regarding study population, monitoring technique and the definition of
AKI-together with the lack of a clear and consistent association between
RSO<inf>2</inf> values and AKI, currently preclude recommending NIRS
monitoring as a reliable and valid clinical tool to "predict" AKI in the
individual patient. Copyright © The Author(s) 2025.

<68>
Accession Number
2035660755
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. 14(2) (no pagination), 2025.
Article Number: e035010. Date of Publication: 21 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, and
Critical Care Medicine, Duke University School of Medicine, Durham, NC,
United States
(Mosher, Palmer, Jones, O'brien) Duke Clinical Research Institute, Durham,
NC, United States
(Osazuwa-Peters, Palmer, Jones, O'brien) Department of Population Health
Sciences, Duke University School of Medicine, Durham, NC, United States
(Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, United States
(Jones) Division of Cardiovascular Disease, Duke University School of
Medicine, Durham, NC, United States
Publisher
American Heart Association Inc.
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. Copyright © 2025 The
Author(s).

<69>
Accession Number
2035660552
Title
Days at Home After Transcatheter Mitral Valve Repair Versus Medical
Therapy Alone in Heart Failure.
Source
Journal of the American Heart Association. 14(1) (no pagination), 2025.
Article Number: e038401. Date of Publication: 07 Jan 2025.
Author
Chung M.; Almarzooq Z.I.; Tale A.; Song Y.; Dahabreh I.J.; Kazi D.S.;
Baron S.J.; Yeh R.W.
Institution
(Chung) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Chung, Almarzooq, Tale, Song, Dahabreh, Kazi, Baron, Yeh) Smith Center
for Outcomes Research in Cardiology, Division of Cardiovascular Medicine,
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA,
United States
(Almarzooq) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Tale, Song, Kazi, Yeh) Division of Cardiovascular Medicine, Department of
Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
(Dahabreh) CAUSALab, Department of Epidemiology and Department of
Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,
United States
(Baron) Division of Cardiology, Department of Medicine, Massachusetts
General Hospital, Boston, MA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Transcatheter edge-to-edge repair of the mitral valve (mTEER)
reduced a hierarchical end point that included death and heart failure
hospitalization in COAPT (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation Trial). However, the magnitude to which mTEER
increases the number of days a patient spends at home (DAH) in the first
few years after treatment, a patient-centered end point not captured
routinely in clinical trials, has not been evaluated. We compared 1-and
2-year DAH among patients with functional mitral regurgitation and heart
failure randomized to mTEER plus medical therapy versus medical therapy
alone (control) by linking the COAPT trial to comprehensive health care
claims data. METHODS AND RESULTS: We linked data from COAPT trial
participants to Medicare fee-for-service claims. DAH was calculated as the
number of days alive and spent outside a hospital, skilled nursing
facility, inpatient rehabilitation, long-term acute care hospital,
emergency department, or observation stay after randomization. Treatment
groups were compared using quantile regression to calculate the area under
the curve of cumulative distribution functions. We linked 271 patients
(mTEER 136/302, control 135/312) for a 2-year follow-up. Mean+/-SD DAH at
1 year was 312.0+/-95.6 in mTEER and 298.1+/-107.5 in controls with
similar area under the curve (difference 13.9 days [-10.5 to 38.3],
P=0.26). DAH at 2 years was 577.2+/-235.6 in mTEER and 518.2+/-253.0 in
control with a higher area under the curve in mTEER (difference 59.0 days
[0.07 to 117.9], P=0.0497). CONCLUSION(S): In the COAPT trial linked
to Medicare claims, patients randomized to mTEER spent a similar number of
DAH at 1 year but more time at home at 2 years compared with medical
therapy alone. Copyright © 2024 The Author(s). Published on
behalf of the American Heart Association, Inc., by Wiley.

<70>
Accession Number
646502914
Title
Association of urgent transcatheter aortic valve replacement (TAVR) with
acute kidney injury 30-days post-TAVR: a systematic review and
meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2024. Athens Greece. 13(Supplement 1) (pp i300), 2024.
Date of Publication: 01 Apr 2024.
Author
Ktenopoulos N.; Apostolos A.; Chlorogiannis D.; Katsaros O.; Korovesis T.;
Koliastasis L.; Kachrimanidis I.; Simopoulou C.; Karmpalioti M.;
Drakopoulou M.; Tsalamandris S.; Karanasos A.; Synetos A.; Tsioufis K.;
Toutouzas K.
Institution
(Ktenopoulos, Apostolos, Katsaros, Korovesis, Koliastasis, Kachrimanidis,
Simopoulou, Karmpalioti, Drakopoulou, Tsalamandris, Karanasos, Synetos,
Tsioufis, Toutouzas) Ippokrateio General Hospital of Athens, Athens,
Greece
(Chlorogiannis) Harvard Medical School, Department of Interventional
Radiology, Boston, United States
Publisher
Oxford University Press
Abstract
Introduction: Recent studies have proven that TAVR is a viable treatment
option for symptomatic aortic stenosis (AS), regardless of surgical risk,
even though, there are certain significant hazards associated with it.
Even with the improvements in technique and experience, peri- and
post-procedural complications like acute kidney injury (AKI) continue to
occur frequently and are recognized for their serious clinical
implications in the setting of TAVR. The vast majority of TAVR procedures
conducted across the US are elective procedures on patients who are
hemodynamically stable. Nonetheless, published data, imply that urgent
TAVR, despite higher mortality rates is a feasible option to treat
decompensated severe aortic valve stenosis. Purpose(s): The aim of
this systematic review and meta-analysis is to assess AKI in patients
30-days after an urgent TAVR and compare them with the elective TAVR
population. Method(s): This meta-analysis adhered to the guidelines
of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA). A comprehensive database search was conducted using three major
databases (Medline, Cochrane Central Register of Controlled Trials and
Scopus) for studies comparing patients submitted to urgent versus elective
TAVR. Primary endpoint of our systematic review and meta-analysis is the
AKI 30-days after TAVR. Only studies provided data about our primary
endpoint were considered in the analysis. Secondary endpoints included
myocardial infarction (MI), permanent pacemaker implantation (PPM) and
bleeding events during the first 30-days post-procedurally. Risk ratio
(RR) was calculated with 95% confidence intervals (CIs) and a
random-effects model (Mantel-Haenzel) was used to estimate the pooled RR.
 Result(s): A total of 16 studies with 101,568 patients were added in
our analysis. Among them, 16,349 patients underwent an urgent TAVR, while
the rest 85,219 had an elective procedure. Our analysis showed that
patients submitted to urgent TAVR have 258% higher risk for AKI during the
first 30-days post-procedurally (RR: 2.58, 95%CI: 1.98, 3.37) (Figure).
Data about the 30-days MI, PPM and bleeding events were available for 9,
15 and 11 studies, respectively. The risk for MI appeared to be
significantly higher in patients undergone urgent TAVR (RR: 5.49, 95% CI:
1.76, 17.05), while the risk for bleeding events was slightly higher in
the same group (RR: 1.39, 95% CI: 1.14, 1.70). No significant differences
were observed in PPM incidence (RR: 1.05, 95%CI: 1.00, 1.11) during
30-days follow-up. Conclusion(s): In this systematic review and
meta-analysis, patients undergoing urgent TAVR procedures compared to
elective procedures have increased risk for AKI during the first 30-days
post-TAVR. Thus, when urgent TAVR is performed risk factors for AKI should
be evaluated and proper renal protection measures, such as adequate
hydration and minimal contrast agent administration, should be
implemented. Further research in this area is warranted.

<71>
Accession Number
646502886
Title
Urgent transcatheter aortic valve implantation (TAVI) is associated with
increased in-hospital mortality: a systematic review and meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2024. Athens Greece. 13(Supplement 1) (pp i298), 2024.
Date of Publication: 01 Apr 2024.
Author
Apostolos A.; Ktenopoulos N.; Chlorogiannis D.; Katsaros O.; Korovesis T.;
Koliastasis L.; Oikonomou G.; Karmpalioti M.; Sakalidis A.; Drakopoulou
M.; Tsalamandris S.; Trantalis G.; Aggeli C.; Tsioufis C.; Toutouzas K.
Institution
(Apostolos, Ktenopoulos, Katsaros, Korovesis, Koliastasis, Oikonomou,
Karmpalioti, Sakalidis, Drakopoulou, Tsalamandris, Trantalis, Aggeli,
Tsioufis, Toutouzas) National and Kapodistrian University of Athens
Medical School, Athens, Greece
(Chlorogiannis) Massachusetts General Hospital, Harvard Medical School,
Department of Interventional Radiology, Boston, United States
Publisher
Oxford University Press
Abstract
Introduction: Transcatheter Aortic Valve Implantation (TAVI) is
recommended for patients suffering from severe aortic stenosis (AoS) as an
elective procedure. Taking into consideration that AoS is associated with
acute heart failure and cardiogenic stroke resistant to pharmacotherapy,
urgent TAVI might be a therapeutic option. However, a few data exist
regarding its safety and efficacy against this background.
 Purpose(s): Aim of our systematic review and meta-analysis is to
compare in-hospital mortality among patients undergoing urgent and
elective TAVI. Method(s): We systematically screened three major
databases (Medline, Cochrane Central Register of Controlled Trials and
Scopus) searching for studies comparing urgent versus elective TAVI.
Primary endpoint of our systematic review and meta-analysis is the
in-hospital mortality. Only studies provided data about in-hospital
mortality were considered for our analysis. Secondary endpoints included
acute kidney injury (AKI), permanent pacemaker implantation (PPM) and
ischemic stroke. All the secondary endpoints were evaluated during the
first 30-days after TAVI. Risk ratio (RR) was calculated with 95%
confidence intervals (CIs) and a random-effects model (Mantel-Haenzel) was
used to estimate the pooled RR. Result(s): Twelve studies, all
retrospective except one, published between 2014 and 2023 were included in
our analysis. A total of 133,348 patients undergoing TAVI were included in
our analysis; 110,606 had elective procedure and the 22,742 urgent
intervention. Mortality rate was 5.1% in urgent and 2.2% in elective
group. The risk of mortality is 2.38 times higher in the urgent TAVI group
compared to the elective TAVI group (RR: 2.38, 95% CI: 1.80, 3.15). Data
about AKI, PPM and stroke during the first 30-days were available for 12,
11 and 11 studies, respectively. The risk for AKI is significantly higher
in patients having undergone urgent TAVI (RR: 2.10, 95% CI:1.62, 2.73). No
significant differences were observed in stroke incidence (RR: 1.07, 95%
CI: 0.97, 1.18) and PPM (RR: 1.05, 95%CI: 0.99, 1.11) during 30-days
follow-up. Conclusion(s): To the best of our knowledge, this is the
first systematic review and meta-analysis showing that urgent TAVI is
associated with significantly higher in-hospital mortality rates, compared
to elective TAVI. Given these results, it is advisable to prefer an
elective procedure, prior disease's worsening, in order to prevent the
increased risk of in-hospital mortality associated with urgent TAVI.

<72>
Accession Number
646502898
Title
Urgent transcatheter aortic valve replacement (TAVR) in patients with
severe aortic stenosis is associated with increased 30-days mortality: a
systematic review and meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2024. Athens Greece. 13(Supplement 1) (pp i299), 2024.
Date of Publication: 01 Apr 2024.
Author
Ktenopoulos N.; Apostolos A.; Chlorogiannis D.; Katsaros O.; Korovesis T.;
Koliastasis L.; Kachrimanidis I.; Simopoulou C.; Oikonomou G.; Karmpalioti
M.; Drakopoulou M.; Tsalamandris S.; Karanasos A.; Tsioufis C.; Toutouzas
K.
Institution
(Ktenopoulos, Apostolos, Katsaros, Korovesis, Koliastasis, Kachrimanidis,
Simopoulou, Oikonomou, Karmpalioti, Drakopoulou, Tsalamandris, Karanasos,
Tsioufis, Toutouzas) Ippokrateio General Hospital of Athens, Athens,
Greece
(Chlorogiannis) Harvard Medical School, Department of Interventional
Radiology, Boston, United States
Publisher
Oxford University Press
Abstract
Introduction: In patients with severe symptomatic aortic stenosis (AS),
transcatheter aortic valve replacement (TAVR) has emerged as a safe and
effective therapeutic option; yet, 20% of these patients' hospitalizations
are related to acute decompensation. The vast majority of TAVR procedures
conducted across the US are elective procedures on patients who are
hemodynamically stable. Despite that, according to recent research, urgent
TAVR may be a feasible option for AS patients experiencing acutely
decompensated heart failure or cardiogenic shock. Additionally, there is
also a gap in the guidelines concerning the interventions in this acute
setting, with only a brief recommendation for aortic balloon valvuloplasty
as a bridge to TAVR or surgery in decompensated AS. Purpose(s): The
aim of this systematic review and meta-analysis is to assess 30-days
mortality post-TAVR in patients submitted to an urgent procedure and
compare them with the elective TAVR population. Method(s): We
systematically searched three major databases (Medline, Cochrane Central
Register of Controlled Trials and Scopus) for studies comparing patients
submitted to urgent versus elective TAVR. Primary endpoint of our
systematic review and meta-analysis is the 30-days mortality
post-procedurally. Only studies provided data about our primary endpoint
were considered in this analysis. Secondary endpoints comprised acute
kidney injury (AKI), permanent pacemaker implantation (PPM) and stroke
during the first 30-days post-TAVR. Risk ratio (RR) was calculated with
95% confidence intervals (CIs) and a random-effects model (Mantel-Haenzel)
was used to estimate the pooled RR. Result(s): This systematic review
acquired 497 results. After duplicates removal, we screened 454 reports
and we read full-text articles of 35 studies. Fourteen studies were
included in our analysis. A total of 43,051 patients undergoing TAVR were
included in our analysis; 3,607 patients submitted to an urgent TAVR,
while the rest 39,444 had an elective procedure. Our analysis showed that
patients undergoing urgent TAVR have 244% higher risk for mortality during
the first 30-days post-procedurally (RR: 2.44, 95%CI: 1.49, 3.99)
(Figure). Data about AKI, PPM and stroke during the first 30-days
post-TAVR were available for 10 studies. The risk for AKI appeared to be
significantly higher in patients undergone urgent TAVR (RR: 2.68, 95% CI:
1.60, 4.47). No significant differences were observed in stroke incidence
(RR: 1.04, 95% CI: 0.89, 1.20) and PPM (RR: 1.08, 95%CI: 0.95, 1.22)
during 30-days follow-up. Conclusion(s): Compared to elective
procedures, urgent TAVR seems to have increased 30-days mortality and AKI,
and comparable PPM and stroke rates. These findings provide valuable
insights offering potential updates to current guidelines in this field.
Further studies on long-term outcomes and in a larger patient population
are needed.

