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<1>
Accession Number
2036984973
Title
The Efficacy and Safety of Angiotensin II for Treatment of Vasoplegia in
Critically Ill Patients: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(3) (pp 653-665),
2025. Date of Publication: 01 Mar 2025.
Author
Kotani Y.; Lezzi M.; Murru C.P.; Khanna A.K.; Zarbock A.; Bellomo R.;
Landoni G.
Institution
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Lezzi, Murru, Landoni) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(Khanna) Section on Critical Care Medicine, Department of Anesthesiology,
Wake Forest University School of Medicine, Winston-Salem, NC, United
States
(Khanna) Perioperative Outcomes and Informatics Collaborative, Wake Forest
University School of Medicine, Medical Center Boulevard, Winston-Salem,
NC, United States
(Khanna) Outcomes Research Consortium, Houston, TX, United States
(Zarbock) Department of Anesthesiology, Intensive Care Medicine and Pain
Therapy, University Hospital Muenster, Muenster, Germany
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Department of Critical Care, Melbourne Medical School, The
University of Melbourne, Melbourne, Australia
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
Publisher
W.B. Saunders
Abstract
Objectives: To summarize evidence regarding intravenous angiotensin II
administration in critical illness and provide an updated understanding of
its effects on various organ dysfunction and renin-angiotensin system
(RAS) biomarkers. Design(s): A systematic review. Setting(s): A
search of PubMed, Embase, and the Cochrane Library from inception to May
3, 2024. Randomized controlled trials (RCTs), nonrandomized trials,
quasi-randomized trials, observational studies, case reports, and case
series were included. Comparative studies (RCTs and observational studies
with comparator) were used for the main analysis. Participant(s):
Critically ill adults and children. Intervention(s): Intravenous
angiotensin II administration. Measurements and Main Results:
Fifty-nine studies with a total of 2,918 participants (5 RCTs, 15
observational studies, and 39 case reports or case series) were analyzed.
Septic shock and cardiac surgery were the most common clinical conditions
(14 studies for each). In 14 comparative studies (5 RCTs and 9
observational studies), mortality was not different from that in controls,
except in 1 observational study. Several studies reported decreased renal
replacement therapy use, improved oxygenation and blood pressure response,
and decreased rate of myocardial injury with angiotensin II therapy. There
was no increase in thrombotic events or adverse events. Angiotensin II
therapy reduced renin and angiotensin I levels without affecting other RAS
biomarkers. Conclusion(s): Intravenous angiotensin II has been
reported in almost 3000 critically ill patients with diverse types of
shock. Despite unclear mortality impacts, angiotensin II seems to confer
beneficial effects on several organ systems and RAS derangements, without
increasing adverse events. Copyright © 2024 Elsevier Inc.

<2>
Accession Number
2037480251
Title
Early Versus Late Post Cesarean Section Warfarin Initiation and Increased
Risk of Maternal Complications in Patients With Mechanical Heart Valves: A
Randomized, Open-Label Pilot Study.
Source
Korean Circulation Journal. 55(2) (pp 151-160), 2025. Date of Publication:
01 Feb 2025.
Author
Youssef G.; El Husseiny Mohamed T.; Raouf M.A.A.; Tammam A.S.F.; Gabr A.A.
Institution
(Youssef) Department of Cardiovascular Medicine, Faculty of Medicine,
Cairo University, Cairo, Egypt
(El Husseiny Mohamed, Raouf, Tammam, Gabr) Department of Obstetrics and
Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: The timing of the reinstitution of warfarin
after cesarean section (CS) delivery was not adequately addressed in the
literature. This study aims to evaluate the risks of early versus late
initiation of warfarin post-CS in patients with mechanical heart valves.
 Method(s): This randomized, open-label cohort study included 114
pregnant women with mechanical heart valves planned to be delivered by CS
at or after 28 weeks of gestation. Patients were randomly divided into two
groups: Day-2-group, where warfarin was started on day 2, and Day-5-group,
where warfarin was started on day 5 after CS. Maternal postoperative
bleeding complications, mechanical valve thrombosis, need for blood
transfusion or reoperation, and maternal mortality were identified.
 Result(s): Ten women (8.8%) had 11 bleeding complications, of whom 2
patients (20%) had intraperitoneal hemorrhage (none in Day-2-group and 2
in Day-5-group), 3 patients (30%) had subcutaneous hematoma (none in
Day-2-group and 3 in Day-5-group), and 6 patients (60%) had sub-rectus
hematoma (3 in Day-2-group and 3 in Day-5-group). No mechanical valve
thrombosis, other thromboembolic events, or in-hospital maternal mortality
were reported. Conclusion(s): Despite the small number of events, the
bleeding risk was lower in the group with early post-CS warfarin
introduction than in the group with late warfarin introduction in patients
with prosthetic heart valves. Trial Registration: ClinicalTrials.gov
Identifier: NCT04855110. Copyright © 2025. The Korean Society of
Cardiology.

<3>
Accession Number
2037154159
Title
CABG triumphs over PCI: A meta-analysis reveals superior long-term
outcomes for LMCAD.
Source
Current Problems in Surgery. 63 (no pagination), 2025. Article Number:
101699. Date of Publication: 01 Feb 2025.
Author
Akemu J.; Aimaiti G.; Xia D.
Institution
(Akemu) Cardiovascular Center, The First Affiliated Hospital of Xinjiang
Medical University, Xinjiang, Urumqi City, China
(Aimaiti) Department of Critical Care Medicine, The First Affiliated
Hospital of Xinjiang Medical University, Xinjiang, Urumqi City, China
(Xia) Cardiovascular Intensive Care Unit, The First Affiliated Hospital of
Xinjiang Medical University, Xinjiang, Urumqi City, China
Publisher
Elsevier Inc.

<4>
Accession Number
2035694686
Title
The Ticking Surgical Clock: Outcome, Predictor, or a Bit of Both?.
Source
Brazilian Journal of Cardiovascular Surgery. 40(1) (no pagination), 2025.
Article Number: e20240084. Date of Publication: 2025.
Author
Magoon R.; Kalaiselvan J.; Jose J.
Institution
(Magoon, Kalaiselvan) Department of Cardiac Anaesthesia, Atal Bihari
Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia
Hospital, New Delhi, India
(Jose) Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Karnataka, Bengaluru, India
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular

<5>
Accession Number
2037330812
Title
The Potential Role of Albumin in Reducing Cardiac Surgery-Associated Acute
Kidney Injury: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(2) (pp 453-460),
2025. Date of Publication: 01 Feb 2025.
Author
Miralles Bagan J.; Parrilla Quiles L.; Paniagua Iglesias P.; Betbese Roig
A.J.; Sabate Tenas S.; Perez Garcia S.; Garcia Alvarez M.
Institution
(Miralles Bagan, Parrilla Quiles, Paniagua Iglesias, Sabate Tenas, Perez
Garcia, Garcia Alvarez) Department of Anesthesiology, Reanimation and Pain
Therapy, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Betbese Roig) Department of Intensive Care Medicine, Hospital de la Santa
Creu i Sant Pau, Barcelona, Spain
Publisher
W.B. Saunders
Abstract
Objectives: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a
common complication with high morbidity and mortality. This study was
designed to determine whether adding human albumin to the cardiopulmonary
bypass (CPB) priming solution reduces the incidence of CSA-AKI.
 Design(s): A double-blind, randomized controlled trial (RCT)
involving 248 patients scheduled for cardiac surgery with CPB.
 Setting(s): A single-center tertiary university hospital.
 Participant(s): Adults with a baseline estimated glomerular
filtration rate (eGFR) of >=60 mL/min/1.73 m2 and left
ventricular ejection fraction >=40%. Intervention(s): Patients were
randomized to receive either a crystalloid priming solution (Plasma-Lyte)
plus 4% albumin (intervention group, n = 126) or a crystalloid solution
alone (control group, n = 122) for CPB. Measurements and Main
Results: Data analyses were performed using the Chi-square test and
Student's t-test, or their nonparametric equivalent. The primary outcome
was the incidence of CSA-AKI, as defined by the Kidney Disease Improving
Global Outcomes criteria, within 5 days postoperatively. Both cohorts were
comparable in baseline and perioperative characteristics, including
preoperative albumin levels. The incidence of CSA-AKI was 29.3% (n = 37)
in the intervention group compared with 31.2% (n = 38) in the control
group (odds ratio: 0.91, 95% confidence interval: 0.53-1.58). The observed
difference in CSA-AKI incidence between the groups was not statistically
significant. A post-hoc subgroup analysis of patients with a baseline eGFR
of 60 to 70 mL/min/1.73 m2 indicated a trend toward a reduced incidence of
CSA-AKI in the intervention group compared with the control group (35.7% v
57.6%; odds ratio: 0.41, 95% confidence interval: 0.16-1.03). This trend
was not observed in patients with an eGFR greater than 70 mL/min/1.73 m2.
No significant differences were observed between groups for the need for
inotropes or vasoconstrictors, incidence of cardiogenic or distributive
shock, bleeding, need for transfusion, or use of nephrotoxic drugs.
 Conclusion(s): Adding albumin to the CPB priming solution did not
decrease the incidence of CSA-AKI in patients with normal preoperative
renal function. These findings suggest that albumin might benefit patients
with impaired renal function, warranting further
investigation. Copyright © 2024 Elsevier Inc.

<6>
Accession Number
2037521770
Title
Comparison of 1-Year Clinical Outcomes Between Ticagrelor Versus
Clopidogrel in Type 2 Diabetes Patients After Implantation of Small
Diameter Stents.
Source
Anatolian Journal of Cardiology. 29(2) (pp 95-103), 2025. Date of
Publication: 01 Feb 2025.
Author
Algazzar A.S.; Aljondi R.M.; Metwalli E.M.; Dhaher G.Y.; Mushaeb H.H.;
Aljadani R.H.; Balahmar R.S.; Hafiz A.; Qutub M.A.
Institution
(Algazzar) Department of Cardiology, Ahmed Maher Teaching Hospital, Cairo,
Egypt
(Aljondi, Metwalli, Dhaher, Mushaeb, Aljadani, Balahmar, Qutub) Department
of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
(Hafiz) Department of Pharmacy Practice, Faculty of Pharmacy, King
Abdulaziz University, Jeddah, Saudi Arabia
Publisher
Turkish Society of Cardiology
Abstract
Background: Type 2 diabetes mellitus (T2DM) patients with small-diameter
stents (SDS), that are equal to or less than 2.5 mm in diameter, face
increased risks of restenosis and complications. This study aimed to
evaluate the 1-year follow-up to assess the rate of major adverse cardiac
events (MACE) and bleeding risk between ticagrelor and clopidogrel in T2DM
patients after SDS implantation. Method(s): The study was a
single-center, prospective controlled registry trial, which included 332
T2DM patients who underwent percutaneous coronary intervention with SDS
implantation. Follow-up was conducted for 1 year. Result(s):
Following propensity score matching, the 1-year analysis revealed no
significant difference in the risk of the composite MACE between
clopidogrel and ticagrelor groups (P= .295). Male gender, history of
ischemic heart disease, ejection fraction (EF), coronary lesion type, and
chronic kidney disease (CKD) were identified as potential predictors for
the composite endpoint. In a sub-analysis of CKD patients, the 12-month
rates of composites of cardiac death (CD), myocardial infarction (MI),
stroke, and target vessel revascularization (TVR) were lower in the
ticagrelor group than in the clopidogrel group (P= .024). However, the
ticagrelor group was associated with a higher rate of bleeding compared to
the clopidogrel group (20% vs. 9%) (P= .041). Conclusion(s): Our
study demonstrated that ticagrelor did not show improvement in the
composite of CD, MI, stroke, TVR, or the risk of bleeding events defined
by the BARC criteria in patients with T2DM and SDS compared with
clopidogrel emphasizing the importance of individualized treatment
decisions based on patient characteristics. However, the results may not
be representative of the entire population. Copyright@Author(s)

<7>
Accession Number
2037326974
Title
Normobaric hyperoxia combined with endovascular treatment for acute
ischaemic stroke in China (OPENS-2 trial): a multicentre, randomised,
single-blind, sham-controlled trial.
Source
The Lancet. 405(10477) (pp 486-497), 2025. Date of Publication: 08 Feb
2025.
Author
Li W.; Lan J.; Wei M.; Liu L.; Hou C.; Qi Z.; Li C.; Jiao L.; Yang Q.;
Chen W.; Liu S.; Yue X.; Dong Q.; Yuan H.; Gao Z.; Wu X.; Wen C.; Li T.;
Jiang C.; Li D.; Chen Z.; Shi J.; Shi W.; Yuan J.; Qin Y.; Li B.; Fisher
M.; Feng W.; Liu K.J.; Ji X.
Institution
(Li, Lan, Wei, Liu, Ji) Beijing Institute of Brain Disorders, Laboratory
of Brain Disorders, Ministry of Science and Technology, Collaborative
Innovation Center for Brain Disorders, Capital Medical University,
Beijing, China
(Hou) Center for Evidence-Based Medicine, Xuanwu Hospital Capital Medical
University, Beijing, China
(Qi) Cerebrovascular Diseases Research Institute, Xuanwu Hospital Capital
Medical University, Beijing, China
(Li) The Stroke Center, Xuanwu Hospital Capital Medical University,
Beijing, China
(Jiao, Ji) Department of Neurosurgery, Xuanwu Hospital Capital Medical
University, Beijing, China
(Yang) Department of Radiology, Beijing Chaoyang Hospital, Capital Medical
University, Beijing, China
(Chen) Department of Neurology, Zhangzhou Affiliated Hospital of Fujian
Medical University, Zhangzhou, China
(Wei, Liu) Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin,
China
(Yue) Department of Neurocritical Care, Zhoukou Central Hospital, Zhoukou,
China
(Dong, Qin) Department of Emergency Medicine, People's Hospital of Rizhao,
Rizhao, China
(Yuan) Department of Neurology, Qingdao Central Hospital, Qingdao, China
(Gao) Department of Neurology, Central Hospital of Shengli Oil Field,
Dongying, China
(Wu) Department of Neurology, Jiujiang University Affiliated Hospital,
Jiujiang, China
(Wen) Department of Neurology, Nanyang Central Hospital of Xinxiang
Medical University, Nanyang, China
(Li) Department of Neurology, The Second Nanning People's Hospital,
Nanning, China
(Jiang) Department of Neurology, Baotou Central Hospital of Inner Mongolia
Medical University, Baotou, China
(Li) Department of Neurointervention and Neurocritical Care, Dalian
Municipal Central Hospital, Dalian, China
(Chen) Department of Neurosurgery, Shanghai Tenth People's Hospital,
Tongji University School of Medicine, Shanghai, China
(Shi) Cerebrovascular Center, Nanshi Hospital of Nanyang, Nanyang, China
(Shi) Department of Neurosurgery, Peking University Binhai Hospital,
Tianjin, China
(Yuan) Department of Neurology, Beijing Daxing District People's Hospital,
Beijing, China
(Li) Department of Neurology, Jinan Third People's Hospital, Jinan, China
(Fisher) Department of Neurology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Feng) Department of Neurology, Duke University School of Medicine,
Durham, NC, United States
(Liu) Department of Pathology, Renaissance School of Medicine, Stony Brook
University, Stony Brook, NY, United States
(Ji) State Key Laboratory of Kidney Diseases, Beijing, China
Publisher
Elsevier B.V.
Abstract
Background: Endovascular treatment improves the recanalisation rate for
patients with acute ischaemic stroke; however, even with endovascular
treatment, approximately half of patients do not have a favourable
functional outcome. We aimed to evaluate the effect of normobaric
hyperoxia combined with endovascular treatment on functional outcomes up
to 90 days after treatment in patients who had an acute ischaemic stroke
with large-vessel occlusion. Method(s): In this multicentre,
randomised, single-blind, sham-controlled trial, patients aged 18-80 years
presenting within 6 h of acute ischaemic stroke attributed to large-vessel
occlusion in anterior circulation, who were candidates for endovascular
treatment, were recruited from 26 comprehensive stroke centres in China.
Eligible patients were randomly assigned (1:1), with an Interactive Web
Response System on the basis of a minimisation process to balance
assignment at each participating site both overall and according to age,
sex, occlusion location, and use of intravenous thrombolytics, to receive
either normobaric hyperoxia combined with endovascular treatment or sham
normobaric hyperoxia combined with endovascular treatment. Participants
and assessors were blinded to treatment assignment. Normobaric hyperoxia
treatment involved inhaling 100% oxygen at a flow rate of 10 L/min through
a non-rebreather mask for 4 h, or an inspiratory oxygen fraction
(FiO<inf>2</inf>) of 1.0 in participants for whom intubation was
necessary. Sham treatment was 100% oxygen delivered at a flow rate of 1
L/min or an FiO<inf>2</inf> of 0.3. The primary outcome was the comparison
of the ordinal scores on the modified Rankin Scale (mRS) at 90 days
assessed in the intention-to-treat population (including all patients
randomly assigned to treatment). Safety was assessed in all patients who
received any oxygen therapy. This trial is registered with
ClinicalTrials.gov, NCT04681651, and is now complete. Finding(s):
Between April 22, 2021, and Feb 5, 2023, 473 patients were screened, of
whom 282 were randomly assigned to either normobaric hyperoxia plus
endovascular treatment (n=140) or sham normobaric hyperoxia plus
endovascular treatment (n=142; intention-to-treat population). The median
age was 65 years (IQR 57-71), 75 (27%) of 282 participants were female,
207 (73%) were male, and 282 (100%) of participants were of Chinese Han
ethnicity. At 90 days, the median score on the mRS for the normobaric
hyperoxia group was 2 (IQR 1-4) and it was 3 (1-4) in the sham normobaric
hyperoxia group (adjusted common odds ratio 1.65 [95% CI 1.09-2.50];
p=0.018). At 90 days, 14 (10%) of 140 patients in the normobaric hyperoxia
group and 17 (12%) of 142 in the sham normobaric hyperoxia group died
(adjusted risk difference -0.02 [95% CI -0.09 to 0.06]) and 28 (20%) and
33 (23%) had serious adverse events (adjusted risk difference -0.03 [-0.12
to 0.07]). Interpretation(s): In patients with acute ischaemic stroke
caused by large-vessel occlusion in the anterior circulation who were
candidates for endovascular treatment, normobaric hyperoxia yielded
superior functional outcomes at 90 days compared with the sham normobaric
hyperoxia, without raising safety concerns. Funding(s): Beijing
Municipal Education Commission, Beijing Municipal Finance Bureau, and
National Natural Science Foundation of China. Copyright © 2025
Elsevier Ltd

<8>
Accession Number
2032427699
Title
Sleep apnea prevalence and severity after coronary revascularization
versus no intervention: a systematic review & meta-analysis.
Source
Sleep and Breathing. 29(1) (no pagination), 2025. Article Number: 13. Date
of Publication: 01 Mar 2025.
Author
Marjo A.; Satu S.; Tero V.; Ulla A.-L.; Peker Y.; Nea K.; Jenni T.
Institution
(Marjo, Satu, Nea, Jenni) Department of Pulmonary Diseases and Clinical
Allergology, Sleep Research Center, University of Turku, Turku, Finland
(Marjo, Ulla, Jenni) Department of Anesthesiology and Intensive Care,
University of Turku, Turku, Finland
(Marjo, Jenni) Division of Perioperative Services, Intensive Care and Pain
Medicine, Turku University Hospital, Turku, Finland
(Tero) Department of Biostatistics, University of Turku and Turku
University Hospital, Turku, Finland
(Nea) Heart Center, Turku University Hospital, University of Turku, Turku,
Finland
(Peker) Department of Pulmonary Medicine, Koc University School of
Medicine, TR, Istanbul, Turkey
(Peker) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, University of Gothenburg, SE, Gothenburg, Sweden
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, SE, Lund, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Obstructive sleep apnea (OSA) is a common disease in patients
with coronary artery disease (CAD). Approximately 40-80% of cardiovascular
disease patients have obstructive sleep apnea. The manifestation of it can
vary significantly in different types of CAD patients. This systematic
review and meta-analysis investigate the prevalence and severity of OSA in
patients with acute coronary syndrome (ACS). Method(s): This
systematic review was conducted according to PRISMA guidelines. The first
inclusion criteria were that a reliable sleep study had to be done after
treating the patients' acute coronary incident. All patients in the
studies included were adults suffering from an ACS who underwent either
coronary artery bypass grafting surgery (CABG), a percutaneous coronary
intervention (PCI) or had no invasive coronary intervention done. A search
was conducted within four valid databases 27.1.2023 and all suitable
articles published after 1.1.2010 were included. Result(s): Eight
studies fulfilled the full inclusion criteria. In five of them, a sleep
study had been performed after PCI, in two after no coronary intervention,
and in one study after CABG. Mean AHI in no-OSA group after PCI was 9.5 /h
(95% CI 5.3-13.7) and in the no intervention group 6.4 /h (95% CI
3.5-9.4). In OSA patients, mean AHI after PCI was 34.9 /h (95% CI
25.9-43.8) vs. 24.1 /h without intervention (95% CI 15.6-32.6).
 Conclusion(s): Sleep apnea is very common among ACS patients and
should be screened for and addressed after the acute coronary
intervention. Moreover, we found that OSA is more severe in patients in
whom PCI for ACS was indicated as opposed to patients who underwent no
coronary intervention. Copyright © The Author(s) 2024.

<9>
Accession Number
2033194553
Title
Comparisons of open surgical repair, thoracic endovascular aortic repair,
and optimal medical therapy for acute and subacute type B aortic
dissection: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
86. Date of Publication: 01 Dec 2025.
Author
Liu J.; Chen X.; Xia J.; Tang L.; Zhang Y.; Cao L.; Zheng Y.
Institution
(Liu, Tang, Zhang, Zheng) Department of Cardiovascular Surgery, Suining
Central Hospital, 27 Dong Ping Street, Sichuan, Suining, China
(Chen) Department of Anesthesiology, Suining Central Hospital, Sichuan,
Suining, China
(Xia) Department of Hospital-Acquired Infection Control, Suining Central
Hospital, Sichuan, Suining, China
(Cao) Department of Intensive Care Unit, Suining Central Hospital,
Sichuan, Suining, China
Publisher
BioMed Central Ltd
Abstract
Background: Various treatments have been employed in managing type B
aortic dissection (TBAD), encompassing open surgical repair (OSR),
thoracic endovascular aortic repair (TEVAR), and optimal medical therapy
(OMT). Nonetheless, the determination of the most efficacious treatment
protocol remains a subject of debate. We aim to compare the treatments in
patients with acute and subacute TBAD using a meta-analytic approach.
 Method(s): A systematic search was conducted across databases
including PubMed, EmBase, and the Cochrane Library for relevant studies
published from their inception up to September 2024. Studies comparing
OSR, TEVAR, and OMT for TBAD through controlled or direct comparative
designs were incorporated. Pairwise comparison meta-analyses were
performed employing odds ratios (OR) alongside 95% confidence intervals
(CIs) to quantify intervention effects by using the random-effects model.
 Result(s): Thirty-one studies involving 34,681 patients with TBAD
were included in the final meta-analysis. We noted OSR were associated
with an increased risk of in-hospital mortality (OR: 2.41; 95%CI:
1.67-3.49; P < 0.001), paraplegia (OR: 3.60; 95%CI: 2.20-5.89; P < 0.001),
limb ischemia (OR: 7.80; 95%CI: 2.39-25.49; P = 0.001) and bleeding (OR:
9.54; 95%CI: 6.57-13.85; P < 0.001) as compared with OMT. Moreover, OSR
versus TEVAR showed an increased risk of in-hospital mortality (OR: 2.67;
95%CI: 1.92-3.72; P < 0.001), acute renal failure (OR: 1.98; 95%CI:
1.61-2.42; P < 0.001), myocardial infaraction (OR: 2.76; 95%CI: 1.64-4.65;
P < 0.001), respiratory failure (OR: 2.19; 95%CI: 1.73-2.76; P < 0.001),
or bleeding (OR: 1.88; 95%CI: 1.33-2.67; P < 0.001), and lower risk of
reintervention (OR: 0.30; 95%CI: 0.10-0.89; P = 0.030). Finally, TEVAR was
associated with an increased risk of stroke (OR: 1.77; 95%CI: 1.41-2.21; P
< 0.001), limb ischemia (OR: 13.00; 95%CI: 4.33-39.06; P < 0.001), and
bleeding (OR: 3.65; 95%CI: 2.40-5.55; P < 0.001) as compared with OMT.
 Conclusion(s): This study systematically compared various treatments
and showed their safety and efficacy for acute and subacute TBAD. The
results require further large-scale randomized controlled
trials. Copyright © The Author(s) 2025.

<10>
Accession Number
2035685677
Title
The Usefulness of 3D Heart Models as a Tool of Congenital Heart Disease
Education: A Narrative Review.
Source
Journal of the Saudi Heart Association. 37(1) (pp 7-10), 2024. Date of
Publication: 2024.
Author
Alhojailan R.A.; Alkhalifah R.H.M.; Albani B.; Wadi M.
Institution
(Alhojailan, Alkhalifah) College of Medicine, Qassim University, Qassim,
Saudi Arabia
(Albani) College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
(Wadi) Centre for Medical Education, School of Medicine, University of
Dundee, United Kingdom
Publisher
Saudi Heart Association
Abstract
Objectives: The objective of this review is to evaluate the effectiveness
of three-dimensional (3D) heart models as teaching tools for congenital
heart disease (CHD), addressing the limitations of traditional medical
education methods. Method(s): A thorough literature review was
conducted using PubMed, Google Scholar, Scientific Direct and Scopus
databases. Relevant articles were screened and selected based on their
discussion of the application of 3D models in CHD education.
 Result(s): The comprehensive review of 19 studies revealed that 3D
heart models provide students, healthcare pro-fessionals, and patients
with meaningful experiences that significantly enhance understanding and
learning outcomes. These models improve objective knowledge, structural
conceptualization, and personal satisfaction in medical education,
especially in complex CHD compared to traditional methods such as books
and 2D images (p< 0.001). Additionally, they enhance spatial orientation,
surgical planning, simulation training, clinical reasoning, and critical
thinking of healthcare providers. Patients and parents showed better
comprehension and confidence in explaining their condition to others.
Despite the cost and technical limitations, 3D models of CHD show
promising potential. Conclusion(s): Integrating 3D heart models into
CHD education has positively impacted knowledge acquisition,
satis-faction, and confidence across various learner populations. The
interactive and tangible nature of 3D models offers advantages over
traditional teaching methods, fostering a deeper understanding of complex
cardiac structures and pa-thology. However, further research is necessary
to investigate long-term benefits and develop effective integration
strategies in medical curricula and practice. Copyright © 2025
Saudi Heart Association.

<11>
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.

<12>
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.

<13>
Accession Number
2031249744
Title
Catheter ablation alone versus catheter ablation with combined
percutaneous left atrial appendage closure for atrial fibrillation: a
systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. 67(9) (pp 2147-2158),
2024. Date of Publication: 01 Dec 2024.
Author
Junarta J.; Siddiqui M.U.; Abaza E.; Zhang P.; Roshandel A.; Barbhaiya
C.R.; Jankelson L.; Park D.S.; Holmes D.; Chinitz L.A.; Aizer A.
Institution
(Junarta, Barbhaiya, Jankelson, Park, Holmes, Chinitz, Aizer) Leon H.
Charney Division of Cardiology, New York University Langone Health, 550
1st Ave, New York, NY, United States
(Siddiqui) Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, United States
(Abaza, Zhang, Roshandel) Department of Internal Medicine, New York
University Langone Health, New York, United States
Publisher
Springer
Abstract
Background: Combined catheter ablation (CA) with percutaneous left atrial
appendage closure (LAAC) may produce comprehensive treatment for atrial
fibrillation (AF) whereby rhythm control is achieved and stroke risk is
reduced without the need for chronic oral anticoagulation. However, the
efficacy and safety of this strategy is still controversial.
 Method(s): This meta-analysis was reported according to the Preferred
Reporting Items for Systematic Review and Meta-Analyses guidelines.
Medline, Scopus, and Cochrane Central Register of Controlled Trials were
systematically searched to identify relevant studies. The risk of bias was
assessed using the Modified Newcastle-Ottawa scale and Cochrane risk of
bias tool. Eligible studies reported outcomes in patients with AF who
underwent combined CA and LAAC vs CA alone. Studies performing CA without
pulmonary vein isolation were excluded. Result(s): Eight studies
comprising 1878 patients were included (2 RCT, 6 observational). When
comparing combined CA and LAAC vs CA alone, pooled results showed no
difference in arrhythmia recurrence (risk ratio (RR) 1.04; 95% confidence
interval (CI) 0.82-1.33), stroke or systemic embolism (RR 0.78; 95% CI
0.27-2.22), or major periprocedural complications (RR 1.28; 95% CI
0.28-5.89). Total procedure time was shorter with CA alone (mean
difference 48.45 min; 95% CI 23.06-74.62). Conclusion(s): Combined CA
with LAAC for AF is associated with similar rates of arrhythmia-free
survival, stroke, and major periprocedural complications when compared to
CA alone. A combined strategy may be as safe and efficacious for patients
at moderate to high risk for bleeding events to negate the need for
chronic oral anticoagulation. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<14>
Accession Number
2037545969
Title
A randomised controlled trial comparing video laryngoscopy versus
conventional blind technique for transoesophageal echocardiography probe
insertion in paediatric patients undergoing cardiac surgery: A pilot
study.
Source
Indian Journal of Anaesthesia. 69(3) (pp 268-274), 2025. Date of
Publication: 01 Mar 2025.
Author
Singh G.; Pujara J.; Chauhan A.; Rajesh V.S.P.; Sonune S.; Kumar J.S.;
Pandya H.
Institution
(Singh, Pujara, Chauhan, Rajesh, Sonune, Kumar) Department of Cardiac
Anaesthesia, U.N. Mehta Institute of Cardiology and Research Centre,
Gujarat, Ahmedabad, India
(Pandya) Department of Research, U.N. Mehta Institute of Cardiology and
Research Centre, Gujarat, Ahmedabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Inserting a transoesophageal echocardiography (TEE)
probe can cause pharyngeal and oesophageal injuries in paediatric patients
undergoing cardiac surgery. The study's primary objective was to assess
the incidence of oropharyngeal injury on video laryngoscope (VL)
examination at the end of surgery. Method(s): This randomised
controlled study was conducted on 100 patients, aged 2-10 years,
undergoing elective cardiac surgery requiring TEE evaluation. Patients
having a deranged coagulation profile, sore throat, difficult tracheal
intubation, trauma during tracheal intubation and contraindications for
TEE insertion were excluded from the study. Patients were randomised into
the conventional group (Group C; n = 50), where the TEE probe was inserted
using the conventional blind insertion technique, and the VL group (Group
VL; n = 50). All patients were examined with VL for oropharyngeal injury
after removal of the TEE probe at the completion of surgery, and the
injury site was documented. Result(s): The incidence of pharyngeal
mucosal injury was significantly lesser in Group VL (n = 2) than in the
Group C (n = 9) (P = 0.025). The number of attempts for successful TEE
probe insertion was significantly lower in Group VL (P < 0.05). The mean
duration for successful TEE probe insertion at the first attempt was
significantly longer in Group VL than in Group C (P < 0.0001).
 Conclusion(s): The use of VL for TEE probe insertion in paediatric
patients significantly reduced the incidence of pharyngeal injury related
to its insertion and provided direct visualisation of the oesophageal
inlet. Copyright © 2025 Indian Journal of Anaesthesia.

<15>
Accession Number
644361237
Title
Comparison of dexmedetomidine versus propofol sedation on microcirculation
and organ injuries in critically ill surgical patients: A randomized
controlled pilot study.
Source
Clinical hemorheology and microcirculation. 89(1) (pp 43-53), 2025. Date
of Publication: 2025.
Author
Chen P.-Y.; Huang H.-H.; Chan W.-S.; Liu C.-M.; Wu T.-T.; Chen J.-H.; Chao
A.; Tien Y.-W.; Chiu C.-T.; Yeh Y.-C.
Institution
(Chen, Huang, Liu, Chen, Chao, Chiu, Yeh) Department of Anesthesiology,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Chan) Department of Anesthesiology, Far Eastern Memorial Hospital, Taiwan
(Republic of China)
(Wu) Department of Anesthesiology, National Taiwan University Hospital,
Hsin-Chu Branch ,Hsinchu City, Taiwan (Republic of China)
(Tien) Department of Surgery, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
Abstract
BACKGROUND: Recent studies have shown that dexmedetomidine may improve
microcirculation and prevent organ failure. However, most evidence was
obtained from experimental animals and patients receiving cardiac surgery
with cardiopulmonary bypass. This study aimed to investigate the effect of
dexmedetomidine on microcirculation and organ injuries in critically ill
general surgical patients. METHOD(S): In this prospective randomized
trial, patients admitted to the surgical intensive care unit after general
surgery were enrolled and randomly allocated to the dexmedetomidine or
propofol groups. Patients received continuous dexmedetomidine or propofol
infusions to meet their requirement of sedation according to their
grouping. At each time point, sublingual microcirculation images were
obtained using the incident dark field video microscope. RESULT(S):
Overall, 60 patients finished the trial and were analyzed.
Microcirculation parameters did not differ significantly between two
groups. Heart rate at 4 h after ICU admission and mean arterial pressures
at 12 h and 24 h after ICU admission were lower in the dexmedetomidine
group than in the propofol group. At 24 h, serum aspartate
aminotransferase (41 (25-118) vs 86 (34-129) U/L, p = 0.035) and alanine
aminotransferase (50 (26-160) vs 68 (35-172) U/L, p = 0.019) levels were
significantly lower in the dexmedetomidine group than in the propofol
group. CONCLUSION(S): Microcirculation parameters did not differ
significantly between the dexmedetomidine and propofol groups. At 24 h
after ICU admission, serum liver enzyme levels were lower in patients
receiving dexmedetomidine as compared to propofol.