<73>
Accession Number
646502874
Title
Urgent TAVI not associated with higher rates of conversion to urgent
cardiac surgery: a systematic review and meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2024. Athens Greece. 13(Supplement 1) (pp i297), 2024.
Date of Publication: 01 Apr 2024.
Author
Apostolos A.; Ktenopoulos N.; Chlorogiannis D.-D.; Katsaros O.;
Koliastasis L.; Kachrimanidis I.; Simopoulou C.; Sagris M.; Konstantinou
K.; Tsalamandris S.; Drakopoulou M.; Karanasos A.; Aggeli C.; Tsioufis C.;
Toutouzas K.
Institution
(Apostolos, Ktenopoulos, Katsaros, Koliastasis, Kachrimanidis, Simopoulou,
Sagris, Tsalamandris, Drakopoulou, Aggeli, Tsioufis, Toutouzas) National
and Kapodistrian, University of Athens Medical School, Athens, Greece
(Chlorogiannis) Massachusetts General Hospital, Harvard Medical School,
Department of Interventional Radiology, Boston, United States
(Konstantinou) Royal Brompton and Harefield NHS Foundation Trust, Greater
London, United Kingdom
(Karanasos) University Hospital of Patras, Patras, Greece
Publisher
Oxford University Press
Abstract
Introduction: Transcatheter Aortic Valve Implantation (TAVI) has been
established as a therapeutic option in patients with severe Aortic valve
Stenosis (AoS). Although TAVI has been associated with high procedural
success, it is rarely required conversion to cardiac surgery, for the
management of complications. It remains unknown whether the rate of
conversion to urgent cardiac surgery is higher in patients undergoing
urgent TAVI compared to elective TAVI. Purpose(s): The aim of our
systematic review and meta-analysis is to investigate whether patients
treated with urgent TAVI are under higher risk for urgent conversion to
cardiac surgery. Method(s): We systematically conducted a thorough
search of three major databases (Medline, Cochrane Central Register of
Controlled Trials, and Scopus) to identify studies comparing urgent and
elective TAVI. Our primary endpoint in this systematic review and
meta-analysis was the incidence of unanticipated, emergent conversions to
open cardiac surgery during the TAVI procedure. Only studies that provided
data on this endpoint were considered for inclusion in our analysis.
Secondary endpoints included vascular complications, the presence of
post-procedural moderate or severe aortic regurgitation, in-hospital
mortality, and the device success. These secondary endpoints were
evaluated during the inpatient stay of the patients. For the statistical
analysis, we computed risk ratios (RR) with corresponding 95% confidence
intervals (CIs). We employed a random-effects model (Mantel-Haenszel), to
estimate the pooled RR. Result(s): A total of six studies,
encompassing 70,296 patients, were included in our analysis. Among them,
5,021 patients underwent an urgent TAVI procedure, while the remaining
65,275 underwent elective TAVI. During TAVI, conversion to urgent cardiac
surgery did not vary significantly between the two groups (RR: 0.90, 95%
CI:0.66-1.24]. Moreover, no significant differences were observed in
vascular complications (RR:1.55, 95% CI: 0.92-2.61), post-procedural
moderate or severe aortic regurgitation (RR:1.20, 95% CI: 0.85-1.69) and
device success (RR:0.99, 95% CI: 0.98-1.00). Notably, in-hospital
mortality was higher in urgent TAVR group (RR: 2.08, 95% CI: 1.69-2.56).
 Conclusion(s): Our systematic review and meta-analysis have
demonstrated that patients undergoing urgent TAVI are not at a higher risk
for urgent cardiac surgery, device failure, vascular complications, or
post-procedural moderate or severe aortic regurgitation. Notably, despite
these findings, the higher in-hospital mortality observed in patients
undergoing urgent TAVI suggests the presence of other factors that should
be explored to account for this increased mortality.

<74>
[Use Link to view the full text]
Accession Number
2037332181
Title
Stepwise Provisional Versus Systematic Dual-Stent Strategies for Treatment
of True Left Main Coronary Bifurcation Lesions.
Source
Circulation. (no pagination), 2025. Date of Publication: 2025.
Author
Arunothayaraj S.; Egred M.; Banning A.P.; Brunel P.; Ferenc M.; Hovasse
T.; Wlodarczak A.; Pan M.; Schmitz T.; Silvestri M.; Erglis A.; Kretov E.;
Lassen J.F.; Chieffo A.; Lefevre T.; Burzotta F.; Cockburn J.; Darremont
O.; Stankovic G.; Morice M.-C.; Louvard Y.; Hildick-Smith D.
Institution
(Arunothayaraj, Cockburn, Hildick-Smith) Department of Cardiology, Sussex
Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, United
Kingdom
(Egred) Department of Cardiology, Freeman Hospital and Newcastle
University, Newcastle upon Tyne, United Kingdom
(Banning) Department of Cardiology, Oxford Heart Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Brunel) Clinique de Fontaine, Interventional Cardiology Unit, Dijon,
France
(Ferenc) Department of Cardiology and Angiology, University Heart Center
Freiburg-Bad Krozingen, Germany
(Hovasse, Lefevre, Morice, Louvard) Department of Cardiology, Institut
Cardiovasculaire Paris Sud, Ramsay Sante, Massy, France
(Wlodarczak) Department of Cardiology, Poland Miedziowe Centrum Zdrowia
Lubin, Poland
(Pan) Department of Cardiology, University of Cordoba, Reina Sofia
Hospital, Spain
(Schmitz) Contilia Heart and Vascular Center, Elisabeth Krankenhaus Essen,
Germany
(Silvestri) Department of Cardiology, GCS Axium, Rambot, Aix en Provence,
France
(Erglis) Department of Cardiology, Pauls Stradins Clinical University
Hospital, University of Latvia, Riga, Latvia
(Kretov) Sibirskiy Federal Biomedical Research Center Novosibirsk,
Interventional Cardiology Unit, Russian Federation
(Lassen) Department of Cardiology, Odense University Hospital, Denmark
(Chieffo) Interventional Cardiology Unit, San Raffaele Scientific
Institute, Milan, Italy
(Burzotta) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore,
Rome, Italy
(Darremont) Department of Cardiology, Clinique Saint-Augustin-Elsan,
Bordeaux, France
(Stankovic) Department of Cardiology, University Clinical Center of Serbia
and Faculty of Medicine, University of Belgrade, Serbia
(Ferenc) Institute of Heart Diseases, Wroclaw Medical University, Poland
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The optimal coronary stenting technique for true left main
bifurcation lesions is uncertain. EBC MAIN (European Bifurcation Club Left
Main Trial) aimed to evaluate clinical outcomes of a stepwise provisional
strategy compared with a systematic dual-stent approach. METHOD(S):
EBC MAIN was a randomized, investigator-initiated, open-label,
multicenter, parallel-group trial conducted across 35 hospitals in 11
European countries. A total of 467 participants undergoing percutaneous
coronary intervention for unprotected true left main bifurcation lesions
were randomly assigned to the stepwise provisional strategy (n=230) or an
upfront dual-stent approach (n=237). The mean (SD) age was 71 (10) years
and 23% of participants were women. The primary end point was a composite
of major adverse cardiac events, defined as all-cause mortality, all
myocardial infarction, or clinically driven target lesion
revascularization. Events were adjudicated by an independent clinical
events committee and all analyses were by the intention-to-treat
principle. RESULT(S): At 3 years, the primary end point occurred in
54 of 230 (23.5%) stepwise provisional and 70 of 237 (29.5%) dual-stent
patients (hazard ratio, 0.75 [95% CI, 0.53-1.07]; P=0.11). There was no
significant difference in all-cause mortality (10.0% versus 13.1%) or
myocardial infarction (12.2% versus 11.0%). However, target lesion
revascularization was significantly lower in the stepwise provisional
group (8.3% versus 15.6%; hazard ratio, 0.50 [95% CI, 0.29-0.86];
P=0.013). In this population, the mean side vessel diameter by
quantitative angiography was 2.9 mm, and median side vessel lesion length
was 5 mm. Significant interactions were identified between the assigned
bifurcation strategy and both side vessel diameter and lesion length with
respect to the primary outcome (P=0.009 and P=0.005, respectively), with
smaller vessels (<3.25 mm diameter) and shorter lesions (<10 mm length)
favoring the provisional approach. CONCLUSION(S): In a European
population with true left main stem bifurcation coronary disease requiring
intervention, there was no difference in major adverse cardiovascular
events between stepwise provisional and systematic dual-stent strategies
at 3 years. Target lesion revascularization was significantly less
frequent with the stepwise provisional approach, which should be the
default strategy for noncomplex left main bifurcation coronary
intervention. Copyright © 2025 American Heart Association, Inc.

<75>
Accession Number
646486955
Title
Aortic Annular Enlargement: Y-Incision Rationale, Technique, and Outcomes.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 30 Jan 2025.
Author
Chen S.A.; Do-Nguyen C.C.; Titsworth M.; Yang B.
Institution
(Chen) Division of Cardiac Surgery, University of California, Davis,
Sacramento, CA
(Do-Nguyen, Titsworth, Yang) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
Abstract
BACKGROUND: Trials comparing transcatheter (TAVR) and surgical aortic
valve replacements (SAVR) have shown that in patients with annuli <26 mm,
SAVR had negative hemodynamic and clinical outcomes. Recently, studies
revealed that the effective orifice diameter of surgical prosthetic valves
is 5-7 mm smaller than the labeled valve size. To improve outcomes of
SAVR, the Y-incision aortic annular enlargement (AAE) enlarges the
surgical aortic annulus to accommodate a prosthetic valve 3-4 sizes larger
with an effective orifice area that matches the patient's native annulus.
This review discussed when and how the Y-incision AAE should be performed.
 METHOD(S): OVID MEDLINE, OVID Embase, and Cochrane Library were
searched with terms that included "Y-incision aortic annular enlargement,"
"valve sizes," and "long-term survival." The search included publications
after 2020. The reference lists of included studies were reviewed to
retrieve additional studies. RESULT(S): In patients with matched
native annular sizes, AAE significantly improved midterm survival without
increasing perioperative complications. Patients treated with a larger
valve had significantly better long-term survival and small valve sizes
were significant risk factors for operative and long-term mortality.
Compared with patients treated with a Nicks or Manougian procedure, the
hemodynamics in patients treated with Y-incision AAE were significantly
better. CONCLUSION(S): Y-incision AAE could be routinely considered
for patients with a normal annulus (17-25 mm) undergoing
SAVR. Copyright © 2025. Published by Elsevier Inc.

<76>
Accession Number
646488748
Title
Impact of behavior change theory-based nursing interventions on cardiac
function recovery and quality of life among cardiac surgery patients with
cardiopulmonary bypass.
Source
Journal of cardiothoracic surgery. 20(1) (pp 109), 2025. Date of
Publication: 31 Jan 2025.
Author
Zhao Y.; Wei W.; Wang Z.; Dong Y.; Su Z.; Guo S.
Institution
(Zhao, Wei, Wang, Dong, Su) Department of Cardiac Surgery, First Hospital
of Hebei Medical University, No. 89 Donggang Road ,Yuhua District,
Shijiazhuang, Hebei, China
(Guo) Department of Cardiac Surgery, First Hospital of Hebei Medical
University, No. 89 Donggang Road ,Yuhua District, Shijiazhuang, Hebei,
China
Abstract
BACKGROUND: This study investigates the impact of nursing interventions,
guided by behavior change theory, on the recovery of cardiac function and
quality of life in patients undergoing cardiac surgery with
cardiopulmonary bypass (CPB). METHOD(S): A total of 120 patients
scheduled for CPB in the Department of Cardiology at our hospital, from
February 2021 to May 2023, were enrolled. According to the study protocol,
patients were randomly assigned to either a control group (n = 60) or an
observation group (n = 60) post-surgery. The control group received
routine nursing care, while the observation group received nursing
interventions based on behavior change theory, including health education,
psychological support, and behavioral incentives. Informed consent was
obtained from all patients. General patient data were collected from
clinical records. Cardiac function was assessed using echocardiography.
The wall motion score index (WMSI) and 6-minute walk distance (6MWD) were
evaluated post-care. Serum levels of inflammatory cytokines TNF-alpha,
IL-6, and IL-10 were measured via ELISA. Quality of life was assessed
using the WHOQOL-BREF questionnaire, while anxiety and depression levels
were evaluated using the HAM-A and HAM-D scales, respectively.
 RESULT(S): The baseline clinical characteristics and biochemical data
of both groups were comparable (P > 0.05). The observation group showed a
significantly higher left ventricular ejection fraction (LVEF) compared to
the control group (P < 0.05), while both left ventricular end-systolic
diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were
significantly lower (P < 0.05). Additionally, the observation group had a
significantly lower WMSI score and a longer 6MWD (P < 0.05). Regarding
inflammatory markers, TNF-alpha and IL-6 levels were significantly reduced
in the observation group, while IL-10 levels were significantly elevated
compared to the control group (P < 0.05). In terms of quality of life, the
observation group reported significantly higher scores in physical health,
mental health, social relationships, and environmental factors (P < 0.05).
Moreover, anxiety and depression levels were significantly lower in the
observation group, as evidenced by reduced HAM-A and HAM-D scores (P <
0.05). CONCLUSION(S): Nursing care guided by behavior change theory
significantly improves cardiac function and overall quality of life in
patients recovering from cardiac surgery with CPB. This approach enhances
LVEF, reduces left intraventricular diameter, lowers inflammatory cytokine
levels, and improves mental health and social functioning. These findings
underscore the importance of behavior change theory-based nursing
interventions in optimizing postoperative recovery. Copyright ©
2024. The Author(s).

<77>
Accession Number
2037505825
Title
ROLE OF THORACOSCOPY AS A TOOL IN ADVANCED OVARIAN CANCER SURGERY.
Source
International Journal of Gynecological Cancer. Conference: ESGO 2025
Congress. Rome Italy. 35(2 Supplement 1) (no pagination), 2025. Article
Number: 100180. Date of Publication: 01 Feb 2025.
Author
Utrilla-Layna J.; Garcia J.E.; Bouthelier I.
Institution
(Utrilla-Layna, Garcia, Bouthelier) Hospital Fundacion Jimenez Diaz,
Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Introduction/Background Advanced ovarian cancer represents a constant
challenge. Complete cytoreduction directly impacts in overall survival;
however, this is only possible in 12% FIGO stage IV cases. Improvements in
surgical techniques, standardization processes, and surgeries performed by
gynecologic oncologists have led to higher rates of primary R0. In cases
of thoracic involvement after CT or PET-CT regarding suspicious lymph
nodes or implants, whether in the mediastinum, pericardiophrenic,
diaphragm, or chest wall, the possibility of operating on them should be
considered. Although it has been shown that the resection of suspicious
cardiophrenic lymph nodes is feasible without associating relevant
comorbidities, evidence on therapeutic benefits remains limited, and
therefore, the impact on progression-free survival and overall survival
remains controversial. Given that there is currently no evidence on the
therapeutic benefit of removing pathological cardiophrenic lymph nodes in
patients with complete cytoreduction in advanced epithelial ovarian
cancer, and there are no clear established guidelines recommending
surgical indications for patients with suspicious cardiophrenic lymph
nodes. Methodology At our Tertiary Hospital, we perform thoracoscopy for
the excision of thoracic enlarged/suspicious lymph nodes. Initially It is
performed laparoscopy for staging and biopsy. In case of patients with
PCI<20 and Fagotti Score <10, within the same time of surgery, a
video-assisted thoracoscopy is carried out for excision of lymph nodes in
the costophrenic and cardiophrenic recesses. Within 2 weeks after
confirming biopsy results, cytorreductive surgery is performed. Results It
has been performed in 10 patients, without complications and discharged
within 24 hours after surgery. This is surgery has low morbidity rates,
requiring only a one-day hospital stay, and it allows for complete
cytoreduction in patients who would have otherwise received neoadjuvant
chemotherapy due to being stage IV with extra-abdominal involvement.
Conclusion We must consider thoracoscopy as a management option for
advanced ovarian cancer. Patients who are not candidates for primary
cytoreduction due to thoracic involvement could benefit from thoracic
surgery during the same surgical procedure and achieve R0, which has been
shown to be most effective in increasing overall and disease-free survival
in this type of tumor. Therefore, "thoracic cytoreduction" of
cardiophrenic lymph nodes should only be considered in cases without other
extra-abdominal disease where complete primary surgery is feasible.
Thoracoscopy allows for histological confirmation and removal of disease
in the thorax, increasing the chances of achieving R0 in patients with
stage IV ovarian cancer. The role of thoracoscopy in randomized trials,
remains to be defined. Disclosures Kengsakul M, Nieuwenhuyzen-de Boer GM,
Bijleveld AHJ, et al. Survival in advanced-stage epithelial ovarian cancer
patients with cardiophrenic lymphadenopathy who underwent cytoreductive
surgery: a systematic review and metaanalysis. Cancers (Basel) 2021;13:19.
Prader S, Harter P, Grimm C, et al. Surgical management of cardiophrenic
lymph nodes in patients with advanced ovarian cancer. Gynecol Oncol
2016;141:271-5. Wimberger P, Wehling M, Lehmann N, et al. Influence of
residual tumor on outcome in ovarian cancer patients with FIGO stage IV
disease. Ann Surg Oncol 2010;17:1642-8. Prader S, Vollmar N, du Bois A, et
al. Pattern and impact of metastatic cardiophrenic lymph nodes in advanced
epithelial ovarian cancer. Gynecol Oncol 2019;152:76-81. Sussman SK,
Halvorsen RA Jr, Silverman PM, et al. Paracardiac adenopathy: CT
evaluation. AJR Am J Roentgenol 1987;149:29-34. Agusti N, et al. Int J
Gynecol Cancer 2024;34:150-158. https://doi.org/10.1136/ijgc-2023-004963
Nuruzzaman HSM, Tan GHC, Nadarajah R, et al. Relevance of enlarged
cardiophrenic lymph nodes in determining prognosis of patients with
advanced ovarian cancer. BMJ Case Rep
2018;2018:bcr2017221450. Copyright © 2024

<78>
Accession Number
646488641
Title
Dexmedetomidine for delirium prevention in adult patients following
cardiac surgery: a meta-analysis of randomized controlled trials.
Source
Journal of cardiothoracic surgery. 20(1) (pp 110), 2025. Date of
Publication: 31 Jan 2025.
Author
Meng C.; Wang D.; Zhao Y.; Sun J.; Miao G.; Chen L.; Bai Y.; Liu P.
Institution
(Meng, Zhao, Miao, Chen) Department of Emergency, Emergency General
Hospital, XiBaHe South Road 29, Beijing, China
(Wang) Department of General Medicine, Ordos School of Clinical Medicine,
Ordos Central Hospital, Inner Mongolia Medical University, Ordos, China
(Sun, Bai) Department of Critical Care Medicine, Emergency General
Hospital, XiBaHe South Road 29, Beijing, China
(Liu) Department of Cardiology, Ordos School of Clinical Medicine, Ordos
Central Hospital, Inner Mongolia Medical University, 23 Yijin Huoluo West
Street, Inner Mongolia, China
Abstract
OBJECTIVES: To determine whether perioperative administration of
dexmedetomidine reduces the incidence of postoperative delirium in adult
patients undergoing cardiac surgery. METHOD(S): We searched the
PubMed, Embase and Cochrane Library databases for randomized controlled
trials from the last 10 years up to March 10, 2024. We then conducted a
meta-analysis to evaluate the effectiveness and safety of dexmedetomidine
in preventing delirium after cardiac surgery in adults. This meta-analysis
followed the steps in the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA2020) guidelines. This study is registered with
INPLASY under number INPLASY202430132. RESULT(S): A total of 2689
patients were included in our analyses. All included studies were
randomized controlled trials. Dexmedetomidine can reduce the occurrence of
delirium in patients after cardiac surgery(OR 0.75, 95%CI 0.57-0.98, I2 =
12%, P = 0.04). In terms of other end events, length of intensive care
unit(ICU) stay(MD -0.16, 95%CI -1.85-1.53, I2 = 0%, P = 0.85) and
mortality(OR 1.59, 95%CI 0.74-3.42, I2 = 0%, P = 0.23) were not
statistically different with dexmedetomidine compared with placebo.
Bradycardia (OR 0.85, 95%CI 0.54 ~ 1.34, I2 = 72%, P = 0.49) and
hypotension (OR 1.97, 95%CI 0.96 ~ 4.03, I2 = 84%, P = 0.06) were not
significantly different between the two groups. CONCLUSION(S):
Dexmedetomidine is safe for cardiac surgery patients and to some extent
reduces the incidence of delirium in cardiac surgery patients, which is
more important in preoperative use. Copyright © 2025. The
Author(s).

<79>
Accession Number
2033259470
Title
Tricuspid regurgitation after heart transplantation: where innovation and
intervention are in hibernation.
Source
Heart Failure Reviews. (no pagination), 2025. Article Number: e1452. Date
of Publication: 2025.
Author
Alyaydin E.; Gotschy A.; Parianos D.; Nagele M.P.; Tudorache I.; Flammer
A.J.; Stehli J.
Institution
(Alyaydin, Gotschy, Parianos, Nagele, Flammer, Stehli) Department of
Cardiology, University Hospital Zurich, Zurich, Switzerland
(Gotschy) Institute of Diagnostic and Interventional Radiology, University
Hospital Zurich, Zurich, Switzerland
(Gotschy) Institute for Biomedical Engineering, University and ETH Zurich,
Zurich, Switzerland
(Tudorache) Clinic for Cardiac Surgery, University Heart Center Zurich,
Zurich, Switzerland
(Alyaydin) Department of Cardiology, St. Johannes Hospital, Dortmund,
Germany
Publisher
Springer
Abstract
Tricuspid regurgitation (TR) is a common valvular dysfunction following
heart transplantation (HT), with reported prevalence rates ranging from 19
to 84%, primarily depending on the duration of follow-up. Its etiology is
multifactorial and includes surgical technique, ischemic time, primary
graft dysfunction, pulmonary hypertension, pacemaker leads, and
endomyocardial biopsies. Severe TR can significantly impair graft
function, exercise capacity, and patient survival. This mini-review
explores current management strategies, including surgical techniques such
as annuloplasty and tricuspid valve replacement. HT patients are often
high-risk surgical candidates due to factors such as immunosuppressive
therapy, prior surgeries, and various comorbidities. Therefore, we
primarily focus on the evidence regarding emerging interventional methods,
such as transcatheter edge-to-edge repair. Although these interventions
show promising early results, they remain relatively novel in HT
recipients, and the current evidence is based on case reports and small
studies. Further research is essential to evaluate the long-term efficacy
and safety of these management strategies to enhance outcomes for HT
recipients with TR. Copyright © The Author(s) 2025.

<80>
Accession Number
646461356
Title
Colchicine for the primary prevention of cardiovascular events.
Source
Cochrane Database of Systematic Reviews. 2025(2) (no pagination), 2025.
Article Number: CD015003. Date of Publication: 10 Feb 2025.
Author
Marti-Carvajal A.J.; Gemmato-Valecillos M.A.; Monge Martin D.; De Sanctis
J.B.; Marti-Amarista C.E.; Hidalgo R.; Alegria-Barrero E.; Riera Lizardo
R.J.; Correa-Perez A.
Institution
(Marti-Carvajal, Hidalgo) Universidad UTE, Facultad de Ciencias de la
Salud Eugenio Espejo, Centro Asociado Cochrane Ecuador, Centro de
Investigacion en Salud Publica y Epidemiologia Clinica (CISPEC), Quito,
Ecuador, Universidad UTE, Quito, Ecuador
(Marti-Carvajal, Monge Martin, Alegria-Barrero, Correa-Perez) Faculty of
Medicine, Universidad Francisco de Vitoria, Madrid, Spain
(Marti-Carvajal, Riera Lizardo) Catedra Rectoral de Medicina Basada en la
Evidencia, Universidad de Carabobo, Valencia, Venezuela
(Gemmato-Valecillos) Department of Medicine, NYC Health + Hospitals /
Elmhurst, Icahn School of Medicine at Mount Sinai, New York, United States
(De Sanctis) The Institute of Molecular and Translational Medicine,
Palacky University Olomouc, Faculty of Medicine and Dentistry, Olomouc,
Czechia
(Marti-Amarista) Jencare Senior Medical Center, Geriatric Medicine
Department, Berwyn, IL, United States
(Riera Lizardo) Medicine Department, Rheumatology Unit, Universidad de
Carabobo, Valencia, Venezuela
(Correa-Perez) Department of Hospital Pharmacy and Medical Devices,
Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
Publisher
John Wiley and Sons Ltd
Abstract
Background: Atherosclerotic cardiovascular diseases (ACVDs), a condition
characterised by lipid accumulation in arterial walls, which is often
exacerbated by chronic inflammation disorders, is the major cause of
mortality and morbidity worldwide. Colchicine, with its first medicinal
use in ancient Egypt, is an inexpensive drug with anti-inflammatory
properties. However, its role in primary prevention of ACVDs in the
general population remains unknown. Objective(s): To assess the
clinical benefits and harms of colchicine as primary prevention of
cardiovascular outcomes in the general population. Search Method(s):
We searched the Cochrane Heart Specialised Register, the Cochrane Central
Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including
In-Process & Other Non-Indexed Citations), Ovid Embase, Web of Science,
and LILACS. We searched ClinicalTrials.gov and WHO ICTRP for ongoing and
unpublished studies. We also scanned the reference lists of relevant
included studies, reviews, meta-analyses, and health technology reports to
identify additional studies. There were no limitations on language, date
of publication, or study setting. The search results were updated on 31
May 2023. Selection Criteria: Randomised controlled trials (RCTs) in
any setting, recruiting adults without pre-existing cardiovascular
disease. We included trials that compared colchicine versus placebo,
non-steroidal anti-inflammatory drugs, corticosteroids, immunomodulating
drugs, or usual care. Our primary outcomes were all-cause mortality,
non-fatal myocardial infarction, stroke, and adverse events. Data
Collection and Analysis: Two or more review authors independently selected
studies, extracted data, and performed risk of bias and GRADE assessments.
 Main Result(s): We identified 15 RCTs (1721 participants randomised;
1412 participants analysed) with follow-up periods ranging from 4 to 728
weeks. The intervention was oral colchicine compared with placebo,
immunomodulating drugs, or usual care or no treatment. Due to biases and
imprecision, the evidence was very uncertain for all outcomes. All trials
but one had a high risk of bias. Five out of seven meta-analyses included
fewer than six trials (71.4%). The objectives of the review were to assess
cardiovascular outcomes in the general population, but many of the
included trials focused on liver disease. Colchicine compared to placebo.
Colchicine may reduce all-cause mortality compared to placebo in primary
prevention, but the evidence is very uncertain (risk ratio (RR) 0.68, 95%
confidence interval (CI) 0.51 to 0.91; 6 studies, 463 participants; very
low-certainty evidence; number needed to treat for an additional
beneficial outcome (NNTB) 11, 95% CI 6 to 67). Colchicine may result in
little to no difference in non-fatal myocardial infarction, but the
evidence is very uncertain (RR 0.87, 95% CI 0.41 to 1.82; 1 study, 100
participants; very low-certainty evidence). Colchicine may not reduce the
incidence of stroke, but the evidence is very uncertain (RR 2.43, 95% CI
0.67 to 8.86; 1 study, 100 participants; very low-certainty evidence).
Regarding adverse events, colchicine may increase the incidence of
diarrhoea (RR 3.99, 95% CI 1.44 to 11.06; 8 studies, 605 participants;
very low-certainty evidence; number needed to treat for an additional
harmful outcome (NNTH) 10, 95% CI 6 to 17), and may have little to no
effect on neurological outcomes such as seizure or mental confusion (RR
0.72, 95% CI 0.31 to 1.66; 2 studies, 155 participants; very low-certainty
evidence), but the evidence is very uncertain. The effect of colchicine on
cardiovascular mortality is also very uncertain (RR 1.27, 95% CI 0.03 to
62.43; 2 studies, 160 participants; very low-certainty evidence).
Colchicine may not reduce post-cardiac procedure atrial fibrillation, but
the evidence is very uncertain (RR 0.74, 95% CI 0.25 to 2.19; 1 study, 100
participants). We found no trials reporting on pericardial effusion,
peripheral artery disease, heart failure, or unstable angina. Colchicine
compared to methotrexate (immunomodulating drug). Colchicine may result in
little to no difference in all-cause mortality compared to methotrexate,
but the evidence is very uncertain (RR 0.42, 95% CI 0.12 to 1.51; 1 study,
85 participants; very low-certainty evidence). We found no trials
reporting other cardiovascular outcomes or adverse events for this
comparison. Colchicine compared to usual care or no treatment. The
evidence is very uncertain about the effect of colchicine compared with
usual care on all-cause mortality in primary prevention (RR 1.07, 95% CI
0.90 to 1.27; 2 studies, 729 participants; very low-certainty evidence).
Regarding adverse events, colchicine may increase the incidence of
diarrhoea compared to usual care, but the evidence is very uncertain (RR
3.32, 95% CI 1.56 to 7.03; 2 studies, 729 participants; very low-certainty
evidence; NNTH 18, 95% CI 12 to 42). No trials reported other
cardiovascular outcomes for this comparison. Authors' conclusions: This
Cochrane review evaluated the clinical benefits and harms of using
colchicine for the primary prevention of cardiovascular events in the
general population. Comparisons were made against placebo,
immunomodulating medications, or usual care or no treatment. However, the
certainty of the evidence for the predefined outcomes was very low,
highlighting the pressing need for high-quality, rigorous studies to
ascertain colchicine's clinical impact definitively. We identified
numerous biases and inaccuracies in the included studies, limiting their
generalisability and precluding a conclusive determination of colchicine's
efficacy in preventing cardiovascular events. The existing evidence
regarding colchicine's potential cardiovascular benefits or harms for
primary prevention is inconclusive owing to the limitations inherent in
the current studies. More robust clinical trials are needed to bridge this
evidence gap effectively. Copyright © 2025 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<81>
[Use Link to view the full text]
Accession Number
2037431828
Title
Use of Protamine for Heparin Reversal in Patients Undergoing Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000001855. Date of Publication: 2025.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Burhan M.; Hashmi T.M.; Ahmed R.; Shahid
F.; Alkhouli M.
Institution
(Ahmed, Burhan, Hashmi) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahsan) Foundation University Medical College, Islamabad, Pakistan
(Shafiq) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic Alix, School
of Medicine, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins

<82>
Accession Number
2037428756
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: 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, New York
Presbyterian Hospital, New York, United States
(Netuka) Insitute for Clinical and Experimental Medicine, Prague, Czechia
(Katz) NYU Grossman School of Medicine, Bellevue Hospital, New York, NY,
United States
(Pagani) University of Michigan, Ann Arbor, United States
(Connors) Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Jorde) Montefiore Einstein Center for Heart and Vascular Care, New York,
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, New York, 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, IL, United States
(Mehra) Brigham and Women's Hospital Heart and Vascular Center, Center for
Advanced Heart Disease, Harvard Medical School, Boston, MA, United States
Publisher
American Medical Association
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. Copyright © 2025 Gustafsson F et al.

<83>
Accession Number
2037456074
Title
Effects of a preoperative psychological expectation-focused intervention
in patients undergoing valvular surgery - the randomized controlled ValvEx
(valve patients' expectations) study.
Source
American Heart Journal. 282 (pp 156-169), 2025. Date of Publication: 01
Apr 2025.
Author
Horn N.; Gartner L.; Rastan A.J.; Andrasi T.B.; Lenz J.; Boning A.;
Salzmann-Djufri M.; Puvogel U.; Niemann B.; Genovese M.; Habash S.;
Euteneuer F.; Rief W.; Salzmann S.
Institution
(Horn, Gartner, Genovese, Habash, Rief, Salzmann) Division of Clinical
Psychology and Psychotherapy, Philipps University of Marburg, Marburg,
Germany
(Rastan, Andrasi, Lenz) Department of Cardiovascular Surgery, Heart
Center, Philipps University of Marburg, Marburg, Germany
(Boning, Salzmann-Djufri, Puvogel, Niemann) Department of Cardiovascular
Surgery, Justus Liebig University, Giessen, Germany
(Euteneuer) Biological Psychology and Neuroscience, Vinzenz Pallotti
University, Vallendar, Germany
(Salzmann) Medical Psychology, Department of Medicine, Health and Medical
University, Erfurt, Germany
Publisher
Elsevier Inc.
Abstract
Background: Many patients experience a reduced quality of life for months
after heart surgery. Besides medical factors, psychological factors such
as preoperative expectations influence the recovery process. The ValvEx
study investigated whether an expectation-focused preoperative
intervention before heart valve surgery would (i) improve the
postoperative recovery process by reducing illness-related disability and
ii) impact secondary outcomes such as increased positive realistic
expectations, and reduce preoperative anxiety. Method(s): N = 89
patients undergoing heart valve surgery were randomized into 1 of 2 groups
after a baseline assessment: Standard medical care (SOC) vs SOC plus
psychological expectation-focused intervention (EXPECT) on the day of
hospital admission. Further assessments were conducted on the evening
before surgery, 4 to 6 days and 3 months after surgery. The primary
outcome was illness-related disability. Constrained longitudinal data
analyses were conducted to analyze the intervention effects, while the
need for information was considered as a potential moderator.
 Result(s): No general effects were observed for the EXPECT
intervention over time regarding the primary outcome illness-related
disability (Pain Disability Index, PDI) and the secondary outcomes (P
>=.167). The intervention effects were moderated by the individual need
for information: Patients with a higher need for information who received
the EXPECT intervention were less anxious on the evening before surgery (P
=.020, d = 0.314) and less restricted in their quality of life 4 to 6 days
after surgery compared to patients who received SOC (P =.005, d = 0.464).
 Conclusion(s): The ValvEx study is the first multicentre study
investigating the expectation-optimizing preoperative intervention in
heart valve patients. The implementation of the EXPECT intervention seemed
to optimize outcomes after heart valve surgery for certain patients, such
as patients with a high need for information. It is possible that there
were no direct effects of the EXPECT intervention because the intervention
dose was too low. These preliminary findings need to be corroborated by
larger multicenter trials. Trial registration The study was preregistered
at ClinicalTrials (identifier: NCT04502121,
https://clinicaltrials.gov/study/NCT04502121). Copyright © 2025
The Authors

<84>
Accession Number
2037510840
Title
Cardiac Surgery-Associated Acute Kidney Injury: An Updated Review of
Current Preventive Strategies.
Source
Anesthesiology Clinics. (no pagination), 2025. Date of Publication: 2025.
Author
Jacob K.A.; Leaf D.E.
Institution
(Jacob) Department of Paediatric Cardiothoracic Surgery, Wilhelmina
Children's Hospital, University Medical Center Utrecht, PO Box 85090,
Utrecht, Netherlands
(Leaf) Division of Renal Medicine, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
W.B. Saunders