<16>
Accession Number
2037472211
Title
Clinical guidelines for a dry land: challenges in developing
recommendations for DOAC management in emergent cardiac surgery.
Source
European Journal of Cardio-thoracic Surgery. 67(2) (no pagination), 2025.
Article Number: ezaf015. Date of Publication: 01 Feb 2025.
Author
Erdoes G.; Milojevic M.; Rocca B.; Koster A.
Institution
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital,
University Hospital Bern, University of Bern, Bern, Switzerland
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Rocca) Department of Medicine and Surgery, LUM University, Casamassima,
Bari, Italy
(Koster) Clinics of Anesthesiology and Intensive Care Medicine, Sana Heart
Center Cottbus, Cottbus, Germany
(Koster) Institute of Anesthesiology and Pain Therapy, Heart and Diabetes
Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen,
Germany
Publisher
European Association for Cardio-Thoracic Surgery

<17>
Accession Number
2034733303
Title
Coronary Artery Calcium Density and Risk of Cardiovascular Events: A
Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 18(3) (pp 294-304), 2025. Date of
Publication: 01 Mar 2025.
Author
Yong Y.; Giovannucci J.; Pang S.N.; Hong W.; Han D.; Berman D.S.; Dey D.;
Nicholls S.J.; Nerlekar N.; Lin A.
Institution
(Yong, Giovannucci, Pang) Monash Health, Clayton, VIC, Australia
(Hong) Walter and Eliza Hall Institute of Medical Research, Parkville,
VIC, Australia
(Han, Berman) Department of Imaging and Medicine and the Smidt Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Dey) Biomedical Imaging Research Institute, Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Nicholls, Nerlekar, Lin) Monash Victorian Heart Institute and Monash
Health Heart, Victorian Heart Hospital, Monash University, Clayton, VIC,
Australia
Publisher
Elsevier Inc.
Abstract
Background: There is increasing evidence that coronary artery calcium
(CAC) density is inversely associated with plaque vulnerability and
atherosclerotic cardiovascular disease risk. Objective(s): A
systematic review and meta-analysis were performed to examine the
predictive value of CAC density for future cardiovascular events in
asymptomatic individuals undergoing noncontrast CAC scoring computed
tomography. Method(s): Electronic databases were searched for studies
reporting CAC density and subsequent cardiovascular disease (CVD) or
coronary heart disease (CHD) events. Two independent reviewers performed
data extraction. Random-effects models were used to estimate pooled HRs
and 95% CIs. Subgroup analyses were performed with studies stratified by
CVD vs CHD events and by statin use. Result(s): Of 5,029 citations, 5
studies with 6 cohorts met inclusion criteria. In total, 1,309 (6.1%)
cardiovascular events occurred in 21,346 participants with median
follow-up ranging from 5.2 to 16.7 years. Higher CAC density was inversely
associated with risk of cardiovascular events following adjustment for
clinical risk factors and CAC volume (HR: 0.80 per SD of density [95% CI:
0.72-0.89]; P < 0.01; I2 = 0%). There was no significant
difference in the pooled HRs for CVD vs CHD events (HR: 0.80 per SD [95%
CI: 0.71-0.90] vs 0.74 per SD [95% CI: 0.59-0.94] respectively; P = 0.59).
The protective association between CAC density and event risk persisted
among statin-naive patients (HR: 0.79 per SD [95% CI: 0.70-0.89]; P <
0.01) but not statin-treated patients (HR: 0.97 per SD [95% CI:
0.77-1.22]; P = 0.78); the test for interaction indicated no significant
between-group differences (P = 0.12). Conclusion(s): Higher CAC
density is associated with a lower risk of cardiovascular events when
adjusted for risk factors and CAC volume. Future work may expand the
contribution of CAC density in CAC scoring, and enhance its role in CVD
risk assessment, treatment, and prevention. Copyright © 2025
American College of Cardiology Foundation

<18>
[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

<19>
Accession Number
2037305775
Title
Cardiac testing choices by physician specialty in the CMR-IMPACT trial.
Source
American Journal of Emergency Medicine. 90 (pp 200-204), 2025. Date of
Publication: 01 Apr 2025.
Author
Supples M.W.; Snavely A.C.; Ashburn N.P.; Koehler L.E.; Stopyra J.P.; Park
C.J.; Vasu S.; Kutcher M.; Hundley G.; Mahler S.A.; Miller C.; Raman S.V.;
Caterino J.M.; Clark C.L.; Jones A.E.; Hall M.E.; Hiestand B.C.
Institution
(Supples, Snavely, Ashburn, Koehler, Stopyra, Mahler, Miller, Hiestand)
Department of Emergency Medicine, Wake Forest School of Medicine,
Winston-Salem, NC, United States
(Snavely) Department of Biostatistics and Data Science, Wake Forest School
of Medicine, Winston-Salem, NC, United States
(Ashburn, Park, Vasu, Kutcher) Section on Cardiovascular Medicine,
Department of Internal Medicine, Wake Forest School of Medicine,
Winston-Salem, NC, United States
(Hundley) Division of Cardiology, Department of Internal Medicine,
Virginia Commonwealth University, Richmond, VA, United States
(Mahler) Department of Epidemiology and Prevention, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Mahler) Department of Implementation Science, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Raman) Ohio Health, Columbus, OH, United States
(Caterino) Department of Emergency Medicine, The Ohio State University,
Columbus, OH, United States
(Clark) Department of Emergency Medicine, Corewell Health William Beaumont
University Hospital, Royal Oak, MI, United States
(Jones) Department of Emergency Medicine, University of Mississippi
Medical Center, Jackson, MS, United States
(Hall) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
Publisher
W.B. Saunders
Abstract
Background: Heterogeneity is observed in the care of patients with chest
pain. We investigate the association of physician specialty and diagnostic
testing among patients admitted for suspected acute coronary syndrome
(ACS). Method(s): This is a secondary analysis of the CMR-IMPACT
multicenter randomized controlled trial in which patients with suspected
ACS were admitted and randomized to undergo invasive angiography or
non-invasive CMR stress imaging. Admitting physician was dichotomized to
interventional cardiologist (IC) or not (e.g. hospitalist). We describe
adherence to protocol and angiography during the index visit by treatment
arm and admitting physician specialty. A generalized estimating equation
accounting for clustering within physician was used to evaluate
significance and adjusted for randomization arm. Result(s): The 258
enrolled patients from 2013 to 2018 had a mean age of 60.7 (SD +/- 10.9)
years, 40.3 % (104/258 were female), and 64.7 % (167/258) were white race.
ICs were the admitting physicians for 50.4 % (130/258) of the patients.
Index angiography was performed more often among patients admitted by IC
versus other physicians, 65.4 % (85/130) versus 53.1 % (68/128),
respectively; aOR 1.75 (95 % CI 1.14-2.68). Among patients randomized to
an invasive strategy, higher protocol adherence was observed in those
admitted by IC [85.3 % (58/68)] versus other physicians [64.5 % (40/62)];
OR 2.82 (95 % CI 1.08-7.38). For patients randomized to the CMR-based
strategy, adherence to protocol was similar for IC [67.7 % (42/62)] and
other physicians [66.7 % (44/66)]; OR 0.82 (95 % CI 0.35-1.94).
 Conclusion(s): Invasive angiography was more frequent among patients
admitted by interventional cardiologists compared to other
physicians. Copyright © 2025 The Authors

<20>
[Use Link to view the full text]
Accession Number
2037338589
Title
Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic
Stenosis.
Source
New England Journal of Medicine. 392(3) (pp 217-227), 2025. Date of
Publication: 16 Jan 2025.
Author
Genereux P.; Schwartz A.; Oldemeyer J.B.; Pibarot P.; Cohen D.J.; Blanke
P.; Lindman B.R.; Babaliaros V.; Fearon W.F.; Daniels D.V.; Chhatriwalla
A.K.; Kavinsky C.; Gada H.; Shah P.; Szerlip M.; Dahle T.; Goel K.;
O'Neill W.; Sheth T.; Davidson C.J.; Makkar R.R.; Prince H.; Zhao Y.; Hahn
R.T.; Leipsic J.; Redfors B.; Pocock S.J.; Mack M.; Leon M.B.
Institution
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Schwartz, Davidson, Hahn, Redfors, Leon) Columbia University Medical
Center, New York Presbyterian Hospital, Cardiovascular Research
Foundation, Weill Cornell Medicine, New York, United States
(Davidson) St. Francis Hospital and Heart Center, Roslyn, NY, United
States
(Oldemeyer) University of Colorado Health, Medical Center of the Rockies,
Loveland, United States
(Pibarot) Laval University, Quebec, QC, Canada
(Blanke, Leipsic) St. Paul's Hospital, University of British Columbia,
Vancouver, Canada
(Sheth) McMaster University, Hamilton, ON, Canada
(Lindman, Goel) Vanderbilt University Medical Center, Nashville, United
States
(Babaliaros) Emory University, Atlanta, United States
(Fearon) Division of Cardiovascular Medicine and Stanford Cardiovascular
Institute, Stanford University, Stanford, United States
(Fearon) VA Palo Alto Health Care System, Palo Alto, United States
(Daniels) California Pacific Medical Center, San Francisco, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, United States
(Prince, Zhao) Edwards Lifesciences, Irvine, CA, United States
(Chhatriwalla) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Kavinsky) Beth Israel Deaconess Medical Center, Harvard Medical School
and Brigham and Women's Hospital, Boston, United States
(Shah) Pinnacle Health Harrisburg, Harrisburg, PA, United States
(Gada) Baylor Scott and White the Heart Hospital Plano, Plano, TX, United
States
(Szerlip, Mack) CentraCare Heart and Vascular Center, St. Cloud, MN,
United States
(Dahle) Henry Ford Hospital, Detroit, United States
(O'Neill) Northwestern University, Chicago, United States
(Cohen, Redfors) Gothenburg University, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
Massachussetts Medical Society
Abstract
Background For patients with asymptomatic severe aortic stenosis and
preserved left ventricular ejection fraction, current guidelines recommend
routine clinical surveillance every 6 to 12 months. Data from randomized
trials examining whether early intervention with transcatheter
aortic-valve replacement (TAVR) will improve outcomes in these patients
are lacking. Methods At 75 centers in the United States and Canada, we
randomly assigned, in a 1:1 ratio, patients with asymptomatic severe
aortic stenosis to undergo early TAVR with transfemoral placement of a
balloon-expandable valve or clinical surveillance. The primary end point
was a composite of death, stroke, or unplanned hospitalization for
cardiovascular causes. Superiority testing was performed in the
intention-To-Treat population. Results A total of 901 patients underwent
randomization; 455 patients were assigned to TAVR and 446 to clinical
surveillance. The mean age of the patients was 75.8 years, the mean
Society of Thoracic Surgeons Predicted Risk of Mortality score was 1.8%
(on a scale from 0 to 100%, with higher scores indicating a greater risk
of death within 30 days after surgery), and 83.6% of patients were at low
surgical risk. A primary end-point event occurred in 122 patients (26.8%)
in the TAVR group and in 202 patients (45.3%) in the clinical surveillance
group (hazard ratio, 0.50; 95% confidence interval, 0.40 to 0.63;
P<0.001). Death occurred in 8.4% of the patients assigned to TAVR and in
9.2% of the patients assigned to clinical surveillance, stroke occurred in
4.2% and 6.7%, respectively, and unplanned hospitalization for
cardiovascular causes occurred in 20.9% and 41.7%. During a median
follow-up of 3.8 years, 87.0% of patients in the clinical surveillance
group underwent aortic-valve replacement. There were no apparent
differences in procedure-related adverse events between patients in the
TAVR group and those in the clinical surveillance group who underwent
aortic-valve replacement. Conclusions Among patients with asymptomatic
severe aortic stenosis, a strategy of early TAVR was superior to clinical
surveillance in reducing the incidence of death, stroke, or unplanned
hospitalization for cardiovascular causes. (Funded by Edwards
Lifesciences; EARLY TAVR ClinicalTrials.gov number,
NCT03042104.) Copyright © 2024 Massachusetts Medical Society.

<21>
Accession Number
2037330610
Title
Effect of del Nido Cardioplegia on Isolated Coronary Artery Bypass
Grafting: A Study-level Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Yamashita Y.; Baudo M.; Magouliotis D.E.; Sicouri S.; Wertan M.A.C.;
Spragan D.D.; Torregrossa G.; Ramlawi B.; Sutter F.P.
Institution
(Yamashita, Wertan, Spragan, Torregrossa, Ramlawi, Sutter) Department of
Cardiothoracic Surgery, Lankenau Heart Institute, Wynnewood, PA, United
States
(Yamashita, Baudo, Magouliotis, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
Publisher
W.B. Saunders
Abstract
The purpose of this study was to evaluate the effect of del Nido
cardioplegia versus conventional cardioplegic solutions on early outcomes
of isolated coronary artery bypass grafting (CABG). PubMed, Scopus, and
the Cochrane Central Register of Controlled Trials were searched through
July 2024 to conduct a meta-analysis for a comparison between del Nido and
other cardioplegic solutions in isolated CABG. Major end points of the
study included operative mortality and morbidities. A random effects model
was used to estimate the pooled effect size. For subgroup analyses,
meta-analyses were conducted for outcomes derived from either randomized
controlled-trials, propensity score analysis, or multivariable analysis.
Twenty-four studies met our eligibility criteria, including 4 randomized
controlled trials and 5 propensity score-matched studies with a total of
34,737 patients. Operative mortality was not significantly associated with
cardioplegic solutions (del Nido vs other solutions; p = 0.262). The
incidence of postoperative stroke, reoperation, deep wound infection, and
atrial fibrillation was also comparable between the 2 groups. The
incidence of postoperative myocardial infarction and renal failure was
significantly lower in the del Nido group with a pooled odds ratio of 0.43
(95% confidence interval, 0.24-0.77) and 0.61 (95% confidence interval,
0.45-0.81), respectively. Subgroup analyses also demonstrated these
significant differences. In patients undergoing isolated CABG, del Nido
cardioplegia provides comparable mortality compared with other
cardioplegic solutions. Del Nido solution was significantly protective
against myocardial infarction and renal failure. Copyright © 2025
Elsevier Inc.

<22>
Accession Number
2035829836
Title
Transcatheter Aortic Valve Replacement in Patients With Systolic Heart
Failure and Moderate Aortic Stenosis: TAVR UNLOAD.
Source
Journal of the American College of Cardiology. 85(9) (pp 878-890), 2025.
Date of Publication: 11 Mar 2025.
Author
Van Mieghem N.M.; Elmariah S.; Spitzer E.; Pibarot P.; Nazif T.M.; Bax
J.J.; Hahn R.T.; Popma A.; Ben-Yehuda O.; Kallel F.; Redfors B.; Chuang
M.L.; Alu M.C.; Lindeboom W.; Kolte D.; Zahr F.E.; Kodali S.K.; Strote
J.A.; Hermanides R.S.; Cohen D.J.; Tijssen J.G.P.; Leon M.B.
Institution
(Van Mieghem, Spitzer) Department of Cardiology, Thoraxcenter,
Cardiovascular Institute, Erasmus University Medical Center, Rotterdam,
Netherlands
(Elmariah) Division of Cardiology, University of San Francisco, San
Francisco, CA, United States
(Spitzer, Lindeboom, Tijssen) Cardialysis, Rotterdam, Netherlands
(Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Nazif, Hahn, Alu, Kodali, Leon) Division of Cardiology,
NewYork-Presbyterian Hospital/Columbia University Irving Medical Center,
New York, NY, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Hahn, Popma, Redfors, Chuang, Alu, Cohen, Leon) Cardiovascular Research
Foundation, New York, NY, United States
(Ben-Yehuda) Division of Cardiovascular Medicine, University of California
San Diego, San Diego, CA, United States
(Kallel) Edwards Lifesciences, Irvine, CA, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Wallenberg Laboratory, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
(Kolte) Cardiology Division, Massachusetts General Hospital, Boston, MA,
United States
(Kolte) Harvard Medical School, Boston, MA, United States
(Zahr) Oregon Health and Science University, Portland, OR, United States
(Strote) Medical Center of the Rockies, Loveland, CO, United States
(Hermanides) Department of Cardiology, Isala Heart Center, Zwolle,
Netherlands
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Tijssen) Department of Cardiology, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Neurohormonal modulation and afterload reduction are key for
treatment of heart failure with reduced ejection fraction (HFrEF). In
HFrEF patients with concomitant moderate aortic stenosis (AS), treatment
with transcatheter aortic valve replacement (TAVR) may be complementary to
guideline-directed medical therapy (GDMT). Objective(s): This study
sought to determine whether TAVR for moderate AS provides clinical benefit
in patients with HFrEF on top of GDMT. Method(s): We performed an
investigator-initiated, international, randomized controlled trial in
patients with HFrEF on GDMT with moderate AS who were suitable for
transfemoral TAVR with a balloon-expandable valve. Patients were
randomized 1:1 to TAVR or clinical aortic stenosis surveillance (CASS)
with aortic valve replacement upon progression to severe AS. The primary
endpoint was the hierarchical occurrence of: 1) all-cause death; 2)
disabling stroke; 3) disease-related hospitalizations and heart failure
equivalents; and 4) change from baseline in the Kansas City Cardiomyopathy
Questionnaire Overall Summary Score analyzed using the win ratio.
 Result(s): From January 2017 to December 2022, 178 patients were
randomized to TAVR (n = 89) or AS surveillance (n = 89). The mean age was
77 years, 20.8% were female, and 55.6% were in NYHA functional class III
or IV. The median follow-up duration was 23 months (Q1-Q3: 12-33 months).
A total of 38 (43%) patients in the CASS group (of whom 35 had progressed
to severe AS) underwent TAVR at a median of 12 months postrandomization.
TAVR was associated with wins in 47.6% of pairs, compared with 36.6% in
the CASS group, resulting in a win ratio of 1.31 (95% CI: 0.91-1.88; P =
0.14). At 1 year, TAVR resulted in a greater improvement in the Kansas
City Cardiomyopathy Questionnaire Overall Summary Score compared with the
CASS group (12.8 +/- 21.9 points vs 3.2 +/- 22.8 points; P = 0.018).
 Conclusion(s): TAVR was not superior to AS surveillance for the
primary hierarchical composite endpoint in patients with moderate AS and
HFrEF on GDMT. Preemptive TAVR for moderate AS was safe and may provide
clinically meaningful quality-of-life benefits. Copyright © 2025
American College of Cardiology Foundation

<23>
Accession Number
2037585171
Title
Early Aortic Valve Replacement for Asymptomatic Severe Aortic Stenosis:
New Treatment Paradigms.
Source
Journal of the American College of Cardiology. 85(9) (pp 923-925), 2025.
Date of Publication: 11 Mar 2025.
Author
Ahmad Y.; Reddy R.K.; Howard J.P.
Institution
(Ahmad) University of California, San Francisco, San Francisco, CA, United
States
(Reddy, Howard) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
Publisher
Elsevier Inc.

<24>
[Use Link to view the full text]
Accession Number
641969041
Title
The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary
Artery Bypass Graft Surgery: A Double-Blind, Randomized,
Placebo-Controlled Trial.
Source
The Journal of cardiovascular nursing. 40(2) (pp E57-E64), 2025. Date of
Publication: 01 Mar 2025.
Author
Goktuna G.; Dagcan N.; Arslan G.G.
Abstract
BACKGROUND: Pain and anxiety are common postoperative problems that impair
recovery and quality of life in patients undergoing coronary artery bypass
graft (CABG) surgery. Reflexology is a nonpharmacologic method used to
control pain and anxiety. OBJECTIVE(S): The aim of this study was to
examine the effects of reflexology hand massage and stroking massage on
pain and anxiety in patients in the immediate postoperative period after
CABG. METHOD(S): In this double-blind, randomized, placebo-controlled
study, we compared the effects of a 20-minute hand-reflexology massage to
placebo stroking massage on pain and anxiety in newly extubated patients
in the intensive care unit who had undergone CABG surgery. Pain was
measured by visual analog scale and anxiety by the State-Trait Anxiety
Inventory before and at 5, 30, and 60 minutes post intervention.
 RESULT(S): A total of 48 patients were enrolled: 24 in the
intervention group and 24 in the placebo. Mean pain scores were
significantly reduced in the group who received reflexology compared with
the placebo group ( F = 36.569, P = .000). Mean anxiety scores were
significantly reduced at 60 minutes for the reflexology group compared
with the control group ( P = .000). CONCLUSION(S): We found that hand
reflexology massage was effective in reducing pain and anxiety in patients
during the immediate postoperative period after CABG. Copyright ©
2023 Wolters Kluwer Health, Inc. All rights reserved.

<25>
Accession Number
2036882113
Title
Effects of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and
glutamine supplementation on cardiac surgery: A randomized controlled
trial.
Source
Clinical Nutrition. 45 (pp 91-100), 2025. Date of Publication: 01 Feb
2025.
Author
Ogawa M.; Satomi-Kobayashi S.; Yoshida N.; Komaki K.; Hirabayashi T.;
Wakida K.; Saitoh S.; Inoue T.; Yamashita T.; Sakai Y.; Takahashi M.;
Okada K.; Hirata K.-I.
Institution
(Ogawa, Sakai) Division of Rehabilitation Medicine, Kobe University
Graduate School of Medicine, Hyogo, Japan
(Ogawa) Department of Rehabilitation Science, Osaka Health Science
University, Osaka, Japan
(Ogawa) Department of Public Health, Kobe University Graduate School of
Health Sciences, Hyogo, Japan
(Satomi-Kobayashi, Yoshida, Hirata) Division of Cardiovascular Medicine,
Department of Internal Medicine, Kobe University Graduate School of
Medicine, Hyogo, Japan
(Yoshida) Department of Cardiovascular Aging, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Komaki, Hirabayashi) Division of Rehabilitation Medicine, Kobe University
Hospital, Hyogo, Japan
(Wakida, Saitoh, Takahashi) Department of Nutrition, Kobe University
Hospital, Hyogo, Japan
(Inoue) Department of Cardiac Surgery, Hyogo Prefectural Awaji Medical
Center, Hyogo, Japan
(Yamashita) Department of Advanced Medical Science, Kobe University
Graduate School of Science, Technology and Innovation, Hyogo, Japan
(Okada) Division of Cardiovascular Surgery, Department of Surgery, Kobe
University Graduate School of Medicine, Hyogo, Japan
Publisher
Churchill Livingstone
Abstract
Background & aims: In older patients undergoing cardiac surgery, physical
function is a critical determinant of postoperative outcomes.
Beta-hydroxy-beta-methylbutyrate (HMB) supplementation has been shown to
promote muscle protein anabolism and inhibit catabolism, thereby
preventing muscle weakness. However, its efficacy in older patients
undergoing cardiac surgery remains unknown. This study aimed to examine
the effects of preoperative HMB supplementation on postoperative physical
function and complications in this population. Method(s): In this
single-center, open-label, randomized controlled trial, patients aged >=65
years scheduled for cardiac surgery were randomized to receive HMB
supplementation or no nutritional intervention. The HMB group received HMB
1200 mg, L-glutamine 7000 mg, and L-arginine 7000 mg, once or twice daily,
for at least 2 weeks before surgery. Evaluations were performed at
baseline and before and after surgery. The primary outcome was the 6-min
walking distance (6MWD) before and after surgery. Secondary outcomes
included the incidence of complications, muscle mass and strength,
physical performance, and length of hospital stay. Result(s):
Forty-four patients with a mean age of 72.5 years (women, 38 %) were
randomized to the HMB (n = 22) or control (n = 22) group. Compared with
the control group, the HMB group demonstrated a statistically significant
improvement in the 6MWD both at the pre-surgery (448.0 +/- 73.5 m vs.
375.5 +/- 58.8 m; P = 0.01) and post-surgery time points (428.9 +/- 76.4 m
vs. 304.5 +/- 52.3 m; P = 0.001). Muscle strength and physical performance
also showed significant improvements in the HMB group. However, no
significant difference in muscle mass was observed between the groups at
any time point. The HMB group had a shorter hospital length of stay
compared with that of the control group (16.1 +/- 3.8 days vs. 20.4 +/-
7.6 days, P = 0.03), and no adverse events were observed with the
intervention. Conclusion(s): Preoperative HMB supplementation in
older adults undergoing cardiac surgery resulted in significant
improvements in postoperative exercise capacity and physical function,
along with a reduction in the length of hospital stay, without affecting
muscle mass. Registration number of Clinical Trial: UMIN000030490
(UMINhttps://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R00
0034773). Copyright © 2025 The Authors

<26>
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

<27>
Accession Number
2035660744
Title
Influence of Worsening Renal Function and Baseline Chronic Kidney Disease
on Clinical Outcomes in Patients With Chronic Coronary Syndromes: Insights
From the REAL-CAD Study.
Source
Journal of the American Heart Association. 14(2) (no pagination), 2025.
Article Number: e034627. Date of Publication: 21 Jan 2025.
Author
Yoshiki Y.; Ozaki Y.; Abe M.; Ismail T.F.; Takahashi H.; Akao M.; Kawai
H.; Muramatsu T.; Harada M.; Ohta M.; Hashimoto Y.; Shiki Y.; Koshikawa
M.; Miyajima K.; Takatsu H.; Niwa Y.; Kawashima N.; Ozaki R.; Tsuboi N.;
Iimuro S.; Iwata H.; Sakuma I.; Nakagawa Y.; Hibi K.; Hiro T.; Fukumoto
Y.; Hokimoto S.; Miyauchi K.; Ogawa H.; Daida H.; Shimokawa H.; Izawa H.;
Kimura T.; Nagai R.
Institution
(Yoshiki, Ozaki, Kawai, Muramatsu, Harada, Ohta, Hashimoto, Shiki,
Koshikawa, Miyajima, Takatsu, Niwa, Kawashima, Ozaki, Izawa) Department of
Cardiology, Fujita Health University School of Medicine, Aichi, Toyoake,
Japan
(Abe, Akao) Department of Cardiology, National Hospital Organization Kyoto
Medical Center, Kyoto, Japan
(Ismail) King's College London, London, United Kingdom
(Ismail) Guy's and St Thomas' Hospital NHS Foundation Trust, London,
United Kingdom
(Takahashi) Division of Medical Statistics, Fujita Health University
Hospital, Aichi, Toyoake, Japan
(Ozaki) Nagoya University Graduate School of Medicine, Nagoya, Japan
(Tsuboi) Department of Nephrology, Fujita Health University School of
Medicine, Aichi, Toyoake, Japan
(Iimuro) Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
(Iwata, Miyauchi, Daida) Department of Cardiovascular Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science Hospital, Otsu, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Hiro) Division of Cardiology, Department of Medicine, Nihon University
School of Medicine, Tokyo, Japan
(Fukumoto) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kurume University School of Medicine, Kurume, Japan
(Hokimoto, Ogawa) Department of Cardiovascular Medicine, Kumamoto
University Hospital, Kumamoto, Japan
(Shimokawa) Department of Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
(Kimura) Department of Cardiovascular Medicine, Kyoto University Graduate
School of Medicine, Kyoto, Japan
(Nagai) Jichi Medical University, Shimotsuke, Japan
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The effect of worsening renal function and baseline chronic
kidney disease (CKD) on outcomes in patients with chronic coronary
syndrome in the setting of optimal medical therapy remains unknown.
METHODS AND RESULTS: The REAL-CAD (Randomized Evaluation of Aggressive or
Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery
Disease) study is a prospective, multicenter, randomized trial of
high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day)
statin therapy in 12 118 patients with chronic coronary syndrome. The
primary end point was a composite of cardiovascular death, nonfatal
myocardial infarction, stroke, or unstable angina requiring
hospitalization (major adverse cardiac and cerebral events [MACCE]). CKD
was defined as an estimated glomerular filtration rate [eGFR] <60 mL/min
per 1.73 m2. WRF was defined as a decrease in eGFR >=20% in the
initial year; borderline renal function was an annual decrease of
0%<eGFR<20%, and stable renal function was no decrease. Of 12 118
patients, 4340 had baseline CKD and 7778 did not. The rate of MACCE at 5
years was significantly lower in those without (5.5%) versus with CKD
(9.5%) (P<0.0001). After excluding 1247 patients who had MACCE, were
censored, or missing eGFR within 1 year, 10 871 patients were included. Of
these, 3885 were baseline CKD and the remaining 6986 did not have baseline
CKD. Of the 10 871 patients, 577 patients had WRF, 6014 patients showed
borderline renal function, and the remaining 4280 patients maintained
stable renal function. In patients with CKD, WRF was an independent
predictor for MACCE at 4 years as compared with stable renal function
(hazard ratio [HR]: 1.67; [95% CI, 1.03-2.73; P=0.039]). In patients
without CKD, borderline renal function was a significant predictor for
MACCE at 4 years compared with stable renal function (HR: 1.40 [95% CI,
1.03-1.91; P=0.032]). CONCLUSION(S): Baseline CKD was an independent
predictor for MACCE in patients with CCS. WRF was a significant predictor
for MACCE in patients with CKD. Because borderline renal function was an
independent predictor for MACCE even in patients without CKD,
mild-to-moderate annual declines of eGFR should be carefully monitored
(NCT01042730). REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
Identifier: NCT01042730. Copyright © 2025 The Author(s).

<28>
Accession Number
2037426764
Title
Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid
Regurgitation.
Source
JAMA. 333(2) (pp 124-132), 2025. Date of Publication: 14 Jan 2025.
Author
Donal E.; Dreyfus J.; Leurent G.; Coisne A.; Leroux P.-Y.; Ganivet A.;
Sportouch C.; Lavie-Badie Y.; Guerin P.; Rouleau F.; Diakov C.; van der
Heyden J.; Lafitte S.; Obadia J.-F.; Nejjari M.; Karam N.; Bernard A.;
Neylon A.; Pierrard R.; Tchetche D.; Ghostine S.; Ducrocq G.; Si Moussi
T.; Jeu A.; Peltier M.; Cosyns B.; Le Dolley Y.; Habib G.; Auffret V.; Le
Ven F.; Picard F.; Piriou N.; Laperche T.; Galli E.; Istratoaie S.; Jouan
J.; Bonnet G.; de Groote P.; Anselmi A.; Trochu J.-N.; Oger E.
Institution
(Donal, Leurent, Auffret, Galli, Istratoaie, Anselmi) Universite de
Rennes, CHU Rennes, Service de Cardiologie Inserm, LTSI-UMR 1099, Rennes,
France
(Dreyfus, Nejjari, Laperche) Centre Cardiologique du Nord, Service de
Cardiologie, Saint-Denis, France
(Coisne) Universite de Lille, CHU Lille, Service d'Explorations
Fonctionnelles Cardio-vasculaires, Lille, France
(Leroux) Clinique du Medipole, Villeurbanne, France
(Ganivet) CHU Rennes, Direction de la Recherche et de l'Innovation,
Rennes, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Lavie-Badie) Universite de Toulouse, CHU Toulouse Hopital Rangueil,
Centre de valves cardiaques, Toulouse, France
(Guerin, Piriou, Trochu) Universite de Nantes, CHU Nantes, CNRS, INSERM,
Institut du thorax, Nantes, France
(Rouleau) CHU Angers, Service medico-chirurgical des valvulopathies,
Angers, France
(Diakov) Institut mutualiste Montsouris, Service de Cardiologie, Paris,
France
(van der Heyden) St-Jan Hospital, Bruges, Belgium
(Lafitte, Picard, Bonnet) Universite de Bordeaux, CHU Bordeaux Hopital
Haut-Leveque, Service medico-chirurgical, ANR-23-RHUS-0007, RHU Envisage,
Bordeaux, France
(Obadia) Hopital Louis Pradel, Service de chirurgie cardiothoracique et
transplantation, Lyon, France
(Karam) Universite Paris Cite, Hopital Europeen Georges Pompidou, Service
de Cardiologie, Paris, France
(Bernard) Universite de Tours, CHU Tours, Service de Cardiologie, Inserm
U1327 ISCHEMIA, Tours, France
(Neylon) Institut Cardiovasculaire Paris Sud, Massy, France
(Pierrard) CHU Saint-Etienne, Service de Cardiologie, Saint-Etienne,
France
(Tchetche) Clinique Pasteur, Toulouse, France
(Ghostine) Hopital Marie Lannelongue, Service de Cardiologie diagnostique
et interventionnelle, Le Plessis Robinson, France
(Ducrocq) Departement de Cardiologie, Hopital Bichat Assistance Publique
Hopitaux de Paris, France
(Si Moussi) CHU La Reunion, Saint Denis, France
(Jeu) Ramsay sante, Hopital Prive Le Bois, Lille, France
(Peltier) CHU Amiens, Service de Cardiologie, Amiens, France
(Cosyns) Cardiology department, Center of cardiovascular disease (CHVZ),
Universitair Ziekenhuis Brussel, Brussels, Belgium
(Le Dolley) Unite de therapie valvulaire percutanee, Hopital Saint Joseph,
Marseille, France
(Habib) APHM, Hopital La Timone, Service de Cardiologie, URMITE, Aix
Marseille Universite-IHU, Mediterranee Infection, Marseille, France
(Le Ven) CHU Brest, Service de Cardiologie, Brest, France
(Jouan) CHU Limoges, Service de chirurgie Cardio-thoracique, Limoges,
France
(de Groote) CHU Lille, Service de Cardiologie, Inserm U1167, Institut
Pasteur de Lille, Lille, France
(Oger) Universite de Rennes, CHU Rennes, Service de pharmacologie
clinique, Rennes, France
Publisher
American Medical Association
Abstract
IMPORTANCE Correction of tricuspid regurgitation using tricuspid
transcatheter edge-to-edge repair (T-TEER) in addition to
guideline-directed optimized medical therapy (OMT) may improve clinical
outcomes. OBJECTIVE To evaluate the efficacy of T-TEER + OMT vs OMT alone
in patients with severe, symptomatic tricuspid regurgitation. DESIGN,
SETTING, AND PARTICIPANTS Investigator-initiated, prospective, randomized
(1:1) trial evaluating T-TEER + OMT vs OMT alone in adult patients with
severe, symptomatic tricuspid regurgitation. The trial was conducted at 24
centers in France and Belgium (March 2021 to March 2023; latest follow-up
in April 2024). INTERVENTION Patients were randomized to T-TEER + OMT or
OMT alone. MAIN OUTCOMES AND MEASURES The primary outcome was a composite
clinical end point at 1 year comprising change in New York Heart
Association class, change in patient global assessment, or occurrence of
major cardiovascular events. Tricuspid regurgitation severity was the
first of 6 secondary outcomes analyzed in a hierarchical closed-testing
procedure, including Kansas City Cardiomyopathy Questionnaire (KCCQ)
score, patient global assessment, and a composite outcome of all-cause
death, tricuspid valve surgery, KCCQ score improvement, or time to
hospitalization for heart failure. RESULTS Of 300 enrolled patients (mean
age, 78 [SD, 6] years, 63.7% women), 152 were allocated to T-TEER + OMT
and 148 to OMT alone. At 1 year, 109 patients (74.1%) in the T-TEER + OMT
group had an improved composite score compared with 58 patients (40.6%) in
the OMT-alone group. Massive or torrential tricuspid regurgitation was
found in 6.8% of patients in the T-TEER + OMT group and in 53.5% of those
in the OMT-alone group (P < .001). Mean overall KCCQ summary score at 1
year was 69.9 (SD, 25.5) for the T-TEER + OMT group and 55.4 (SD, 28.8)
for the OMT-alone group (P < .001). The win ratio for the composite
secondary outcome was 2.06 (95% CI, 1.38-3.08) (P < .001). CONCLUSIONS AND
RELEVANCE T-TEER reduces tricuspid regurgitation severity and improves a
composite score driven by improved patient-reported outcome measures in
patients with severe, symptomatic tricuspid regurgitation. Copyright
© 2024 American Medical Association.