<85>
Accession Number
2037505823
Title
Machine learning for predicting outcomes of transcatheter aortic valve
implantation: A systematic review.
Source
International Journal of Medical Informatics. 197 (no pagination), 2025.
Article Number: 105840. Date of Publication: 01 May 2025.
Author
Sulaiman R.; Atick Faisal M.A.; Hasan M.; Chowdhury M.E.H.; Bensaali F.;
Alnabti A.; Yalcin H.C.
Institution
(Sulaiman, Atick Faisal, Hasan, Yalcin) Biomedical Research Center, QU
Health, Qatar University, Doha, Qatar
(Atick Faisal, Chowdhury, Bensaali) Department of Electrical Engineering,
Qatar University, Doha, Qatar
(Alnabti) Heart Hospital, Hamad Medical Corporation, Doha, Qatar
(Yalcin) Department of Biomedical Sciences, College of Health Sciences, QU
Health, Qatar University, Doha, Qatar
(Yalcin) Department of Mechanical and Industrial Engineering, Qatar
University, Doha, Qatar
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) therapy has
demonstrated its clear benefits such as low invasiveness, to treat aortic
stenosis. Despite associated benefits, still post-procedural complications
might occur. The severity of these complications depends on pre-existing
clinical conditions and patient specific complex anatomical features.
Accurate prediction of TAVI outcomes will assist in the precise risk
assessment for patients undergoing TAVI. Throughout the past decade,
different machine learning (ML) approaches have been utilized to predict
outcomes of TAVI. This systematic review aims to assess the application of
ML in TAVI for the purpose of outcome prediction. Method(s):
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guideline was adapted for searching the PubMed and Scopus
databases on ML use in TAVI outcomes prediction. Once the studies that
meet the inclusion criteria were identified, data from these studies were
retrieved and were further examined. 17 parameters relevant to TAVI
outcomes were carefully identified for assessing the quality of the
included studies. Result(s): Following the search of the mentioned
databases, 78 studies were initially retrieved, and 17 of these studies
were included for further assessment. Most of the included studies focused
on mortality prediction, utilizing datasets of varying sizes and diverse
ML algorithms. The most employed ML algorithms were random forest,
logistics regression, and gradient boosting. Among the studied parameters,
serum creatinine, age, BMI, hemoglobin, and aortic valve mean gradient
were identified as key predictors for TAVI outcomes. These predictors were
found to be well aligned with established associations in current
literature. Conclusion(s): ML presents a promising opportunity for
improving the success and safety of TAVI and enhancing patient-centered
care. While currently retrospective studies with low generalizability and
heterogeneity form the basis of ML TAVI research, future prospective
investigations with highly heterogeneous patient TAVI cohorts will be
critically important for firmly establishing the applicability of ML in
predicting TAVI outcomes. Copyright © 2025

<86>
Accession Number
646475399
Title
Outcome of ST-segment elevation myocardial infarction (STEMI) patients
with significant non-infarct related artery (IRA) lesions.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2022. Online. 11(Supplement 1) (pp i85), 2022. Date of
Publication: 01 May 2022.
Author
Grech N.; Mizzi J.M.M.; Formosa R.F.; Wang C.Y.W.; Gatt P.M.G.; Buttigieg
M.L.B.; Spiteri J.S.; Agius M.A.; Gatt R.G.; Axisa A.B.A.; Camilleri W.C.;
Mercieca Balbi M.M.B.; Xuereb S.X.; Xuereb R.G.X.; Cassar Maempel A.C.M.
Institution
(Grech, Mizzi, Formosa, Wang, Gatt, Buttigieg, Spiteri, Agius, Gatt,
Axisa, Camilleri, Mercieca Balbi, Xuereb, Xuereb, Cassar Maempel) Mater
Dei Hospital of Malta, Msida, Malta
Publisher
Oxford University Press
Abstract
Background: Multivessel disease is common (50%) in patients presenting
with ST-segment elevation myocardial infarction (STEMI), and this is
associated with a higher mortality compared to single-vessel disease. The
optimal timing for revascularisation of significant non-infarct related
artery (IRA) (non-culprit) lesions in STEMI patients remains
controversial. The two main approaches include immediate revascularisation
during the primary percutaneous coronary intervention (PPCI) or deferred
(48 hours after the index procedure) percutaneous coronary intervention
(PCI). The European Society of Cardiology guidelines recommend
consideration of immediate non-IRA PCI in STEMI patients with cardiogenic
shock, while revascularisation of other patients with non-IRA significant
lesions should be considered prior to hospital discharge. Purpose(s):
To determine the optimal timing of intervention of significant non-IRA
lesions in patients presenting with STEMI. Method(s): Coronary
angiograms of nationwide STEMI patients who underwent a PPCI between 2013
and 2017 were reviewed to determine whether a significant non-IRA lesion
was present (defined as >70% stenosis, or >50% of left main stem). The
patients were divided into Group 1: immediate PCI of the non-IRA lesion
during the PPCI, and Group 2: deferred PCI of non-IRA lesion prior to
hospital discharge. Patients were followed up till end 2020 to determine
whether a major adverse cardiovascular event occurred (death, myocardial
infarction [MI], hospitalization due to pulmonary oedema and
revascularization with repeat PCI and coronary artery bypass [CABG]).
Chi-square and Fisher's exact test were used for statistical analysis.
 Result(s): 1080 patients underwent a PPCI between 2013 and 2017. 578
patients were excluded as they had no bystander disease, and a further 340
were excluded as they underwent CABG or medical treatment for the non-IRA
lesions. From the remaining cohort, 55 patients were stratified to group 1
and 107 patients in group 2. There were no significant differences in
baseline characteristics (Picture 1). Picture 2 demonstrates the
distribution of non-IRAs which required PCI. Patients who had immediate
non-IRA lesion PCI had a significantly higher mortality (Group 1, 21.8% vs
Group 2, 8.4%, p=0.016) and more admissions with pulmonary oedema (Group
1, 10.9% vs Group 2, 0.9%, p=0.006). Group 1 patients were found to have a
higher occurrence of cardiac arrest during the PPCI (10.9% vs 0.9%,
p=0.006) and cardiogenic shock (12.7% vs 3.7%, p=0.046). There were no
differences with regards to angina (p=0.386), MI (p=0.426) or
re-vascularisation with repeat PCI (p= 0.090) or CABG (p=0.114).
 Conclusion(s): STEMI patients who underwent immediate PCI to non-IRA
lesions had a poorer outcome with higher rates of mortality and pulmonary
oedema admissions compared to the deferred PCI cohort. Large randomised
controlled trials are required to determine the optimal timing for
intervention of significant non-IRA lesions.

<87>
Accession Number
646475481
Title
Levosimendan in patients undergoing cardiac surgery: does timing matter?.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2022. Online. 11(Supplement 1) (pp i36), 2022. Date of
Publication: 01 May 2022.
Author
Carvalho P.; Goncalves F.; Pinto C.; Moreira I.
Institution
(Carvalho, Goncalves, Moreira) Hospital Center of Tras-os-Montes and Alto
Douro, Vila Real, Portugal; Hospital Center of Vila Nova de Gaia/Espinho,
Vila Nova de Gaia, Portugal
Publisher
Oxford University Press
Abstract
Introduction: Levosimendan (LEV) is an inotropic drug that improves
myocardial contractility without increasing oxygen requirement and its use
in cardiac surgery has been questioned. Early meta-analysis showed that it
was associated with reduced mortality, however recent randomized trials
failed to show a benefit of this drug in some specific subsets of
patients. Purpose(s): This study sought to evaluate if the timing of
the initiation of LEV infusion could have impact in short-term prognosis.
 Method(s): This was an unicenter retrospective study of patients
submitted to a cardiac surgery between December 2009 and December 2018 and
who did LEV during hospitalization. Three groups were established upon the
beginning of LEV administration: preoperative, intraoperative and
postoperative. Statistical comparisons between groups are presented below
in this order. Result(s): Out of 141 patients, 40,4% belonged to the
preoperative group, 31,2% to the intraoperative group and 28,4% to the
postoperative group. Demographic data was balanced between the three
groups with the exception of past history of peripheral artery disease
(3,6% vs 15,9% vs 2,5%, p=0,024) and previous cardiac surgery (19,3% vs
4,5% vs 2,5%, p=0,009). The type of cardiac surgery, whether with or
without cardiopulmonary bypass, was similar in all groups. Left
ventricular ejection fraction was not significantly different
(36,9+/-12,3% vs 41,2+/-12,5% vs 42,2+/-12,2%, p=0,080) and the same
happened with the proportion of patients with right ventricle dysfunction
(12,3% vs 9,1% vs 10%, p=0,865). Moreover, total dose of LEV and its
infusion duration were not different (p=0,117 and p=0,242, respectively).
Compared to the postoperative group, preoperative and intraoperative
initiation was not independently associated with a significantly lower
risk of in-hospital cardiogenic shock requiring inotropic drugs (adjusted
OR 0,84 (95% CI 0,23-3,06) and 1,04 (95% CI 0,30-3,60), respectively) or
mechanical circulatory support (adjusted OR 1,29 (95% CI 0,18-9,34) and
0,57 (95% CI 0,06-5,64)), myocardial infarction (adjusted OR 1,25 (95% CI
0,16-9,87) and 1,46 (95% CI 0,20-10,51)) and death (adjusted OR 1,85 (95%
CI 0,28-12,18) and 4,41 (95% CI 0,81-24,00)). However, preoperative LEV
was associated with less acute kidney injury (adjusted OR 0,36 (95% CI
0,14-0,93)) compared to postoperative initiation. Still, the need for
renal replacement therapy didn't differ significantly between all groups.
Overall, subgroup analysis showed identical results independently of
biventricular systolic function, type of surgery and need of
cardiopulmonary bypass. Conclusion(s): In this heterogeneous
population submitted to a cardiac surgery, timing of LEV initiation did
not have a significant impact on short-term in-hospital major adverse
outcomes, independently of biventricular systolic function and type of
surgery.

<88>
Accession Number
2037428651
Title
Early Versus Bail-Out Left Ventricular Unloading During Venoarterial
Extracorporeal Membrane Oxygenation: A Systematic Review And
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Picado-Loaiza S.; Ayala R.; Ferreira R.O.M.; Zeledon F.; Almeidinha L.;
Clemente M.; Bittar de Pontes V.; Lee E.C.
Institution
(Picado-Loaiza, Zeledon) Cardiovascular Surgery Department, Caja
Costarricense del Seguro Social, San Jose, Costa Rica
(Ayala) Cardiovascular Surgery Department, Robert Bosch Hospital,
Stuttgart, Germany
(Ferreira) Federal University of Santa Catarina, Florianopolis, Brazil
(Almeidinha) Rochester General Hospital, Rochester, NY, United States
(Clemente) Petropolis School of Medicine, Petropolis, Brazil
(Bittar de Pontes) University Centre of Associated Colleges of Education,
Sao Joao da Boa Vista, Sao Paulo, Brazil
(Lee) Sands Constellation Heart Institute, Rochester, NY, United States
Publisher
W.B. Saunders
Abstract
Left ventricular (LV) unloading has demonstrated favorable outcomes in
patients undergoing venoarterial extracorporeal membrane oxygenation
(VA-ECMO). However, the optimal timing for LV unloading during VA-ECMO
remains controversial. PubMed, Embase, and Cochrane were searched for
studies comparing early versus bail-out LV unloading in patients
undergoing VA-ECMO. We computed mean differences (MD) for continuous
outcomes and risk ratios (RR) for binary outcomes, with 95% confidence
intervals (95%CIs). Heterogeneity was assessed using I2 statistics.
Statistical analyses were performed using R version 4.2.3. Six studies
comprising 1,556 participants were included in the meta-analysis, of whom
936 (60%) were referred to early LV unloading. There were no significant
differences between groups in weaning from VA-ECMO (MD 1.07; 95% CI 0.86 -
1.33; p = 0.55; I2 = 26%), in-hospital mortality (RR 0.95; 95% CI 0.86 -
1.05; p = 0.28; I2 = 0%), 30-day mortality (RR 0.75; 95% CI 0.52 - 1.10; p
= 0.14; I2 = 64%), or duration of VA-ECMO (MD 0.37; 95% CI -1.57 - 2.32; p
= 0.71; I2 = 20%). Sepsis (RR 0.84; 95% CI 0.63 - 1.11; p = 0.22; I2 =
0%), stroke (RR 0.90; 95% CI 0.52 - 1.56; p = 0.70; I2 = 48%), and bridge
to heart transplantation or left ventricular assist device (RR 1.20; 95%
CI 0.90 - 1.62; p = 0.22; I2 = 0%) also did not differ significantly
between the groups. In patients undergoing VA-ECMO, early LV unloading was
not associated with improved efficacy and safety outcomes when compared to
the bail-out strategy for LV unloading. Copyright © 2025 Elsevier
Inc.

<89>
Accession Number
2037436163
Title
Late Clinical Outcomes of Balloon-Expandable Valves in Small Annuli:
Results From the PARTNER Trials.
Source
JACC: Cardiovascular Interventions. 18(4) (pp 506-517), 2025. Date of
Publication: 24 Feb 2025.
Author
Hahn R.T.; Pibarot P.; Abbas A.; Makkar R.; Thourani V.H.; Genereux P.;
Kodali S.; Kapadia S.; Babaliaros V.; Ternacle J.; Theron A.; Cristell N.;
Clarke S.; Zhao Y.; Alu M.; Madhavan M.V.; Cohen D.J.; Leipsic J.; Webb
J.; Mack M.J.; Leon M.B.
Institution
(Hahn, Kodali, Madhavan, Leon) Department of Medicine, Columbia University
Irving Medical Center, New York, NY, United States
(Hahn, Cristell, Alu, Madhavan, Cohen, Leon) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Pibarot, Theron) Departement de Cardiologie, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec City,
QC, Canada
(Abbas) Department of Cardiovascular Medicine, CHE-William Beaumont
University Hospital, Royal Oak, MI, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Kapadia) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Babaliaros) Emory University School of Medicine, Atlanta, GA, United
States
(Ternacle) Haut-Leveque Cardiology Hospital, CHU Bordeaux, Pessac, France
(Theron) Assistance Publique-Hopitaux de Marseille, Marseille, France
(Clarke, Zhao) Edwards Lifesciences, Irvine, CA, United States
(Cohen) St. Francis Hospital, Roslyn, New York, United States
(Leipsic, Webb) Centre for Heart Valve Innovation, St. Paul's Hospital,
Vancouver, BC, Canada
(Mack) Baylor Scott & White Health, Plano, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Short-term clinical outcomes after transcatheter aortic valve
replacement (TAVR) are similar in individuals with small or large annuli.
The longer term impact of prosthesis-patient mismatch (PPM) and mean
gradient (MG) post-TAVR in these patients remains controversial.
 Objective(s): The aim of this study was to investigate 5-year
outcomes in patients with small vs large annuli. Method(s): Patients
from the PARTNER (Placement of Aortic Transcatheter Valves) 2 SAPIEN 3
intermediate-risk registry and the PARTNER 3 low-risk randomized
controlled trial were grouped according to small (<=430 mm2) or
large (>430 mm2) annular size. The primary endpoint was a
composite of all-cause death, disabling stroke, or heart failure
hospitalization. In addition, the relationships between both PPM and
post-TAVR MG and clinical outcomes were analyzed. Result(s): In
total, 1,355 patients were included: 476 with small annuli (376.7 +/- 41.9
mm2) and 879 with large annuli (518.3 +/- 58.0 mm2).
Patients with small annuli were older (age 79.6 +/- 7.1 years vs 78.7 +/-
7.8 years; P = 0.047), were more often female (75.0% vs 16.2%; P <
0.0001), had higher baseline Society of Thoracic Surgeons scores (4.3% +/-
1.93% vs 4.0% +/- 1.93%; P < 0.0001), and had higher left ventricular
ejection fractions (66.3% +/- 15.82% vs 59.7% +/- 13.68%; P < 0.0001).
Primary endpoint rates were similar at 1 year (7.8% vs 8.0%; P = 0.94) and
5 years (36.3% vs 35.8%; P = 0.83). Bioprosthetic valve failure was
infrequent at 5 years in both groups (2.9% vs 2.1%; P = 0.46). Among
female patients, outcomes were similar for small vs large annuli (primary
endpoint; 33.6% vs 34.2%; P = 0.90). Among patients with small annuli,
there was no association between 5-year outcomes and any severity of PPM
(P = 0.22) or 30-day MG (P for nonlinearity = 0.96). Conclusion(s):
Five-year clinical outcomes were excellent and comparable between patients
with small vs large aortic annuli. Outcomes in patients with small annuli
were not affected by 30-day MG or PPM. Copyright © 2025 The
Authors

<90>
Accession Number
2037440672
Title
Commentator Discussion: A randomized study of cryoablation of intercostal
nerves in patients undergoing minimally invasive thoracic surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Anonymous
Publisher
Elsevier Inc.

<91>
Accession Number
2033123035
Title
Perioperative Cardiovascular Outcomes and Risk Assessment in Older Adults
for Noncardiac Surgery.
Source
Current Anesthesiology Reports. 15(1) (no pagination), 2025. Article
Number: 21. Date of Publication: 01 Dec 2025.
Author
Hong S.J.; Smilowitz N.R.
Institution
(Hong, Smilowitz) Leon H. Charney Division of Cardiology, Department of
Medicine, NYU Langone Health, New York University School of Medicine, 423
East 23rd Street, 12-West Cardiology, New York, NY, United States
(Smilowitz) Division of Cardiology, Department of Medicine, Veterans
Affairs New York Harbor Health Care System, New York, NY, United States
Publisher
Springer
Abstract
Purpose of Review: Older adults age > 65 years are the fastest growing
segment of the United States population, and many undergo non-cardiac
surgery each year. Despite the high prevalence of cardiovascular disease
in this population, data to guide perioperative care in older adults are
limited. This review summarizes the literature on cardiovascular outcomes
associated with non-cardiac surgery in older adults, identifies unique
clinical factors to consider in geriatric cohorts, and highlights clinical
practice guidelines relevant to perioperative management of older adults.
Recent Findings: Cardiovascular complications of non-cardiac surgery are
most common in older adults. Current cardiovascular risk calculators may
significantly underestimate preoperative cardiovascular risk in these
patients. Frailty assessments and novel risk calculators can improve risk
stratification in older adults. Clinical factors, including coronary
artery disease, heart failure, vascular stiffness, and aortic stenosis are
key pathologies that may impact surgical outcomes. Preoperative diagnostic
cardiovascular testing may be helpful to identify cardiovascular disease
in select patients, but routine testing is not generally recommended.
 Summary: Older adults have worse perioperative cardiovascular
outcomes than younger individuals. Providers should consider clinical
factors beyond those captured in traditional risk perioperative
calculators to guide clinical decision making prior to non-cardiac
surgery. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<92>
Accession Number
2033181823
Title
Pulmonary Valve Fibroelastoma, Still a Very Rare Cardiac Tumor: Case
Report and Literature Review.
Source
Diagnostics. 15(3) (no pagination), 2025. Article Number: 283. Date of
Publication: 01 Feb 2025.
Author
Anitei E.-D.; Harpa M.M.; Al Hussein H.; Ghiragosian C.; Stroe V.I.;
Calburean P.; Gurzu S.; Suciu H.
Institution
(Anitei, Harpa, Al Hussein, Ghiragosian, Calburean, Gurzu, Suciu)
Department of Surgery IV, George Emil Palade University of Medicine,
Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania
(Anitei, Harpa, Al Hussein, Ghiragosian, Stroe, Calburean, Gurzu, Suciu)
Department of Cardiovascular Surgery, Emergency Institute for
Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures,
Romania
(Harpa) Department of Regenerative Medicine Laboratory, George Emil Palade
University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Targu Mures, Romania
(Gurzu) Research Center of Oncopathology and Translational Medicine
(CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and
Technology of Targu Mures, Targu Mures, Romania
(Gurzu) Department of Pathology, Clinical County Emergency Hospital, Targu
Mures, Romania
(Gurzu, Suciu) Department of Medical Research, Romanian Academy of Medical
Sciences, Bucharest, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background and Clinical Significance: Primary cardiac tumors are among the
rarest types of tumor, and until the mid-20th century, they were diagnosed
only post-mortem or during other surgical interventions. With the rapid
evolution of cardiovascular imaging and the widespread use of
echocardiography, the incidence of cardiac fibroelastoma has increased,
though it remains one of the rarest primary cardiac tumors. Papillary
fibroelastoma is a benign primary cardiac tumor that develops from
endocardial tissue, is usually solitary, and can have multiple locations,
with the pulmonary valve being one of the rarest sites. The symptoms and
complications depend on the tumor's location, ranging from asymptomatic
patients to cerebral ischemic embolism or pulmonary embolism. We analyzed
the electronic databases PubMed, Web of Science, and Cochrane and
conducted a systematic review of pulmonary valve papillary fibroelastoma
(PVPF). Additionally, we included a case from the Adult and Pediatric
Cardiovascular Surgery Clinic in Targu Mures. Case Presentation: We
present the case of a 58-year-old patient who complained of exertional
dyspnea. A transthoracic echocardiography (TTE) revealed a tumor mass
attached to the pulmonary valve and coronary angiography identified severe
coronary lesions. Following discussions within the Heart Team, surgical
myocardial revascularization and tumor excision were decided upon due to
the thromboembolic risk. Histopathological examination confirmed the
diagnosis of papillary fibroelastoma. The postoperative course was
uneventful, with an improvement in dyspnea. The mean age of the patients
was 60 years, with half being men (n = 26, 50%). Regarding symptoms, 34%
(n = 18) of cases were incidentally identified, while over 30% (n = 17)
presented with dyspnea. Pulmonary embolism (PE) was reported in only two
patients, and the most common associated comorbidities included high blood
pressure (HBP) in 33% (n = 16) and dyslipidemia in 18%. Tumor size ranged
from 0.7 cm to 3 cm with the initial benign cardiac tumor; its occurrence
in the pulmonary valve remains exceedingly rare. Due to its frequent
overlap with other cardiac pathologies, the clinical presentation is often
a nonspecific diagnosis or suspicion of a tumor predominantly established
via transthoracic echocardiography in 62% of patients. From a surgical
perspective, 63% (n = 33) underwent tumor resection with valve sparing,
25% (n = 12) required pulmonary valve repair, and three patients
necessitated pulmonary valve replacement. Conclusion(s): Although the
incidence of papillary fibroelastoma is increasing, making it the most
common, there is a need to highlight the indispensable role of
echocardiography in diagnosis. Although papillary fibroelastoma is benign,
surgical intervention is recommended, particularly in symptomatic
patients, or if the tumor exceeds 1 cm in size, exhibits increased
mobility, or is present alongside other cardiac surgical
procedures. Copyright © 2025 by the authors.

<93>
Accession Number
2037427144
Title
Characterization of ischemic etiology in heart failure with reduced
ejection fraction randomized clinical trials: A systematic review and
meta-analysis.
Source
European Journal of Internal Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Canepa M.; Anastasia G.; Ameri P.; Vergallo R.; O'Connor C.M.; Sinagra G.;
Porto I.
Institution
(Canepa, Anastasia, Ameri, Vergallo, Porto) Cardiovascular Unit,
Department of Internal Medicine, University of Genova, Italy
(Canepa, Ameri, Vergallo, Porto) Cardiovascular Unit, IRCCS Ospedale
Policlinico San Martino, Genoa, Italy
(O'Connor) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(O'Connor) Division of Cardiology, Duke University Medical Center, Durham,
NC, United States
(Sinagra) Cardiovascular Department, Azienda Sanitaria Universitaria
Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy
Publisher
Elsevier B.V.
Abstract
Aims: We investigated how ischemic etiology has been assigned in heart
failure with a reduced ejection fraction (HFrEF) randomized controlled
trials (RCTs). Methods and Results: We performed a systematic review
and meta-analysis of definitions, rates of ischemic etiology and of each
ischemic definition component: i) coronary artery disease (CAD), ii)
myocardial infarction (MI), iii) coronary revascularization, and iv)
prior/current angina. A total of 145 HFrEF RCTs were selected, of which
133 (91.7 %) enrolling both ischemic and non-ischemic patients (629
patients/study on average, median age 64.8 years and ejection fraction
28.2 %). The majority of these RCTs (84.2 %) lacked of clear ischemic
etiology definition. Rate of ischemic etiology was 57.8 % (122 RCTs,
169,855 patients), of CAD 53.8 % (25 RCTs, 18,756 patients), of prior MI
46.7 % (57 RCTs, 80,582 patients), of prior revascularization 39.9 % (32
RCTs, 30,730 patients), and of prior/current angina 25.5 % (22 RCTs,
25,572 patients). In studies presenting both variables, prior MI showed
the strongest correlations with assigned ischemic etiology (beta = 0.84, p
< 0.0001, 49 RCTs), followed by prior/current angina (beta = 0.84, p <
0.0001, 20 RCTs), prior revascularization (beta = 0.30, p = 0.006, 28
RCTs), whereas CAD had no significant correlation (beta = 0.29, p = 0.162,
from 17 RCTs). Rate of prior MI decreased over time (1986-2007: 51.4 +/-
11.6 %; 2008-2016: 48.2 +/- 8.8 %; 2017-2023: 41.4 +/- 16.6 %; p = 0.057),
whereas the one of prior revascularization increased (28.3 +/- 11.2 %;
40.7 +/- 19.6 %; 49.3 +/- 19.4 %; p = 0.048). Conclusion(s): An
accurate definition of ischemic etiology is mostly lacking in HFrEF RCTs,
and primarily assigned based on investigators clinical judgment, sometimes
in the presence of a prior MI, although the rate of this component showed
a decline over time. Copyright © 2025 The Authors

<94>
Accession Number
2033089172
Title
Intracardiac or transesophageal echocardiography for left atrial appendage
occlusion: an updated systematic review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 2025.
Author
Beneki E.; Dimitriadis K.; Theofilis P.; Pyrpyris N.; Iliakis P.;
Kalompatsou A.; Kostakis P.; Koukos M.; Soulaidopoulos S.; Tzimas G.;
Tsioufis K.; Lancellotti P.; Aggeli C.
Institution
(Beneki, Dimitriadis, Theofilis, Pyrpyris, Iliakis, Kalompatsou, Kostakis,
Koukos, Soulaidopoulos, Tsioufis, Aggeli) First Cardiology Department,
School of Medicine, Hippokration General Hospital, National and
Kapodistrian University of Athens, Athens, Greece
(Beneki, Tzimas) Department of Cardiology, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
(Lancellotti) Department of Cardiology, University Hospital Center, Liege,
Belgium
Publisher
Springer Science and Business Media B.V.
Abstract
Background: Intracardiac echocardiography (ICE) appears to be a potential
alternative for percutaneous left atrial appendage occlusion (LAAO) to
transesophageal echocardiography (TEE). Thus, a meta-analysis was
performed comparing ICE vs. TEE for LAAO guidance. Method(s): A
comprehensive literature search was performed using MEDLINE, Scopus and
Web of Science electronic databases from their inception to November 2023.
 Result(s): 18 studies (124,230 patients) were included. Technical
success was higher in ICE- compared to TEE-guidance (OR: 1.36, 95% CI 1.14
to 1.63, p = 0.006) and fewer devices employed (SMD: -0.22, 95% CI -0.43
to -0.01, p = 0.04, I2 = 62%). ICE guidance related with more pericardial
effusion/tamponade and iatrogenic residual shunts (logRR: 0.62, 95% CI
0.36 to 0.89, p < 0.001 and RR: 1.53, 95% CI 1.12 to 2.09, p = 0.02, I2 =
1%, respectively). More vascular complications were noted in ICE group
(logRR: 0.45, 95% CI 0.11 to 0.78, p = 0.009). Conclusion(s):
ICE-guided imaging is an effective alternative to TEE in LAAO, as it shows
better efficacy than TEE, considering technical success. However, the
higher rates of adverse events should be carefully
considered. Copyright © The Author(s) 2025.

<95>
Accession Number
646472173
Title
Blood-pressure targets in comatose survivors of cardiac arrest with
ST-elevation myocardial infarction treated with primary percutaneous
coronary intervention - a BOX sub-study.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2023. Marseille France. 12(Supplement 1) (pp i122),
2023. Date of Publication: 01 May 2023.
Author
Klein A.; Helle S.; Moller J.E.; Schmidt H.; Hassager C.; Kjaergaard J.
Institution
(Klein, Helle, Moller, Schmidt, Hassager, Kjaergaard) Zealand University
Hospital, Roskilde, Denmark; Odense University Hospital, Odense, Denmark;
Rigshospitalet - Copenhagen University Hospital, Heart Centre, Department
of Cardiology, Copenhagen, Denmark
Publisher
Oxford University Press
Abstract
Background: After successful resuscitation from out-of-hospital cardiac
arrest (OHCA), patients who remain comatose often need hemodynamic support
with vasoactive drugs in order to secure an adequate perfusion pressure to
vital organs. However, evidence regarding specific blood-pressure targets
is sparse, and patients with concomitant heart disease such as acute
ST-elevation myocardial infarction (STEMI) might benefit from a lower
afterload and lower doses of vasoactive drugs. Purpose(s): To assess
the impact of blood-pressure on biochemical infarct size in comatose
survivors of OHCA with STEMI and, further, to investigate whether a high
or low mean arterial blood-pressure target is superior in preventing death
or severe brain injury. Method(s): The BOX study (n=789) is a
randomized trial with a 2-by-2 factorial design which evaluated a
double-blind intervention of a high (77 mmHg) versus a low (63 mmHg) mean
arterial blood-pressure target in comatose survivors of OHCA of presumed
cardiac cause. In this pre-specified sub-study we included patients who
had an initial electrocardiogram with STEMI recorded after return of
spontaneous circulation (ROSC). The primary outcome was creatine kinase
(CK), creatine kinase MB (CKMB), and troponin T (TnT) levels measured at
48 hours as surrogate markers of infarct size. A secondary outcome was a
composite of all-cause death within one year from admission or discharge
from the hospital with a Cerebral Performance Category (CPC) of 3 to 4,
indicating severe neurological disability or a comatose or vegetative
state. Result(s): A total of 350 patients were included. Mean time to
ROSC was 21+/-13 minutes. The mean age was 63+/-12 years and approximately
4 out of 5 were male. The prevalence of relevant prior medical history was
as follows; hypertension 42%, diabetes 12%, chronic ischemic heart disease
20%, percutaneous coronary intervention 11%, coronary artery bypass
grafting 4%, and congestive heart failure 10%. Mean CK, CKMB and TnT
measured at 48 hours did not differ between the two blood-pressure target
groups (p=0.42, p=0.14 and p=0.65, respectively). Within one year, 138
patients (39%) had died or been discharged with a CPC of 3 to 4 with no
difference found between high or low blood pressure targets (hazard ratio,
1.02; 95% CI, 0.73-1.43; p=0.9). Conclusion(s): Targeting a high
versus a low mean arterial blood-pressure in comatose survivors of OHCA
with STEMI did not affect infarct size estimated by coronary biomarkers at
48 hours nor did it result in a significant difference in death or severe
neurologic disability. Although not evaluating side effects, this study
thus suggests that the use of pharmacologic circulatory support in
post-resuscitation care can be limited.

<96>
Accession Number
646472043
Title
The prognostic impacts of frailty status on clinical and patient-related
outcomes in patients undergoing coronary artery or valvular
surgeries/procedures: a systematic review and meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2023. Marseille France. 12(Supplement 1) (pp
i255-i256), 2023. Date of Publication: 01 May 2023.
Author
Wong C.W.Y.; Yu D.S.F.; Li P.W.C.; Chan B.S.Y.
Institution
(Wong, Yu, Li, Chan) University of Hong Kong, Hong Kong, Hong Kong
Publisher
Oxford University Press
Abstract
Background: Frailty is emerging as an important prognostic indicator for
patients undergoing cardiac surgeries or procedures. Purpose(s): We
sought to evaluate the prognostic and differential impacts of frailty on
patients undergoing coronary artery or valvular surgical procedures of
different levels of invasiveness, as well as to explore the differential
predictability of various frailty measurement models. Method(s): Nine
databases were searched for prospective cohort studies that have adopted
validated measure(s) of frailty and reported clinical, healthcare service
utilisation, or patient-reported outcomes in patients undergoing coronary
artery or valvular surgeries/procedures. Meta-analysis was conducted using
random-effects model. Result(s): Sixty-two articles were included (N
= 16,679). Frailty significantly predicted mortality (short-term [<= 30
days]: odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.28-4.26;
mid-term [1 year]: OR: 3.93, 95% CI: 2.65-5.83; long-term [>1 year]: HR:
2.23, 95% CI: 1.60-3.11), postoperative complications (ORs: 2.54-3.57),
discharge to care facilities (OR: 5.52, 95% CI: 3.84-7.94), hospital
readmissions (OR: 2.00, 95% CI: 1.15-3.50), and reduced health-related
quality of life (HRQoL; SMD: -0.74, 95% CI: -1.30 to -0.18) (Figure 1 and
2). Subgroup analyses showed that frailty exerted a greater impact on
short-term mortality in patients undergoing open-heart surgeries than
those receiving transcatheter procedures (Figure 1A), but no significant
difference was observed for mid- and long-term mortality between these two
groups of patients (Figure 1B and C). Multidimensional and
physical-aspect-focused frailty measurements equally predicted mortality
and complications, but multidimensional measurements were more predictive
of hospital readmissions than physical-aspect-focused measurements (Figure
2B). Conclusion(s): Frailty was predictive of postoperative
mortality, complications, increased healthcare service utilisation, and
reduced HRQoL. The impact of frailty on short-term mortality was more
prominent in patients undergoing open-heart surgeries than those receiving
transcatheter procedures. Multidimensional measures of frailty enhanced
prognostic risk estimation, especially for hospital readmissions,
demonstrating a need to incorporate a formal frailty assessment into
routine preoperative risk evaluation to inform therapeutic
decision-making. (Figure Presented).