<29>
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.

<30>
Accession Number
2037566163
Title
A Membrane Modification Technique for Left Atrial Appendage Occlusion: A
Multicenter Randomized Controlled Trial.
Source
JACC: Asia. 5(3P1) (pp 374-387), 2025. Date of Publication: 01 Mar 2025.
Author
Fan Y.; Ma D.; Wang C.; Luo J.; Ling Z.; Li S.; Peng X.; Zhang Z.; Chu H.;
Wang J.
Institution
(Fan, Wang) Department of Cardiology of the Second Affiliated Hospital,
School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China
(Ma) Department of Cardiology, the Third Medical Center, Chinese PLA
General Hospital, Beijing, China
(Wang) Department of Cardiology, Shanghai Ninth People's Hospital,
Shanghai, China
(Luo) Department of Cardiology, Ganzhou People's Hospital, Jiangxi, China
(Ling) Department of Cardiology, The Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Li) Department of Cardiology, The First Hospital of Jilin University,
Changchun, China
(Peng) Department of Cardiology, The First Affiliated Hospital of Nanchang
University, Nanchang, China
(Zhang) Department of Cardiology, The First Hospital of Lanzhou
University, Lanzhou, China
(Chu) Department of Cardiology, Ningbo First Hospital, Ningbo, China
(Wang) State Key Laboratory of Transvascular Implantation Devices,
Hangzhou, China
(Wang) Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China
(Wang) Research Center for Life Science and Human Health, Binjiang
Institute of Zhejiang University, Hangzhou, China
Publisher
Elsevier Inc.
Abstract
Background: We previously pioneered a negatively ionized polyethylene
terephthalate membrane method (the SMART technique) with the LAMax (test)
occluder to reduce platelet adhesion and promote endothelialization.
 Objective(s): This study aimed to compare the safety and efficacy of
the test occluder with the Watchman 2.5 device (control) in patients with
nonvalvular atrial fibrillation to reduce stroke risk. Method(s):
Overall, 236 patients were randomly assigned (1:1) (open-label) to the
test or control device for left atrial appendage occlusion (LAAO). The
effectiveness endpoints included 12-month successful left atrial appendage
(LAA) sealing with residual flow <=5 mm and clinical success (composite of
ischemic stroke, transient ischemic attack, and systemic embolism). Safety
endpoints were also studied. A noninferiority margin of -7% was set
between the devices. Result(s): The test device was noninferior to
the control device for the effectiveness endpoints of successful LAA
sealing (test 93.2% vs control 89.8%; P < 0.05) and clinical success (test
93.2% vs control 89.8%; P < 0.05). The 12-month safety endpoints were
similar between the 2 devices. The device-related thrombus rates for the
control device at the 3- and 12-month visits were 5.7% and 4.6%,
respectively; no cases of device-related thrombus occurred with the test
device. Conclusion(s): This study suggests that transcatheter LAAO
using the SMART technique may effectively and safely prevent stroke in
patients with nonvalvular atrial fibrillation. Although further studies
with larger sample sizes are needed, this novel technique may prevent
device-related thrombus formation and has high potential for application
in interventional therapies. (LAMax Vs. Watchman LAAC Device for Subjects
With Non-valvular AF to Reduce the Risk of Stroke;
NCT04429646) Copyright © 2025 The Authors

<31>
Accession Number
2035660546
Title
Thromboembolic Events in the Hemodialysis Setting: Understanding Risk
Profiles and Cumulative Incidences to Inform Clinical Trial Design.
Source
Journal of the American Heart Association. 14(1) (no pagination), 2025.
Article Number: e033983. Date of Publication: 07 Jan 2025.
Author
Karaboyas A.; Zhao J.; Tanko L.B.; Joergensen K.T.; Pap A.F.; Dasgupta I.;
Nangaku M.; Jadoul M.; Pecoits-Filho R.
Institution
(Karaboyas, Zhao, Pecoits-Filho) Arbor Research Collaborative for Health,
Ann Arbor, MI, United States
(Tanko) Clinical Development and Operations, Bayer Consumer Care AG,
Basel, Switzerland
(Joergensen) Bayer A/S, Copenhagen, Denmark
(Pap) Clinical Data Sciences and Analytics, Bayer AG, Wuppertal, Germany
(Dasgupta) University Hospitals Birmingham NHS Foundation Trust and
Warwick Medical School, University of Warwick, United Kingdom
(Nangaku) Division of Nephrology and Endocrinology, Graduate School of
Medicine, The University of Tokyo, Japan
(Jadoul) Cliniques Universitaires Saint-Luc, Universite catholique de
Louvain, Brussels, Belgium
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: People with kidney failure have a high risk of cardiovascular
morbidity/death, including thromboembolic events. Factor XIa inhibitors
are a new class of anticoagulants in development that may offer
antithrombotic benefits with a lower risk of incremental bleeding events
than traditional therapies. We investigated major adverse vascular events
(MAVEs), a relevant composite outcome for testing novel antithrombotic
agents, in a large cohort of patients on hemodialysis, to better
understand the key requirements to adequately design a phase 3 trial.
METHODS AND RESULTS: We included 25 211 patients on hemodialysis for >90
days in phases 4 to 7 (2009-2021) of the DOPPS (Dialysis Outcomes and
Practice Patterns Study). Atherosclerotic cardiovascular disease (ASCVD)
was defined as history/ presence of coronary, peripheral, or
cerebrovascular disease. We estimated MAVE rates and cumulative incidence,
overall and by ASCVD. Over half (52%) of the cohort met the ASCVD
criteria. The MAVE hospitalization/death composite rate (per 100
patient-years) was 6.0 in the overall cohort and 8.7 in the ASCVD subset.
Three-year cumulative incidence of MAVE was 13% in the overall cohort and
18% in the ASCVD subset. The estimated sample size to be randomized in a
hypothetical trial in the ASCVD population was =7000 patients.
 CONCLUSION(S): Even in the enriched ASCVD group, the observed MAVE
incidence combined with a high competing risk, regulatory requirements
(alpha=0.01), and limited recruitment pool makes feasibility of a
potential randomized trial targeting MAVE reduction challenging. These
results highlight key considerations and challenges for developers of
novel therapies targeting systemic thromboembolic events in patients on
hemodialysis. Copyright © 2024 The Author(s).

<32>
Accession Number
2037472015
Title
Impact of ticagrelor with or without aspirin on total and recurrent
bleeding and ischaemic events after percutaneous coronary intervention: a
sub-study of the TWILIGHT trial.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 11(1) (pp 66-74),
2025. Date of Publication: 01 Jan 2025.
Author
Baber U.; Cao D.; Collier T.; Sartori S.; Dangas G.; Angiolillo D.J.;
Vogel B.; Kunadian V.; Briguori C.; Cohen D.J.; Dudek D.; Gibson C.M.; Gil
R.; Huber K.; Kaul U.; Kornowski R.; Krucoff M.W.; Mehta S.; Moliterno
D.J.; Ohman E.M.; Escaned J.; Sardella G.; Sharma S.K.; Shlofmitz R.;
Weisz G.; Witzenbichler B.; Steg P.G.; Pocock S.; Mehran R.
Institution
(Baber) Department of Cardiology, The University of Oklahoma, Health
Sciences Center, Oklahoma City, OK, United States
(Cao, Sartori, Dangas, Vogel, Sharma, Mehran) The Zena and Michael A.
Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai,
1 Gustave L. Levy Pl, NY, United States
(Cao) Department of Biomedical Sciences, Humanitas University, MI, Pieve
Emanuele, Italy
(Collier, Pocock) Department of Medical Statistics, London School of
Hygiene and Tropical Medicine, London, United Kingdom
(Angiolillo) Division of Cardiology, University of Florida, College of
Medicine, Jacksonville, FL, United States
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle University, Newcastle upon Tyne, United
Kingdom
(Kunadian) Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation
Trust, Newcastle upon Tyne, United Kingdom
(Briguori) Mediterranea Cardiocentro, Naples, Italy
(Cohen) Cardiovascular Research Foundation, NY, NY, United States
(Cohen, Shlofmitz) St. Francis Hospital, Roslyn, Roslyn, NY, United States
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
Krakow, Poland
(Gibson) Division of Cardiovascular Medicine, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Gil) Center of Postgraduate Medical Education, Central Clinical Hospital,
the Ministry of Interior and Administration, Warsaw, Poland
(Huber) 3rd Department Medicine, Cardiology and Intensive Care Medicine,
Wilhelminen Hospital, Vienna, Austria
(Huber) Medical Faculty, Sigmund Freud University, Vienna, Austria
(Kaul) Batra Hospital and Medical Research Centre, New Delhi, India
(Kornowski) Rabin Medical Center, Petah Tikva, Israel
(Krucoff, Ohman) Duke University Medical Center, Duke Clinical Research
Institute, Durham, NC, United States
(Mehta) Hamilton Health Sciences, Hamilton, ON, Canada
(Moliterno) Gill Heart and Vascular Institute, Division of Cardiovascular
Medicine, University of Kentucky, Lexington, KY, United States
(Escaned) Hospital Clinico San Carlos IDISCC, Complutense University of
Madrid, Madrid, Spain
(Sardella) Department of Clinical, Internal, Anesthesiology and
Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome,
Roma, Italy
(Weisz) NewYork Presbyterian Hospital, Columbia University Medical Center,
NY, United States
(Witzenbichler) Helios Amper-Klinikum, Dachau, Germany
(Steg) Universite de Paris and Assistance paris-Hopitaux de Paris, Paris,
France
Publisher
Oxford University Press
Abstract
Aims In standard time-to-first event analysis, early aspirin
discontinuation followed by ticagrelor monotherapy has been shown to
reduce bleeding without increasing ischaemic complications compared with
ticagrelor plus aspirin after percutaneous coronary intervention (PCI). We
evaluated whether these treatment effects are preserved when recurrent
events are considered. Methods and results In this TWILIGHT trial post-hoc
analysis, we assessed the effects of ticagrelor monotherapy on the total
number of events that occurred over the 12-month follow-up among 7119
high-risk patients randomized to aspirin or placebo in addition to
ticagrelor at 3 months post-PCI if event-free and adherent to treatment.
There were 391 patients with at least one Bleeding Academic Research
Consortium (BARC) type 2, 3, or 5 bleeding (primary endpoint). Of those,
28 (7.2%) had a recurrent event. The total number of BARC 2, 3, or 5
bleeding events was 148 in the ticagrelor monotherapy arm compared with
278 with ticagrelor plus aspirin arm (P < 0.001). Among 272 patients with
at least one key secondary ischaemic endpoint (all-cause death, myocardial
infarction, or stroke), 37 (13.6%) sustained a recurrent event. Total
ischaemic events were similar (155 vs. 159) in the two groups. Conclusion
Among selected high-risk patients who underwent PCI and completed 3 months
of dual antiplatelet therapy followed by ticagrelor with or without
aspirin, recurrent bleeding was less common than recurrent ischaemic
events over 12 months. Analysis of total events indicates that ticagrelor
monotherapy continues to be more effective than ticagrelor plus aspirin in
reducing bleeding without a signal of ischaemic harm. Copyright ©
The Author(s) 2024. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<33>
Accession Number
2037472014
Title
An aspirin-free strategy for percutaneous coronary intervention in
patients with diabetes: a pre-specified subgroup analysis of the
STOPDAPT-3 trial.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 11(1) (pp 34-44),
2025. Date of Publication: 01 Jan 2025.
Author
Yamamoto K.; Natsuaki M.; Watanabe H.; Morimoto T.; Obayashi Y.; Nishikawa
R.; Ando K.; Suwa S.; Isawa T.; Takenaka H.; Ishikawa T.; Ikari Y.; Kurita
T.; Kaitani K.; Sugimoto A.; Ogata N.; Ikuta A.; Hashimoto K.; Ishibashi
Y.; Masuda K.; Miyabe T.; Ono K.; Kimura T.
Institution
(Yamamoto, Ando) Department of Cardiology, Kokura Memorial Hospital,
Kitakyushu, Japan
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Saga,
Japan
(Watanabe, Takenaka, Kimura) Department of Cardiology, Hirakata Kohsai
Hospital, Hirakata, Japan
(Morimoto) Department of Data Science, Hyogo Medical University,
Nishinomiya, Japan
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Kyoto
University, Graduate School of Medicine, Kyoto, Japan
(Suwa) Department of Cardiology, Juntendo University, Shizuoka Hospital,
Izunokuni, Japan
(Isawa) Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
(Ishikawa) Department of Cardiology, Dokkyo Medical University, Saitama
Medical Center, Koshigaya, Japan
(Ikari) Department of Cardiology, Tokai University Hospital, Isehara,
Japan
(Kurita) Department of Cardiology, Mie University Hospital, Tsu, Japan
(Kaitani) Department of Cardiology, Japanese Red Cross Otsu Hospital,
Otsu, Japan
(Sugimoto) Department of Cardiology, Sagamihara Kyodo Hospital,
Sagamihara, Japan
(Ogata) Department of Cardiology, Ageo Central General Hospital, Ageo,
Japan
(Ikuta) Department of Cardiology, Kurashiki Central Hospital, Kurashiki,
Japan
(Hashimoto) Department of Cardiovascular Medicine, Minamino Cardiovascular
Hospital, Hachioji, Japan
(Ishibashi) Department of Cardiology, St. Marianna University Hospital,
Kawasaki, Japan
(Masuda) Department of Cardiovascular Medicine, Uji-Tokushukai Medical
Center, Uji, Japan
(Miyabe) Department of Cardiology, Tokyo Metropolitan Tama Medical Center,
Fuchu, Japan
Publisher
Oxford University Press
Abstract
Aims Safety of aspirin-free strategy immediately after percutaneous
coronary intervention (PCI) for cardiovascular events in patients with
diabetes was unknown. Methods and results We conducted the prespecified
subgroup analysis on diabetes in the STOPDAPT-3 trial, which randomly
compared prasugrel (3.75 mg/day) monotherapy (2984 patients) to dual
antiplatelet therapy (DAPT) with prasugrel and aspirin (2982 patients) in
patients with acute coronary syndrome or high bleeding risk. The
co-primary endpoints were major bleeding events (Bleeding Academic
Research Consortium 3 or 5) and cardiovascular events (a composite of
cardiovascular death, myocardial infarction, definite stent thrombosis, or
stroke) at 1 month. Of 5966 study patients, there were 2715 patients
(45.5%) with diabetes. Patients with diabetes more often had chronic
coronary syndrome, heart failure or cardiogenic shock, and comorbidities
than those without. Patients with diabetes compared to those without had
higher incidences of major bleeding and cardiovascular events. Regardless
of diabetes, the effect of no-aspirin relative to DAPT was not different
for the co-primary bleeding (diabetes: 5.05% vs. 5.47%; HR, 0.92; 95%CI,
0.66-1.28 and non-diabetes: 3.99% vs. 4.07%; HR, 0.98; 95%CI, 0.69-1.38; P
for interaction = 0.81) and cardiovascular (diabetes: 5.54% vs. 5.15%; HR,
1.08; 95%CI, 0.78-1.49 and non-diabetes: 2.95% vs. 2.47%; HR, 1.20; 95%CI,
0.79-1.82; P for interaction = 0.70) endpoints. The incidences of subacute
definite or probable stent thrombosis and any coronary revascularization
were higher in the no-aspirin group than in the DAPT group regardless of
diabetes. Conclusions The effects of an aspirin-free prasugrel monotherapy
(3.75 mg/day) relative to DAPT for major bleeding and cardiovascular
events were not different regardless of diabetes. Copyright © The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<34>
[Use Link to view the full text]
Accession Number
2037228573
Title
Three-Dimensional CT for Preprocedural Planning of PCI for Ostial Right
Coronary Artery Lesions: A Randomized Controlled Pilot Trial.
Source
Circulation: Cardiovascular Interventions. 18(2) (no pagination), 2025.
Article Number: e013584. Date of Publication: 01 Feb 2025.
Author
van den Buijs D.M.F.; Poels E.M.; Willems E.; Cottens D.; Dotremont K.; De
Leener K.; Meekers E.; Ferdinande B.; Vrolix M.; Dens J.; Ameloot K.
Institution
(van den Buijs, Poels, Willems, Cottens, Meekers, Ferdinande, Vrolix,
Dens, Ameloot) Department of Cardiology, Ziekenhuis Oost-Limburg, Genk,
Belgium
(Dotremont, De Leener) Materialise HQ, Leuven, Belgium
(Meekers, Dens, Ameloot) Faculty of Medicine and Life Sciences, University
Hasselt, Diepenbeek, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Geographic stent-ostium mismatch is an important predictor of
target lesion failure after percutaneous coronary intervention of an
aorto-ostial right coronary artery lesion. Optimal visualization of the
aorto-ostial plane is crucial for precise stent implantation at the level
of the ostium. This study investigates whether preprocedural 3-dimensional
computed tomography (3DCT), with determination of the optimal viewing
angle, would allow for more precise stent implantation and reduce
procedure time, contrast, and radiation dose. METHOD(S): In this
single-center, prospective, open-label, core-laboratory blinded trial, a
total of 30 patients with an aorto-ostial right coronary artery lesion
were randomly assigned to either percutaneous coronary intervention with a
preprocedural 3DCT or angiography-guided percutaneous coronary
intervention. The optimal working view angle was determined by 3DCT in the
intervention group and by the operators' discretion in the control group.
The primary end point was the percentage of patients without geographic
mismatch, as determined by intravascular ultrasound. RESULT(S):
3DCT-determined C-arm angles were heterogenous but, in general, more
extreme left anterior oblique projections were used (P<0.0001). While
stent implantation was in the optimal position in all patients randomized
to the intervention group, geographic mismatch was present in 5 (33%)
patients randomized to the control group (P=0.06). The mean amount of
procedural contrast (P<0.0001), mean radiation (P=0.03), and median
procedure time (P=0.03) were significantly lower in the intervention
group. The 3DCT scan was able to predict the calcium arc (P<0.0001) and
minimal lumen area by intravascular ultrasound (P=0.003).
 CONCLUSION(S): Preprocedural 3DCT planning for percutaneous coronary
intervention of aorto-ostial right coronary artery lesions allows for
optimal stent positioning while reducing procedure time, contrast, and
radiation dose. Copyright © 2025 American Heart Association, Inc.

<35>
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

<36>
Accession Number
2037510927
Title
Current state of artificial intelligence in liver transplantation.
Source
Transplantation Reports. 10(2) (no pagination), 2025. Article Number:
100173. Date of Publication: 01 Jun 2025.
Author
Montgomery A.E.; Rana A.
Institution
(Montgomery) Baylor College of Medicine, Department of Student Affairs,
Houston, TX, United States
(Rana) Division of Abdominal Transplantation, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
Publisher
Elsevier Inc.
Abstract
Over the past few decades, substantial progress has been made in the field
of liver transplantation. Yet, challenges remain in the field due to an
increasing organ allograft shortage as well as significant waitlist
mortality. With these challenges, organ allocation policies have been
developed and are constantly being modified to result in more efficient
organ allocation. One tool that has been explored to improve the field of
liver transplantation is artificial intelligence, which is an umbrella
term for techniques such as machine learning and deep learning. This
review article explores the use of artificial intelligence in the field of
liver transplantation. Specifically, studies have shown potential
applications of artificial intelligence in improving waitlist mortality
models, assessing allograft characteristics, using large language models
for research question development and patient education, developing
post-transplant models, as well as predicting multiple risk factors such
as cardiovascular disease, infection, graft failure, malignancy, graft
fibrosis, and pneumonia. However, even with these studies, several
limitations for the use of artificial intelligence exist such as biased
data sets leading to biased model development, lack of extensive
validation of the artificial intelligence models, and the need for large
datasets for model development. With additional studies evaluating the use
of artificial intelligence and wide-scale validation of these studies
highlighted, the use of artificial intelligence may transform the field of
transplantation in the future. Copyright © 2025

<37>
Accession Number
2035697046
Title
The effect of hydroxocobalamin and methylene blue for vasoplegic
syndromes: A systematic review.
Source
Electronic Journal of General Medicine. 22(1) (no pagination), 2025.
Article Number: em622. Date of Publication: 01 Feb 2025.
Author
Mananda W.; Musalim D.A.P.; Oktavian P.; Budi D.S.; Multazam C.E.C.Z.;
Wungu C.D.K.
Institution
(Mananda) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga, Surabaya, Indonesia
(Mananda) Department of Anesthesiology and Reanimation, Dr. Soetomo
General Academic Hospital, Surabaya, Indonesia
(Musalim, Oktavian, Budi) Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
(Multazam) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Wungu) Department of Physiology and Medical Biochemistry, Universitas
Airlangga, Surabaya, Indonesia
(Wungu) Institute of Tropical Disease, Universitas Airlangga, Surabaya,
Indonesia
Publisher
Modestum LTD
Abstract
Background: The role of methylene blue (MB) and hydroxocobalamin (B12) in
treating patients with vasoplegic syndromes remains uncertain.
 Objective(s): This systematic review aimed to assess the effects of
MB and hydroxocobalamin on patients with vasoplegic syndromes following
surgery. Method(s): A systematic search was conducted for articles
reporting the use of MB and hydroxocobalamin in vasoplegic syndromes. The
databases PubMed, ScienceDirect, Cochrane Library, Springer, Scopus, and
medRxiv were systematically searched up to 9 June 2024. Clinical outcomes,
hemodynamic outcomes, length of stay (LOS), mortality, and adverse events
were extracted from each study. Result(s): This review included five
studies. The findings from these studies suggested that hydroxocobalamin,
with or without MB, effectively reduced vasopressor requirements and
improved MAP mainly at 1-hour post-administration. The LOS and mortality
did not differ between the two groups. The most common reported side
effects for MB include serotonin syndrome. Meanwhile, chromaturia affects
the hydroxocobalamin group. Conclusion(s): Hydroxocobalamin could
lower the need for vasopressors and increase MAP better than MB only.
Hydroxocobalamin can also cause temporary chromaturia, which resolves
itself. Given the side effects, the choice between MB or hydroxocobalamin
for treating vasoplegic syndrome should be based on the patient's
condition. Further studies are required to confirm its
findings. Copyright © 2025 by Author/s and Licensed by Modestum.

<38>
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

<39>
Accession Number
2035684976
Title
Sex Differences in Computed Tomography Coronary Stenosis Severity Versus
Flow Impairment and Impact on Revascularization, Clinical Events and
Health Care Costs: A FORECAST Substudy.
Source
Journal of the American Heart Association. 14(3) (no pagination), 2025.
Article Number: e029950. Date of Publication: 04 Feb 2025.
Author
Gabara L.; Hinton J.; Kira M.; Shambrook J.; Abbas A.; Wilding S.; Leipsic
J.A.; Douglas P.S.; Curzen N.
Institution
(Gabara, Hinton, Kira, Curzen) Coronary Research Group, University
Hospital Southampton NHS FT, Southampton, United Kingdom
(Gabara, Hinton, Kira, Curzen) Faculty of Medicine, University of
Southampton, United Kingdom
(Shambrook, Abbas) Department of Cardiothoracic Radiology, Wessex Cardiac
Centre, University Hospital Southampton, Southampton, United Kingdom
(Wilding) Clinical Trials Unit, University of Southampton, United Kingdom
(Leipsic) Department of Radiology, Centre for Heart Lung Innovation,
University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
(Douglas) Division of Cardiology, Department of Medicine, Duke University
Medical Centre, Duke Clinical Research Institute, Duke University School
of Medicine, Durham, NC, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The impact of sex-related differences in coronary atheroma and
flow impairment severity on clinical events and costs remains unclear.
METHODS AND RESULTS: This is a secondary analysis of patients with stable
coronary artery disease who underwent both coronary computed tomography
angiography and fractional flow reserve derived from computed tomography
as part of the FORECAST (Fractional Flow Reserve Derived From Computed
Tomography Coronary Angiography in the Assessment and Management of Stable
Chest Pain) trial, investigating (1) the relationship between coronary
stenosis severity on coronary computed tomography angiography and
fractional flow reserve derived from computed tomography FFR<inf>CT</inf>
by sex and (2) the association with revascularization, resource usage, and
adverse clinical events. A total of 212 patients (64 female participants
[32.1%]) and 1245 vessels were included. There was no significant sex
difference in the frequencies of significant coronary artery disease
(38.2% of women versus 51.3% of men; P=0.073), but female participants had
significantly less coronary flow impairment, according to the presence of
at least 1 fractional flow reserve derived from computed tomography<=0.8
(47.0% versus 71.5%; P=0.008). Female subjects underwent fewer
revascularization procedures (23.5% versus 42.3%; P=0.014), less coronary
artery bypass graft surgery (2.9% versus 13.1%; P=0.025) and were less
likely to be on statin treatment (72.0% versus 84.7%; P=0.022) by 9-month
follow-up. This resulted in lower overall health care costs for female
participants compared with male counterparts (median total cost, 1276
versus 2051; P=0.014). In multivariable Cox analysis the presence of
significant coronary artery disease (hazard ratio [HR], 2.91; 95% CI,
1.30-6.51) and having a positive fractional flow reserve derived from
computed tomography (HR, 4.11; 95% CI, 1.15-14.69) were independent
predictors of major adverse cardiovascular events at 9 months, whereas sex
was not statistically significant ( p=0.13). CONCLUSION(S): There are
significant sex differences in the anatomico-functional assessment of
coronary artery disease leading to differences in clinical management,
costs, and adverse events. Copyright © 2025 The Author(s).

<40>
[Use Link to view the full text]
Accession Number
2037415111
Title
Efficacy comparison of two doses of dezocine on preventing
sufentanil-induced cough in patients undergoing coronary artery bypass
grafting surgery: A prospective, randomized controlled trial.
Source
Medicine (United States). 104(6) (pp e41416), 2025. Date of Publication:
07 Feb 2025.
Author
Xie C.-M.; He L.-X.; Shen M.-Q.; Yao Y.-T.
Institution
(Xie, He, Shen) Department of Anesthesiology, Affiliated Cardiovascular
Hospital of Kunming Medical University, Fuwai Yunnan Hospital, Chinese
Academy of Medical Sciences, Kunming, China
(Yao) Department of Anesthesiology, Peking Union Medical College and
Chinese Academy of Medical Sciences, Fuwai Hospital, National Center for
Cardiovascular Diseases, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Sufentanil-induced cough (SIC) is a common but irritating
phenomenon during general anesthesia (GA) induction; studies have reported
that high doses of dezocine can effectively prevent it. The aim is to
explore the efficacy and safety of low-dose dezocine in preventing SIC
during GA induction in coronary artery bypass grafting (CABG) surgery.
 Method(s): 81 elective CABG surgery patients were randomly and
equally divided into 2 dezocine groups of different doses and 1 control
group. Before GA induction, the patients received "pre-injection"solution:
0.1 mg/kg dezocine in the high-dose (HD) group, 0.05 mg/kg dezocine in the
low-dose (LD) group or an equal volume of saline in the control (C) group.
The primary outcome was the incidence of SIC within 1 minute after
sufentanil administration. The secondary outcomes included the severity of
SIC, the adverse reactions within 1 minute after injection of the
"pre-injection"solution, and the vital signs at various time points.
 Result(s): One patient had moderate SIC in the HD group (3.7%), 3
patients (11.1%) had SIC (1 mild and 2 severe) in the LD group, and 8
patients (29.6%) had SIC (3 mild, 1 moderate, and 4 severe) in the C
group. The difference between the HD and the C groups was statistically
significant (P = .01). In contrast, in comparing the LD and the C groups,
the LD and the HD groups had no statistically significant difference (P >
.017). Conclusion(s): The current study suggested that pretreatment
of 0.05 mg/kg dezocine neither prevented SIC occurrence nor attenuated SIC
severity during GA induction in CABG surgery, but 0.1 mg/kg dezocine
did. Copyright © 2025 the Author(s).

<41>
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

<42>
Accession Number
2032665712
Title
Using artificial intelligence to predict post-operative outcomes in
congenital heart surgeries: a systematic review.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
718. Date of Publication: 01 Dec 2024.
Author
Mohammadi I.; Rajai Firouzabadi S.; Hosseinpour M.; Akhlaghpasand M.;
Hajikarimloo B.; Zeraatian-Nejad S.; Sardari Nia P.
Institution
(Mohammadi, Rajai Firouzabadi, Hosseinpour, Akhlaghpasand, Hajikarimloo,
Zeraatian-Nejad) Cardiovascular Surgery Research and Development
Committee, Iran University of Medical Sciences (IUMS), PO box 14665-354,
Tehran, Iran, Islamic Republic of
(Rajai Firouzabadi) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Teheran, Iran, Islamic Republic
of
(Akhlaghpasand, Zeraatian-Nejad) Department of Surgery, Surgery Research
Center, School of Medicine, Rasool-E Akram Hospital, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Sardari Nia) Department of Cardiothoracic Surgery, Maastricht University
Medical Centre, Maastricht, Netherlands
(Sardari Nia) Foundation Heart Team Academy, Maastricht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Introduction: Congenital heart disease (CHD) represents the most common
group of congenital anomalies, constitutes a significant contributor to
the burden of non-communicable diseases, highlighting the critical need
for improved risk assessment tools. Artificial intelligence (AI) holds
promise in enhancing outcome predictions for congenital cardiac surgery.
This study aims to systematically review the utilization of AI in
predicting post-operative outcomes in this population. Method(s):
Following PRISMA guidelines, a comprehensive search of Pubmed, Scopus, and
Web of Science databases was conducted. Two independent reviewers screened
articles based on predefined criteria. Included studies focused on AI
models predicting various post-operative outcomes in congenital heart
surgery. Result(s): The review included 35 articles, primarily
published within the last four years, indicating growing interest in AI
applications. Models predominantly targeted mortality and survival (n =
16), prolonged length of hospital or ICU stay (n = 7), postoperative
complications (n = 6), prolonged mechanical ventilatory support time (n =
4), with additional focus on specific outcomes such as peri-ventricular
leucomalacia (n = 2) and malnutrition (n = 1). Performance metrics, such
as area under the curve (AUC), ranged from 0.52 to 0.997. Notably, these
AI models consistently outperformed traditional risk stratification
categories. For instance, in assessing the risk of morbidity and
mortality, the AI models demonstrated superior performance compared to
conventional methods. Conclusion(s): AI-driven prediction models show
significant promise in improving outcome predictions for congenital heart
surgery. They surpass traditional risk prediction tools not only in
immediate postoperative risks but also in long-term outcomes such as
1-year survival and malnutrition. Further studies with robust external
validation are necessary to assess the practical applicability of these
models in clinical settings. The protocol of this review was prospectively
registered on PROSPERO (CRD42024550942). Copyright © The
Author(s) 2024.

<43>
Accession Number
2037381783
Title
Practice Patterns and Outcomes of Potassium Repletion Thresholds during
Critical Illness.
Source
Annals of the American Thoracic Society. 21(3) (pp 456-463), 2024. Date of
Publication: 01 Mar 2024.
Author
Bosch N.A.; Vail E.A.; Law A.C.; Homer-Bouthiette C.; Walkey A.J.; Moitra
V.K.
Institution
(Bosch, Law, Homer-Bouthiette, Walkey) Section of Pulmonary, Allergy,
Sleep, and Critical Care Medicine, Department of Medicine, Boston
University Chobanian & Avedisian School of Medicine, Boston, MA, United
States
(Vail) Department of Anesthesiology and Critical Care, University of
Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
(Vail) Penn Center for Perioperative Outcomes Research and Transformation,
Philadelphia, PA, United States
(Moitra) Department of Anesthesiology, Columbia University Vagelos College
of Physicians and Surgeons, New York, NY, United States
Publisher
American Thoracic Society
Abstract
Rationale: Potassium repletion is common in critically ill patients.
However, practice patterns and outcomes related to different intensive
care unit (ICU) potassium repletion strategies are unclear.
 Objective(s): 1) Describe potassium repletion practices in critically
ill adults; 2) compare the effectiveness of potassium repletion
strategies; and 3) compare effectiveness and safety of specific potassium
repletion thresholds on patient outcomes. Method(s): This was a
retrospective analysis of the PINC AI Healthcare Database (2016-2022),
including all critically ill adults admitted to an ICU on Hospital Day 1
and with a serum potassium concentration measured on Hospital Day 2. We
determined the frequency of potassium repletion (any formulation) at each
measured serum potassium concentration in each ICU, then classified ICUs
as having threshold-based (a large increase in potassium repletion rates
at a specific serum potassium concentration) or probabilistic (linear
relationship between serum concentration and the repletion probability)
patterns of repletion. Between patients in threshold-based and
probabilistic repletion ICUs, we compared outcomes (primary outcome:
potassium repletion frequency). We reported unadjusted percentages per
exposure group and the adjusted odds ratios (from hierarchical regression
models) for each outcome. Among patients in threshold-based ICUs with the
most common repletion thresholds (3.5 mEq/L and 4.0 mEq/L), we conducted
regression discontinuity analyses to examine the effectiveness of
potassium repletion at each potassium threshold. Result(s): We
included 190,490 patients in 88 ICUs; 35.0% received at least one dose of
potassium on the same calendar day. Rates of potassium repletion were
similar between 22 threshold-based strategy ICUs (33.5%) and 22
probabilistic strategy ICUs (36.4%). There was no difference in the
adjusted risk of potassium repletion between patients admitted to
threshold-based strategy ICUs versus probabilistic strategy ICUs (adjusted
odds ratio, 1.09; 95% confidence interval [CI], 0.76-1.57). In regression
discontinuity analysis, crossing the 3.5 mEq/L threshold from high to low
potassium levels resulted in a 39.1% (95% CI, 23.7-42.4) absolute increase
in potassium repletion but no change in other outcomes. Similarly,
crossing the 4.0 mEq/L threshold resulted in a 36.4% (95% CI, 22.4-42.2)
absolute increase in potassium repletion but no change in other outcomes.
 Conclusion(s): Potassium repletion is common in critically ill
patients and occurs over a narrow range of "normal" potassium levels
(3.5-4.0 mEq/L); use of a threshold-based repletion strategy to guide
potassium repletion in ICU patients is not associated with clinically
meaningful differences in outcomes. Copyright © 2024 by the
American Thoracic Society.

<44>
Accession Number
2023045999
Title
The effect of the multiple arterial grafts compared with single arterial
graft for coronary artery bypass grafting on sternal wound complications:
A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3249-3254), 2023. Date of
Publication: 01 Oct 2023.
Author
Yang X.; Fu J.; Zhang S.
Institution
(Yang, Zhang) Department of Cardiothoracic Surgery, the First College of
Clinical Medical Science, China Three Gorges University, Hubei, Yichang,
China
(Yang, Zhang) Department of Cardiothoracic Surgery, Yichang Central
People's Hospital, Hubei, Yichang, China
(Fu) Department of Oncology, the Second People's Hospital of China Three
Gorges University, Hubei, Yichang, China
(Fu) Department of Oncology, Yichang Second People's Hospital, Hubei,
Yichang, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the influence of
multiple arterial grafts (MAGs) compared with single arterial graft (SAG)
for coronary artery bypass grafting (CABG) on sternal wound complications
(SWCs). A comprehensive literature inspection till February 2023 was
applied and 1048 interrelated investigations were reviewed. The seven
chosen investigations enclosed 11 201 individuals with CABG in the chosen
investigations' starting point, 4870 of them were using MAGs, and 6331
were using SAG. Odds ratio (OR) in addition to 95% confidence intervals
(CIs) were utilised to compute the value of the effect of the MAGs
compared with SAG for CABG on SWCs by the dichotomous approaches and a
fixed or random model. MAGs had significantly higher SWC (OR, 1.38; 95%
CI, 1.10-1.73, P =.005) compared with those with SAG in CABG. MAGs had
significantly higher SWC compared with those with SAG in CABG. However,
care must be exercised when dealing with its values because of the low
number of selected investigations for the meta-analysis. Copyright
© 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<45>
Accession Number
2032639559
Title
The Utility of Coronary Revascularization to Reduce Ventricular
Arrhythmias in Coronary Artery Disease Patients: A Systematic Review.
Source
Catheterization and Cardiovascular Interventions. 105(3) (pp 605-612),
2025. Date of Publication: 15 Feb 2025.
Author
Junarta J.; Siddiqui M.U.; Abaza E.; Zhang P.; Patel A.; Park D.S.; Aizer
A.; Razzouk L.; Rao S.V.
Institution
(Junarta, Park, Aizer, Razzouk, Rao) Leon H. Charney Division of
Cardiology, New York University Langone Health, New York, NY, United
States
(Siddiqui) Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
(Abaza, Zhang) Department of Internal Medicine, New York University
Langone Health, New York, NY, United States
(Patel) Department of Internal Medicine, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Ventricular arrhythmias (VA) are a major cause of morbidity and mortality
in patients with coronary artery disease (CAD). Current guidelines
recommend revascularization of significant CAD to improve survival in
patients with ventricular fibrillation (VF), polymorphic ventricular
tachycardia (VT), or those who are post-cardiac arrest. However,
revascularization is not recommended for CAD patients with suspected
scar-mediated monomorphic VT. There is a paucity of data detailing the
utility of revascularization in reducing VA in CAD patients who do not
present with acute coronary syndrome (ACS) and are not immediately
post-cardiac arrest, which is the focus of this review. Medline, Scopus,
and the Cochrane Central Register of Controlled Trials were systematically
searched to identify relevant studies addressing this question. Studies
that included patients presenting with ACS or those who were immediately
post-cardiac arrest at the time of revascularization were excluded. In
total, five studies comprising 2663 patients were reviewed. Copyright
© 2024 Wiley Periodicals LLC.

<46>
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

<47>
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.

<48>
Accession Number
2032862448
Title
The molecular and cellular landscape of hypertrophic cardiomyopathy
phenotypes: transition from obstructive to end-stage heart failure.
Source
Journal of Molecular Medicine. 103(1) (pp 113-123), 2025. Date of
Publication: 01 Jan 2025.
Author
Taylor J.; Lal S.; Braet F.; McLachlan C.S.; Li A.
Institution
(Taylor, McLachlan, Li) Centre for Healthy Futures, Torrens University
Australia, Surry Hills, NSW, Australia
(Lal, Li) School of Medical Sciences, Faculty of Medicine and Health,
University of Sydney, Sydney, NSW, Australia
(Braet) School of Medical Sciences (Molecular and Cellular Biomedicine),
University of Sydney, Sydney, NSW, Australia
(Braet) Australian Centre for Microscopy and Microanalysis, University of
Sydney, Sydney, NSW, Australia
(Li) Department of Rural Clinical Sciences, La Trobe Rural Health School,
La Trobe University, Bendigo, VIC, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Abstract: Hypertrophic cardiomyopathy (HCM) is a myocardial disorder which
commonly presents as an obstructive or end-stage disease. This study aims
to investigate the transcriptomic changes related to cardiac cell-specific
expression profiles that underpin the molecular transition between the HCM
phenotypes. This study utilizes bioinformatics meta-analysis to integrate
independent datasets to generate a comprehensive gene expression profile
of obstructive HCM and end-stage HCM phenotypes compared to donor hearts.
Gene set enrichment and cellular deconvolution were applied to identify
ontologies and pathways related to each phenotype and to enumerate cell
abundances. The intersection between cell lineage genes and meta-genes was
identified to explore the cellular contribution to the phenotypic
molecular signatures. Meta-analysis revealed, enhanced muscle function and
myocardial remodeling, alongside impaired immune and inflammatory
processes in obstructive HCM. In contrast, enriched tissue matrix
remodeling pathways and altered metabolic and signaling cascades were
identified in end-stage HCM, indicating a shift towards cellular
dysfunction and loss of homeostasis. These molecular profiles were
associated with an altered cellular landscape, with increased
cardiomyocytes and lower immune cell populations in obstructive samples
but increased fibroblasts and smooth muscle cells in end-stage HCM,
implicating extensive tissue remodeling. This study provides novel
insights into the cellular contributions of contractile, immune,
homeostatic, and vascular alterations underpinning each of the HCM
phenotypes. Key messages: HCM phenotypes are characterized by distinct
molecular and cellular profiles. Obstructive HCM has an enriched
contractile profile underpinned by an expanded cardiomyocyte population.
End-stage HCM shifts the cellular profile towards extracellular and
vascular remodeling. Copyright © The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<49>
Accession Number
2033538831
Title
Comparing the efficacy and safety of endovascular therapy versus surgical
revascularization for critical limb-threatening ischemia: A systematic
review and Meta-analysis.
Source
Progress in Cardiovascular Diseases. 88 (pp 126-135), 2025. Date of
Publication: 01 Jan 2025.
Author
Abouzid M.R.; Vyas A.; Kamel I.; Anwar J.; Elshafei S.; Subramaniam V.;
Bennett W.; Lavie C.J.; Nwaukwa C.; White C.J.; Patel R.A.G.
Institution
(Abouzid, Anwar, Elshafei, Nwaukwa) Department of Internal Medicine,
Baptist Hospitals of Southeast Texas, Beaumont, TX, United States
(Vyas, Subramaniam, Bennett, Lavie, White, Patel) Department of
Cardiology, Ochsner Clinic Foundation, New Orleans, LA, United States
(Kamel) Department of Internal Medicine, Carney Hospital, Dorchester, MA
Publisher
W.B. Saunders
Abstract
Introduction: Critical limb-threatening ischemia (CLTI) is a severe
manifestation of peripheral artery disease (PAD) that can lead to limb
amputation and significantly reduce quality of life. In addition to
guideline-directed medical therapy (GDMT), endovascular therapy and
surgical revascularization are the two revascularization options for CLTI.
In recent years, there has been an ongoing debate about the best approach
for CLTI patients. The purpose of this meta-analysis is to examine the
current evidence and compare the clinical outcomes of endovascular therapy
and surgical revascularization for CLTI. Method(s): We conducted a
systematic search of electronic databases (PubMed, Embase, Cochrane
Library, and Web of Science) for studies comparing the outcomes of
endovascular therapy versus surgery in patients with CLTI. The primary
outcomes were major adverse limb events (MALE) and major adverse
cardiovascular events (MACE), while secondary outcomes included risk of
bleeding, wound complications, readmission, unplanned reoperation, acute
renal failure, and length of hospital stay. Pooled data was analyzed using
the fixed-effect model or the random-effect model in Review Manager 5.3.
The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were
used to assess the bias of included studies. Result(s): A total of 16
studies (47,609 patients) were included in this meta-analysis. The overall
effect favors surgery over endovascular intervention in terms of MALE
[odds ratio (OR) 1.13, 95% CI (1.01-1.28), P = 0.04]. Endovascular therapy
is associated with lower MACE rates compared to surgery [OR 0.62, 95% CI
(0.51-0.76), P < 0.00001]. Furthermore, the risk of bleeding, wound
complications, readmission, unplanned reoperation, acute renal failure as
well as the length of hospital stay was lower for endovascular
intervention. Finally, there was no statistically significant difference
in 30-day mortality between the two groups [OR 0.94, 95% CI 0.79-1.12, P =
0.52; Fig. 3i], and the pooled studies were homogeneous [P = 0.39; I2 =
5%]. Conclusion(s): Surgery may be the preferred treatment option for
CLTI patients, as it is associated with a lower risk of MALE than
endovascular therapy. However, endovascular therapy may be associated with
a lower risk of MACE and lower rates of bleeding, wound complications,
readmission, unplanned reoperation, acute renal failure, and shorter
hospital stays. There was no statistically significant difference in
30-day mortality between the two groups. Ultimately, the decision to use
endovascular therapy or surgery as the primary treatment strategy should
be based on a multi-disciplinary team approach with careful consideration
of patient characteristics and anatomy. Copyright © 2023

<50>
Accession Number
2033150681
Title
Development and current status of anti-reflux esophagogastrostomy after
proximal gastrectomy: a literature review.
Source
Langenbeck's Archives of Surgery. 410(1) (no pagination), 2025. Article
Number: 41. Date of Publication: 01 Dec 2025.
Author
Tian Y.; Sun K.; Shao Q.; Nunobe S.; Wu Y.
Institution
(Tian, Sun, Shao, Wu) Department of Gastrointestinal Surgery, The Second
Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China
(Nunobe) Department of Gastroenterological Surgery, Gastroenterological
Center, Cancer Institute Hospital, Japanese Foundation for Cancer
Research, 3-8-31 Ariake, Koto-Ku, Tokyo, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The selection of an appropriate gastrointestinal (GI)
reconstruction procedure after proximal gastrectomy (PG) has long been a
challenge. Surgeons have had a long history of exploring anti-reflux
gastroesophageal anastomosis. The aim of this article is to systematically
summarize the anti-reflux principles of GI reconstructive procedures
through a review of the previous literature and to provide a theoretical
basis for clinicians to select or innovate procedures. Method(s): The
PubMed, Google Scholar, China National Knowledge Infrastructure, Cochrane
Databases and Medline were searched using Medical Subject Headings terms
and keywords from inception until May 1, 2023. We traced the early
research on the anti-reflux mechanisms of the esophagogastric junction and
analyzed each piece of literature. Result(s): Three principles
according to the current mainstream anti-reflux esophagogastrostomy: (1)
reduction of the acid secreting glands; (2) reconstruction of the His
angle or fundus; (3) reconstruction of the anti-reflux valve resembles the
cardiac (including barrier method, rotation method, and compression
method). This article provides a literature review of anti-reflux
esophagogastrostomy after PG. Conclusion(s): Anti-reflux
esophagogastrostomy, represented by seromuscular flap valvuloplasty, which
restored the natural physiological structure, had better feasibility and
safety theoretically. However, this still needs to be supported by
evidence from large multi-center prospective randomized controlled
studies. Copyright © The Author(s) 2025.

<51>
Accession Number
2033211624
Title
Cost-effectiveness of semaglutide in people with obesity and
cardiovascular disease without diabetes.
Source
Journal of Medical Economics. 28(1) (pp 268-278), 2025. Date of
Publication: 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, Health Economics and
Outcomes Research Ltd, Cardiff, United Kingdom
(Bog, Lubker) Novo Nordisk A/S, Bagsvaerd, Denmark
(Faurby, Toliver) Novo Nordisk Inc, Plainsboro, 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
Publisher
Taylor and Francis Ltd.
Abstract
Aims: The 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.
 Material(s) and Method(s): A 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). Result(s): Mean 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. Limitation(s): The 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. Conclusion(s):
Semaglutide 2.4 mg use as in SELECT is cost-effective at list price, using
a $150,000/QALY willingness-to-pay threshold. Copyright © 2025
Health Economics and Outcomes Research Ltd. Published by Informa UK
Limited, trading as Taylor & Francis Group.

<52>
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.

<53>
Accession Number
2033162053
Title
Incidence and risk factors for skin cancer after heart transplantation: a
systematic review and meta-analysis.
Source
Archives of Dermatological Research. 317(1) (no pagination), 2025. Article
Number: 248. Date of Publication: 01 Dec 2025.
Author
Yang Y.; Song Y.; Liu F.; Yao H.
Institution
(Yang, Song) School of Nursing, Zhejiang Chinese Medical University,
Hangzhou, China
(Liu) Department of Emergency affiliationision, Municipal Hospital,
Qingdao, China
(Yao) Department of Intensive Care Unit, Zhejiang Provincial People's
Hospital, Hangzhou, China
Publisher
Springer Nature
Abstract
Studies have shown that patients who undergo heart transplantation (HTx)
are at an increased risk for developing skin cancer. This condition can
add physiological and psychological burden to patients. Therefore,
assessing the incidence and identifying risk factors for skin cancer are
crucial steps in its prevention. The purpose of this skin study is to
systematically evaluate the incidence and risk factors of skin cancer in
HTx. Two researchers independently conducted literature searches across 8
databases. The search covered publications from the establishment of the
database through October 1, 2024. After screening title, abstract, and the
full text, 34 eligible cohort studies were included. The studies were
evaluated using the New castle-Ottawa Scale (NOS) for non-randomized
studies, and papers selection followed PRISMA guidelines. The
meta-analysis was conducted using the Stata 15.0 software. Among 34 cohort
studies on HTx, the pooled incidence of skin cancer was 16% (95% CI:
14-19%). The incidences by type were 10% (95% CI: 8-12%) for squamous cell
carcinoma and 8% (95% CI: 6-9%) for basal cell carcinoma. Regionally, the
highest incidence was observed in the USA 22% (95% CI: 18-27%). Risk
factors significantly associated with skin cancer included age (RR: 1.08,
95% CI: 1.04-1.11), male (RR: 1.53, 95% CI:1.11-2.12), white race (RR:
10.23, 95% CI: 7.32-14.30), smoking history (RR:1.26, 95% CI:1.05-1.51),
prolonged sunlight exposure (>= 2500 h) (RR:3.66, 95% CI: 2.11-6.36),
pre-transplant cancer (RR: 1.61, 95% CI: 1.43-1.82), muromonab-CD3 (OKT3)
(RR: 2.61, 95% CI: 2.11-3.24). The higher incidence of skin cancer
observed in this study highlights the urgent need for follow-up care in
heart transplant recipients. To address this, tailored skin cancer
prevention strategies should be implemented, focusing on modifiable risk
factors. Our findings provide a theoretical foundation to help healthcare
professionals prevent and manage skin cancer in heart transplant patients.
Patient or Public Contribution: YY, and HPY, were responsible for the
conception and design of the study. YYS, FYL, and HPY, were responsible
for the acquisition, analysis and interpretation of the data. All of the
authors drafted the article or revised it critically for important
intellectual content and provided final approval of the version to be
submitted. Copyright © The Author(s) 2024.

<54>
Accession Number
2032511940
Title
Impact of nondiameter aortic indices on surgical eligibility: Results from
the Treatment in Thoracic Aortic Aneurysm: Surgery Versus Surveillance
(TITAN: SvS) randomized controlled trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(3) (pp 857-865.e1),
2025. Date of Publication: 01 Mar 2025.
Author
Dagher O.; Appoo J.J.; Herget E.; Atoui R.; Baeza C.; Brinkman W.;
Bozinovski J.; Chu M.W.A.; Dagenais F.; Demers P.; Desai N.; El-Hamamsy
I.; Estrera A.; Grau J.B.; Hughes G.C.; Jassar A.; Kachroo P.; Lachapelle
K.; Ouzounian M.; Patel H.J.; Pozeg Z.; Tseng E.; Whitlock R.; Guo M.H.;
Boodhwani M.
Institution
(Dagher, Appoo) Department of Cardiac Sciences, Libin Cardiovascular
Institute, Calgary, AB, Canada
(Dagher) Department of Biomedical Sciences, Faculty of Medicine,
Universite de Montreal, Montreal, QC, Canada
(Herget) Department of Diagnostic Imaging, University of Calgary, Calgary,
AB, Canada
(Atoui) Division of Cardiothoracic Surgery, Northern Ontario School of
Medicine, Sudbury, ON, Canada
(Baeza) Division of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Brinkman) Division of Cardiothoracic Surgery, Baylor Scott & White
Health, Dallas, Tex
(Bozinovski) Division of Cardiothoracic Surgery, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Dagenais) Department of Cardiac Surgery, Quebec Heart and Lung Institute,
Quebec, QC, Canada
(Demers) Department of Surgery, Montreal Heart Institute, Montreal, QC,
Canada
(Desai) Division of Cardiothoracic Surgery, University of Pennsylvania,
Philadelphia, Pa
(El-Hamamsy) Division of Cardiothoracic Surgery, Mount Sinai Hospital, New
York, NY
(Estrera) Department of Cardiothoracic Surgery, McGovern Medical School at
UTHealth Houston, Houston, Tex
(Grau) Division of Cardiothoracic Surgery, The Valley Hospital, Ridgewood,
NJ, United States
(Hughes) Division of Cardiothoracic Surgery, Duke University Medical
Center, Durham, NC
(Jassar) Division of Cardiothoracic Surgery, Massachusetts General
Hospital, Boston, Mass
(Kachroo) Division of Cardiothoracic Surgery, Washington University School
of Medicine, St Louis, Mo
(Lachapelle) Division of Cardiac Surgery, McGill University Health Centre,
Montreal, QC, Canada
(Ouzounian) Division of Cardiovascular Surgery, Toronto General Hospital,
Toronto, ON, Canada
(Patel) Division of Cardiiothoracic Surgery, University of Michigan
Hospital, Ann Arbor, Mich
(Pozeg) Division of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, New-Brunswick, Canada
(Tseng) Division of Cardiothoracic Surgery, University of California, San
Francisco Medical Center, San Francisco, Calif
(Whitlock) Division of Cardiac Surgery, Population Health Research
Institute, Hamilton, ON, Canada
(Guo, Boodhwani) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: Traditional criterion for intervention on an asymptomatic
ascending aortic aneurysm has been a maximal aortic diameter of 5.5 cm or
more. The 2022 American College of Cardiology/American Heart Association
aortic guidelines adopted cross-sectional aortic area/height ratio, aortic
size index, and aortic height index as alternate parameters for surgical
intervention. The objective of this study was to evaluate the impact of
using these newer indices on patient eligibility for surgical intervention
in a prospective, multicenter cohort with moderate-sized ascending aortic
aneurysms between 5.0 and 5.4 cm. Method(s): Patients enrolled from
2018 to 2023 in the randomization or registry arms of the multicenter
trial, Treatment In Thoracic Aortic aNeurysm: Surgery versus Surveillance,
were included in the study. Clinical data were captured prospectively in
an online database. Imaging data were derived from a core computed
laboratory. Result(s): Among the 329 included patients, 20% were
female. Mean age was 65.0 +/- 11.6 years, and mean maximal aortic diameter
was 50.8 +/- 3.9 mm. In the one-third of all patients (n = 109) who met
any 1 of the 3 criteria (ie, aortic size index >=3.08 cm/m2,
aortic height index >=3.21 cm/m, or cross-sectional aortic area/height >=
10 cm2/m), their mean maximal aortic diameter was 52.5 +/- 0.52
mm. Alternate criteria were most commonly met in women compared with men:
20% versus 2% for aortic size index (P <.001), 39% versus 5% for aortic
height index (P <.001), and 39% versus 21% for cross-sectional aortic
area/height (P =.002), respectively. Conclusion(s): One-third of
patients in Treatment In Thoracic Aortic aNeurysm: Surgery versus
Surveillance would meet criteria for surgical intervention based on novel
parameters versus the classic definition of diameter 5.5 cm or more.
Surgical thresholds for aortic size index, aortic height index, or
cross-sectional aortic area/height ratio are more likely to be met in
female patients compared with male patients. Copyright © 2024 The
American Association for Thoracic Surgery

<55>
Accession Number
2032815026
Title
Safety and efficacy of a pharmacist-driven protocolized transition from
insulin infusion to subcutaneous insulin in patients undergoing
cardiothoracic surgery.
Source
JACCP Journal of the American College of Clinical Pharmacy. 8(2) (pp
123-128), 2025. Date of Publication: 01 Feb 2025.
Author
Bird S.A.; Thuyns M.R.
Institution
(Bird, Thuyns) Renown Regional Medical Center, Reno, NV, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Few validated approaches exist for the transition from
intravenous (IV) insulin infusion to subcutaneous (SQ) insulin
post-operatively in cardiothoracic surgery patients. Objective(s):
This study aimed to assess whether a pharmacist-driven protocol utilizing
basal, prandial, correctional, or correctional-only SQ insulin is safe and
efficacious for post-operative glycemic control following 24 h of IV
insulin administration. Method(s): A retrospective, single-center,
observational study investigating outcomes associated with a
pharmacist-driven protocol utilizing basal, prandial, correctional, or
correctional-only insulin from May 2023 through July 2023 when compared
with a historical nursing-driven protocol observed from May 2021 through
July 2021. Adult cardiac intensive care unit patients who received an
insulin infusion within 24 h of cardiothoracic surgery and subsequently
transitioned to SQ insulin were observed. The primary outcome was
percentage of blood glucose (BG) readings at goal (140-180 mg/dL).
Secondary outcomes included percentage of BG readings in a clinically
acceptable range (110-180 mg/dL), hypoglycemia (<70 mg/dL), severe
hypoglycemia (<40 mg/dL), administration of rescue dextrose, reinitiation
of insulin infusion following transition, and surgical site infection.
 Result(s): Use of a pharmacist-driven protocol improved the
percentage of BG readings in goal range when compared with a nursing
driven protocol (24.4% vs. 12.4%, p = 0.001). More BG readings were in the
clinically acceptable range in the pharmacist-driven group: 69.6% of
readings versus 58.5% in the nursing-driven group (p = 0.011). There were
fewer hypoglycemic events in the pharmacist-driven group. There were no
reports of severe hypoglycemia, further IV insulin requirements, or
surgical site infections in either group. Pharmacist compliance to the
protocol was high at 92.4%. Conclusion(s): A pharmacist-driven
protocolized approach to the transition to SQ insulin post-operatively in
cardiothoracic patients is both safe and efficacious. The
pharmacist-driven protocol resulted in an improved percentage of BG
readings in goal range and fewer hypoglycemic events when compared with
the historical nursing-driven protocol. Copyright © 2025
Pharmacotherapy Publications, Inc.

<56>
Accession Number
2036026066
Title
A systematic review of reporting and handling of missing data in
observational studies using the UNOS database.
Source
Journal of Heart and Lung Transplantation. 44(3) (pp 462-468), 2025. Date
of Publication: 01 Mar 2025.
Author
Baker W.L.; Moore T.E.; Baron E.; Kittleson M.; Parker W.F.; Jaiswal A.
Institution
(Baker) Department of Pharmacy Practice, University of Connecticut School
of Pharmacy, Storrs, Connecticut, United States
(Moore) Statistical Consulting Services (Center for Open Research
Resources & Equipment), University of Connecticut, Storrs, CT, United
States
(Baron) Servier Pharmaceuticals, Boston, Massachusetts, United States
(Kittleson) Department of Cardiology, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, California, United States
(Parker) Departments of Medicine and Public Health Sciences, University of
Chicago Medicine, Chicago, Illinois, United States
(Jaiswal) Hartford HealthCare Heart and Vascular Institute, Hartford
Hospital, Hartford, Connecticut, United States
Publisher
Elsevier Inc.
Abstract
Background: Missing data decreasing study power and introducing bias,
thereby undermining a registry's ability to draw valid inferences. We
evaluated how missing data are reported and addressed in heart
transplantation (HT) studies using the United Network for Organ Sharing
(UNOS) database. Method(s): We conducted a systematic literature
search of Medline from January 1, 2018 through August 22, 2023 and
included studies that used the UNOS database to evaluate adult (>=18
years) de novo HT recipients. We collected details on the study
population, timeframe, primary end-point, use of missing data, and whether
and what methods were used to handle missing data. Approaches were
classified as variable selection, complete case analysis (CCA), missing
indicator method, single imputation, or multiple imputation.
 Result(s): Of the 229 included studies, 67 (29.3%) limited their
cohorts to those without missing data for the outcome or key variables and
93 (40.6%) reported missing data in their final cohort. 78 (34.1%) studies
reported how they handled missing data in their statistical modeling. Of
these, CCA was most used (n = 41, 52.6%) followed by multiple imputation
(n = 22, 28.2%), and other methods (n = 15, 19.2%). Thirty-one (13.5%)
studies reported removing covariates from their analysis because of
missingness. Conclusion(s): Merely a third of the identified UNOS
database studies reported how they handled missing data in their analysis,
with strategies varying. Although no singular approach to handling missing
data exists, methods are available that can improve upon the most used
approaches. Future best practices should include explicit reporting of
missingness, detailed methods, and sensitivity checks. Copyright
© 2024 International Society for the Heart and Lung Transplantation

<57>
Accession Number
2032393133
Title
The impact of permanent pacemaker implantation on long-term survival after
cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(3) (pp 896-906.e14),
2025. Date of Publication: 01 Mar 2025.
Author
Sakurai Y.; Mehaffey J.H.; Kuno T.; Yokoyama Y.; Takagi H.; Denning D.A.;
Kaneko T.; Badhwar V.
Institution
(Sakurai, Denning) Department of Surgery, Marshall University Joan Edwards
School of Medicine, Huntington, WVa
(Mehaffey, Badhwar) Department of Cardiovascular and Thoracic Surgery,
West Virginia University, Morgantown, WVa
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
(Yokoyama) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St
Louis, St Louis, Mo
Publisher
Elsevier Inc.
Abstract
Objectives: The long-term impact of permanent pacemaker (PPM) implantation
on survival after cardiac surgery remains ill defined. We aimed to
investigate the effect of PPM on survival and explore factors driving
outcomes using meta-regression according to the type of surgery.
 Method(s): MEDLINE, EMBASE, and the Cochrane Library Central Register
of Controlled Trials were searched through October 2023 to identify
studies reporting the long-term outcomes of PPM implantation. The primary
outcome was all-cause mortality during follow-up. The secondary outcome
was heart failure rehospitalization. The subgroup analysis and
meta-regression analysis were performed according to the type of surgery.
 Result(s): A total of 28 studies met the inclusion criteria. 183,555
patients (n = 6298; PPM, n = 177,257; no PPM) were analyzed for all-cause
mortality, with a weighted median follow-up of 79.7 months. PPM
implantation was associated with increased risks of all-cause mortality
during follow-up (hazard ratio, 1.22; confidence interval, 1.08-1.38, P
<.01) and heart failure rehospitalization (hazard ratio, 1.24; confidence
interval, 1.01-1.52, P =.04). Meta-regression demonstrated the adverse
impact of PPM was less prominent in patients undergoing mitral or
tricuspid valve surgery, whereas studies with a greater proportion with
aortic valve replacement were associated with worse outcomes. Similarly, a
greater proportion with atrioventricular block as an indication of PPM was
associated with worse survival. Conclusion(s): PPM implantation after
cardiac surgery is associated with a greater risk of long-term all-cause
mortality and heart failure rehospitalization. This impact is more
prominent in patients undergoing aortic valve surgery or atrioventricular
block as an indication than those undergoing mitral or tricuspid valve
surgery. Copyright © 2024 The American Association for Thoracic
Surgery

<58>
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.