<97>
Accession Number
646471885
Title
Wearable cardioverter defibrillator shortens the length of stay: a single
center real-world experience.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2023. Marseille France. 12(Supplement 1) (pp i12-i13),
2023. Date of Publication: 01 May 2023.
Author
Cardelli L.S.; Casella G.; Roubille F.; Pasquie J.L.; Leclercq F.
Institution
(Cardelli, Casella, Roubille, Pasquie, Leclercq) Maggiore Hospital,
Cardiology Department, Bologna, Italy; University Hospital Arnaud de
Villeneuve, Montpellier, France
Publisher
Oxford University Press
Abstract
Background: The wearable cardioverter defibrillator (WCD) has been proven
to have efficacy in treating sudden cardiac death (SCD) in patients soon
after acute myocardial infarction (AMI) and left ventricular ejection
fraction (LVEF) <=35%. However, data regarding hospitalization rate and
length of stay among these patients have not yet been evaluated.
 Purpose(s): WCD can shorten hospital stays (total length, time in
intensive care unit (ICU) and in cardiac intensive care unit (CICU)) of
patients post-AMI, with severe reduced LVEF. Method(s): We performed
a single center, retrospective observational study of patients prescribed
WCD upon hospital discharge, from June 2016 to June 2022. We selected
patients referred for management of SCD, post-AMI, with age over 18 years
and LVEF <=35%. Patients who already had ICD or CRT-D (or who had
previously received it) were excluded from the analysis. Patients with the
same characteristics, and who were discharged from the hospital without
WCD or ICD served as a control group. Clinical characteristics were
obtained from hospital electronic and WCD specific database. The clinical
characteristics and length of index hospitalization of two groups were
compared. An initial propensity score analysis was performed, then a
weighted regression models for total hospitalization, days in ICU, and
days in CICU were conducted. Result(s): 101 patients in the WCD group
and 29 in the control group were enrolled in the analysis (Figure 1). The
two groups showed similar clinical characteristics (Table 1), even if
patients in the WCD group had lower LVEF (p <0.001), more cardiogenic
shocks (p = 0.045) and higher NT-proBNP values (p = 0.033). After a
propensity score analysis and a weighted regression model, LVEF emerged as
independent variable for WCD use (odds ratio (OR) 0.755, confidence
interval (CI) 95% 0.654 - 0.872, p <0.001). Left ventricular thrombosis
also affected the use of WCD (OR 5.574, CI 95% 1.139 - 27.267, p =
0.0339). In a weighted regression model, WCD significantly influenced the
days spent in CICU (p<0.001), and those in ICU even without statistical
significance (p = 0.251). Even after excluding all patients undergoing
extracorporeal membrane oxygenation (ECMO) or heart transplantation, WCD
reduced days spent in CICU (p<0.001). Furthermore, when excluding from the
analysis all patients with very long hospitalizations (> 30 days),WCD
patients showed significantly shorter total hospitalization (p=0.005) and
days spent in CICU (p<0.001), compared with control group.
 Conclusion(s): At the propensity score analysis, WCD reduce CICU
length of stay for patients post-AMI with LVEF <=35%. The association
between WCD use and hospitalization is more relevant for days spent in
CICU, but there is also a positive trend for the days spent in ICU. The
study has the limitation of a retrospective analysis and can only serve as
hypothesis-generating research, which will be verified with further
randomized clinical trial. (Table Presented).

<98>
Accession Number
646472400
Title
Association of early surgery and mortality in patients with native or
prosthetic valve endocarditis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2023. Marseille France. 12(Supplement 1) (pp i220),
2023. Date of Publication: 01 May 2023.
Author
Tao M.; Manikantan P.; Despotidis G.; Alkhalil A.; Parikh P.; Pyo R.
Institution
(Tao, Manikantan, Despotidis, Alkhalil, Parikh, Pyo) Stony Brook
University Hospital, Stony Brook, United States
Publisher
Oxford University Press
Abstract
Background: Infective endocarditis (IE) is a disease associated with high
risk of morbidity and mortality. Recent studies suggests that surgery
during index hospitalization may be performed without increased risk of
mortality. However, differences in this association in patients with
native valve IE and prosthetic valve IE remain unclear. Purpose(s):
The purpose of this meta-analysis is to explore differences in the
association between early surgery and mortality in patients with native
valve IE and prosthetic valve IE. Method(s): We performed a
literature search for studies reporting an association between early
surgery and study endpoints in patients with either native valve IE or
prosthetic valve IE. The primary endpoint was in-hospital mortality. The
secondary endpoints was long-term mortality. The search included the
following databases: Ovid MEDLINE, EMBASE, Web of Science, and Google
Scholar. The search was not restricted to time or publication status.
Studies reporting mixed native and prosthetic valve populations were
excluded. Result(s): A total of 10 studies with 5493 participants
(2505 with early surgery vs 2988 with conventional therapy) were included.
The mean duration of follow-up was 55 months (ranging between 12 to 120
months). Early surgery in patients with native valve IE was associated
with lower risk of in-hospital mortality (OR 0.48, 95% CI 0.28, 0.83;
p<0.01). Early surgery in patients with native valve IE was associated
with lower risk of long-term mortality, however this effect was primarily
driven by a single study (OR 0.26, 95% CI 0.08, 0.83; p=0.02). Early
surgery in patients with prosthetic valve IE was not significantly
associated with risk of in-hospital mortality, however there is a trend
toward lower risk (OR 0.77, 95% CI 0.58, 1.02; p=0.07). There was not
enough studies reporting long-term outcomes to assess the association
between early surgery and long-term mortality in patients with prosthetic
valve IE Conclusion(s): Early surgery is associated with lower risk
of in-hospital mortality in patients with native valve IE and is not
associated with increased risk of mortality in patients with prosthetic
valve IE. Further high-quality studies are needed to elucidate the
association between early surgery and long-term outcomes in both patients
with native valve IE and prosthetic valve IE. (Figure Presented).

<99>
Accession Number
646475222
Title
Comparison of erector spinae block versus thoracic epidural anaesthesia
for postoperative pain management in adult patients undergoing
thoracotomy.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S3), 2022. Date of Publication: 2022.
Author
Meka S.P.
Institution
(Meka) JSS medical college and Hospital, Mysore, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Thoracic epidural analgesia (TEA) was compared with
erector spinae block (ESP) for postoperative pain management in patients
undergoing thoracotomy. Method(s): A prospective, randomised clinical
study was conducted. 64 patients were enroled and randomised by simple
randomsampling into either group A: TEA (n=32) or group B: ESP block
(n=32). Both groups received standardised general anaesthesia and
continuous infusion of 0.125% bupivacaine plus 2 mug per ml fentanyl at
the rate of 5 ml/hour till 48 hours postextubation.The primary outcome was
to compare Visual analogue scale (VAS) for postoperative pain. Secondary
outcomes included peakinspiratory flow rates, ventilator stay duration,
haemodynamic parameters, adverse effects, ICU stay.Statistical analysis
was performed using independent Student's t-test. p value of <0.05 was
considered statistically significant. Result(s): Group A had
statistically significant higher VAS score than B at 3,6,12,24 h
post-extubation. Group B had higher peak inspiratory flow rates compared
with group A at 3,6,12,24,36, 48 h respectively. Duration of ICU stay was
longer in group A than B. Rescue analgesia usage was higher in group A
compared to group B. No adverse effects were reported in both groups.
 Conclusion(s): ESP block is an efficacious alternative to TEA in
providing better postoperative pain management with minimal ICU stay
following open thoracic surgeries.

<100>
Accession Number
646475068
Title
To study the safety and efficacy of preoperative oral carbohydrate loading
in type 2 Diabetics undergoing elective off pump coronary artery bypass
grafting.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S4-S5), 2022. Date of Publication: 2022.
Author
Ram R.S.
Institution
(Ram) Aster Medcity, Cochin, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: The aim was to study the safety and efficacy of oral
carbohydrate loading in type 2 diabetics undergoing off-pump coronary
artery bypass grafting (CABG). The primary objective was to evaluate the
residual gastric volume and secondary objectives included evaluating
insulin resistance and inotrope requirement. Method(s): This
prospective, unicentric, non-blinded randomised controlled study was
conducted on 40 American Society of Anesthesiologists grade III & IV
subjects. The study population was randomly allocated into Control Group
in which patients were given 800 ml of clear fluids on the night before
surgery and 400 ml of clear fluids 2 hours before on the day of surgery
and Study group in which patients were given carbohydrate drink (50 gm of
two carbohydrate sachets mixed with 800 ml of water) night before
surgeryand 50 gm of one carbohydrate sachet mixed with 400 ml of water 2 h
before surgery. Result(s): Both the groups had comparable residual
gastric volumes. The Carboload group had higher blood sugar levels in the
preoperative and intraoperative periods. Blood sugar control was better in
the Carboload group during the postoperativeperiod, and the mean total
insulin requirement and lactate levels for the Carboload group were less
than the clear fluid group.Patient wellbeing was significantly higher in
the Carboload group. No episodes of regurgitation or aspiration were
recordedin either group. Conclusion(s): In patients with type 2
diabetes, consuming a Carboload drink two hours before surgery was safe
and didnot increase the risk of pulmonary aspiration. Although there was a
slight increase in their preoperative blood glucose levels, the
postoperative glucose levels were easier to control and required a lesser
amount of insulin to achieve normoglycemia. Moreover, we found a
remarkable improvement in the patient's well being as the carbohydrate
consumed group experiencedless thirst, and hunger. Patients with Type 2
diabetes may benefit from the physiologic benefits of this beverage,
justas do patients without diabetes in enhanced recovery after surgery
(ERAS) protocols. RBS levels during the perioperative period (mg/dl).

<101>
Accession Number
646475096
Title
Comparison of landmark versus ECG-guided technique for correct insertion
of central venous catheter in paediatric patients undergoing
cardiothoracic surgery.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S84), 2022. Date of Publication: 2022.
Author
Garg M.
Institution
(Garg) SMS Medical College, Jaipur, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Central venous catheters (CVC), commonly indicated in
paediatric patients during cardiac surgeries can cause various
complications if not correctly positioned. Objective of this study was to
compare correct placement of the CVC tip using anatomical landmark
technique with ECG-guided technique. Method(s): A prospective,
randomised interventional study was conducted on 72 patients of <12 years
age, randomly allotted to two groups of 36 patients each (landmark and
ECG). After induction, central venous cannulation was performed in right
IJV in all patients using either of the techniques. Post operative chest X
rays were obtained in all patients and correct position of CVC was
checked. CVC tip position within 0.5cm above/ below or at carina was
considered as correct position. Analyses were performed using Student's
t-tests and Chi square-tests. Result(s): It was found that 22
(61.11%) in the landmark group were positioned correctly as compared to 33
(91.67%) in the ECG group (p = 0.006). The mean depth of CVC insertion was
9.05+/-1.66 in landmark group and 8.26+/-1.41 in the ECG group (p= 0.032).
The landmark group had 12 (33.33%) participants with complications during
the procedure, compared to 3 (8.33%) in the ECG-guided group (p = 0.020).
 Conclusion(s): ECG-guided technique was found to be more accurate for
CVC tip placement than the anatomical landmark technique. ECG-guided
technique had less complications than the anatomical landmark technique.
Hence, ECG-guided CVC placement is relatively accurate, efficient, and
safe.

<102>
Accession Number
646475201
Title
Anaesthetic management of children with a single ventricle with pulmonary
atresia coming for emergency burr hole tapping.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S79-S80), 2022. Date of Publication: 2022.
Author
Palaniappan P.
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Post-operative atrial fibrillation (POAF) occurs in
30-50% of patients after coronary artery bypass surgery (CABG). Serum
hypomagnesemia is common after cardiac surgeries. The primary objective
was to evaluate whether magnesium infusion could reduce the incidence of
POAF after off-pump CABG. Method(s): This prospective, single-centre,
randomised controlled study was conducted among 100 patients who underwent
off-pump CABG. The participants were classified into two groups: group
(M), study group, started on magnesium infusion for 3 days after an
initial bolus dose as the patient is received in the intensive care unit
(ICU), and group (C), control group, managed with usual care. The target
in group M was to attain a serum magnesium level of 1.5 to 2 mmol/L. The
incidence of POAF was observed in both the groups. A p value < 0.05 was
taken as statistically significant. Result(s): The incidence of POAF
was significantly higher in the control group (20%) when compared to the
study group (2%) (p = 0.008). There were no significant changes in the
secondary objectives (vasoactive inotropic scores, length of ICU stay,
additional pharmacotherapy, and cardioversion needed) between both the
groups. Conclusion(s): The study established that continuous
magnesium infusion was effective in preventing POAF in patients undergoing
off-pump CABGs.

<103>
Accession Number
646475119
Title
Comparison of the effect of two balanced crystalloid intraoperative
(intravenous) solutions (PlasmalyteTM versus Sterofundin TM) on lactate
levels during major cancer surgeries.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S29), 2022. Date of Publication: 2022.
Author
Gupta D.
Institution
(Gupta) Park Hospital, Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Use of balanced fluids as intraoperative fluids
substantially decrease the incidence of lactic acidosis; especially after
major cancer surgeries. Aim of present study was to compare the effects of
two acetate based balanced solutions, PlasmalyteTM and SterofundinTM on
lactate, pH, electrolytes and haemodynamics after major onco-surgery.
 Method(s): In this prospective randomised parallel group study, 60
patients undergoing major onco surgeries were randomised in one o fthe two
groups to receive either PlasmalyteTM (PL) (30 patients) or SterofundinTM
(SF) (30 patients) as an intraoperative fluid. Arterial Blood Gas analysis
(ABG) was sampled before surgery (Baseline) and at the time of haemostasis
(Post surgery). Heart rate and mean blood pressure were noted every 30
minutes. Blood loss during surgery was replaced with either colloid or
blood. Descriptive statistical analyses, including mean and standard
deviation for continuous variables, and count and percentage for
categorical variables was performed. Student t-test was used to compare
continuous variables and Fisher's exact test was used for categorical
variables. p <0.05 was considered to indicate statistical significance.
Analysis was performed using SPSS Version 23.0 software. Result(s):
The patient's age was found to be comparable in both the groups (p=0.19).
There was not any statistically significant difference seen in lactate
(p=0.085) or pH (p=0.89) values between the two groups. Electrolyte levels
were well maintained within normal limits in both PL and SF groups except
calcium which was significantly higher in SF group post surgery(p<0.001).
Difference in heart rate and mean blood pressure was found to be
insignificant at all time points. Blood loss during the surgery was also
similar in both the groups (p=0.937). Conclusion(s): Both PL and SF
balanced crystalloid solutions can be safely recommended as an
intraoperative fluid in major oncological surgeries. Both the fluids
effectively maintain the pH and significantly decrease the incidence of
lactic acidosis during cancer surgeries. Calcium levels are better
maintained with the infusion of Sterofundin solution.