<59>
Accession Number
2032699736
Title
Physiological Performance of Drug-Coated Balloons in Small Coronary
Arteries PICCOLETO II muFR.
Source
Catheterization and Cardiovascular Interventions. 105(3) (pp 643-649),
2025. Date of Publication: 15 Feb 2025.
Author
Fezzi S.; Trevisanello A.; Buccheri D.; Borgi M.; Orrego P.S.; Zoccai
G.B.; Cortese B.
Institution
(Fezzi, Trevisanello) Department of Medicine, Division of Cardiology,
University of Verona, Verona, Italy
(Buccheri) Cardiovascular Department, Ospedale di Trapani, Trapani, Italy
(Borgi) Department of Clinical and Experimental Medicine, Policlinico G.
Martino, University of Messina, Messina, Italy
(Orrego) Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano,
Italy
(Zoccai) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University of Rome, Latina, Italy
(Cortese) DCB Academy, Milano, Italy
(Cortese) Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy
(Cortese) Harrington Heart & Vascular Institute, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Drug-coated balloons (DCB) are emerging as an alternative to
permanent implants for managing de novo coronary artery disease,
particularly in small vessels (SVD). This sub-analysis of the PICCOLETO II
study aimed to compare the performance of DCB and DES in terms of Murray's
law-based quantitative flow ratio (muFR) changes between baseline,
post-percutaneous coronary intervention (PCI), and follow-up.
 Method(s): Patients with a clinical indication for PCI were assigned
to receive either Xience DES or Elutax SV/Emperor DCB. Coronary angiograms
were blindly analyzed by an independent Core Laboratory (Consorzio Futuro
in Ricerca, University of Ferrara, Italy). Result(s): Among 232
patients, 59 were included in this analysis. Pre-PCI muFR was comparable
between groups (0.65 +/- 0.29 vs. 0.58 +/- 0.25; p = 0.20). Post-PCI, the
DCB group had a lower acute functional gain compared to DES (+0.21 vs.
+0.31; p = 0.064), with lower muFR values (0.86 +/- 0.36 vs. 0.89 +/- 0.3;
p = 0.074). At 6-month follow-up, muFR values were similar between groups
(0.84 +/- 0.29 vs. 0.84 +/- 0.31, p = 0.93), with a comparable late
functional loss (-0.02 vs. -0.05; p = 0.93). Angiographic late lumen loss
was significantly lower in the DCB group (-0.03 vs. +0.29 mm; p = 0.027).
 Conclusion(s): DCB-based PCI showed a trend toward less favorable
immediate post-PCI functional result but a comparable performance at
follow-up, suggesting its potential in treating de novo SVD. Copyright
© 2024 Wiley Periodicals LLC.

<60>
Accession Number
2037042953
Title
Transcatheter Aortic Valve Replacement in Heart Failure, Reduced Ejection
Fraction, and Moderate Aortic Stenosis.
Source
Journal of the American College of Cardiology. 85(9) (pp 894-895), 2025.
Date of Publication: 11 Mar 2025.
Author
O'Gara P.T.
Institution
(O'Gara) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.

<61>
Accession Number
2036120458
Title
Aortic Valve Replacement vs Clinical Surveillance in Asymptomatic Severe
Aortic Stenosis: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. 85(9) (pp 912-922), 2025.
Date of Publication: 11 Mar 2025.
Author
Genereux P.; Banovic M.; Kang D.-H.; Giustino G.; Prendergast B.D.;
Lindman B.R.; Newby D.E.; Pibarot P.; Redfors B.; Craig N.J.; Bartunek J.;
Schwartz A.; Seyedin R.; Cohen D.J.; Iung B.; Leon M.B.; Dweck M.R.
Institution
(Genereux, Giustino) Gagnon Cardiovascular Institute, Morristown Medical
Center, Morristown, NJ, United States
(Banovic) Belgrade Medical School, University of Belgrade, Belgrade,
Serbia
(Banovic) Cardiology Department, University Clinical Center of Serbia,
Belgrade, Serbia
(Kang) Asan Medical Center, College of Medicine, University of Ulsan,
Seoul, South Korea
(Prendergast) Department of Cardiology, Guys and St Thomas' NHS Foundation
Trust Hospital London, London, United Kingdom
(Prendergast) Heart, Vascular and Thoracic Institute, Cleveland Clinic
London, London, United Kingdom
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN, United States
(Newby, Dweck) British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Edinburgh, United Kingdom
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec City,
QC, Canada
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Craig) Centre for Cardiovascular Sciences, University of Edinburgh,
Edinburgh, United Kingdom
(Bartunek) Clinical Trial Service Unit and Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Schwartz, Leon) Columbia University Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Seyedin) Edwards Lifesciences, Irvine, CA, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Iung) Bichat Hospital, Assistance Publique-Hopitaux de Paris, and INSERM
LVTS 1148, Universite Paris-Cite, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Current guidelines recommend a strategy of clinical
surveillance (CS) for patients with asymptomatic severe aortic stenosis
(AS) and a normal left ventricular ejection fraction. Objective(s):
The aim of this study was to conduct a study-level meta-analysis of
randomized controlled trials (RCTs) evaluating the effect of early aortic
valve replacement (AVR) compared with CS in patients with asymptomatic
severe AS. Method(s): Studies were quantitatively assessed in a
meta-analysis using random-effects modeling. Prespecified outcomes
included all-cause and cardiovascular mortality, unplanned cardiovascular
or heart failure (HF) hospitalization, and stroke. The meta-analysis is
registered at the International Platform of Registered Systematic Review
and Meta-Analysis Protocols (INPLASY202490002). Result(s): Four RCTs
were identified, including a total of 1,427 patients (719 in the early AVR
group and 708 in the CS group). At an average follow-up time of 4.1 years,
early AVR was associated with a significant reduction in unplanned
cardiovascular or HF hospitalization (pooled rate 14.6% vs 31.9%; HR:
0.40; 95% CI: 0.30-0.53; I2 = 4%; P < 0.01) and stroke (pooled
rate 4.5% vs 7.2%; HR: 0.62; 95% CI: 0.40-0.97; I2 = 0%; P =
0.03). No differences in all-cause mortality (pooled rate 9.7% vs 13.7%;
HR: 0.68; 95% CI: 0.40-1.17; I2 = 61%; P = 0.17) and
cardiovascular mortality (pooled rate 5.1% vs 8.3%; HR: 0.67; 95% CI:
0.35-1.29; I2 = 50%; P = 0.23) were observed with early AVR
compared with CS, although there was a high degree of heterogeneity among
studies. Conclusion(s): In this meta-analysis of 4 RCTs, early AVR
was associated with a significant reduction in unplanned cardiovascular or
HF hospitalization and stroke and no differences in all-cause and
cardiovascular mortality compared with CS. Copyright © 2025 The
Authors

<62>
Accession Number
2033184325
Title
Effects of Anesthesia and Surgery on the Morphologic and Functional
Development of the Premature Neonatal Brain: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 14(3) (no pagination), 2025. Article Number:
918. Date of Publication: 01 Feb 2025.
Author
Heisel A.G.U.; Stevens M.F.; Konigs M.; Jamaludin F.S.; Keunen K.;
Polderman J.A.W.
Institution
(Heisel, Stevens, Keunen, Polderman) Department of Anesthesiology,
Location AMC, Amsterdam University Medical Centres, P.O. Box 22660,
Amsterdam, Netherlands
(Konigs) Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC
Location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
(Konigs) Amsterdam Reproduction and Development Research Institute,
Meibergdreef 9, Amsterdam, Netherlands
(Jamaludin) Amsterdam UMC Location University of Amsterdam, Medical
Library AMC, Meibergdreef 9, Amsterdam, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The percentage of preterm infants requiring surgery before 44
weeks of postmenstrual age (PMA) varies between 19% and 36%. The potential
impact of general anesthesia on the vulnerable developing brain of preterm
infants remains unknown. Method(s): A systematic review and
meta-analysis on the impact of general anesthesia on brain integrity and
neurodevelopmental outcomes in preterm infants undergoing surgery before
44 weeks PMA was conducted. Studies were identified via a PubMed, EMBASE
(Ovid), and Cochrane CENTRAL search conducted from inception until 8 March
2023, following PRISMA guidelines. Brain abnormality was assessed using
MRI-based brain volume and abnormality scores. Neurodevelopment was
evaluated through Bayley Infant and Toddler Development (BSID) or Wechsler
Preschool and Primary Scale of Intelligence (WPPSI) tests. Quality was
assessed via the Cochrane ROBINS-I tool and GRADE. Result(s): Our
systematic search identified 2883 records, leading to the inclusion of 12
observational studies. Very low-quality evidence suggests that preterm
infants exposed to anesthesia were more likely to show postoperative brain
abnormalities on MRI (OR 2.01, 95%CI 1.24-3.25, p = 0.005). They had lower
neurodevelopmental scores on the BSID II and III (psychomotor
developmental index: mean difference (MD) -10.98; 95%CI -12.04 to -9.91; p
< 0.001 and cognitive composite score: (MD) -10.11; 95%CI -11.06 to -9.16;
p < 0.001 at two years of age compared to preterm infants not exposed to
anesthesia. Conclusion(s): Exposure to surgery and anesthesia before
term age is associated with brain abnormalities and neurodevelopmental
delay at two years, but conclusions are limited by low evidence quality,
uncontrolled confounders, and the methodological biases of the included
studies; thus further robust studies are required
(PROSPERO:CRD42021255907). Copyright © 2025 by the authors.

<63>
Accession Number
2037315175
Title
Tricuspid Transcatheter Edge-to-Edge Repair in Patients With Transvalvular
CIED Leads: The TRILUMINATE Pivotal Trial.
Source
JACC: Clinical Electrophysiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Naik H.; Price M.J.; Kapadia S.; Whisenant B.K.; Tadros P.; Makkar R.;
Asgar A.W.; Fam N.; Tang G.H.L.; Mehta S.R.; Byrne T.; Singh G.; Panaich
S.S.; Peterman K.; Trusty P.M.; Hamid N.; Hahn R.T.; Adams D.H.; Sorajja
P.
Institution
(Naik) Arizona Cardiovascular Research Center, Phoenix, AZ, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Kapadia) Cleveland Clinic Foundation. Cleveland, OH, United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Tadros) Kansas University Medical Center, Kansas City, KS, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Asgar) Montreal Heart Institute, Montreal, QC, Canada
(Fam) St. Micheal's Hospital, Toronto, ON, Canada
(Tang, Adams) Mount Sinai Hospital, New York, NY, United States
(Mehta) Hamilton Health Science Centre, Hamilton, ON, Canada
(Byrne) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States
(Singh) University of California, Davis Medical Center, Sacramento, CA,
United States
(Panaich) Swedish Medical Center, Seattle, WA, United States
(Peterman, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
(Hamid, Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United
States
(Hahn) NewYork-Presbyterian/Columbia University Medical Center, New York,
NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with tricuspid regurgitation (TR) frequently have
transvalvular cardiac implantable electronic device (CIEDs).
 Objective(s): The aim of this study was to determine the safety and
efficacy of tricuspid transcatheter edge-to-edge repair in patients with
transvalvular CIED leads. Method(s): The TRILUMINATE (Trial to
Evaluate Cardiovascular Outcomes in Patients Treated With the Tricuspid
Valve Repair System) Pivotal Trial (NCT03904147) is an international
randomized, controlled trial in symptomatic subjects with severe TR.
Subjects with CIED leads were screened by an eligibility committee prior
to inclusion into the randomized or single-arm cohorts. Safety events were
adjudicated by an independent review committee. All echocardiograms were
analyzed by an independent core laboratory. Result(s): A total of 98
subjects (of 469) with attempted TriClip procedures had transvalvular CIED
leads. CIED+ subjects were older (80.2 +/- 8.6 years vs 78.2 +/- 7.6
years; P = 0.02), with a higher prevalence of renal disease (46.9% vs
31.5%; P = 0.004) and lower health status (Kansas City Cardiomyopathy
Questionnaire overall summary score 51.9 +/- 21.0 vs 55.0 +/- 23.1) at
baseline compared with CIED- subjects. Slightly fewer clips were implanted
in CIED+ subjects (mean 1.9) than in CIED- subjects (mean 2.2) (P =
0.0018). Procedural times were significantly shorter in CIED+ subjects
(132.9 +/- 63.3 minutes vs 155.9 +/- 71.9 minutes; P = 0.0043) although
greater in those with lead-induced TR (149.5 +/- 87.5 minutes). Major
adverse events (1.0% vs 1.1%) and major bleeding (3.1% vs 3.0%) were
infrequent in CIED+ and CIED- subjects. At 30 days, TR reduction to
moderate or less was similar in CIED+ and CIED- subjects (88% vs 87%) and
was sustained out to 1 year in the majority of subjects (81% vs 84%).
Compared with baseline, Kansas City Cardiomyopathy Questionnaire overall
summary score significantly improved through 1 year in CIED+ subjects
(18.7 +/- 22.6; P < 0.0001) and CIED- subjects (16.8 +/- 22.6; P <
0.0001). Heart failure symptoms were reduced in both groups at 30 days,
with 85% of CIED+ subjects and 87% of CIED- subjects in NYHA functional
class I or II. There were no differences in mortality, heart failure
hospitalization, and need for tricuspid valve surgery or intervention
between groups. No lead revisions, removals, or replacements were reported
through follow-up. Conclusion(s): Tricuspid transcatheter
edge-to-edge repair with the TriClip system was safe and effective in
selected CIED+ subjects and did not affect CIED function. CIED+ subjects
experienced similar TR reduction and quality-of-life improvements as CIED-
subjects. Future work should define the treatable scope of patients with
transvalvular CIED leads. (TRILUMINATE Pivotal Trial;
NCT03904147) Copyright © 2025

<64>
Accession Number
2033057037
Title
RBT-1, a "preconditioning" agent, mitigates syndecan-1 shedding in
patients undergoing "on pump" cardiac surgery and following experimental
AKI.
Source
Physiological Reports. 13(3) (no pagination), 2025. Article Number:
e70218. Date of Publication: 01 Feb 2025.
Author
Johnson A.C.M.; Zager R.A.
Institution
(Johnson, Zager) Renibus Therapeutics, Southlake, TX, United States
(Zager) Fred Hutch Cancer Center, Seattle, WA, United States
(Zager) The University of Washington, Seattle, WA, United States
Publisher
American Physiological Society
Abstract
During systemic stress, syndecan-1 (SDC-1) shedding into plasma results,
implying endothelial damage. RBT-1, a "preconditioning" agent, has been
shown to mitigate postoperative complications following cardiac surgeries.
This study assessed whether RBT-1 preconditioning attenuated SDC-1
shedding in these patients, implying a vascular protective effect.
Patients (n, 112) were randomized to receive low-dose RBT-1, high-dose
RBT-1, or placebo 24-48 h prior to surgery. Plasma samples were obtained
before and 2 days postsurgery and assayed for SDC-1 (ELISA). To gain
further insights, male CD-1 mice were subjected to acute renal injuries,
and RBT-1's impact on plasma SDC-1 increases, vascular/aortic stress
responses (NGAL/KIM-1/IL-6 gene induction), and two vascular
cytoprotective pathways (Nrf2; ferritin) were assessed. Baseline plasma
SDC-1 levels did not differ between patient groups. The placebo group
developed an approximate 50% plasma SDC-1 (ng/mL) increase (p, 0.012).
Conversely, no significant SDC-1 increases were seen in the RBT-1
treatment groups. Experimental injury markedly increased plasma SDC-1
concentrations, and these were significantly blunted by RBT-1
preconditioning. RBT-1 also mitigated AKI-induced aortic NGAL/KIM-1/IL-6
mRNA increases, activated aortic Nrf2, and increased vascular ferritin
levels. RBT-1 preconditioning diminishes SDC-1 release and upregulates
vascular ferritin and Nrf2. Hence, RBT-1 preconditioning can confer select
vasoprotective effects. Copyright © 2025 The Author(s).
Physiological Reports published by Wiley Periodicals LLC on behalf of The
Physiological Society and the American Physiological Society.

<65>
[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.

<66>
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.

<67>
[Use Link to view the full text]
Accession Number
2034641870
Title
Effects of Serratus Anterior Plane Block on Early Recovery from
Thoracoscopic Lung Resection: A Randomized, Blinded, Placebo-controlled
Trial.
Source
Anesthesiology. 141(6) (pp 1065-1074), 2024. Date of Publication: 01 Dec
2024.
Author
Jackson J.C.; Tan K.S.; Pedoto A.; Park B.J.; Rusch V.W.; Jones D.R.;
Zhang H.; Desiderio D.; Fischer G.W.; Amar D.
Institution
(Jackson, Tan, Pedoto, Zhang, Desiderio, Fischer, Amar) Department of
Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer
Center, New York, NY, United States
(Jackson, Pedoto, Desiderio, Fischer, Amar) Department of Anesthesiology,
Weill Cornell Medical College, New York, NY, United States
(Park, Rusch, Jones) Thoracic Service, Department of Surgery, Memorial
Sloan Kettering Cancer Center, New York, NY, United States
(Park, Rusch, Jones) Department of Surgery, Weill Cornell Medical College,
New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The efficacy of serratus anterior plane block for treatment of
pain after minimally invasive thoracic surgery remains unclear. This trial
assesses the impact of serratus anterior plane block on postoperative
opioid consumption and on measures of early recovery after thoracoscopic
lung resection. Method(s): Patients undergoing minimally invasive
anatomic lung resection at a single center were randomized to undergo
serratus anterior plane block with 40 ml injectate containing bupivacaine
0.25%, clonidine 100 mug, and dexamethasone 4 mg (serratus anterior plane
block group) or sham block with 40 ml normal saline (placebo group) at the
conclusion of surgery. The primary outcome was cumulative intravenous
morphine equivalents during the first 24 h postoperatively. Secondary
outcomes were intravenous morphine equivalents, pain scores at rest and
with cough, inspiratory volume on incentive spirometry, incidence of
nausea or vomiting during the first 48 h postoperatively, Quality of
Recovery-15 score on postoperative day 7, and length of stay.
 Result(s): Using the protocol-specified intention-to-treat analysis,
the median (interquartile range) intravenous morphine equivalents was 10.6
(5.0 to 27.1) mg in serratus anterior plane block patients (n = 46) versus
18.8 (9.9 to 29.6) mg in placebo patients (n = 46; 32% reduction; ratio,
0.68 [95% CI, 0.44 to 1.06]; P = 0.085). Of the secondary outcomes, only
the composite pain with cough scores differed significantly in the
serratus anterior plane block group by a coefficient of -0.41 (95% CI,
-0.81 to -0.01; P = 0.044). A sensitivity as-treated analysis reported
median (interquartile range) intravenous morphine equivalents of 10.0 (5.0
to 27.2) mg in serratus anterior plane block patients (n = 44) versus 19.9
(10.4 to 29.0) mg in placebo patients (n = 48; 36% reduction; ratio, 0.64
[95% CI, 0.41 to 1.00]; P = 0.048). Conclusion(s): The
protocol-specified intention-to-treat analysis demonstrated that serratus
anterior plane block did not result in a significant reduction in opioid
consumption when added to a multimodal analgesic regimen after
thoracoscopic anatomic lung resection. The sensitivity as-treated analysis
showed a significant and modest clinical reduction in the primary outcome
that warrants further investigation. Copyright © 2024 American
Society of Anesthesiologists. All Rights Reserved.

<68>
Accession Number
2033080439
Title
Phenomapping the Response of Patients With Ischemic Cardiomyopathy With
Reduced Ejection Fraction to Surgical Revascularization.
Source
Clinical Cardiology. 48(2) (no pagination), 2025. Article Number: e70094.
Date of Publication: 01 Feb 2025.
Author
Satish T.; Hendren N.S.; Peltz M.; Heid C.A.; Farr M.; Bavry A.; Girotra
S.; Kumbhani D.J.; Drazner M.H.; Tang W.H.W.; Grodin J.L.
Institution
(Satish, Hendren, Peltz, Heid, Farr, Bavry, Girotra, Kumbhani, Drazner,
Grodin) Department of Internal Medicine, Division of Cardiology,
University of Texas Southwestern Medical Center, Dallas, TX, United States
(Tang) Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland,
OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary artery bypass grafting (CABG) has demonstrated
long-term mortality benefits in patients with HFREF and obstructive
coronary artery disease (CAD), but whether phenotypic heterogeneity
influences the benefits of CABG is unknown. We applied clustering analysis
to STICHES (Surgical Treatment for Ischemic Heart Failure Extension Study)
to identify phenogroups with different long-term risk profiles and
investigate differences in CABG benefits between phenogroups. Methods
and Results: STICHES was a randomized controlled trial evaluating the
effect of CABG in addition to medical therapy versus medical therapy
alone. We split the STICHES participants into derivation (n = 753) and
validation (n = 459) cohorts. We phenomapped the derivation cohort using
penalized model-based clustering. We fit multivariable Cox models to
investigate long-term differences in all-cause mortality, cardiovascular
(CV) mortality, and a composite of all-cause mortality/CV hospitalization
between phenogroups and whether phenogroup assignment modified the effects
of CABG on these outcomes. Findings were internally validated on the
validation cohort. Four phenogroups were identified in the derivation
cohort. The highest-risk group was at a twofold greater risk of death (HR:
2.0, 95% CI: 1.4-2.9, p < 0.001) and CV death (HR: 2.0, 95% CI: 1.3-3.1, p
= 0.002), and a 1.5-fold greater risk for death/CV hospitalization (HR:
1.5, 95% CI: 1.1-2.1, p = 0.016). Phenogroup assignment did not modify the
effects of CABG on the outcomes (p > 0.05 for all). Similar results were
obtained in the validation cohort. Conclusion(s): The beneficial
effects of CABG on all-cause mortality, CV mortality, and a composite of
all-cause mortality and CV hospitalization persist despite phenotypic
heterogeneity in HFREF and CAD. Copyright © 2025 The Author(s).
Clinical Cardiology published by Wiley Periodicals, LLC.

<69>
Accession Number
646191587
Title
Coronary revascularisation deferral based on quantitative flow ratio or
fractional flow reserve: a post hoc analysis of the FAVOR III Europe
trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
21(3) (pp e161-e170), 2025. Date of Publication: 03 Feb 2025.
Author
Andersen B.K.; Holm N.R.; Mogensen L.J.H.; Maillard L.; Ramunddal T.;
Erriquez A.; Christiansen E.H.; Escaned J.; Of The Favor Iii Europe Study
Team O.B.
Institution
(Andersen, Holm, Mogensen, Christiansen) Department of Cardiology, Aarhus
University Hospital, Aarhus, Denmark
(Maillard) GCS ES Axium Rambot, Clinique Axium, Aix-en-Provence, France
(Ramunddal) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Erriquez) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Ferrara, Italy
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University of
Madrid, Spain and Centro de Investigacion Biomedica en Red - Enfermedades
Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
Abstract
BACKGROUND: Safe deferral of revascularisation is a key aspect of
physiology-guided percutaneous coronary intervention (PCI). While recent
evidence gathered in the FAVOR III Europe trial showed that quantitative
flow ratio (QFR) guidance did not meet non-inferiority to fractional flow
reserve (FFR) guidance, it remains unknown if QFR might have a specific
value in revascularisation deferral. AIMS: We aimed to evaluate the safety
of coronary revascularisation deferral based on QFR as compared with FFR.
 METHOD(S): Patients randomised in the FAVOR III trial in whom PCI was
deferred in at least one coronary artery, based on QFR or FFR>0.80, were
included in the present substudy. The primary outcome was the 1-year rate
of major adverse cardiac events (MACE), with results reported for two
subsets of deferred patients: (1) any study lesion deferral and (2)
complete study lesion deferral. RESULT(S): A total of 523 patients
(55.2%) in the QFR group and 599 patients (65.3%) in the FFR group had at
least one coronary revascularisation deferral. Of these, 433 patients
(82.8%) and 511 (85.3%) patients, respectively, had complete study lesion
deferral. In the "complete study lesion deferral" patient group, the
occurrence of MACE was significantly higher in QFR-deferred patients as
compared with FFR-deferred patients (24 [5.6%] vs 14 [2.8%], adjusted
hazard ratio [HR] 2.07, 95% confidence interval [CI]: 1.07-4.03; p=0.03).
In the subgroup of "any study lesion deferral", the MACE rate was 5.6% vs
3.6% (QFR vs FFR), adjusted HR 1.55, 95% CI: 0.88-2.73; p=0.13.
 CONCLUSION(S): QFR-based deferral of coronary artery
revascularisation resulted in a higher incidence of 1-year MACE as
compared with FFR-based deferral.

<70>
Accession Number
646556081
Title
Detection and management of postoperative atrial fibrillation after
coronary artery bypass grafting or non-cardiac surgery: a survey by the
AF-SCREEN International Collaboration.
Source
Internal and emergency medicine. (no pagination), 2025. Date of
Publication: 08 Feb 2025.
Author
Boriani G.; Imberti J.F.; McIntyre W.F.; Mei D.A.; Healey J.S.; Schnabel
R.B.; Svennberg E.; Camm A.J.; Freedman B.
Institution
(Boriani, Imberti, Mei) Cardiology Division, Department of Biomedical,
Metabolic and Neural Sciences, University of Modena and Reggio Emilia,
Policlinico Di Modena, Via del Pozzo, Modena, Italy
(Imberti, Mei) Clinical and Experimental Medicine PhD Program, University
of Modena and Reggio Emilia, Modena, Italy
(McIntyre, Healey) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Schnabel) Department of Cardiology, University Heart and Vascular Center
Hamburg-Eppendorf, Hamburg, Germany
(Schnabel) German Center for Cardiovascular Research (DZHK), Partner Site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Svennberg) Department of Medicine, Karolinska Institutet, Karolinska
University Hospital, Huddinge, Stockholm, Sweden
(Camm) Cardiology Clinical Academic Group, City St George's University of
London, London, United Kingdom
(Freedman) Heart Research Institute, Charles Perkins Centre, University of
Sydney, Sydney, Australia
(Freedman) Department Cardiology, Concord Repatriation General Hospital,
Hospital Road, Concord, Sydney, NSW, 2139, Australia
Abstract
We developed a survey to describe current practice on the detection and
management of new-onset postoperative atrial fibrillation (POAF) occurring
after coronary artery bypass grafting (CABG) or non-cardiac surgery. We
e-mailed an online anonymous questionnaire of 17 multiple choice or rank
questions to an international network of healthcare professionals. Between
June 2023 and June 2024, 158 participants from 25 countries completed the
survey. For CABG patients, 62.7% of respondents reported use of telemetry
to detect POAF on the ward until discharge, and 40% reported no dedicated
methods for monitoring AF recurrences during follow-up. The largest number
(46%) reported prescribing oral anticoagulants (OACs) at discharge if
patients were at risk according to CHA2DS2-VASc/CHA2DS2-VA scores, and the
most common duration of OAC therapy was 3 months to 1 year (43%). For
non-cardiac surgery patients, POAF detection methods varied, with 29%
using periodic 12-lead ECG and 27% using telemetry followed by periodic
ECGs. For monitoring AF recurrence, 33% reported planned cardiology visits
with ECG. Regarding OAC prescription during follow-up, 51% reported they
prescribe OACs only for patients who are at risk of stroke, and 42%
prescribe OACs for an interval of 3 months to 1 year. The most commonly
reported barrier to OAC prescription was the lack of randomized controlled
trial data. For both CABG and non-cardiac surgery, the reported methods
for POAF detection and recurrences monitoring were heterogeneous and
prescription patterns for OACs varied greatly. The most frequently
reported concern about long-term anticoagulation was lack of randomized
data, indicating the urgent need for sound studies that inform daily
clinical practice. Copyright © 2025. The Author(s).

<71>
Accession Number
2037565578
Title
Contemporary Incidence of Cognitive Impairment or Dementia in Patients
Undergoing Coronary Artery Bypass Grafting: A Systematic Review and
Meta-Analysis.
Source
Dementia and Geriatric Cognitive Disorders. 54(1) (pp 52-66), 2025. Date
of Publication: 01 Feb 2025.
Author
Lo H.Z.; Wee C.F.; Low C.E.; Teo Y.H.; Teo Y.N.; Yun C.Y.; Syn N.L.; Tan
B.Y.Q.; Chai P.; Yeo L.L.L.; Yeo T.-C.; Chong Y.F.; Poh K.-K.; Kong
W.K.F.; Wong R.C.C.; Chan M.Y.; Sia C.-H.
Institution
(Lo) School of Medicine, Faculty of Medicine, Nursing and Health Sciences,
Monash University, Melbourne, VIC, Australia
(Wee, Low, Teo, Teo, Tan, Chai, Yeo, Yeo, Chong, Poh, Kong, Wong, Chan,
Sia) Department of Medicine, Yong Loo Lin School of Medicine, , National
University of Singapore, Singapore, Singapore
(Yun, Chai, Yeo, Poh, Kong, Wong, Chan, Sia) Department of Cardiology,
National University Heart Centre Singapore, Singapore, Singapore
(Syn) Department of Surgery, Yong Loo Lin School of Medicine, , National
University of Singapore, Singapore, Singapore
(Tan, Yeo, Chong) Division of Neurology, Department of Medicine, National
University Hospital, Singapore, Singapore
Publisher
S. Karger AG
Abstract
Introduction: Despite the high prevalence of cognitive impairment or
dementia post-coronary artery bypass grafting (CABG), the incidence of
cognitive impairment or dementia post-CABG in contemporary practice is
currently unclear. Therefore, this paper aims to investigate the incidence
and associated risk factors of cognitive impairment or dementia in
patients' post-CABG. Method(s): A systematic search across three
databases (PubMed, SCOPUS, and Embase) was conducted for studies published
in or after 2013 that reported cognitive impairment or dementia post-CABG.
Subgroup analyses and metaregression by risk factors were performed to
determine their influence on the results. Result(s): This analysis
included 23 studies with a total of 2,620 patients. The incidence of
cognitive impairment or dementia less than 1 month, 2 to 6 months, and
more than 12 months post- CABG was 35.96% (95% confidence interval [CI]:
28.22-44.51, I2 = 87%), 21.33% (95% CI: 13.44-32.15, I2 = 88%), and 39.13%
(95% CI: 21.72-58.84, I2 = 84%), respectively. Meta-regression revealed
that studies with more than 80% of the cohort diagnosed with hypertension
were significantly associated with incidence of cognitive impairment or
dementia less than 1 month post- CABG. Conclusion(s): This
meta-analysis demonstrates a high incidence of cognitive impairment or
dementia in patients' post-CABG in contemporary practice, particularly
less than 1 month post-CABG and more than 12 months post-CABG. We found
that hypertension was a significant risk factor in the short-term (less
than 1 month) follow-up period for cognitive impairment or dementia
post-CABG. Future research should be done to assess strategies to reduce
cognitive impairment post-CABG. Copyright © 2024 The Author(s).

<72>
Accession Number
2033398409
Title
Pericardial Disease: Contemporary Techniques and Management.
Source
Current Treatment Options in Cardiovascular Medicine. 27(1) (no
pagination), 2025. Article Number: 23. Date of Publication: 01 Dec 2025.
Author
Bae J.Y.; Saleh A.; Hu J.-R.; Setaro J.F.; Altin S.E.
Institution
(Bae) Section of Cardiovascular Medicine, Department of Internal Medicine,
Yale New Haven Health Bridgeport Hospital, Bridgeport, CT, United States
(Saleh) Department of Internal Medicine, St. Mary's Hospital, Trinity
Health of New England, Waterbury, CT, United States
(Hu) Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Setaro, Altin) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale University School of Medicine, Yale University, Section of
Cardiology, 800 Howard Ave, New Haven, CT, United States
(Altin) Veterans' Affair Connecticut, West Haven, CT, United States
Publisher
Springer
Abstract
Purpose of the Review: Pericardial diseases, although common, can present
significant management challenges, notably in recurrent or refractory
cases. This review highlights evidence-based diagnostic and therapeutic
approaches, focusing on recent advancements. Recent Findings: Emerging
diagnostic techniques and therapeutic options have significantly enhanced
the management of pericardial diseases including computed
tomography-assisted pericardiocentesis, particularly in patients with poor
visualization by transthoracic echocardiography. Therapeutic advances for
the treatment of recurrent pericarditis include new immunosuppressive
therapies with promising efficacy in reducing both recurrence rates and
symptom burden. Summary: Pericardial diseases are prevalent and often
complex, requiring a tailored approach to management. Novel advances in
imaging technologies and pharmacologic therapies have improved diagnostic
precision and patient care. Continued research and clinical trials are
essential to further refine these strategies. Copyright © This is
a U.S. Government work and not under copyright protection in the US;
foreign copyright protection may apply 2025.

<73>
Accession Number
2037567062
Title
COMPARATIVE STUDY OF THE EFFICACY OF INTRAVENOUS ESMOLOL, DILTIAZEM, AND
LIGNOCAINE IN ATTENUATING THE PRESSURE RESPONSE TO LARYNGOSCOPY AND
TRACHEAL INTUBATION.
Source
International Journal of Academic Medicine and Pharmacy. 7(1) (pp
360-365), 2025. Date of Publication: 2025.
Author
Sharma A.D.; Garg R.; Sharan A.; Zeliang E.; Kumar P.
Institution
(Sharma) NIIMS, Uttar Pradesh, India
(Garg, Kumar) NCRIMS, Uttar Pradesh, Meerut, India
(Sharan) Rama Medical College Hospital and Research Centre, Uttar Pradesh,
Hapur, India
(Zeliang) CIHSR, Chumoukedima, Nagaland, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Laryngoscopy and tracheal intubation often lead to significant
hemodynamic disturbances due to sympathetic nervous system activation.
This study compares the efficacy of intravenous Esmolol, Diltiazem, and
Lignocaine in reducing the pressor response to laryngoscopy and
intubation. Material(s) and Method(s): This randomized controlled
trial included 90 ASA I and II adult patients scheduled for elective
non-cardiac surgery under general anaesthesia. Patients were randomly
allocated into three groups (n=30 each): Group EG (Esmolol 1 mg/kg IV),
Group DG (Diltiazem 0.3 mg/kg IV), and Group LG (Lignocaine 1.5 mg/kg IV).
Hemodynamic parameters-systolic arterial pressure (SAP), diastolic
arterial pressure (DAP), heart rate (HR), and mean arterial pressure
(MAP)-were recorded at baseline, immediately post-intubation (0 min), and
at 1, 3, 5, and 10 minutes post-intubation. Adverse effects were also
documented. Result(s): Diltiazem demonstrated the most effective
control of SAP, DAP, and MAP at all time points (p<0.05). Esmolol was
superior in controlling HR (p<0.001). Lignocaine exhibited the least
impact on hemodynamic stability but effectively reduced airway reflexes.
Side effects included mild bradycardia (10%) in Group EG, headache (6.7%)
in Group DG, and injection site discomfort (13.3%) in Group LG.
 Conclusion(s): Diltiazem is recommended for patients at risk of
hypertension, while Esmolol is preferred for tachycardia control.
Lignocaine had limited hemodynamic benefits. Further studies are needed to
establish optimal perioperative management strategies. Copyright
© 2025 Society for Healthcare and Research Development. All rights
reserved.

<74>
Accession Number
2037618856
Title
Intraoperative Oxygenation and Microcirculatory Changes Following Off-pump
Coronary Artery Bypass Grafting: An Exploratory Secondary Analysis of a
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Nam K.; Chung J.; Ju J.-W.; Cho Y.J.; Jeon Y.
Institution
(Nam, Chung, Ju, Cho, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: The effect of perioperative hyperoxia on microcirculation
after cardiac surgery remains inconclusive. We evaluated the relationship
between intraoperative fractional inspired oxygen and microcirculation
after off-pump coronary artery bypass grafting (OPCAB). Design(s):
Exploratory secondary analysis of a multicenter cluster-randomized trial.
 Setting(s): Three teaching hospitals. Participant(s): Adult
patients who underwent OPCAB. Intervention(s): Seven postoperative
microcirculatory parameters, including De Backer scores and the proportion
of perfused vessels via sublingual microscopy (from all and small
vessels), and thenar muscle tissue oxygenation, occlusion slope, and
recovery slope via the vascular occlusion test, were compared between
patients receiving 30% and 80% oxygen intraoperatively. Generalized
estimating equations were used to account for intracluster correlation.
 Measurements and Main Results: The analysis included 52 and 51
patients from the 30% and 80% oxygen groups, respectively, for sublingual
microscopy and 59 and 53 patients for the vascular occlusion test.
Although all microcirculatory parameters were similar between groups, the
80% oxygen group had higher De Backer scores for all vessels (mean, 9.8
+/- 2.9 mm-1 vs. 8.7 +/- 2.0 mm-1; p = 0.011) and
small vessels (4.0 +/- 1.8 mm-1 vs. 3.4 +/- 1.1
mm-1; p = 0.024) than the 30% oxygen group at the end of
surgery. The 80% oxygen group also exhibited greater thenar muscle tissue
oxygenation immediately before vascular occlusion (78.4% +/- 10.5 vs.
74.0% +/- 9.3; p = 0.031) and a higher recovery score (4.1%.s-1
+/- 1.7 vs. 3.2%.s-1 +/- 1.4; p = 0.001). Conclusion(s):
Patients receiving 80% oxygen during OPCAB had significantly better
postoperative microcirculatory profiles than those receiving 30% oxygen.
These findings highlight the potential for optimizing perioperative
oxygenation to improve or mitigate microcirculatory impairment, thereby
reducing postoperative complications. Copyright © 2025 Elsevier
Inc.

<75>
Accession Number
2037560054
Title
Improving atrial fibrillation or flutter detection and management by
smartphone-based photoplethysmography rhythm monitoring following cardiac
surgery: a pragmatic randomized trial.
Source
Europace. 27(2) (no pagination), 2025. Article Number: euaf015. Date of
Publication: 01 Feb 2025.
Author
Gruwez H.; De Melio N.; Vermunicht P.; Van Langenhoven L.; Desteghe L.;
Lamberigts M.; Nuyens D.; Van Herendael H.; Rodrigus I.; Van Kerrebroeck
C.; Vandervoort P.; Heidbuchel H.; Pison L.; Rega F.; Haemers P.
Institution
(Gruwez, Lamberigts, Rega, Haemers) Department of Cardiovascular Sciences,
UZ Leuven, Herestraat 49, Leuven, Belgium
(Gruwez, Nuyens, Van Herendael, Van Kerrebroeck, Vandervoort, Pison)
Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
(Gruwez, De Melio) Limburg Clinical Research Center, Faculty of Medicine
and Life Sciences, Hasselt University, Hasselt, Belgium
(Vermunicht, Desteghe, Rodrigus, Heidbuchel) Department of Cardiology,
Antwerp University Hospital, Antwerp, Belgium
(Van Langenhoven) KU Leuven - University of Leuven, Leuven Biostatistics
and Statistical Bioinformatics Centre (L-BioStat), Leuven, Belgium
Publisher
Oxford University Press
Abstract
Aims Atrial fibrillation (AF) and atrial flutter (AFL) after cardiac
surgery are common and associated with adverse outcomes. The increased
risk related to AF or AFL may extend beyond discharge. This study aims to
determine whether photoplethysmography (PPG)-based smartphone monitoring
to detect AF or AFL after hospital discharge following cardiac surgery
improves AF management. Methods and results The intervention group
performed 1 min rhythm checks three times daily using a smartphone-based
PPG application during 6 weeks after hospitalization for cardiac surgery.
The primary outcome involved AF management interventions by independent
physicians, including initiation of oral anticoagulation (OAC), direct
cardioversion, and up-titration or initiation of antiarrhythmic drugs. The
study included 450 patients [mean (SD) age, 64.1 (9.2) years; 96 women
(21.3%); 130 patients with AF history (28.9%); median (IQR) CHA2DS2-VASc
score, 2 (1-3)], of whom 238 were randomized to PPG-based monitoring and
212 to usual care. AF/AFL was detected with PPG or electrocardiography in
44 patients (18.5%) in the monitoring group and 4 patients (1.9%) in the
usual care group (OR 11.8; 95% CI, 4.2-33.3; P < 0.001); these were new
detections in, respectively, 22 patients (9.2%) and 1 patient (0.5%) (OR
21.3; 95% CI, 2.9-166.7; P = 0.003). AF management interventions occurred
in 24 patients (10.1%) in the monitoring group compared to 5 patients
(2.4%) in the usual care group [odds ratio (OR), 5.1; 95% CI, 1.8-14.4; P
= 0.002]. Conclusion In unselected patients discharged home following
cardiac surgery, PPG-based smartphone monitoring revealed significantly
more AF/AFL which led to significantly more optimization of AF
management. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<76>
Accession Number
2037618835
Title
Chloroquine and hydroxychloroquine induced cardiomyopathy: A systematic
review of literature.
Source
REC: CardioClinics. (no pagination), 2025. Date of Publication: 2025.
Author
Devesa Neto V.; Gouveia Fiuza J.; Pires I.; Ferreira Santos L.; Costa A.
Institution
(Devesa Neto, Gouveia Fiuza, Pires, Ferreira Santos, Costa) Cardiology
Department, Unidade Local de Saude Viseu Dao-Lafoes, Viseu, Portugal
(Devesa Neto) Faculty of Health Sciences, University of Beira Interior,
Covilha, Portugal
Publisher
Elsevier Espana S.L.U
Abstract
Introduction and objectives: Chloroquine (CQ) and hydroxychloroquine
(HCQ), initially developed for malaria prophylaxis, are now widely used in
rheumatic diseases, such as systemic lupus erythematosus and rheumatoid
arthritis. Despite their therapeutic benefits, these drugs can induce
cardiotoxicity, particularly cardiomyopathy. This systematic review
evaluates the prevalence, clinical features, and diagnostic challenges of
CQ/HCQ-induced cardiomyopathy. Method(s): A comprehensive literature
search was conducted in PubMed, EMBASE, and Cochrane databases,
identifying 60 studies reporting 79 cases of CQ/HCQ-induced
cardiomyopathy. Inclusion criteria required histopathological confirmation
via endomyocardial biopsy. Data on clinical presentations, diagnostic
findings, and outcomes were extracted and analyzed. Result(s):
Patients were predominantly female (76%), with a median age of 56 years.
The cardiomyopathies observed included hypertrophic, dilated, and
restrictive forms, frequently presenting with heart failure and conduction
disorders, such as atrioventricular block and arrhythmias. Cardiac
magnetic resonance imaging and endomyocardial biopsy revealed
characteristic toxicological changes, including myocyte vacuolization and
fibrosis. Management often involved discontinuation of therapy, but severe
cases progressed to cardiac transplantation or resulted in mortality
(19%). Conclusion(s): CQ/HCQ-induced cardiomyopathy is an
underrecognized complication with significant morbidity and mortality.
Early detection through continuous cardiac monitoring in patients on
long-term CQ/HCQ therapy is crucial. Effective management, including
timely drug discontinuation, may improve outcomes, although prognosis
remains guarded in advanced stages. Copyright © 2025 Sociedad
Espanola de Cardiologia

<77>
Accession Number
2037559938
Title
Minimally invasive lung surgery with an intraoperative completely or
partially tubeless protocol: randomized clinical trial.
Source
BJS Open. 9(1) (no pagination), 2025. Article Number: zrae132. Date of
Publication: 01 Feb 2025.
Author
Zhao Y.; Shan L.; Zhang W.; Li P.; Li N.; Zhang H.; Peng C.; Cong B.; Zhao
X.
Institution
(Zhao, Shan, Zhang, Li, Li, Zhang, Peng, Cong, Zhao) Department of
Thoracic Surgery, The Second Hospital of Shandong University, Shandong
Province, Jinan, China
Publisher
Oxford University Press
Abstract
Background: Thoracic surgery is an invasive procedure and there has been a
move towards minimally invasive approaches. This includes video-assisted
thoracoscopic surgery. Non-intubated video-assisted thoracoscopic surgery
without endotracheal intubation has been developed with a view to avoiding
complications associated with intubation including tracheal injury, vocal
cord injury and lung impairment due to mechanical ventilation. This study
aims to compare outcomes from non-intubated 'completely tubeless' versus
intubated 'partially tubeless' minimally invasive thoracic surgery.
 Method(s): A single-institution, prospective randomized clinical
trial was conducted comparing patients who underwent minimally invasive
lung completely tubeless versus partially tubeless surgery, both with
enhanced recovery. The primary outcome was the short-term postoperative
complication rate. Binary logistic regression analysis was performed to
determine the significant predictors of severe mediastinal shift and
receiver operating characteristic (ROC) curve plots were drawn.
 Result(s): Among the 348 patients, 174 patients were assigned to the
completely tubeless group and 174 patients were assigned to the partially
tubeless group. There was no difference in postoperative complications
including pulmonary complications, supraventricular arrhythmia, acute
myocardial infarction, acute cerebral stroke, venous thromboembolism and
urinary retention. The completely tubeless protocol was associated with a
higher proportion of early mobilization (66.7% versus 55.7%, P = 0.047), a
shorter median duration of drainage (1.0 versus 2.0 days, P = 0.002), and
a shorter median duration of postoperative hospital stay (2.0 versus 3.0
days, P = 0.001). The completely tubeless group had less of a difference
in white blood cell count before and after the operation (P = 0.042).
Binary logistic regression analysis revealed that weight was a significant
predictor of mediastinal shift in the completely tubeless group.
 Conclusion(s): Under enhanced recovery after surgery protocols, there
is no difference in postoperative complications in patients undergoing
completely or partially tubeless surgery. However, patients having
completely tubeless surgery have shorter durations of postoperative
drainage, shorter durations of hospital stay, milder systemic inflammatory
reactions, and better immune protection than patients who undergo lung
resection with a partially tubeless protocol. The severity of mediastinal
shift may be mainly related to body-weight. Copyright © The
Author(s) 2025. Published by Oxford University Press on behalf of BJS
Foundation Ltd.

<78>
Accession Number
2033387983
Title
Effectiveness of perioperative remimazolam in preventing postoperative
delirium: a systematic review and meta-analysis.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 122. Date of Publication: 01 Dec 2025.
Author
Wang M.; Liu J.; Liu W.; Zhang X.; Zhang G.; Sun L.; Bi Y.; Wang H.; Dong
R.
Institution
(Wang) School of Anesthesiology, Shandong Second Medical University, No. 5
Donghai Middle Road, Qingdao, China
(Wang, Liu, Liu, Zhang, Sun, Bi, Dong) Department of Anesthesiology,
Qingdao Hospital, University of Health and Rehabilitation Sciences
(Qingdao Municipal Hospital), Qingdao, China
(Zhang) Department of Anesthesiology, Dezhou Third People'S Hospital,
Dezhou, China
(Wang) Department of Pediatrics, Qingdao Women and Children'S Hospital,
Qingdao University, No. 217 Liaoyang West Road, Qingdao, China
(Dong) Key Laboratory of Anesthesiology and Resuscitation, Huazhong
University of Science and Technology), Ministry of Education, Wuhan, China
Publisher
BioMed Central Ltd
Abstract
Background: To compare the POD rates in patients undergoing non-cardiac
surgery who received remimazolam perioperatively versus placebo or other
sedatives. Method(s): We systematically searched four major databases
(Cochrane Central Register of Controlled Trials, Web of Science, Embase,
and PubMed) for relevant randomized controlled trials (RCTs) up to July
11, 2024. Literature quality evaluation was used the bias risk table in
Review Manager 5.4. The primary outcome of interest was POD, and secondary
outcomes were the hypotension risk, bradycardia and, nausea and vomiting.
 Result(s): Across 11 trials involving 1985 participants, we recorded
309 cases of POD during follow-up. In trials where the control group
received saline, remimazolam decrease the risk of POD significantly by 70%
(RR 0.30, 95% CI [0.19, 0.46]; p < 0.00001). Statistical analysis did not
show significant difference in the risk of POD between the remimazolam
group and the groups receiving either dexmedetomidine (RR 1.23 [0.64,
2.37]; p = 0.53) or propofol (RR 0.83 [0.60, 1.16]; p = 0.28). Regarding
adverse events, remimazolam significantly reduces the morbidity of
hypotension compared to dexmedetomidine (RR 0.25 [0.10, 0.65]; p = 0.004)
and propofol (RR 0.45 [0.33, 0.60]; p < 0.00001). In addition, there were
no significant differences in the incidence of bradycardia (RR 0.85; 95%
CI [0.34-2.12], p = 0.72) and nausea and vomiting (RR 1.06; 95% CI
[0.74-1.51], p = 0.77) between remimazolam and the control group.
 Conclusion(s): During the perioperative period, using remimazolam can
lower POD risk after surgery for patients who had non-cardiac surgery, but
remimazolam does not work better than dexmedetomidine or propofol.
Compared with the dexmedetomidine and propofol, remimazolam also has
apparent advantages in preventing intraoperative
hypotension. Copyright © The Author(s) 2025.

<79>
[Use Link to view the full text]
Accession Number
2037425426
Title
Management of Kidney Disease in Heart Transplant Patients: A National
Delphi Survey-based Consensus Expert Paper.
Source
Transplantation. (no pagination), 2025. Article Number:
10.1097/TP.0000000000005302. Date of Publication: 2025.
Author
Garcia-Cosio Carmena M.D.; Farrero M.; Blasco Peiro M.T.; Crespo M.;
Delgado Jimenez J.; Diaz Molina B.; Fernandez Rivera C.; Garrido Bravo
I.P.; Lopez Jimenez V.; Melilli E.; Mirabet Perez S.; Perez Tamajon M.L.;
Rangel Sousa D.; Rodrigo E.; Cruzado J.M.; Hernandez Marrero D.; Dalmau
A.G.; Sanchez Fructuoso A.I.; Gavela Martinez E.; Zarraga Larrondo S.;
Rodriguez Benot A.; Mazuecos Blanca A.; Moreso Mateos F.J.; Torregrosa
Prats J.V.; Andres Belmonte A.; Franco Esteve A.; Beneyto Castello M.I.;
Gonzalez Roncero F.M.; Facundo Molas C.; Perez Saez, M.J.; Jimenez Martin
C.; Gregorio Rbago J.-A.; Lopez Granados A.; Almenar Bonet L.; Sobrino
Marquez J.M.; Crespo Leiro M.; Gonzalez Costello J.; Rodriguez Chaverri
A.; De La Fuente Galan L.; Garcia Quintana A.; Gomez Bueno M.; Gonzalez
Vilchez F.; Ortiz Bautista C.; Segovia Cubero J.; Caravaca Perez P.
Institution
(Garcia-Cosio Carmena) Cardiology Department, CIBERCV, Hospital
Universitario 12 de OctubreImas12, Madrid, Spain
(Farrero) Cardiology Department, Hospital Clinic, Barcelona, Spain
(Blasco Peiro) Cardiology Department, Hospital Universitario Miguel
Servet, Zaragoza, Spain
(Crespo) Nephrology Department, Hospital del Mar, Hospital del Mar
Research Institute, National Network for Kidney Research RICORS2040
RD21/0005/0022, Barcelona, Spain
(Delgado Jimenez) Cardiology Department, Universidad Complutense de
Madrid, CIBERCV, Hospital Universitario 12 de Octubre, Imas12, , Madrid,
Spain
(Diaz Molina) Cardiology Department, Hospital Universitario Central de
Asturias, Oviedo, Spain
(Fernandez Rivera) Nephrology Department, Complexo Hospitalario
Universitario A Coruna, A Coruna, Spain
(Garrido Bravo) Cardiology Department, Hospital Clinico Universitario
Virgen de la Arrixaca, El Palmar, Murcia, Spain
(Lopez Jimenez) Nephrology Department, Hospital Regional Universitario de
Malaga, National Network for Kidney Research RICORS2040 RD21/0005/0012,
Instituto Biomedico de Investigacion de Malaga (IBIMA), Universidad de
Malaga, Malaga, Spain
(Melilli) Nephrology Department, Hospital Universitario de Bellvitge,
Barcelona, Spain
(Mirabet Perez) Cardiology Department, Hospital de la Santa Creu i Sant
Pau, CIBERCV, Barcelona, Spain
(Perez Tamajon) Nephrology Department, Complejo Hospitalario Universitario
de Canarias, Santa Cruz de Tenerife, Spain
(Rangel Sousa) Cardiology Department, Hospital Universitario Virgen del
Rocio, Sevilla, Spain
(Rodrigo) Nephrology Department, Hospital Universitario Marques de
Valdecilla, IDIVAL, Santander, Spain
(Cruzado) Nephrology Department, Hospital Universitario de Bellvitge,
Bellvitge Institute for Biomedical Research (IDIBELL), University of
Barcelona, Barcelona, Spain
(Hernandez Marrero) Nephrology Department, Hospital Universitario de
Canarias, National Network for Kidney Research RICORS2040 RD21/0005/0012,
Instituto de Tecnologias Biomedicas, Universidad de La Laguna, Santa Cruz
de Tenerife, Spain
(Dalmau) Hospital Universitario Miguel Servet, Zaragoza, Spain
(Sanchez Fructuoso) Hospital Clinico San Carlos, Madrid, Spain
(Gavela Martinez) Hospital Universitario Dr Peset, Valencia, Spain
(Zarraga Larrondo) Hospital Universitario de Cruces, Vizcaya, Baracaldo,
Spain
(Rodriguez Benot, Lopez Granados) Hospital Universitario Reina Sofia,
Cordoba, Spain
(Mazuecos Blanca) Hospital Puerta del Mar, Cadiz, Spain
(Moreso Mateos) Hospital Universitario Vall d'Hebron, Barcelona, Spain
(Torregrosa Prats, Caravaca Perez) Hospital Clinic, Barcelona, Spain
(Andres Belmonte) Hospital Universitario 12 de Octubre, Madrid, Spain
(Franco Esteve) Hospital General Universitario de Alicante, Alicante,
Spain
(Beneyto Castello, Almenar Bonet) Hospital Universitari i Politecnic La
Fe, Valencia, Spain
(Gonzalez Roncero, Sobrino Marquez) Hospital Universitario Virgen del
Rocio, Seville, Spain
(Facundo Molas) Fundacio Puigvert, Barcelona, Spain
(Perez Saez) Hospital del Mar, Barcelona, Spain
(Jimenez Martin, Rodriguez Chaverri) Hospital Universitario La Paz,
Madrid, Spain
(Gregorio Rbago) Clinica Universitaria de Navarra, Pamplona, Spain
(Crespo Leiro) Hospital Universitario de A Coruna A Coruna, Spain
(Gonzalez Costello) Hospital Universitari de Bellvitge, L'Hospitalet de
Llobregat, Barcelona, Spain
(De La Fuente Galan) Hospital Clinico Universitario de Valladolid,
Valladolid, Spain
(Garcia Quintana) Hospital Universitario de Gran Canaria Doctor Negrin,
Las Palmas de Gran Canaria, Spain
(Gomez Bueno, Segovia Cubero) Hospital Puerta de Hierro-Majadahonda,
Majadahonda, Madrid, Spain
(Gonzalez Vilchez) Hospital Universitario Marques de Valdecilla,
Santander, Spain
(Ortiz Bautista) Hospital Universitario Gregorio Maranon, Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Kidney disease is a common complication in heart transplant recipients and
requires a comprehensive and personalized approach. The interplay between
preexisting kidney disease, perioperative factors, immunosuppression, and
cardiovascular complications makes the management of kidney dysfunction
challenging in these patients. The objective of this expert consensus was
to look for agreements for the management of chronic kidney disease in
heart transplant recipients. A panel of Spanish cardiologists and
nephrologists with expertise in heart and kidney transplantation reviewed
the evidence related to the current management of chronic kidney disease
in heart transplant recipients and consensus statements were developed
using a 2-round Delphi methodology. Consensus statements were proposed
covering key topics, including the identification and management of kidney
disease in heart transplant recipients and the indications for kidney
transplantation. These statements provide additional expert guidance for
the management of kidney disease in patients undergoing heart
transplantation where published clinical evidence is scarce. Copyright
© 2025 Wolters Kluwer Health, Inc.

<80>
Accession Number
646557206
Title
Bempedoic Acid for Prevention of Cardiovascular Events in People With
Obesity: A CLEAR Outcomes Subset Analysis.
Source
Journal of the American Heart Association. (pp e037898), 2025. Date of
Publication: 08 Feb 2025.
Author
Bays H.E.; Bloedon L.; Brennan D.; Lei L.; Lincoff A.M.; Nicholls S.J.;
Plutzky J.; Powell H.A.; Nissen S.E.
Institution
(Bays) Louisville Metabolic and Atherosclerosis Research Center Louisville
KY
(Bloedon, Lei, Powell) Esperion Therapeutics, Inc. Ann Arbor MI
(Brennan, Lincoff, Nissen) Cleveland Clinic Cleveland OH
(Nicholls) Victorian Heart Institute Monash University Melbourne
Australia, Australia
(Plutzky) Brigham and Women's Hospital, Harvard University Boston MA
Abstract
BACKGROUND: Obesity and hypercholesterolemia independently increase
cardiovascular disease risk. This analysis evaluated the efficacy and
safety of bempedoic acid in people with obesity participating in the CLEAR
(Cholesterol Lowering via Bempedoic Acid [ECT1002], an ACL-Inhibiting
Regimen) Outcomes trial. METHOD(S): CLEAR Outcomes randomized 13 970
patients to daily bempedoic acid 180 mg or placebo. Exploratory outcomes
including major adverse cardiovascular events-4 (cardiovascular death,
nonfatal myocardial infarction, nonfatal stroke, or coronary
revascularization), low-density lipoprotein cholesterol, hs-CRP
(high-sensitivity C-reactive protein), weight change, and safety were
assessed over a median of 40.7 months in 6177 patients with baseline body
mass index >=30 kg/m2. RESULT(S): In people with obesity, bempedoic
acid resulted in placebo-corrected reductions in low-density lipoprotein
cholesterol of -22.5% and hs-CRP of -23.2% at 6 months. Bempedoic acid
treatment resulted in a major adverse cardiovascular events-4 reduction of
23% (hazard ratio [HR], 0.77 [95% CI, 0.67-0.89]) versus placebo. Nonfatal
and fatal MI were reduced by 32% (HR, 0.68 [95% CI, 0.53-0.86]), coronary
revascularization was reduced by 24% (HR, 0.76 [95% CI, 0.63-0.92]), and
fatal and nonfatal stroke were reduced by 36% (HR, 0.64 [95% CI,
0.45-0.89]) compared with placebo. At month 36, mean+/-SD change in weight
from baseline was -2.3 (6.3) kg for bempedoic acid and -1.4 (6.1) kg for
placebo. Adverse events were reported in 87.4% of bempedoic acid patients
and 86.7% of placebo patients. The mean+/-SD change in uric acid at 6
months was 0.81 (1.26) mg/dL for bempedoic acid versus -0.04 (1.05) mg/dL
for placebo. CONCLUSION(S): Among people with obesity, bempedoic acid
reduced major adverse cardiovascular events, low-density lipoprotein
cholesterol, and hs-CRP, with a safety profile consistent with previous
reports. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
Identifier: NCT02993406.

<81>
Accession Number
2037619821
Title
Design and rationale of the multicenter randomized clinical trial
(REVERSE): Efficacy and safety of rivaroxaban in the early postoperative
period for patients with bioprosthetic valve replacement or valve repair.
Source
International Journal of Cardiology. 425 (no pagination), 2025. Article
Number: 133023. Date of Publication: 15 Apr 2025.
Author
Wang X.; Zhang C.; Pan M.-M.; Lin H.-W.; Xue S.; Xie B.; Gu Z.-C.
Institution
(Wang, Zhang, Gu) Department of Pharmacy, Punan Branch of Renji Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Wang, Zhang, Pan, Lin, Gu) Department of Pharmacy, Ren Ji Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Wang, Zhang, Pan, Lin, Gu) College of Clinical Pharmacy, Shanghai Jiao
Tong University School of Medicine, Shanghai, China
(Zhang) School of Medicine, Tongji University, Shanghai, China
(Xue, Xie) Department of Cardiovascular Surgery, Ren Ji Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
Publisher
Elsevier Ireland Ltd
Abstract
Background: Rivaroxaban, a Non-vitamin K oral anticoagulant (NOAC), is
extensively employed for patients at heightened risk of thrombosis,
including those with non-valvular atrial fibrillation (NVAF) and venous
thromboembolism (VTE). However, to date, there is a lack of robust
clinical data to explore the efficacy and safety of rivaroxaban in
thromboprophylaxis during the early postoperative period (<6 months) in
patients following surgical bioprosthetic valve (BPV). Method(s): The
REVERSE trial is a prospective, multicenter, non-inferior, randomized
controlled trial enrolling a planned 250 patients in China. Patients are
randomly assigned 1:1 to receive rivaroxaban (20 mg once daily) or
dose-adjusted warfarin (target international normalized ratio 2.0-3.0) for
6 months. The primary outcome is defined as the composite of all-cause
death, major cardiovascular events, or major bleeding. The safety outcome
is all bleeding events defined by the International Society on Thrombosis
and Haemostasis (ISTH). Conclusion(s): The REVERSE trial stands as
the inaugural multicenter study dedicated to evaluating the efficacy and
safety of rivaroxaban for early postoperative anticoagulation in BPV
surgery patients. Its findings are anticipated to contribute pivotal
evidence regarding the clinical advantages of NOACs. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT06476301. Copyright © 2025 Elsevier B.V.

<82>
Accession Number
2037600640
Title
Non-intubated video-assisted thoracoscopy: a narrative review.
Source
Acta Anaesthesiologica Belgica. 75 (pp 125-136), 2024. Date of
Publication: 01 Dec 2024.
Author
Ushakova V.; Coppens S.
Institution
(Ushakova) Department of Anaesthesiology, University Hospitals of Leuven,
Herestraat 49, Leuven, Belgium
(Coppens) Department of Anaesthesiology, University Hospitals of Leuven,
Department of Cardiovascular Sciences, Biomedical Sciences Group,
University of Leuven, Herestraat 49, Leuven, Belgium
Publisher
BeSARPP
Abstract
Non-intubated video-assisted thoracoscopic surgery (NIVATS) is an emerging
technique in thoracic surgery that avoids the use of general anaesthesia
and mechanical ventilation. The evolution from traditional VATS to NIVATS
has shown significant potential in reducing postoperative complications,
shortening hospital stays, and improving patient satisfaction. By allowing
spontaneous breathing, NIVATS minimizes the invasiveness of thoracic
procedures and reduces the risks associated with tracheal intubation and
general anaesthesia. A comprehensive literature search was conducted
across multiple databases, including the Cochrane Library, Embase, Medline
(Ovid), PubMed, and Scopus, focusing on studies published between 2013 and
2023. Keywords included terms related to NIVATS, spontaneous breathing,
and one-lung ventilation. The search yielded 56 relevant studies selected
for inclusion in our review. This narrative review explores the
physiological aspects and clinical implications induced by the respiratory
management in thoracoscopic surgery. It also examines equipment and
techniques for lung isolation, emphasizing the importance of optimizing
perioperative management. In conclusion, both VATS and NIVATS offer
significant advantages over traditional open thoracotomy. NIVATS, in
particular, shows promise in enhancing patient outcomes through reduced
complications and faster recovery. We present our current protocol for
NIVATS at the University Hospitals in Leuven, although further studies
areneeded to confirm these benefits and refine protocols for broader
clinical adoption. Copyright © 2024 BeSARPP. All rights reserved.