<104>
Accession Number
646475230
Title
ISACON 2021.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (no pagination), 2022. Date of Publication: 2022.
Author
Anonymous
Publisher
Wolters Kluwer Medknow Publications
Abstract
The proceedings contain 140 papers. The topics discussed include: effect
of use of entropy monitoring on consumption of sevoflurane inhalational
agent in patients undergoing off-pump coronary artery bypass graft
surgery; comparison of erector spinae block versus thoracic epidural
anesthesia for postoperative pain management in adult patients undergoing
thoracotomy; continuous positive airway pressure versus differential lung
ventilation during one lung ventilation for thoracic surgery; efficacy of
continuous magnesium infusion in prevention of post- operative atrial
fibrillation in patients undergoing off-pump coronary artery bypass graft
surgery; to study the safety and efficacy of preoperative oral
carbohydrate loading in type 2 diabetics undergoing elective off pump
coronary artery bypass grafting; and comparison of efficacy of ultrasound
guided pectoral blocks plus serratus anterior plane block versus
ultrasound guided erector spinae block with fentanyl group as control for
analgesia in patients undergoing off-pump coronary artery bypass grafting.

<105>
Accession Number
646475060
Title
Efficacy of continuous magnesium infusion in prevention of post- operative
atrial Fibrillation in patients undergoing off-Pump Coronary Artery Bypass
Graft Surgery Robin George.
Source
Indian Journal of Anaesthesia. Conference: 68th Annual National Conference
of the Indian Society of Anaesthesiologists, ISACON 2021. Online.
66(Supplement 1) (pp S4), 2022. Date of Publication: 2022.
Author
Medcity A.
Institution
(Medcity) CochinIndia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Postoperative atrial fibrillation (POAF) occurs in
30-50% of patients after coronary artery bypass surgery (CABG). Serum
hypomagnesemia is common after cardiac surgeries.The primary objective was
to evaluate whether magnesium infusion could reduce the incidence of
postoperative atrial fibrillation (POAF) after off pump CABG.
 Method(s): This prospective, singe centre, randomised controlled
study was conducted among 100 patients who underwent off-pump CABG. The
participants were classified into two groups: Group (M); study group in
which magnesium infusion was started for three days after an initial bolus
dose when the patient was received in intensive care unit (ICU) and Group
(C); control group was managed with usual care. The target in Group M was
to attain a serum magnesium level of 1.5 to 2 mmol/L. Theincidence of POAF
was observed in both the groups. A p value < 0.05 was taken as
statistically significant. Result(s): The incidence of POAF was
significantly higher in control group (20%) when compared to the study
group (2%) (p=0.008). There were no significant changes in vasoactive
inotropic scores, length of ICU stay, additional pharmacotherapy and
cardioversion needed between both the groups. Conclusion(s): The
study established that continuous magnesium infusion was effective in
preventing POAF in patients undergoing off-pump CABGs.

<106>
[Use Link to view the full text]
Accession Number
646463268
Title
Continuation versus Interruption of Oral Anticoagulation during TAVI.
Source
The New England journal of medicine. 392(5) (pp 438-449), 2025. Date of
Publication: 30 Jan 2025.
Author
van Ginkel D.J.; Bor W.L.; Aarts H.M.; Dubois C.; De Backer O.;
Rooijakkers M.J.P.; Rosseel L.; Veenstra L.; van der Kley F.; van Bergeijk
K.H.; Van Mieghem N.M.; Agostoni P.; Voskuil M.; Schotborgh C.E.;
IJsselmuiden A.J.J.; Van Der Heyden J.A.S.; Hermanides R.S.; Barbato E.;
Mylotte D.; Fabris E.; Frambach P.; Dujardin K.; Ferdinande B.; Peper J.;
Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer J.; Nijenhuis V.J.;
Overduin D.C.; Adriaenssens T.; Kobari Y.; Vriesendorp P.A.;
Montero-Cabezas J.M.; El Jattari H.; Halim J.; Van den Branden B.J.L.;
Leonora R.; Vanderheyden M.; Lauterbach M.; Wykrzykowska J.J.; van 't Hof
A.W.J.; van Royen N.; Tijssen J.G.P.; Delewi R.; Ten Berg J.M.
Institution
(van Ginkel, Bor, Aarts, Dubois, De Backer, Rooijakkers, Rosseel,
Veenstra, van der Kley, van Bergeijk, Van Mieghem, Agostoni, Voskuil,
Schotborgh, IJsselmuiden, Van Der Heyden, Hermanides, Barbato, Mylotte,
Fabris, Frambach, Dujardin, Ferdinande, Peper, Rensing, Timmers, Swaans,
Brouwer, Nijenhuis, Overduin, Adriaenssens, Kobari, Vriesendorp,
Montero-Cabezas, El Jattari, Halim, Van den Branden, Leonora,
Vanderheyden, Lauterbach, Wykrzykowska, van 't Hof, van Royen, Tijssen,
Delewi, Ten Berg) From the Department of Cardiology, St. Antonius
Hospital, Nieuwegein (D.J.G., W.L.B., J.P., B.J.W.M.R., L.T., M.J.S.,
J.B., V.J.N., D.C.O., J.M.B.), the Department of Cardiology, Amsterdam
UMC, Amsterdam (H.M.A., J.G.P.T., R.D.), the Department of Cardiology,
University Medical Center Utrecht, Utrecht (H.M.A., M. Voskuil), the
Department of Cardiology, Radboud University Medical Center, Nijmegen
(M.J.P.R., V.J.N., N.R.), the Department of Cardiology, Maastricht
University Medical Center (L.V., A.J.J.I., P.A.V., A.W.J.H.), and
Cardiovascular Research Institute Maastricht (L.V., P.A.V., A.W.J.H.,
J.M.B.), Maastricht, the Department of Cardiology, Leiden University
Medical Center, Leiden (F.K., J.M.M.-C.), the Department of Cardiology,
University Medical Center Groningen, Groningen (K.H.B., J.J.W.), the
Department of Cardiology, Erasmus University Medical Center, Rotterdam
(N.M.V.M.), the Department of Cardiology, Haga Hospital, the Hague
(C.E.S.), the Department of Cardiology, Amphia Hospital, Breda (A.J.J.I.,
J.H., B.J.L.V.B.), the Department of Cardiology, Isala Hospital, Zwolle
(R.S.H., R.L.), and the Department of Cardiology, Elisabeth-Tweesteden
Hospital, Tilburg (J.H.) - all in the Netherlands; the Department of
Cardiovascular Medicine, University Hospital Leuven, Leuven (C.D., T.A.),
the Department of Cardiology, Algemeen Stedelijk Hospital Aalst (L.R.)
Abstract
BACKGROUND: One third of patients undergoing transcatheter aortic-valve
implantation (TAVI) have an indication for oral anticoagulation owing to
concomitant diseases. Interruption of oral anticoagulation during TAVI may
decrease the risk of bleeding, whereas continuation may decrease the risk
of thromboembolism. METHOD(S): We conducted an international,
open-label, randomized, noninferiority trial involving patients who were
receiving oral anticoagulants and were planning to undergo TAVI. Patients
were randomly assigned in a 1:1 ratio to periprocedural continuation or
interruption of oral anticoagulation. The primary outcome was a composite
of death from cardiovascular causes, stroke from any cause, myocardial
infarction, major vascular complications, or major bleeding within 30 days
after TAVI. RESULT(S): A total of 858 patients were included in the
modified intention-to-treat population: 431 were assigned to continuation
and 427 to interruption of oral anticoagulation. A primary-outcome event
occurred in 71 patients (16.5%) in the continuation group and in 63
(14.8%) in the interruption group (risk difference, 1.7 percentage points;
95% confidence interval [CI], -3.1 to 6.6; P = 0.18 for noninferiority).
Thromboembolic events occurred in 38 patients (8.8%) in the continuation
group and in 35 (8.2%) in the interruption group (risk difference, 0.6
percentage points; 95% CI, -3.1 to 4.4). Bleeding occurred in 134 patients
(31.1%) in the continuation group and in 91 (21.3%) in the interruption
group (risk difference, 9.8 percentage points; 95% CI, 3.9 to 15.6).
 CONCLUSION(S): In patients undergoing TAVI with a concomitant
indication for oral anticoagulation, periprocedural continuation was not
noninferior to interruption of oral anticoagulation during TAVI with
respect to the incidence of a composite of death from cardiovascular
causes, stroke, myocardial infarction, major vascular complications, or
major bleeding at 30 days. (Funded by the Netherlands Organization for
Health Research and Development and the St. Antonius Research Fund;
POPular PAUSE TAVI ClinicalTrials.gov number, NCT04437303.). Copyright
© 2024 Massachusetts Medical Society.

<107>
Accession Number
2033112338
Title
The role of amino acids and protein administration in preventing cardiac
surgery-associated acute kidney injury.
Source
Future Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Bottussi A.; D'Andria Ursoleo J.; Agosta V.T.; De Luca M.; Monaco F.
Institution
(Bottussi, D'Andria Ursoleo, Agosta, De Luca) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Acute kidney injury (AKI) persists as one of the most common complications
after cardiac surgery. Beyond being burdened by high morbidity and
mortality rates, effective therapeutic options are still lacking. To date,
the management of cardiac surgery-associated AKI (CSA-AKI) mainly focuses
on preventive strategies, e.g. the implementation of standardized care
bundles. Interestingly, recent experimental studies have suggested a
potential nephroprotective role for both amino acids (AA) and proteins. As
such, these compounds show multiple beneficial renal effects, spanning
enhancement of renal blood flow, improved oxygenation, and recruitment of
renal functional reserve. Moreover, clinical studies have investigated the
therapeutic potential of single AA, AA combinations, and proteins. A
recent large multicenter randomized controlled trial showed reduced AKI
incidence in cardiac surgery patients receiving intravenous AA
supplementation. However, these interventions have not yet demonstrated
beneficial effects on major clinical outcomes, such as survival. Given the
well-established AA safety profile and the underlying biological rationale
supporting their use, this review summarizes the existing literature on
the effects of various formulations and combinations of perioperative AA
and protein on renal outcomes when administered in cardiac surgery
patients. Copyright © 2025 Informa UK Limited, trading as Taylor
& Francis Group.

<108>
Accession Number
646459071
Title
Cost-effectiveness of semaglutide in people with obesity and
cardiovascular disease without diabetes.
Source
Journal of medical economics. (pp 1-16), 2025. Date of Publication: 30
Jan 2025.
Author
McEwan P.; Bog M.; Faurby M.; Foos V.; Lingvay I.; Lubker C.; Miller R.;
Toliver J.C.; Yeates F.; Lincoff A.M.
Institution
(McEwan, Foos, Miller, Yeates) Health Economics and Outcomes Research
Ltd., Cardiff, United Kingdom
(Bog, Lubker) Novo Nordisk A/S, Denmark
(Faurby, Toliver) Novo Nordisk Inc., NJ, United States
(Lingvay) Department of Internal Medicine (Endocrinology Division) and
Peter O'Donnel Jr. School of Public Health, University of Texas
Southwestern Medical Center, Dallas, TX, United States
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
Abstract
AimsThe cardioprotective effects of semaglutide 2.4 mg reported in the
SELECT cardiovascular (CV) outcomes trial (ClinicalTrials.gov NCT03574597)
provide clinical benefit for subjects with overweight or obesity and
established CV disease without type 2 diabetes (T2D). We assessed
cost-effectiveness of semaglutide 2.4 mg in this population against the
American College of Cardiology/American Heart Association value
framework.Materials and methodsA cohort-level Markov-state
cost-effectiveness model using trial-derived data with outcomes from a
healthcare sector perspective measured over a lifetime horizon was
developed. Treatment costs were based on US list prices; scenario analyses
used literature-reported estimated rebates. Healthcare costs and benefits
were discounted at 3.0%. A simulated cohort of 100,000 subjects was
aligned to the SELECT trial population baseline characteristics and
time-on-treatment. Subjects received either semaglutide 2.4 mg or placebo
in addition to standard of care (SoC). Modelled outcomes included clinical
events (CV events, progression to T2D, chronic kidney disease [CKD]) and
health economic measures, including direct costs and quality-adjusted life
years (QALYs).ResultsMean semaglutide 2.4 mg treatment duration was 2.79
years. Per 100,000 subjects, treatment avoided 2,791 non-fatal myocardial
infarctions, 3,000 coronary revascularizations, 487 non-fatal strokes, and
115 CV deaths over the modeled lifetime horizon. Average per-subject
lifetime treatment costs were $47,353; savings arose from avoided T2D
($14,431), CKD ($2,074), and CV events ($1,512). Semaglutide 2.4 mg was
associated with increased lifetime costs ($29,767), additional QALYs
gained (0.218) and an incremental cost-effectiveness ratio of
$136,271/QALY at list price; a scenario using an empirically estimated 48%
rebate predicted $32,219/QALY.LimitationsThe generalizability of
observations from SELECT to a broader US population is unknown. Our model
does not capture all outcomes nor costs that may be affected by weight
loss. Modeling assumptions may present limitations.ConclusionsSemaglutide
2.4 mg use as in SELECT is cost-effective at list price, using a
$150,000/QALY willingness-to-pay threshold.

<109>
Accession Number
646435131
Title
Comparison of after-effects of protamine-heparin in two different ratios
in patients undergoing cardiac surgery.
Source
Indian Journal of Anaesthesia. Conference: 70th Annual Conference of the
Indian Society of Anaesthesiologists, ISACON 2023. Gurugram India.
68(Supplement 1) (pp S42), 2024. Date of Publication: 01 Feb 2024.
Author
Yedurupaka A.S.; Kilambi A.D.
Institution
(Yedurupaka, Kilambi) NRI Medical College and General Hospital, NRIGH,
Chinakakani, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: In cardiac surgery, protamine is administered to
eliminate the effect of heparin, which can have an anticoagulant effect
when administered in large doses and under-dosing leaves unbound heparin
in the circulation and may increase bleeding post-operatively.[1,2] The
study aimed to evaluate the optimal protamine: heparin ratio.
 Method(s): This cross-sectional observational study was conducted
among 60 patients willing to undergo cardiac surgery. The study had two
groups: Group A: Protamine/heparin ratio of 1:1; Group B: Protamine
/heparin ratio of 1.3:1. Data was collected as Preoperative,
postoperative, and intraoperative activated clotted time are all measured
as secondary outcome variables. Statistical analysis included continuous
variables expressed as mean, standard deviation, median, and interquartile
range. Categorical variables were presented as frequency and percentage. A
p-value < 0.05 was considered statistically significant. Result(s):
Median 12 h postoperative blood loss in groups A and B was significant
(p=0.002). Intraoperative whole blood (WB) transfusions were lower in
group A than in group B (p=0.04). Pre- and post-operative blood
investigations within groups were significant except for platelet count in
almost all measured parameters. Post-operative haematocrit within six h
postoperatively was lower in group B. Conclusion(s): A 1.3: 1 ratio
of protamine to heparin significantly increased intra-operative whole
blood transfusion and 12-h post-op blood loss compared with a 1:1 ratio.
Therefore, it is better not to exceed the 1:1 ratio.

<110>
Accession Number
646435139
Title
Comparative study of caudal dexmedetomidine versus morphine on
postoperative pain in paediatric cardiac surgery patients.
Source
Indian Journal of Anaesthesia. Conference: 70th Annual Conference of the
Indian Society of Anaesthesiologists, ISACON 2023. Gurugram India.
68(Supplement 1) (pp S42-S43), 2024. Date of Publication: 01 Feb 2024.
Author
Mankhair S.; Panbude P.; Jadhav J.
Institution
(Mankhair, Panbude, Jadhav) JNMC, DMIHER, Maharashtra, Wardha, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: The study aimed to compare the analgesic effects of
dexmedetomidine versus morphine in caudal analgesia in paediatric cardiac
surgery. It also measured the effects of caudal dexmedetomidine versus
morphine on haemodynamics, the postoperative FLACC scale, time to
extubation, and stay in the paediatric intensive care unit (PICU).
 Method(s): In this study, 60 patients, 1-10 years old and 5-15 kg,
were enrolled. Patients with bleeding diathesis, anomalies or active
infection in the spinal cord, and any allergy to study drugs were
excluded. The institutional ethics committee approved the study. The
sample size was calculated using the Open Epi open-source calculator. Out
of these, 30 patients were allocated to either caudal dexmedetomidine
(dexmedetomidine group) or morphine (morphine group) for postoperative
pain relief in paediatric patients undergoing cardiac surgery.
 Result(s): Heart rate (HR) was recorded before induction (Baseline
[BL]), 10 min after caudal injection (T1), 5 min after sternotomy (T2),
after cardiopulmonary bypass (CPB) (T3), at PICU admission (T4) and
extubation (T5). The heart rate was lower in the dexmedetomidine group. HR
was comparable and markedly lower in the dexmedetomidine group. The mean
blood pressure did not show variation between the two groups except during
extubation and at the time of PICU admission. Oxygen saturation
(SpO<inf>2</inf>) variation was significant during extubation and PICU
transfer. The morphine group showed a significant fall in SpO<inf>2</inf>
compared to the other group. The fall in SpO2 was not significant enough,
though, which needed intervention. Post extubation, the FLACC score was
recorded in all patients every 6 h. The FLACC score was significantly
lower in the dexmedetomidine group till the first 4 h, implying good
analgesia compared to the morphine group. The mean time required for
extubation in the dexmedetomidine group was significantly lower than in
the morphine group. The analgesia was better in dexmedetomidine, needing
rescue analgesia much later compared to the morphine group.
 Conclusion(s): Caudal dexmedetomidine, when used as a sole analgesic
agent in paediatric open-heart surgeries, performed better than morphine
in attenuating the haemodynamic stress response of sternotomy and
cardiopulmonary bypass. It has better intraoperative haemodynamic control
and provides adequate and more prolonged postoperative analgesia. It also
has a shorter time to extubation with fewer complications.