<83>
Accession Number
2037585172
Title
Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients:
An Updated Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. 85(9) (pp 926-940), 2025.
Date of Publication: 11 Mar 2025.
Author
Reddy R.K.; Howard J.P.; Mack M.J.; Reardon M.J.; Jorgensen T.H.; Horsted
Thyregod H.G.; Toff W.D.; Van Mieghem N.M.; Vora A.N.; Makkar R.R.;
Kapadia S.; Forrest J.K.; Leon M.B.; Ahmad Y.
Institution
(Reddy, Howard) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Mack) Department of Cardiovascular Disease, Baylor Scott and White
Health, Plano, TX, United States
(Reardon) Houston Methodist DeBakey Heart and Vascular Center, Houston,
TX, United States
(Jorgensen, Horsted Thyregod) The Heart Centre, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Toff) Department of Cardiovascular Sciences, University of Leicester and
NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester,
United Kingdom
(Van Mieghem) Department of Interventional Cardiology, Thoraxcenter,
Erasmus University Medical Center, Rotterdam, Netherlands
(Vora, Forrest) Section of Cardiovascular Medicine, Yale University School
of Medicine, New Haven, CT, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Leon) Division of Cardiology, Columbia University Irving Medical Center,
NewYork-Presbyterian Hospital, New York, NY, United States
(Leon) The Cardiovascular Research Foundation, New York, NY, United States
(Ahmad) Division of Cardiology, University of California, San Francisco,
San Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Longer-term outcomes are especially important for lower-risk
patients with severe aortic stenosis undergoing transcatheter aortic valve
replacement (TAVR) or surgical aortic valve replacement (SAVR). Additional
randomized data comparing TAVR and SAVR have recently become available.
 Objective(s): The purpose of this study was to perform an updated
systematic review with conventional pairwise meta-analyses and pooled
survival analyses using reconstructed time-to-event individual participant
data (IPD) including the totality of randomized evidence comparing
longer-term clinical outcomes after TAVR and SAVR in lower-risk patients.
 Method(s): The prespecified primary endpoint was all-cause death. Key
secondary endpoints included stroke and the composite of death or
disabling stroke. Cox proportional hazards frailty regression and
restricted mean survival time models were fitted using reconstructed
time-to-event IPD. In sensitivity analyses, proportional odds models were
fitted with frailty terms. Conventional pairwise meta-analyses were
performed under random and fixed effects assumptions. Result(s): Six
trials enrolling 5,341 lower-risk patients were included with 2,717
randomized to TAVR and 2,624 randomized to SAVR (weighted mean follow-up
of 35.7 months). At 5 years in the pooled survival analyses of
reconstructed time-to-event IPD, TAVR was associated with a 20% reduction
in the hazard of all-cause death (HR: 0.80; 95% CI: 0.66-0.97; P = 0.02)
and a 19% reduction in the hazard of all-cause death or disabling stroke
(HR: 0.81; 95% CI: 0.68-0.96; P = 0.01) compared with SAVR. There was no
difference in stroke (HR: 0.97; 95% CI: 0.74-1.26; P = 0.80).
 Conclusion(s): In lower-risk patients, TAVR was associated with a
reduced hazard of death and death or disabling stroke compared with SAVR,
while rates of stroke were equivalent. Most patients have not yet
undergone 5-year follow-up, and so these findings may change as further
longer-term data become available. The present data are informative for
lower-risk patients and treating clinicians, but further randomized trials
and longer-term follow-up are required, particularly in younger
patients. Copyright © 2025 American College of Cardiology
Foundation

<84>
Accession Number
2037606155
Title
Clinical and hemodynamic outcomes of self-expanding and balloon-expandable
valves for valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI): An updated systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 57 (no pagination), 2025. Article Number:
101627. Date of Publication: 01 Apr 2025.
Author
Yasmin F.; Moeed A.; Iqbal K.; Ali A.; Kumar A.; Basit J.; Hamza M.; Dani
S.S.; Kalra A.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Moeed, Iqbal, Ali) Dow Medical College, Dow University of Health
Sciences, Karachi, Pakistan
(Kumar) Cleveland Clinic Akron General, Akron General Avenue, Akron Ohio,
OH, United States
(Basit) Rawalpindi Medical College, Rawalpindi, Karachi, Pakistan
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Dani) Department of Cardiology, Beth Israel Lahey Health, Burlington, MA,
United States
(Kalra) Franciscan Health, Lafayette, IN, United States
(Kalra) Krannert Cardiovascular Research Center, Indiana University School
of Medicine, Indianapolis, IN, United States
Publisher
Elsevier Ireland Ltd
Abstract
Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has
emerged as a feasible alternative to reoperative surgery in patients with
degenerated surgical bio-prosthesis. However, data regarding the choice of
valve type in ViV-TAVI remain inconclusive. This meta-analysis compares
the procedural and clinical outcomes of self-expanding (SE) vs.
balloon-expandable (BE) valves in ViV-TAVI. MEDLINE and Scopus were
queried to identify studies reporting outcomes of ViV-TAVI by SE/BE valve
type or comparing outcomes between SE or BE valves for ViV-TAVI. The
primary outcome was incidence of all-cause mortality at 30 days. Data were
presented as incidence of outcomes, analyzed via random effects model
using inverse variance method with 95 % confidence intervals. Further
incidence rates of primary and secondary outcomes were presented as
subgroups of BE and SE, with comparison in incidence rates between the
subgroups made using p-interaction of proportions. 27 studies with 13,182
patients (SE: 7346; BE: 5836) were included. There were no significant
differences between the BE vs. SE valves in 30-day mortality (BE 4 % vs.
SE 3 %, p = 0.44), 1-year mortality (BE 12 % vs. SE 10 %, p = 0.60), and
moderate-to-severe AR at 1 year (BE 1 % vs. SE 3 %, p = 0.36). However,
patients with SE valves had higher rates of new permanent pacemaker
insertion (BE 4 % vs. SE 9 %, p = 0.0019). There were no significant
differences in the incidence of 30-day safety outcomes, including stroke,
AKI, coronary obstruction, major bleeding, and major vascular
complications. Both BE and SE valve types showed comparable mortality and
safety outcomes in ViV-TAVI, except pacemaker insertion, which was higher
in SE compared with BE valves. Copyright © 2025 The Authors

<85>
Accession Number
2037546492
Title
Patient and family engagement interventions for enhancing patient safety
in the perioperative journey: A scoping review.
Source
BMJ Open Quality. 14(1) (no pagination), 2025. Article Number: e002986.
Date of Publication: 17 Feb 2025.
Author
Seyfulayeva A.; Fonte B.F.; Alho A.M.; Shaikh A.; Nunes A.B.; Casaca
P.G.C.; Leite A.; Taha A.; Dhingra-Kumar N.; Sousa P.
Institution
(Seyfulayeva, Fonte, Shaikh, Nunes, Casaca, Leite, Sousa) NOVA University,
Lisbon National School of Public Health, Lisbon, Portugal
(Seyfulayeva, Fonte, Sousa) Collaborating Centre for Education, Research
and Evaluation of Safety and Quality in Healthcare, WHO, Lisbon, Portugal
(Alho, Nunes, Casaca, Leite, Sousa) Public Health Research Centre,
Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University,
Lisbon National School of Public Health, Lisbon, Portugal
(Alho) ULS Santa Maria, Public Health Unit Francisco George, Lisbon,
Portugal
(Shaikh) The Aga Khan University, Sindh, Karachi, Pakistan
(Leite) Departamento de Epidemiologia, Instituto Nacional de Saude Doutor
Ricardo Jorge, Lisbon, Portugal
(Taha) Patient Safety and Quality of Care, World Health Organization,
Geneva, Switzerland
(Dhingra-Kumar) Patient Safety Flagship Unit, World Health Organisation,
Geneva, Switzerland
Publisher
BMJ Publishing Group
Abstract
Background Surgical procedures present intricate challenges within
healthcare delivery, often associated with higher risks of adverse events
compared with non-surgical contexts. Patient and family engagement (PFE)
throughout the perioperative journey is a possibility to enhance care
quality, safety and patient-centredness. However, literature addressing
PFE across the entirety of the perioperative journey remains sparse.
Objective The current scoping review aims to comprehensively map the
existing interventions with PFE approach focused on improving patient
safety across various types of surgical procedures throughout the
perioperative journey. In addition, the review aims to understand the
level and type of PFE approach adopted in this context. Eligibility
criteria Articles published in indexed peer-reviewed journals from 2003 to
2023, written in English, Portuguese or Spanish, that report on
interventions with PFE approach targeting adult surgical patients, their
families, caregivers, patient advocates and patient champions. The review
includes articles reporting on both inpatient and ambulatory surgical
patients. Methods Following Joanna Briggs Institute guidelines and the
Preferred Reporting Items for Systematic reviews and Meta-Analyses
extension for Scoping Reviews framework, this review systematically
searched PubMed, Web of Science, SCOPUS, CINAHL, and PsycINFO for relevant
articles. Eligible interventions were categorised using PFE framework
regarding the level of engagement and mapped according to the WHO Global
Patient Safety Action Plan 2021-2030. Results Out of 765 records initially
identified, 32 met the eligibility criteria for data extraction and
analysis, of which 40% originated from the USA, followed by the UK (18%)
and Canada (12%). 47% of the interventions targeted multiple/all types'
of procedures, 19% focused on cardiothoracic surgeries and 9% on
gynaecological procedures or organ transplant. The majority of the
interventions (88%) focused on PFE at the direct care level, predominantly
adopting a consultation-based approach. Furthermore, 81% of eligible
interventions emphasised patient information and education, 16% addressed
codevelopment of policy and 3% of interventions focused on patient
advocacy. Conclusion The findings show a predominant focus on PFE
interventions targeting patient safety at the direct care level,
particularly in the provision of patient information and education.
However, interventions at organisational and policy-making levels are
notably scarce. Further investment is required to promote interventions
engaging patients and families at broader organisational and policy-making
levels. Copyright © 2025 BMJ Publishing Group. All rights
reserved.

<86>
Accession Number
2033281951
Title
Regional anesthesia for pediatric cardiac surgery: a review.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 77. Date
of Publication: 01 Dec 2025.
Author
Dost B.; De Cassai A.; Amaral S.; Balzani E.; Karapinar Y.E.; Beldagli M.;
Yalin M.S.O.; Turunc E.; Ahiskalioglu A.; Tulgar S.
Institution
(Dost, Turunc) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Ondokuz Mayis University, Samsun, Turkey
(De Cassai) Institute of Anesthesia and Intensive Care Unit, University
Hospital of Padua, Padua, Italy
(De Cassai) Department of Medicine - DIMED, University of Padua, Padua,
Italy
(Amaral) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Balzani) Department of Surgical Sciences, University of Turin, Turin,
Italy
(Karapinar, Yalin, Ahiskalioglu) Department of Anesthesiology and
Reanimation, Ataturk University School of Medicine, Erzurum, Turkey
(Karapinar, Yalin, Ahiskalioglu) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum, Turkey
(Beldagli, Tulgar) Department of Anesthesiology and Reanimation, Faculty
of Medicine, Samsun Training and Research Hospital, Samsun University,
Samsun, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: Effective pain management in pediatric cardiac surgery is
essential for optimizing postoperative outcomes and promoting faster
recovery. While intravenous analgesia remains a standard approach,
regional anesthesia (RA) techniques have gained attention in this
population due to their analgesic efficacy, reduced dependence on systemic
opioids, and enhanced hemodynamic stability. Main Body: This article
provides an overview of current evidence of RA techniques for pediatric
cardiac surgery. We discuss the role of RA in pediatric pain management,
outlining various techniques, such as epidural, paravertebral block,
fascial plane blocks and their specific applications, clinical outcomes,
and the challenges posed by pediatric anatomy and pharmacokinetics. Pain
assessment in pediatric populations and the complications associated with
RA are also explored. Conclusion(s): Despite the demonstrated
efficacy of RA in this patient group, there is a need for large-scale
randomized multicenter studies to establish standardized protocols and
strengthen the evidence base for its use in pediatric cardiac
surgery. Copyright © The Author(s) 2025.

<87>
Accession Number
646544023
Title
Comment on stroke prevention strategies for cardiac surgery: a systematic
review and meta-analysis of randomized controlled trials.
Source
ANZ journal of surgery. (no pagination), 2025. Date of Publication: 07
Feb 2025.
Author
Wang H.; Yang M.; Gao H.; Liu X.
Institution
(Wang, Yang) Operating Room, Rehabilitation University Qingdao Central
Hospital, Qingdao, China
(Gao, Liu) Department of Cardiovascular Surgery, Affiliated Hospital of
Qingdao University, Qingdao, China

<88>
Accession Number
646516193
Title
Glucagon-like peptide 1 (GLP-1) receptor agonists for people with chronic
kidney disease and diabetes.
Source
Cochrane Database of Systematic Reviews. 2025(2) (no pagination), 2025.
Article Number: CD015849. Date of Publication: 18 Feb 2025.
Author
Natale P.; Green S.C.; Tunnicliffe D.J.; Pellegrino G.; Toyama T.;
Strippoli G.F.M.
Institution
(Natale, Tunnicliffe) Sydney School of Public Health, The University of
Sydney, Sydney, Australia
(Natale, Pellegrino, Strippoli) Department of Precision and Regenerative
Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari,
Italy
(Green) Department of Medicine, University of Otago Christchurch,
Christchurch, New Zealand
(Toyama) Department of Nephrology, Kanazawa University, Kanazawa, Japan
(Toyama) Innovative Clinical Research Center, Kanazawa University,
Kanazawa, Japan
(Strippoli) Nephrology, Dialysis and Transplantation Unit, Department of
Medical and Surgical Sciences, University of Foggia, Foggia, Italy
(Strippoli) Cochrane Kidney and Transplant, Centre for Kidney Research,
The Children's Hospital at Westmead, Westmead, Australia
Publisher
John Wiley and Sons Ltd
Abstract
Background: Approximately 40% of people with diabetes develop kidney
failure and experience an accelerated risk of cardiovascular
complications. Glucagon-like peptide 1 (GLP-1) receptor agonists are
glucose-lowering agents that manage glucose and weight control.
 Objective(s): We assessed the benefits and harms of GLP-1 receptor
agonists in people with chronic kidney disease (CKD) and diabetes.
 Search Method(s): The Cochrane Kidney and Transplant Register of
Studies was searched to 10 September 2024 through contact with the
Information Specialist using search terms relevant to this review. Studies
in the Register are identified through searches of CENTRAL, MEDLINE, and
EMBASE, conference proceedings, the International Clinical Trials Registry
Platform (ICTRP) Search Portal, and ClinicalTrials.gov. Selection
Criteria: Randomised controlled studies were eligible if participants with
diabetes and CKD were randomly allocated to a GLP-1 receptor agonist,
placebo, standard care or a second glucose-lowering agent. CKD included
all stages (from 1 to 5). Data Collection and Analysis: Three authors
independently extracted data and assessed the risk of bias using the risk
of bias assessment tool 2. Pooled analyses using summary estimates of
effects were obtained using a random-effects model, and results were
expressed as risk ratios (RR) and/or hazard ratio (HR) and their 95%
confidence intervals (CI) for dichotomous outcomes and mean difference
(MD) and 95% CI for continuous outcomes. The primary outcomes included
death (all-cause and cardiovascular), 3- and 4-point major adverse
cardiovascular events (MACE), kidney failure, composite kidney outcome,
and severe hypoglycaemia. The secondary outcomes included non-fatal or
fatal myocardial infarction (MI) or stroke, non-fatal peripheral arterial
events, heart failure, hospitalisation due to heart failure, estimated
glomerular filtration rate or creatinine clearance, doubling of serum
creatinine, urine albumin-to-creatinine ratio, albuminuria progression,
vascular access outcomes, body weight, body mass index, fatigue, life
participation, peritoneal dialysis infection, peritoneal dialysis failure,
adverse events, serious adverse events, withdrawal due to adverse events,
HbA1c, sudden death, acute MI, ischaemic stroke, and coronary
revascularisation. Confidence in the evidence was assessed using the
Grading of Recommendations Assessment, Development and Evaluation (GRADE)
approach. Main Result(s): Forty-two studies involving 48,148
participants were included. All studies were conducted on people with type
2 diabetes, and no studies were carried out on children. The median study
age was 66 years. The median study follow-up was 26 weeks. Six studies
were conducted in people with CKD stages 1-2, 11 studies in people with
CKD stages 3-5, one study in people on dialysis, and the remaining studies
included people with both CKD stages 1-2 and 3-5. Risks of bias in the
included studies for all the primary outcomes in studies that compared
GLP-1 receptor agonists to placebo were low in most methodological
domains, except one study that was assessed at high risk of bias due to
missing outcome data for death (all-cause and cardiovascular). The overall
risk of bias for all-cause and cardiovascular death in studies that
reported the treatment effects of GLP-1 receptor agonists compared to
standard care, dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose
cotransporter 2 (SGLT2) inhibitors were assessed as unclear or at high
risk of bias due to deviations from intended interventions or missing
data. For GLP-1 receptor agonists compared to insulin or another GLP-1
receptor agonist, the risk of bias for all-cause and cardiovascular death
was low or unclear. Compared to placebo, GLP-1 receptor agonists probably
reduced the risk of all-cause death (RR 0.85, 95% CI 0.74 to 0.98;
I2 = 23%; 8 studies, 17,861 participants; moderate-certainty
evidence), but may have little or no effect on cardiovascular death (RR
0.84, 95% CI 0.68 to 1.05; I2 = 42%; 7 studies, 17,801
participants; low-certainty evidence). Compared to placebo, GLP-1 receptor
agonists probably decreased 3-point MACE (RR 0.84, 95% CI 0.73 to 0.98; I2
= 65%; 4 studies, 19,825 participants; moderate-certainty evidence), and
4-point MACE compared to placebo (RR 0.77, 95% CI 0.67 to 0.89; 1 study,
2,158 participants; moderate-certainty evidence). Based on absolute risks
of clinical outcomes, it is likely that GLP-1 receptor agonists prevent
all-cause death in 52 people with CKD stages 1-2 and 116 in CKD stages
3-5, cardiovascular death in 34 people with CKD stages 1-2 and 71 in CKD
stages 3-5, while 95 CKD stages 1-2 and 153 in CKD stages 3-5 might
experience a major cardiovascular event for every 1000 people treated over
1 year. Compared to placebo, GLP-1 receptor agonists probably had little
or no effect on kidney failure, defined as starting dialysis or kidney
transplant (RR 0.86, 95% CI 0.66 to 1.13; I2 = 0%; 3 studies,
4,134 participants; moderate-certainty evidence), or on composite kidney
outcomes (RR 0.89, 95% CI 0.78 to 1.02; I2 = 0%; 2 studies,
16,849 participants; moderate-certainty evidence). Compared to placebo,
GLP-1 receptor agonists may have little or no effect on the risk of severe
hypoglycaemia (RR 0.82, 95% CI 0.54 to 1.25; I2 = 44%; 4
studies, 6,292 participants; low-certainty evidence). The effects of GLP-1
receptor agonists compared to standard care or other hypoglycaemic agents
were uncertain. No studies evaluated treatment on risks of fatigue, life
participation, amputation or fracture. Authors' conclusions: GLP-1
receptor agonists probably reduced all-cause death but may have little or
no effect on cardiovascular death in people with CKD and diabetes. GLP-1
receptor agonists probably lower major cardiovascular events, probably
have little or no effect on kidney failure and composite kidney outcomes,
and may have little or no effect on the risk of severe hypoglycaemia in
people with CKD and diabetes. Copyright © 2025 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<89>
Accession Number
2033273337
Title
Risk and benefit analysis of single-shot nerve block for postoperative
analgesia for uniportal video-assisted thoracic surgery (uVATS): a
randomized controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 68. Date
of Publication: 01 Dec 2025.
Author
Wang L.F.; Qi F.; Feng H.X.; Shi Y.H.; Li Y.; Zheng M.T.; Bu T.; Li W.X.;
Zhang Z.R.
Institution
(Wang, Zheng) Department of Anesthesiology, China-Japan Friendship
Hospital, Beijing, China
(Qi, Feng, Shi, Li, Li, Zhang) Department of Thoracic Surgery, China-Japan
Friendship Hospital, Beijing, China
(Bu) Department of Anesthesiology, Peking University First Hospital,
Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: There is lack of the clinical evidence of optimized
perioperative analgesic protocol for uniportal video-assisted
thoracoscopic surgery (uVATS). Method(s): We performed a RCT
enrolling participants scheduled for uVATS (Trial registration:
NCT06016777; registration date: Aug 28, 2023). Participants were
randomized for thoracic paravertebral block combined with
patient-controlled intravenous analgesia (PVB + PCIA), erector spinae
block combined with PCIA (ESPB + PCIA), or PCIA group. Participants were
followed-up till 6 months. Primary outcome was total opioid consumption.
Secondary outcomes included postoperative rest and cough pain scores,
ambulation time, chest tube duration, length of stay, anaesthesia expense
and adverse events. Result(s): We enrolled 108 participants between
October 16th, 2023 to April 14th, 2024. Neural block did not reduce opioid
consumption. Postoperative rest and cough pain scores did not differ among
the groups at all the follow-up time points. None of the participants
experienced chronic pain. The ambulation time, duration of chest tube
maintenance and length of stay did not differ among groups. Duration of
anaesthesia procedure was significantly prolonged in both neural blockade
groups compared to PCIA group (p = 0.033). Anaesthesia expenses were
significantly higher in both nerve block groups than in the PCIA group (p
< 0.001). Adverse events related to neural blockade occurred in 17.9% in
PVB + PCIA group and 2.9% in ESPB + PCIA group (p = 0.010), including
local haemorrhage and block failure. Adverse events related to opioid use
did not differ among groups. Conclusion(s): Both PVB and ESPB did not
exhibit analgesic advantage for uVATS. Neural block may carry the risk of
haemorrhage and block failure, prolonged the anaesthesia procedure and
increased the anaesthesia expenses. Trial registration: Clinical Trial
Number was NCT06016777, trial registration date was Aug 28th,
2023. Copyright © The Author(s) 2025.

<90>
Accession Number
2035694679
Title
Prevalence of Hearing Loss After Open-Heart Surgery: A Systematic Review.
Source
Brazilian Journal of Cardiovascular Surgery. 40(1) (no pagination), 2025.
Article Number: e20230197. Date of Publication: 2025.
Author
Emamzadehashemi K.R.; Paryad E.; Salari A.; Noveiri M.J.S.
Institution
(Emamzadehashemi) Department of Neurosurgery, Faculty of Medicine, Imam
Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran,
Islamic Republic of
(Paryad, Noveiri) Cardiovascular Diseases Research Center, Department of
Cardiology, Heshmat Hospital, Department of Nursing, School of Nursing and
Midwifery, Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Salari) Cardiovascular Diseases Research Center, Department of
Cardiology, Heshmat Hospital, School of Medicine, Guilan University of
Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Today, due to the increase in the incidence of heart
problems in people, we see an increase in the number of heart surgeries
worldwide. Hearing disorders in the form of hearing loss have been
reported as one of the side effects of this kind of surgery in some
studies. Considering the evidence of the effect of open-heart surgery on
patients' hearing loss, this systematic review study was conducted to
determine the frequency of hearing loss after open-heart surgery.
 Method(s): To carry out this systematic review, studies that
investigated hearing loss after open-heart surgery in Iran and the rest of
world, published in Persian or English, and various international
electronic databases including PubMed, Web of Science, Scopus, and
authentic Persian sources (e.g., Irandoc and Scientific Information
Database) until the end of 2021 have been indexed. Result(s): In the
initial review, 46 of the 2230 initially searched articles had the
conditions for further review. After checking the articles' title and
abstract and the working method of the studies and removing duplicates and
incomplete articles, a total of 16 articles were included in the study.
Then, their results were analyzed as the frequency of hearing loss after
open-heart surgery by age and sex. Conclusion(s): The review of
various studies confirms the fact that after open-heart surgery, the
existence of evidence of hearing changes is not far from
expected. Copyright © 2025, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<91>
Accession Number
646544807
Title
Early and late clinical outcomes and cost-effectiveness of aortic valve
replacement using the Inspiris Resilia bioprosthesis : A systematic review
and meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 117), 2025. Date of
Publication: 05 Feb 2025.
Author
Ahmed A.; Aziz T.A.A.; AlAsaad M.M.R.; Majthoob M.; Altahmody K.A.
Institution
(Ahmed) Cardiothoracic Surgery Department, Ain Shams University, Cairo,
Egypt
(Aziz, AlAsaad, Majthoob, Altahmody) Dubai Hospital, Dubai, United Arab
Emirates
(Altahmody) Cardiology Department, Tanta University, Egypt
Abstract
BACKGROUND: The present study aimed to critically revise the published
literature on clinical outcomes and cost-effectiveness of Inspiris Resilia
valve. METHOD(S): This work was conducted according to the Preferred
Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)
guidelines. Full text research articles discussing clinical or
cost-effectiveness aspects of Inspiris Resilia bioprosthesis published in
English were included in this analysis. Studies were excluded if they
weren't exclusively conducted on patients submitted to surgical aortic
valve replacement using the Inspiris Resilia bioprosthesis.
 RESULT(S): The technical success rate was almost perfect in all
studies. Reported complications included severe prosthesis-patient
mismatch, reoperation, endocarditis, and paravalvular leak. In almost all
studies, there were significant improvement of NYHA at the end of follow
up as compared to baseline. In all studies, there were significant
improvement of one or more hemodynamic parameters at the end of follow up
as compared to baseline. CONCLUSION(S): Surgical aortic valve
replacement using Inspiris Resilia tissue valve appears to be safe and
effective with low rate of aortic valve and systemic complications and
mortality. Its performance appears to be equal to or better than many
other bioprosthetic valves. As compared to mechanical valves, its use is
suggested to be more cost-effective. Copyright © 2024. The
Author(s).

<92>
Accession Number
2033318173
Title
Thymus transplantation for DiGeorge Syndrome: a systematic review.
Source
Pediatric Surgery International. 41(1) (no pagination), 2025. Article
Number: 82. Date of Publication: 01 Dec 2025.
Author
Ahmed H.S.; Dias A.F.; Pulkurthi S.R.
Institution
(Ahmed) Bangalore Medical College and Research Institute, K.R Road,
Karnataka, Bangalore, India
(Dias, Pulkurthi) M S Ramaiah Medical College, M S Ramaiah Nagar,
Karnataka, Bangalore, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: DiGeorge syndrome (DGS) is a condition typically associated
with athymia, parathyroid hypoplasia or aplasia, and congenital heart
defects. Athymia in these patients causes severe immunodeficiency, causing
high mortality and morbidity, often requiring thymic tissue
transplantation. The present systematic review aims to consolidate the
present evidence on thymus transplantation in DGS. Method(s): An
electronic literature search of five databases (PubMed, Medline, Scopus,
EBSCOhost, and CINAHL) was performed from inception till September 2024.
Relevant articles were selected, and data was extracted by two independent
reviewers. Result(s): A total of 16 articles were included from an
initial set of 1227 articles. Patients diagnosed with DGS in the included
studies were predominantly male, and the age at which thymus
transplantation was done typically varied from 0.8 to 26 months. Several
patients had chromosome 22q11 hemizygosity. Thymic tissue was taken from
tissues of pediatric patients undergoing cardiothoracic surgery.
Pre-transplant medication included immunosuppressants with rabbit
anti-thymocyte globulin (RATGAM) being frequently used alongside steroids
and tacrolimus. This tissue was cultured and transplanted into the
quadriceps muscle of the patients under general anesthesia. Thymopoiesis
was well described in most patients with graft failures and rejections
occurring rarely. Naive T-cell development was noted in almost all
patients with clearance of infections in many cases. Common postoperative
complications include sepsis, haemorrhage, gastrointestinal disturbances,
among others. Mortality was uncommon but often associated with
intracerebral hemorrhages and sepsis. Conclusion(s): Thymus
transplantation is a relatively safe and effective procedure in patients
with DGS with athymia. Future research should explore the addition of
allogenic parathyroid gland transplantation along with thymic
tissue. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<93>
Accession Number
646542234
Title
Transcatheter edge-to-edge mitral valve repair versus medical therapy for
secondary mitral regurgitation: a meta-analysis of randomized controlled
trials.
Source
Monaldi archives for chest disease = Archivio Monaldi per le malattie del
torace. (no pagination), 2025. Date of Publication: 06 Feb 2025.
Author
Mata E.; Lage Garcia B.; Tinoco M.; Castro M.; Pinheiro L.; Portugues J.;
Ferreira F.; Ribeiro S.; Melica B.; Lourenco A.
Institution
(Mata, Lage Garcia, Tinoco, Castro, Pinheiro, Portugues, Ferreira,
Ribeiro, Lourenco) Department of Cardiology, Local Health Unit of Alto
Ave, Guimaraes
(Melica) Department of Cardiology, Local Health Unit of Gaia and Espinho,
Vila Nova de Gaia, Portugal
Abstract
Secondary mitral regurgitation (SMR) is associated with increased
hospitalizations and mortality. Clinical trials comparing mitral valve
transcatheter edge-to-edge repair (M-TEER) with guideline-directed medical
therapy (GDMT) show conflicting results, but the RESHAPE-HF2 trial offers
new insights. This study aims to assess the M-TEER effect in addition to
GDMT in reducing all-cause mortality, cardiovascular death, and heart
failure hospitalizations (HHF) in patients with SMR when compared to GDMT
alone. On September 2, 2024, PubMed, Cochrane CENTRAL, Scopus, and Web of
Science were searched for randomized controlled trials comparing M-TEER in
addition to GDMT with GDMT in SMR patients with heart failure. A
study-level random-effects meta-analysis was conducted using
trial-reported point estimates. Seven records from three trials (COAPT,
MITRA-FR, RESHAPE-HF2) involving 1426 participants were included. At 24
months, M-TEER (using MitraClip) significantly reduced the first HHF
[hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.45-0.96] and all
HHF (HR 0.63, 95% CI 0.49-0.81). However, no significant reduction was
observed in all-cause mortality (HR 0.76, 95% CI 0.57-1.01) or
cardiovascular death (HR 0.77, 95% CI 0.56-1.06). The intervention group
had more patients in the New York Heart Association class I/II at 12 and
24 months but no significant improvement in 6-minute walk test performance
at 12 months. High trial heterogeneity requires careful interpretation of
pooled estimates. Differences in medical therapy and patient
characteristics likely affected outcomes across trials. While M-TEER
demonstrates benefits in reducing HHF, its effectiveness in reducing
mortality remains inconclusive. The degree of left ventricular enlargement
may have influenced outcomes, underscoring the importance of careful
patient selection.

<94>
Accession Number
2037534866
Title
Comparison of strategies for vascular ACCESS closure after Transcatheter
Aortic Valve Implantation: the ACCESS-TAVI randomized trial.
Source
European Heart Journal. 46(7) (pp 635-645), 2025. Date of Publication: 14
Feb 2025.
Author
Rheude T.; Ruge H.; Altaner N.; Pellegrini C.; Covarrubias H.A.; Mayr P.;
Cassese S.; Kufner S.; Taniguchi Y.; Thilo C.; Klos M.; Erlebach M.;
Schneider S.; Jurisic M.; Laugwitz K.-L.; Lange R.; Schunkert H.; Kastrati
A.; Krane M.; Xhepa E.; Joner M.
Institution
(Rheude, Altaner, Pellegrini, Covarrubias, Cassese, Kufner, Taniguchi,
Jurisic, Schunkert, Kastrati, Xhepa, Joner) Department of Cardiovascular
Diseases, German Heart Center Munich, Technical University Munich
University Hospital, Lazarettstrasse 36, Munich, Germany
(Ruge, Erlebach, Lange, Krane) Department of Cardiovascular Surgery,
Institute Insure, German Heart Center Munich, School of Medicine & Health,
Technical University of Munich, Lazarettstrasse 36, Munich, Germany
(Covarrubias) Hospital de Cardiologia, Centro Medico Nacional Siglo XXI,
IMSS, Ciudad de Mexico, Mexico
(Mayr) Institute of Anaesthesiology, German Heart Center Munich, Technical
University Munich University Hospital, Munich, Germany
(Kufner, Laugwitz, Schunkert, Kastrati, Krane, Joner) DZHK (German Center
for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich,
Germany
(Thilo) Department of Internal Medicine I, RoMed Klinikum Rosenheim,
Rosenheim, Germany
(Klos) Medicum Tegernsee, Rottach-Weissach, Germany
(Schneider) Department of Cardiology, Benedictus Krankenhaus Tutzing,
Tutzing, Germany
(Laugwitz) Department of Internal Medicine I, Technical University Munich
University Hospital, Munich, Germany
Publisher
Oxford University Press
Abstract
Background and Data from randomized trials investigating different access
closure strategies after transfemoral transcatheter aortic valve Aims
implantation (TF-TAVI) remain scarce. In this study, two vascular closure
device (VCD) strategies to achieve haemostasis after TF-TAVI were
compared. Methods The ACCESS-TAVI (Comparison of Strategies for Vascular
ACCESS Closure after Transcatheter Aortic Valve Implantation) is a
prospective, multicentre trial in which patients undergoing TF-TAVI were
randomly assigned to a strategy with a combined suture-/plug-based VCD
strategy (suture/plug group) using one ProGlideTM/ProStyleTM (Abbott
Vascular) and one Angio-Seal (Terumo) vs. a suture-based VCD strategy
(suture-only group) using two ProGlidesTM/ProStylesTM. The primary
endpoint was a composite of major or minor access site-related vascular
complications during index hospitalization according to Valve Academic
Research Consortium 3 criteria. Key secondary endpoints included time to
haemostasis, bleeding type >= 2, and all-cause mortality over 30 days.
Results Between September 2022 and April 2024, 454 patients were
randomized. The primary endpoint occurred in 27% (62/230) in the
suture/plug group and 54% (121/224) in the suture-only group [relative
risk .55 (95% confidence interval: .44, .68); P < .001]. Time to
haemostasis was significantly shorter in the suture/plug group compared
with the suture-only group (108 +/- 208 s vs. 206 +/- 171 s; P < .001). At
30 days, bleeding type >= 2 occurred less often in the suture/plug group
compared with the suture-only group [6.2% vs. 12.1%, relative risk .66
(.43, 1.02); P = .032], with no significant difference in mortality.
Conclusions With regard to the composite of major or minor access
site-related vascular complications, a combined suture-/plug-based VCD
strategy was superior to a suture-based VCD strategy for vascular access
closure in patients undergoing TF-TAVI. Copyright © The Author(s)
2024. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved.

<95>
Accession Number
2033531734
Title
Frailty Response in Patients With Aortic Stenosis Undergoing Transcatheter
Aortic Valve Implantation: Protocol for a Pilot, Cluster Randomised
Controlled Trial (FRAIL-AS Response Trial).
Source
Heart Lung and Circulation. Conference: 72nd Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Perth Convention and
Exhibition Centre, Perth Australia. 33(Supplement 4) (pp S353-S354), 2024.
Date of Publication: 01 Aug 2024.
Author
Straiton N.; Muller D.; McDonald P.; Arriagada A.; Roy D.; Mills N.;
Middleton S.
Institution
(Straiton, Middleton) Australian Catholic University, Sydney, NSW,
Australia
(Straiton, Middleton) Nursing Research Institute, St Vincent's Health
Network Sydney, Australian Catholic University, NSW, Australia
(Muller, McDonald, Roy, Mills) St Vincent's Public Hospital, Sydney, NSW,
Australia
(Muller, McDonald, Arriagada, Roy, Mills) St Vincent's Private Hospital,
Sydney, NSW, Australia
(Muller, McDonald) University of New South Wales, Sydney, NSW, Australia
(McDonald) Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Three in ten severe aortic stenosis patients undergoing
transcatheter aortic valve implantation (TAVI) are frail. Frailty
correlates with adverse post-procedure patient outcomes, such as higher
1-year mortality, increased adverse events, prolonged hospital stays, and
diminished quality of life. Despite the urgency for evidence-based frailty
management in this population, research in this area is limited.
 Method(s): A pilot, cluster randomised controlled trial to assess the
feasibility of implementing a Frailty Response Program intervention in 10
hospital TAVI programs for frail patients with aortic stenosis undergoing
valve replacement. The intervention includes an implementation strategy
and a Frailty Response Clinical Protocol, focused on malnutrition
identification, patient education, general practitioner notification,
comprehensive geriatric assessment, and cardiac rehabilitation. Eligible
hospitals will be randomised (1:1) to either the intervention or control
(standard care). Primary Outcome: proportion of patients receiving
nutritional assessment upon frailty identification. Secondary outcomes
include mortality, clinical complications, hospital admissions, frailty
improvement, quality of life, and evidence-based frailty management.
Implementation outcomes will be evaluated through a process assessment.
 Discussion(s): The trial aims to bridge the gap between the
recognition of frailty in patients with aortic stenosis undergoing TAVI
and the implementation of evidence-based frailty management practices to
improve patient outcomes and care quality. Funding acknowledgement: An
early-mid career researcher grant received under the NSW Cardiovascular
Research Capacity Program will support the conduct of this
research. Copyright © 2024

<96>
Accession Number
646546223
Title
Clinical applications of metabolomics.
Source
European Journal of Clinical and Experimental Medicine. Conference:
Rzeszow International Medical Students Association Congress, RIMSA 2023.
Rzeszow Poland. 2023(Supplement) (pp 119), 2023. Date of Publication:
2023.
Author
Burbelka A.
Institution
(Burbelka) Institute of Medical Sciences, Medical Collage of Rzeszow
University, University of Rzeszow, Poland
Publisher
Publishing Office of the University of Rzeszow
Abstract
Introduction and aim. One of the most dynamically developing scientific
field is the detection of physicochemical properties of metabolites of the
human body. Researchers currently focus on metabolome analysis due to the
possibility of targeted therapies for various conditions where changes in
metabolism concern not only the levels of single metabolites but
quantitative relationships between the levels of small molecule compounds
making up a whole metabolic profile. The aim of this research was to
summarize the latest findings in the field of metabolomics and its
applications in clinical medicine. Material and methods. The review was
performed according to the up to date literature. Thorough analysis of the
scientific data from PubMed database has been conducted. Analysis of
literature. One groundbreaking study determined the metabolic profile of
patients qualified for transcatheter aortic valve implantation (TAVI).
Acute kidney injury (AKI) is a fairly common complication after TAVI and
is associated with a significant increase in mortality. It has been proved
that in an elderly population undergoing TAVI, metabolite profiling
improves the prediction of AKI and may allow for its prevention by
physicians. Metabolomics has also allowed for early detection of
biochemical changes associated with the risk of type 2 diabetes. Amino
acids such as isoleucine, leucine and valine turned out to be predictive
markers of this condition. In multiple myeloma (MM), metabolomics is used
to detect biomarkers that confirm the presence of MM and to assess disease
progression. Carnitine and acetylcarnitine seem to be significant
biomarkers - their concentration in the blood correlates with the stage of
neoplastic disease. Increase in carnitine concentration can lead to
increase in lipid oxidation in particularly metabolically active myeloma
cells. This finding led to the insight that people suffering MM should
avoid carnitine supplementation (dairy products, meat). It has been
suggested that research into metabolism may also extend human life. So
far, specific lipid compounds such as phosphatidylcholine and
sphingomyelin have been identified as novel biomarkers of longevity.
Conclusion. Metabolomics is an important tool which may provide valuable
data used in diagnosis and monitoring of therapy in nearly every field of
medicine. However, due to the complexity of human metabolism further
studies and research are necessary.