<111>
Accession Number
646433752
Title
Blood Glucose Levels With Normal Saline And Ringer's Lactate In Elective
Non-Cardiac Surgeries In Diabetics: A Randomised Parallel Group Study.
Source
Indian Journal of Anaesthesia. Conference: 69th Annual National Conference
of Indian Society of Anaesthesiologist , ISACON 2022. Shillong India.
67(Supplement 3) (pp S156), 2023. Date of Publication: 01 Oct 2023.
Author
Bohra R.; Patil M.C.; Shetty G.; Shivpujipath M.
Institution
(Bohra, Patil, Shetty, Shivpujipath) Jawaharlal Nehru Medical College,
Belagavi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Intra-operative glycaemic control has many benefits.
Surprisingly, few studies include appropriate intravenous fluid choice in
peri-operative glucose management.[1,2] We observed the effects of 0.9%
normal saline (NS) and Ringer's Lactate (RL) on blood glucose in the
intra-operative period. Method(s): After ethical committee approval
and written informed consent, a total of 60 non-pregnant diabetic patients
aged 18-80 years, of either gender, American Society of Anesthesiologists
(ASA) physical status II and III, with normal renal and liver function
tests, undergoing elective non-cardiac surgery under regional anaesthesia
were randomised into Group R: Patients administered RL only and Group S:
Patients administered NS only during surgery. After checking pre-operative
blood glucose, regional anaesthesia was administered. Blood glucose was
measured every 30 min till either end of surgery, colloid administration,
hypoglycaemia (<80 mg/dL) or hyperglycaemia (>200 mg/dL). Result(s):
Intraoperative mean blood glucose level in Group R and Group S was
148.8+/-27.7 mg/dL and 155.5+/-17.9 mg/ dL respectively. No statistically
significant differences were observed. Conclusion(s): There is no
significant difference between NS and RL apropos effect on intraoperative
blood glucose in diabetic patients undergoing non-cardiac surgeries under
regional anaesthesia. Further studies are warranted for general
anaesthesia and its effects on electrolytes.

<112>
Accession Number
2037394744
Title
How Would We Prevent Our Own Acute Kidney Injury After Cardiac Surgery?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Pruna A.; Monaco F.; Asiller O.O.; Delrio S.; Yavorovskiy A.; Bellomo R.;
Landoni G.
Institution
(Pruna, Monaco, Delrio, Landoni) Department of Anesthesia and Intensive
Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Asiller) Department of Anesthesia and Intensive Care, Ankara University
Faculty of Medicine, Ankara, Turkey
(Yavorovskiy) I.M. Sechenov First Moscow State Medical University of the
Russian Ministry of Health, Moscow, Russian Federation
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
Publisher
W.B. Saunders
Abstract
Acute Kidney Injury (AKI) is a common complication after cardiac surgery
affecting up to 40% leading to increased morbidity and mortality. To date,
there is no specific treatment for AKI, thus, clinical research efforts
are focused on preventive measures. The only pharmacological preventive
intervention that has demonstrated a beneficial effect on AKI in a
high-quality, double-blind, randomized controlled trial is a short
perioperative infusion of a balanced mixture of amino acid solution. Amino
acid infusion reduced the incidence of AKI by recruiting renal functional
reserve and, therefore, increasing the glomerular filtration rate. The
beneficial effect of amino acids was further confirmed for severe AKI and
applied to patients with chronic kidney disease. Among non-pharmacological
interventions, international guidelines on AKI suggest the implementation
of a bundle of good clinical practice measures to reduce the incidence of
perioperative AKI or to improve renal function whenever AKI occurs. The
Kidney Disease Improving Global Outcomes (KDIGO) bundle includes the
discontinuation of nephrotoxic agents, volume status and perfusion
pressure assessment, renal functional hemodynamic monitoring, serum
creatine, and urine output monitoring, and the avoidance of hyperglycemia
and radiocontrast procedures. However, pooled data from a meta-analysis
did not find a significant reduction in AKI. The aim of this review is to
delineate the most appropriate evidence-based approach to prevent AKI in
cardiac surgery patients. Copyright © 2025 Elsevier Inc.

<113>
Accession Number
2037395891
Title
Cardiovascular Disease-Specific Responses to Autonomic Denervation.
Source
JACC: Clinical Electrophysiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Zhang Y.; Po S.S.; Xin F.; Zhao J.; Zhao K.; Tao D.; Chakraborty P.; Yin
Z.; Liu G.; Wang H.
Institution
(Zhang, Xin, Zhao, Zhao, Tao, Yin, Liu, Wang) Department of Cardiovascular
Surgery, General Hospital of Northern Theater Command, Liaoning, Shenyang,
China
(Po, Chakraborty) Section of Cardiovascular Diseases and Heart Rhythm
Institute, University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcium-mediated autonomic denervation has been shown to
suppress postoperative atrial fibrillation (POAF) after coronary artery
bypass grafting. Objective(s): This study sought to evaluate whether
similar autonomic denervation can prevent POAF after mitral or aortic
valve surgeries. Method(s): This research consisted of 2
single-center, randomized, double-blind, sham-controlled trials: CAP-AF2
(Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation
in Patients Undergoing Isolated Mitral Valve Surgery for Mitral
Regurgitation) for mitral valve (MV) surgery and CAP-AF3 (Calcium
Autonomic Denervation Prevents Postoperative Atrial Fibrillation in
Patients Undergoing Isolated Aortic Valve Surgery) for aortic valve
surgery. Patients were randomized to receive injections of either 5%
CaCl<inf>2</inf> or 0.9% NaCl (control) into the atrial ganglionated plexi
during surgery. The primary outcome was the incidence of POAF >=30 seconds
within 7 days after surgery. Secondary outcomes included hospital stay, AF
burden, actionable antiarrhythmic therapy for POAF, and inflammatory
marker. Result(s): After 160 patients were enrolled into the CAP-AF2
trial, mid-term analysis revealed a significant increase in POAF incidence
in the CaCl<inf>2</inf> group (55.13%, CaCl<inf>2</inf> vs 37.80%, NaCl; P
= 0.028). The CAP-AF2 trial was terminated by the safety committee. In the
CAP-AF3 trial, 239 patients were randomized; final analysis showed no
significant difference in the POAF incidence between the CaCl<inf>2</inf>
and NaCl groups (35.59% vs 39.67%, P = 0.516). Postoperative hospital
stay, AF burden, antiarrhythmic therapy for POAF, and plasma levels of
inflammatory markers were not different between the 2 groups in both
trials. Immunohistochemical analyses showed parasympathetic predominance
at the tissue level in patients receiving MV surgery. Conclusion(s):
Calcium-mediated autonomic denervation did not uniformly prevent POAF
across all cardiac surgeries, with an increased incidence observed in the
MV surgery group, highlighting the need for disease-specific strategies to
prevent POAF. (Calcium Autonomic Denervation Prevents Postoperative Atrial
Fibrillation in Patients Undergoing Isolated Mitral Valve Surgery for
Mitral Regurgitation [CAP-AF2]; ChiCTR2000029314; Calcium Autonomic
Denervation Prevents Postoperative Atrial Fibrillation in Patients
Undergoing Isolated Aortic Valve Surgery [CAP-AF3];
ChiCTR2000029313). Copyright © 2025 American College of
Cardiology Foundation

<114>
Accession Number
646453321
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium: A Cluster Randomized Crossover Trial.
Source
JAMA surgery. (no pagination), 2025. Date of Publication: 29 Jan 2025.
Author
Spence J.; Devereaux P.J.; Lee S.-F.; D'Aragon F.; Avidan M.S.; Whitlock
R.P.; Mazer C.D.; Rousseau-Saine N.; Rajamohan R.R.; Pryor K.O.; Klein R.;
Tan E.; Cameron M.J.; Di Sante E.; DeBorba E.; Mustard M.E.; Couture E.J.;
Zamper R.P.C.; Law M.W.Y.; Djaiani G.; Saha T.; Choi S.; Hedlin P.;
Pikaluk D.R.; Lam W.; Deschamps A.; Ramasundarahettige C.F.; Vincent J.;
McIntyre W.F.; Oczkowski S.J.W.; Dulong B.J.; Beaver C.; Kloppenburg S.A.;
Lamy A.; Jacobsohn E.; Belley-Cote E.P.
Institution
(Spence, Devereaux, Lee, Whitlock, Di Sante, DeBorba, Ramasundarahettige,
Vincent, McIntyre, Beaver, Kloppenburg, Lamy, Belley-Cote) Population
Health Research Institute, Hamilton, Ontario, Canada
(Spence) Department of Anesthesia and Critical Care, McMaster University,
Hamilton, Ontario, Canada
(Spence, Devereaux, Lee, Whitlock, Oczkowski, Belley-Cote) Department of
Health Research Methods, Evidence, and Impact, McMaster University,
Hamilton, Ontario, Canada
(Spence, Devereaux, Whitlock, McIntyre, Lamy, Belley-Cote) World Health
Research Trust, Hamilton, Ontario, Canada
(Devereaux, McIntyre, Lamy) Department of Medicine, Cardiology, McMaster
University, Hamilton, Ontario, Canada
(D'Aragon) Departement d'anesthesiologie, Universite de Sherbrooke,
Sherbrooke, Quebec, Canada
(Avidan) Department of Anesthesia, Washington University at St Louis
School of Medicine, St Louis, MO, United States
(Whitlock) Department of Surgery, Cardiac Surgery, McMaster University,
Hamilton, Ontario, Canada
(Mazer) Department of Anesthesia and Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Departments of Anesthesiology and Pain Medicine, Physiology,
Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'anesthesie, Institut de
cardiologie de Montreal, Universite de Montreal, Montreal, Quebec, Canada
(Rajamohan) Department of Anesthesia, St Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, NY,
United States
(Klein) Department of Anesthesia, Vancouver General Hospital, University
of British Columbia, Vancouver, BC, Canada
(Tan, Dulong) Department of Anesthesia and Critical Care Medicine, Queen
Elizabeth II Health Sciences, Dalhousie University, Halifax, NS, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, McGill
University, Montreal, Quebec, Canada
(Mustard) St Michael's Hospital, Toronto, ON, Canada
(Couture) Institut universitaire de cardiologie et de pneumologie de
Quebec - Universite Laval, Quebec, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Law) Department of Anesthesiology, Royal Columbian Hospital and
Department of Anesthesiology, Pharmacology & Therapeutics, University of
British Columbia, Vancouver, BC, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, Ontario,
Canada
(Choi) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Mazankowski Alberta
Heart Institute, Edmonton, AB, Canada
(Oczkowski) Department of Medicine, Critical Care, McMaster University,
Hamilton, Ontario, Canada
(Lamy, Belley-Cote) Department of Medicine, Cardiology and Critical Care,
McMaster University, Hamilton, Ontario, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine, Critical Care, University of Manitoba, Winnipeg, MB, Canada
Abstract
Importance: Delirium is common after cardiac surgery and associated with
adverse outcomes. Intraoperative benzodiazepines may increase
postoperative delirium but restricting intraoperative benzodiazepines has
not yet been evaluated in a randomized trial. Objective(s): To
determine whether an institutional policy of restricted intraoperative
benzodiazepine administration reduced the incidence of postoperative
delirium. Design, Setting, and Participant(s): This pragmatic,
multiperiod, patient- and assessor-blinded, cluster randomized crossover
trial took place at 20 North American cardiac surgical centers. All adults
undergoing open cardiac surgery at participating centers during the trial
period were included through a waiver of individual patient consent
between November 2019 and December 2022. Intervention(s):
Institutional policies of restrictive vs liberal intraoperative
benzodiazepine administration were compared. Hospitals (clusters) were
randomized to cross between the restricted and liberal benzodiazepine
policies 12 to 18 times over 4-week periods. Main Outcomes and
Measures: The primary outcome was the incidence of delirium within 72
hours of surgery as detected in routine clinical care, using either the
Confusion Assessment Method-Intensive Care Unit or the Intensive Care
Delirium Screening Checklist. Intraoperative awareness by patient report
was assessed as an adverse event. Result(s): During the trial, 19 768
patients (mean [SD] age, 65 [12] years; 14 528 [73.5%] male) underwent
cardiac surgery, 9827 during restricted benzodiazepine periods and 9941
during liberal benzodiazepine periods. During restricted periods,
clinicians adhered to assigned policy in 8928 patients (90.9%), compared
to 9268 patients (93.2%) during liberal periods. Delirium occurred in 1373
patients (14.0%) during restricted periods and 1485 (14.9%) during liberal
periods (adjusted odds ratio [aOR], 0.92; 95% CI, 0.84-1.01; P = .07). No
patient spontaneously reported intraoperative awareness. Conclusions
and Relevance: In intention-to-treat analyses, restricting benzodiazepines
during cardiac surgery did not reduce delirium incidence but was also not
associated with an increase in the incidence of patient-reported
intraoperative awareness. Given that smaller effect sizes cannot be ruled
out, restriction of benzodiazepines during cardiac surgery may be
considered. Research is required to determine whether restricting
intraoperative benzodiazepines at the patient level can reduce the
incidence of postoperative delirium. Trial Registration:
ClinicalTrials.gov Identifier: NCT03928236.

<115>
Accession Number
2033071543
Title
Transcatheter management of residual mitral regurgitation after
transcatheter edge-to-edge repair: a systematic review.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025.
Article Number: 100234. Date of Publication: 2025.
Author
Baudo M.; Cuko B.; Ternacle J.; Sicouri S.; Busuttil O.; Denti P.; Godino
C.; De Vincentiis C.; Ramlawi B.; Leroux L.; Modine T.; Palloshi A.;
Maisano F.
Institution
(Baudo, Sicouri, Ramlawi) Department of Cardiac Surgery Research, Lankenau
Institute for Medical Research, Main Line Health, 100 E Lancaster Avenue,
Wynnewood, PA, United States
(Cuko, Ternacle, Busuttil, Leroux, Modine) Department of Cardiology and
Cardio-Vascular Surgery, Hopital Cardiologique du Haut-Leveque, Bordeaux
University Hospital, Pessac, France
(Denti, Godino, Palloshi, Maisano) Heart Valve Center, IRCCS San Raffaele,
Milan, Italy
(De Vincentiis) Department of Cardiac Surgery, IRCCS San Donato, Milan,
Italy
(Ramlawi) Department of Cardiac Surgery, Lankenau Heart Institute, Main
Line Health, Wynnewood, PA, United States
(Palloshi) Department of Interventional Cardiology, Istituto Clinico Citta
Studi, Milan, Italy
Publisher
Springer
Abstract
Background: Treatment of residual mitral regurgitation (MR) with different
percutaneous devices after transcatheter edge-to-edge repair (TEER) has
been reported as an alternative option to reclipping or surgery. This
review aims at describing the different transcatheter strategies available
and their results when managing residual MR after TEER. Method(s): A
literature search was undertaken across Pubmed, ScienceDirect, SciELO,
DOAJ, and Cochrane library databases, to identify article reporting
patients with post-TEER residual MR managed by a transcatheter approach
that did not involve only the implantation of new clips. Result(s):
From 439 deduplicated studies, 24 articles ultimately met the inclusion
criteria. Fifteen described an occluder device implantation, 12 with an
Amplatzer and 3 with a Cardioform. The most feared complications were
hemolysis and device embolization. Three cases of transcatheter
annuloplasty were reported in patients with residual functional MR. An
electrosurgical detachment of the TEER device from the anterior mitral
leaflet (ELASTA-Clip) before mitral valve replacement was reported in 6
articles. Conclusion(s): Transcatheter procedures addressing residual
MR after TEER in carefully selected patients are feasible in experienced
centers. Outcomes are promising despite some technical issues.
Percutaneous strategies and related complications should be anticipated
using multimodality imaging. Copyright © The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

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