<97>
Accession Number
2037568104
Title
Treatment Selection for the High-Risk Patient with Stage I Non-Small Cell
Lung Cancer: Sublobar Resection, Stereotactic Ablative Radiotherapy or
Image-Guided Thermal Ablation? The American Association for Thoracic
Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Pennathur A.; Lanuti M.; Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.;
Suh R.D.; Mak R.H.; Brunelli A.; Criner G.J.; Mazzone P.J.; Walsh G.;
Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Pettiford B.;
Rocco G.; Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.;
Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Wafford) The American Association for Thoracic Surgery, Beverly,
Massachusetts, United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, Florida, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Keshavarz) Department of Family Medicine, McMaster University, ON, Canada
Publisher
W.B. Saunders
Abstract
A significant proportion of patients with stage I non-small cell lung
cancer (NSCLC) are considered at high risk for complications or mortality
after lobectomy. The American Association for Thoracic Surgery (AATS)
previously published an expert consensus document detailing important
considerations in determining who is at high risk. The current objective
was to evaluate treatment options and important factors to consider during
treatment selection for these high-risk patients. After systematic review
of the literature, treatment options for high-risk patients with stage I
NSCLC were reviewed by an AATS expert panel. Expert consensus statements
and vignettes pertaining to treatment selection were then developed using
discussion and a modified Delphi method. The expert panel identified
sublobar resection, stereotactic ablative radiotherapy (SABR), and
image-guided thermal ablation (IGTA) as modalities applicable in the
treatment of high-risk patients with stage I NSCLC. The panel also
identified lung-nodule-related factors that are important to consider in
treatment selection. Using this information, the panel formulated 14
consensus statements and 5 vignettes illustrating clinical scenarios. This
article summarizes important factors to consider in treatment selection
using these modalities, which are applicable in high-risk patients with
stage I NSCLC. The choice of which modality (sublobar resection, SABR, or
IGTA) is optimal in high-risk patients with stage I NSCLC is complex, but
a surgical approach is generally favored when deemed safe. SABR and IGTA
are reasonable options in select patients. SABR is more commonly used than
IGTA and is likely the next-best choice. A multi-disciplinary review of
patient and tumor characteristics is essential for achieving an optimal
decision. The clinical treatment decision should also take patient
perspectives, preferences, and quality of life into
consideration. Copyright © 2025 Elsevier Inc.

<98>
Accession Number
2037568062
Title
Systematic Review of Sublobar Resection for Treatment of High-Risk
Patients with Stage I Non-Small Cell Lung Cancer: The American Association
for Thoracic Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Merritt R.E.; Brunelli A.; Walsh G.; Murthy S.; Schuchert M.J.; Varghese
T.K.; Lanuti M.; Wolf A.; Keshavarz H.; Loo B.W.; Suh R.D.; Mak R.H.;
Criner G.J.; Mazzone P.J.; Liptay M.; Wafford Q.E.; Marshall M.B.; Tong
B.; Pettiford B.; Rocco G.; Luketich J.; D'Amico T.A.; Swanson S.J.;
Pennathur A.
Institution
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Schuchert, Luketich, Pennathur) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Keshavarz) Department of Family Medicine, McMaster University, Ontario,
Canada
(Loo) Department of Radiation Oncology and Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Wafford) The American Association for Thoracic Surgery, Beverly,
Massachusetts, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
Publisher
W.B. Saunders
Abstract
Sublobar resection offers a parenchymal-sparing surgical alternative to
lobectomy and includes wedge resection and segmentectomy. Sublobar
resection has been historically utilized in high-risk patients with
compromised lung function; however, the technique is becoming more
prevalent for normal-risk patients with peripheral stage IA non-small cell
lung cancer (NSCLC) <2 cm. In this article, we summarize the technique of
sublobar resection, the importance of surgical margins and lymph node
sampling, patient selection, perioperative complications, outcomes, and
the impact of sublobar resection on the quality of life. There is limited
data on short-term and long-term outcomes after sublobar resection for
stage I NSCLC in high-risk patients. Results from randomized clinical
trials (RCTs) of sublobar resection have been variable. We have summarized
the results of the ACOSOG Z4032 RCT, which compared outcomes in high-risk
patients who underwent sublobar resection alone versus sublobar resection
with brachytherapy for stage I NSCLC. In addition, we have summarized
recent findings of the CALGB/Alliance 140503 RCT comparing sublobar
resection and lobectomy, which suggested that disease-free survival after
sublobar resection in patients with small (<2 cm) peripheral stage IA
NSCLC was non-inferior to lobectomy, and another RCT (JCOG 0802) of
segmentectomy vs. lobectomy for small peripheral clinical stage IA NSCLC,
where segmentectomy was associated with better overall survival despite a
higher local recurrence rate. Sublobar resection is primarily performed
with minimally invasive approaches, including robotic-assisted and
video-assisted thoracoscopic techniques. From an oncologic perspective,
obtaining adequate surgical margins and performing an adequate lymph node
evaluation are critical for good outcomes after sublobar
resection. Copyright © 2025

<99>
Accession Number
2037568628
Title
Systematic Review of Image-Guided Thermal Ablation for Treatment of
High-Risk Patients with Stage I Non-Small Cell Lung Cancer: The American
Association for Thoracic Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Lanuti M.; Suh R.D.; Criner G.J.; Mazzone P.J.; Marshall M.B.; Tong B.;
Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.; Mak R.H.; Brunelli A.;
Walsh G.; Liptay M.; Wafford Q.E.; Murthy S.; Pettiford B.; Rocco G.;
Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.; Swanson S.J.;
Pennathur A.
Institution
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Wafford) The American Association for Thoracic Surgery, Beverly,
Massachusetts, United States
(Loo) Department of Radiation Oncology and Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(Luketich, Schuchert, Pennathur) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
(Keshavarz) Department of Family Medicine, McMaster University, ON, Canada
Publisher
W.B. Saunders
Abstract
Image-guided thermal ablation (IGTA) applied to pulmonary pathology is an
alternative to surgery in high-risk patients with stage I non-small cell
lung cancer (NSCLC). Its application to lung neoplasm was first introduced
in 2001 and has been implemented to treat metastatic disease to the lung
or in select medically inoperable patients with peripheral stage I NSCLC.
IGTA may also be an alternative to treat stage I NSCLC in non-operable
patients with interstitial lung disease in whom a radiation modality is
deemed too high risk. There are 3 methods of delivery: radiofrequency
ablation (RFA), microwave ablation and cryoablation. Observational series
and some prospective trials have shown safety and efficacy across all
three modalities. Despite accumulating experience, there are no large
randomized clinical trials comparing the outcomes of lung IGTA to
alternative locoregional therapies (eg, stereotactic body radiotherapy or
sublobar pulmonary resection) for the treatment of stage I NSCLC. Because
IGTA is a local therapy, a higher risk of locoregional recurrence is
inherently understood as compared with anatomic resection. In the
literature, primary tumor control after RFA ranges from 47 to 90% and is
dependent on tumor size and proximity to bronchovascular structures. Local
failure ranges from 10 to 47%, and tumors >=3 cm have the highest rate of
local recurrence. The most prevalent side effects are pneumothorax and
reactive pleural effusion; hemorrhage is uncommon. Of note, observational
series show no significant loss of lung function after IGTA. This expert
review contextualizes limitations, complications and outcomes of IGTA in
patients with stage I NSCLC. Copyright © 2025

<100>
Accession Number
2037571983
Title
Effect of geriatric care on health outcomes in older patients with cardiac
disease: A systematic review.
Source
Archives of Gerontology and Geriatrics. 132 (no pagination), 2025. Article
Number: 105786. Date of Publication: 01 May 2025.
Author
Raijmann R.C.M.A.; van Dalen T.N.; Koek H.L.; van der Meer M.G.;
Emmelot-Vonk M.H.; Keijsers C.J.P.W.
Institution
(Raijmann, Koek, Emmelot-Vonk) Department of Geriatrics, University
Medical Center Utrecht, Utrecht, Netherlands
(Raijmann, van Dalen, Keijsers) Department of Geriatrics, Jeroen Bosch
Hospital, 's-Hertogenbosch, Netherlands
(van der Meer) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: As patients with cardiac disease age and become frail, their
care needs become more complex. Therefore geriatric care might benefit
these patients. This review summarizes current research investigating the
impact of geriatric care on clinical outcomes in older cardiac patients.
 Method(s): The MEDLINE, Embase, and Cochrane databases were searched
on 11 May 2023 for randomized controlled trials (RCTs) and observational
studies comparing additional geriatric care to usual care in older (+70)
cardiac patients. The Cochrane risk of bias tool and Robbins-E tool were
used for quality assessment of RCTs and observational studies
respectively. Data on mortality rates, readmissions, length of stay,
complications, discharge destinations, functional outcomes, and quality of
life (QoL) were extracted. Two authors independently selected studies,
extracted data and assess study quality. Result(s): Twelve articles
involving 3531 patients (average age 73-85 years; 44-59 % male) were
identified, mainly focussing on heart failure or patients requiring
cardiothoracic surgery. The studies had a moderate to high risk of bias.
Two out of three studies (n = 771) showed reduced complication rates (e.g.
delirium incidence) when comparing geriatric assessment to usual care.
Additionally, two out of three studies (n = 449), indicated improved QoL
scores for patients who received a geriatric care. No significant effects
were found for other outcomes. Conclusion(s): Low-quality evidence
suggests that geriatric care may be associated with lower complication
rates and an improved quality of life in older cardiac patients. However,
more research is needed to clarify the effect of a geriatric care in this
patient population. Registration: The study protocol was registered in the
international prospective register of systematic reviews (PROSPERO 2022
CRD42022337353) Copyright © 2025

<101>
Accession Number
2037585281
Title
Long-Term Outcomes of Transcatheter vs Surgical Aortic Valve Replacement
for Lower-Risk Patients: Are We There Yet?.
Source
Journal of the American College of Cardiology. 85(9) (pp 941-943), 2025.
Date of Publication: 11 Mar 2025.
Author
Wallach J.D.; Cohen D.J.
Institution
(Wallach) Department of Epidemiology, Rollins School of Public Health,
Emory University, Atlanta, GA, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
Publisher
Elsevier Inc.

<102>
Accession Number
646523146
Title
The Prevention and Treatment of Postoperative Delirium in the Elderly: A
Narrative Systematic Review of Reviews.
Source
Journal of patient safety. (no pagination), 2025. Date of Publication: 29
Jan 2025.
Author
Deblois S.; Bergeron N.; Vu T.T.M.; Paquin-Lanthier G.; Nauche B.; Pomp A.
Institution
(Deblois, Pomp) Health Technology Assessment Unit, Centre hospitalier de
l'Universite de Montreal (CHUM)
(Bergeron) Departments of Psychiatry and Addictology
(Vu) Medicine
(Paquin-Lanthier) Anesthesiology and Pain Medicine, Faculty of Medicine,
Universite de Montreal
(Nauche) Centre hospitalier de l'Universite de Montreal (CHUM)
(Pomp) Department of Surgery, Faculty of Medicine, Universite de Montreal,
Montreal, QC, Canada
Abstract
OBJECTIVES: Postoperative delirium (POD) is a common complication after
major surgeries, posing significant challenges to patient recovery and
outcomes, particularly among the elderly. A narrative systematic review
was conducted to assess the clinical effectiveness and safety of
interventions aimed at preventing and treating POD. METHOD(S): A
review of the literature from 2017 to September 29, 2023, was conducted
using MEDLINE, EMBASE, and CINAHL. Systematic reviews, with or without
meta-analyses, as well as practice guidelines, were included. Participants
were adults, >=60 years. The methodological quality of included reviews
was appraised using AMSTAR 2. RESULT(S): After the search strategy
identified 2295 references, 36 review studies were selected.
Multicomponent interventions, incorporating both pharmacological and
nonpharmacological approaches, demonstrate promise, particularly in hip
fracture patients. Notably, dexmedetomidine emerges as a potential
preventive measure, showing a notable reduction in delirium incidence
following cardiac surgery. While several pharmacological interventions
show potential, evidence remains inconclusive, necessitating further
investigation. Similarly, varying anesthesia type and monitoring methods
has mixed outcomes on delirium prevention. Despite methodological
variations and quality appraisal limitations, this review underscores the
importance of multicomponent interventions and the potential efficacy of
dexmedetomidine in mitigating POD. Integration of evidence-based protocols
into clinical practice is advocated to improve patient outcomes. However,
the complex interplay between intervention components calls for further
research to optimize delirium management strategies. CONCLUSION(S):
The strength of evidence associated with multicomponent interventions and
dexmedetomidine use should require a genuine commitment from health care
institutions to support their integration into efficient strategies to
prevent and treat POD. Ongoing research is vital to uncover their full
potential and refine clinical protocols, ultimately enhancing patient care
outcomes. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<103>
Accession Number
2033382376
Title
Perioperative Mechanical Circulatory Support for Cardiac Assistance in
Thoracic Surgery: A Scoping Review.
Source
Artificial Organs. (no pagination), 2025. Date of Publication: 2025.
Author
Agosta V.T.; D'Andria Ursoleo J.; Bottussi A.; Bugo S.; Monaco F.
Institution
(Agosta, D'Andria Ursoleo, Bottussi, Bugo, Monaco) Department of
Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients with pre-existing severe cardiovascular comorbidities
are often deemed ineligible for potentially life-saving thoracic surgeries
and are referred to other conservative therapies. However, this patient
population may theoretically benefit from the timely perioperative
implantation of temporary mechanical circulation support (tMCS) to both
mitigate the surgical stress and stabilize hemodynamics. We performed a
scoping review to summarize the evidence regarding the use of tMCS in
thoracic surgery. Method(s): We conducted a systematic search across
PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials,
Web of Science, Scopus, and Google Scholar from their inception, aided by
a search string encompassing a combination of terms for the key research
concepts: i) tMCS devices; ii) thoracic surgery procedures (except lung
transplantation); and iii) the adult population. Result(s): Fifteen
studies pertinent to the research question, which summarized data from 28
patients, were retrieved for inclusion. In 14 patients, tMCS implantation
occurred as a "pre-emptive" strategy, while the remaining patients had
tMCS implanted either intra and/or postoperatively as a "bail-out"
strategy. Specifically, 14 patients required an intra-aortic balloon pump,
10 veno-arterial extracorporeal membrane oxygenation, two required a
multidevice strategy, and one cardiopulmonary bypass. The relative risk
analysis revealed that the mortality rate in the pre-emptive group was
half that of the bail-out group. Additionally, the risk of both infectious
and vascular complications was lower in the pre-emptive group compared to
the bail-out tMCS strategy. Conclusion(s): We found that the timely
implantation of tMCS in thoracic surgery-either to mitigate patients'
heightened cardiovascular risk or as a rescue strategy in the event of
life-threatening surgical complications-may lead to better patient
outcomes, as well as allowing them to undergo curative surgery with an
acceptable safety profile, characterized by overall good survival rates
and a low incidence of device-related complications. Copyright ©
2025 The Author(s). Artificial Organs published by International Center
for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals
LLC.

<104>
Accession Number
2037453363
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium: A Cluster Randomized Crossover Trial.
Source
JAMA Surgery. (no pagination), 2025. Date of Publication: 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, ON, Canada
(Spence) Department of Anesthesia and Critical Care, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Lee, Whitlock, Oczkowski, Belley-Cote) Department of
Health Research Methods, Evidence, and Impact, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Whitlock, McIntyre, Lamy, Belley-Cote) World Health
Research Trust, Hamilton, ON, Canada
(Devereaux, McIntyre, Lamy) Department of Medicine, Cardiology, McMaster
University, Hamilton, ON, Canada
(D'Aragon) Departement d'Anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University, St Louis School
of Medicine, St Louis, MO, United States
(Whitlock) Department of Surgery, Cardiac Surgery, McMaster University,
Hamilton, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Departments of Anesthesiology and Pain Medicine, Physiology, and
Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'Anesthesie, Institut de
Cardiologie de Montreal, Universite de Montreal, Montreal, QC, Canada
(Rajamohan) Department of Anesthesia, St Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, 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, QC, Canada
(Mustard) St Michael's Hospital, Toronto, ON, Canada
(Couture) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Universite Laval, Quebec, QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Law) Department of Anesthesiology, Royal Columbian Hospital, 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, ON, 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, ON, Canada
(Lamy, Belley-Cote) Department of Medicine, Cardiology and Critical Care,
McMaster University, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine, Critical Care, University of Manitoba, Manitoba, Winnipeg,
Canada
Publisher
American Medical Association
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, 19768
patients (mean [SD] age, 65 [12] years; 14528 [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. Copyright © 2025 American
Medical Association. All rights reserved.

<105>
Accession Number
2033337287
Title
Pericardiocentesis Versus Surgical Pericardiotomy for Malignant
Pericardial Effusion: A Systematic Review and Meta-Analysis.
Source
Indian Journal of Surgical Oncology. (no pagination), 2025. Date of
Publication: 2025.
Author
da Nobrega Oliveira R.E.N.; de Andrade Pontual Peres C.; Oliveira A.C.;
Onyeji P.; Kemczenski F.
Institution
(da Nobrega Oliveira) Departament of Thoracic Surgery, Barretos Cancer
Hospital, Street Antenor Duarte Vilela, 1331 - Dr. Paulo Prata, SP,
Barretos, Brazil
(de Andrade Pontual Peres) University of Pernambuco, Recife, Brazil
(Oliveira) Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
(Onyeji) All Saints University, Goodwill, Dominica
(Kemczenski) University of Joinville'S Region, Joinville, Brazil
Publisher
Springer
Abstract
To compare the effectiveness and safety of pericardiocentesis versus
surgical pericardiotomy in managing malignant pericardial effusion (MPE).
We searched PubMed, Embase, and Cochrane databases for studies comparing
pericardiocentesis with surgical pericardial window in patients with MPE.
We computed mean differences (MDs) for continuous endpoints and odds
ratios (ORs) for binary outcomes, with 95% confidence intervals (CIs).
Trial registry: International Prospective Register of Systematic Reviews;
N: CRD42024572468. A total of 12 studies comprising 3,721 patients were
included in this meta-analysis. There was a significant increase in
re-accumulation of pericardial effusion in patients undergoing
pericardiocentesis (OR 3.81; 95% CI 1.99-7.31). However, there were no
significant difference between groups for in-hospital mortality (OR 0.99;
95% CI 0.68-1.46), bleeding (OR 0.05; 95% CI 0.00-2.18), atrial
fibrillation (OR 0.50; 95% CI 0.05-5.12), paradoxical hemodynamic
instability (OR 0.67; 95% CI 0.32-1.38), and length of stay (MD -0.93; 95%
CI -6.17, 4.31). Significant heterogeneity was observed in the length of
hospital stay outcome (I2 = 79%). Additionally, the included
studies had a moderate risk of bias. Pericardiocentesis was associated
with an increase in re-accumulation of pericardial effusion compared with
surgical pericardial window in patients with MPE. However, there was no
significant difference between groups for in-hospital mortality, bleeding,
atrial fibrillation, paradoxical hemodynamic instability, and length of
stay. Copyright © The Author(s), under exclusive licence to
Indian Association of Surgical Oncology 2025.

<106>
Accession Number
2037541325
Title
Monitoring Hemostatic Function during Cardiac Surgery with Point-of-Care
Viscoelastic Assays: A Narrative Review.
Source
Seminars in Thrombosis and Hemostasis. (no pagination), 2025. Date of
Publication: 2025.
Author
Ong B.J.A.; See Tow H.X.; Fong A.T.W.; Ling R.R.; Shekar K.; Teoh K.; Ti
L.K.; Maclaren G.; Fan B.E.; Ramanathan K.
Institution
(Ong, See Tow, Fong, Ling, Teoh, Ti, Maclaren, Fan, Ramanathan) Yong Loo
Lin School of Medicine, National University of Singapore, National
University Health System, Singapore, Singapore
(Ling) Australia and New Zealand Intensive Care Research Centre, School of
Preventive Medicine and Public Health, Monash University, Melbourne, VIC,
Australia
(Ling, Ti) Department of Anaesthesia, National University Hospital,
National University Health System, Singapore, Singapore
(Shekar) Intensive Care Unit, Caboolture Hospital, Brisbane, QLD,
Australia
(Shekar) Adult Intensive Care Services, The Prince Charles Hospital,
Brisbane, QLD, Australia
(Shekar) Faculty of Health Sciences & Medicine, Bond University, Gold
Coast, QLD, Australia
(Shekar) Faculty of Health, Queensland University of Technology,
University of Queensland, Brisbane, QLD, Australia
(Teoh) Faculty of Medicine, University of Queensland, Brisbane, QLD,
Australia
(Teoh) Division of Adult Cardiac Surgery, Department of Cardiac, Thoracic
and Vascular Surgery, National University Heart Centre, National
University Health System, Singapore, Singapore
(Maclaren, Ramanathan) Cardiothoracic Intensive Care Unit, Department of
Cardiac, Thoracic and Vascular Surgery, National University Heart Centre,
National University Health System, Singapore, Singapore
(Fan) Lee Kong Chian School of Medicine, Nanyang Technological University,
Singapore, Singapore
(Fan) Department of Hematology, Tan Tock Seng Hospital, Singapore,
Singapore
Publisher
Thieme Medical Publishers, Inc.
Abstract
Bleeding is a well-known and severe complication of cardiac surgery.
Cardiopulmonary bypass, along with heparinization and hemodilution, is
thought to affect all pathways of the hemostatic process, leading to
excessive bleeding and worsened morbidity and mortality. The traditionally
used standard laboratory tests (SLTs) were not designed for the surgical
setting, have long turnaround times, and are poor predictors of bleeding.
This review aims to give an overview of viscoelastic assays (VEAs),
compare VEAs to conventional testing methods, and summarize the evidence
for VEAs in cardiac surgery. A search of Medline via Pubmed, Scopus, and
Embase yielded 2,868 papers, which we reviewed and summarized the key
findings. VEAs such as rotational thromboelastometry and
thromboelastography provide a quick turnaround, graphical, global
impression of hemostasis in whole blood. VEAs allow for the analysis of
specific contributors to the coagulation process and may facilitate
cause-oriented hemostatic treatment and the development of treatment
algorithms. VEAs have been found to have a high specificity and high
negative predictive value for coagulopathic bleeding. Patients treated
with VEA-based algorithms have been shown to have lower rates of bleeding,
transfusion requirements, and exposure to allogeneic blood products.
However, VEA-based algorithms have not demonstrated a mortality benefit
and evidence for outcomes such as surgical re-exploration and hospital
length of stay remains equivocal. In conclusion, VEAs have been shown to
be comparable if not superior to SLTs in cardiac surgery. Further
large-scale studies are needed to better evaluate the impact of VEAs on
clinical outcomes. Copyright © 2025. Thieme. All rights reserved.

<107>
Accession Number
646522273
Title
Valve Thrombosis and Antithrombotic Therapy After Bioprosthetic Mitral
Valve Replacement: A Systematic Review And Meta-Analysis.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2025. Date of Publication: 04 Feb 2025.
Author
Zorman M.J.; Vibhishanan J.; Dangas K.; Castle J.; Li K.H.C.; Coronelli
M.; Eastwick-Jones K.; Swan A.; Johnson N.; Choksey A.; Yan H.; Scott
S.G.C.; Henry M.; Cassar M.P.; Barnes C.; Ferreira-Martins J.; Newton J.;
Dawkins S.; Alkhouli M.; Rihal C.; Eleid M.F.; Pislaru S.V.; Guerrero
M.E.; Ordonez-Mena J.; Cahill T.J.
Institution
(Zorman, Vibhishanan, Dangas, Castle, Li, Coronelli, Eastwick-Jones, Swan,
Johnson, Choksey, Yan, Scott, Cassar, Barnes, Ferreira-Martins, Newton,
Dawkins, Cahill) Oxford Heart Centre, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Zorman, Alkhouli, Rihal, Eleid, Pislaru, Guerrero) Department of
Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
(Henry) Bodleian Health Care Libraries, University of Oxford, Oxford,
United Kingdom
(Ordonez-Mena) Nuffield Department of Primary Care Health Sciences,
University of Oxford, Oxford, United Kingdom
Abstract
AIMS: Transcatheter mitral valve replacement (TMVR) has become a feasible
alternative to surgical mitral valve replacement (SMVR) in selected
patients at high surgical risk. The risk of valve thrombosis following
SMVR and TMVR, and the optimal antithrombotic therapy following these
procedures, remains uncertain. We aimed to compare the incidence of
bioprosthetic mitral valve thrombosis (bMVT) after SMVR and TMVR, and the
incidence of bMVT between patients on different antithrombotic regimens.
METHODS AND RESULTS: A literature search of Medline, Embase and Cochrane
Library was performed between January 2000 and August 2024. Random-effects
models were used to derive pooled estimates of the incidence of bMVT in
the absence of prior or active endocarditis and valve thrombosis. 47
studies (6170 patients, total follow-up 9541.8 patient-years) were
eligible for inclusion. The overall incidence of bMVT was 5.05 (95%CI
3.18-8.01, I2 = 82%) per 100-patient-years. Subclinical bMVT was more
common than clinically significant bMVT: incidence 19.11 vs 7.91 per
100-patient-years, adjusted incidence rate ratio (aIRR) 4.62 (95%CI
1.39-15.36), p = 0.012. bMVT was numerically more common after TMVR than
SMVR, but the comparison was not statistically significant: incidence 7.03
vs 0.58 per 100-patient-years, aIRR 2.19 (95%CI 0.72-6.72), p = 0.170.
Patients on vitamin-K antagonists (VKA) had a lower incidence of bMVT than
patients on direct oral anticoagulants (DOAC; incidence 5.72 vs 17.08,
aIRR 0.31, 95%CI 0.13-0.73, p = 0.007). CONCLUSION(S): bMVT is not
uncommon, with numerically higher incidence in transcatheter compared to
surgical valves, but the comparison was not statistically significant.
VKAs are associated with a lower incidence of bMVT compared to
DOACs. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<108>
Accession Number
2037523460
Title
Alterations in the intestinal microbiome and immune dysregulation in
infants with CHD undergoing cardiopulmonary bypass: A scoping review.
Source
Cardiology in the Young. (no pagination), 2025. Date of Publication:
2025.
Author
Prout A.J.; Meert K.L.; Al-Ahmadi M.; Dickson R.P.
Institution
(Prout, Meert) Department of Pediatrics, Central Michigan University,
College of Medicine, Mt. Pleasant, MI, United States
(Prout, Meert) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Children's Hospital of Michigan, Detroit, MI, United States
(Al-Ahmadi) Division of Pediatric Cardiovascular Surgery, Department of
Surgery, Children's Hospital of Michigan, Detroit, MI, United States
(Dickson) Division of Pulmonary and Critical Care Medicine, Department of
Internal Medicine, University of Michigan Medical School, Ann Arbor, MI,
United States
(Dickson) Department of Microbiology and Immunology, University of
Michigan Medical School, Ann Arbor, MI, United States
(Dickson) Weil Institute for Critical Care Research & Innovation, Ann
Arbor, MI, United States
Publisher
Cambridge University Press
Abstract
Background: Infants who require cardiopulmonary bypass for surgical repair
of CHD are at high risk for secondary infections, which cause significant
death and disability. The risk of secondary infection is increased by
immune dysfunction. The intestinal microbiome calibrates immune function.
Infants with CHD have substantial changes in their intestinal microbiome.
We performed this scoping review to describe the current understanding of
the relationship between the intestinal microbiome and immune function
after pediatric cardiac surgery with cardiopulmonary bypass.
 Method(s): We searched the PubMed, Cumulative Index to Nursing and
Allied Health Literature, Cochrane, and Scopus databases with the
assistance of a medical librarian. We included trials that analysed
intestinal microbiome composition and immune function after cardiac
surgery with cardiopulmonary bypass in infants. Result(s): We found
two observational cohorts and two interventional trials describing
composition of intestinal microbiome and some measures of immune function
after heart surgery with cardiopulmonary bypass in infants. A total of 114
children were analysed. Three trials were exclusively in infants, and one
was in older children and infants. All trials found a differential
composition of the intestinal microbiome in infants with CHD compared to
those without CHD, and one described a robust correlation between
composition of the intestinal microbiome with cytokine profile and adverse
outcomes. Conclusion(s): Despite robust preclinical data and data
from other disease states, there is minimal data about the correlation
between immune function and intestinal microbiome composition in infants
with CHD after cardiopulmonary bypass. Copyright © The Author(s),
2025. Published by Cambridge University Press.

<109>
Accession Number
2033132097
Title
Correction to: Using artificial intelligence to predict post-operative
outcomes in congenital heart surgeries: a systematic review (BMC
Cardiovascular Disorders, (2024), 24, 1, (718),
10.1186/s12872-024-04336-6).
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
14. Date of Publication: 01 Dec 2025.
Author
Mohammadi I.; Firouzabadi S.R.; Hosseinpour M.; Akhlaghpasand M.;
Hajikarimloo B.; Zeraatian-Nejad S.; Sardari Nia P.
Institution
(Mohammadi, Firouzabadi, Hosseinpour, Akhlaghpasand, Hajikarimloo,
Zeraatian-Nejad) Cardiovascular Surgery Research and Development
Committee, Iran University of Medical Sciences (IUMS), PO box 14665-354,
Tehran, Iran, Islamic Republic of
(Firouzabadi) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Teheran, Iran, Islamic Republic
of
(Akhlaghpasand, Zeraatian-Nejad) Department of Surgery, Surgery Research
Center, School of Medicine, Rasool-E Akram Hospital, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Sardari Nia) Department of Cardiothoracic Surgery, Maastrich University
Medical Centre, Maastricht, Netherlands
(Sardari Nia) Foundation Heart Team Academy, Maastricht, Netherlands
Publisher
BioMed Central Ltd
Abstract
The original publication of this article [1] contained an incorrect author
name Shahryar Rajai Firouzabadi. The incorrect and correct information is
listed in this correction article, the original article has been updated.
Incorrect author name: Sharyar Rajai Firouzabadi Corrected author name:
Shahryar Rajai Firouzabadi Copyright © The Author(s) 2025.

<110>
Accession Number
646518214
Title
Exercise-based cardiac rehabilitation for patients with coronary artery
operation: a systematic review and meta-analysis based on current
randomized controlled trials.
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 04 Feb 2025.
Author
Shi Y.; Xu H.; Dong J.
Institution
(Shi, Dong) Rehabilitation Treatment Center of Wangjing Hospital, Chinese
Academy of Traditional Chinese Medicine, Beijing, China
(Xu) Department of Anesthesiology, Wangjing hospital, Chinese Academy of
traditional Chinese Medicine, Beijing, China
Abstract
BACKGROUND: Currently, exercise-based cardiac rehabilitation (CR) has been
given increasing interest for its potentially beneficial effects on the
health related quality of life (HRQoL) and outcomes of patients with
coronary heart disease (CHD). The aim of this study was to evaluate the
effect of exercise-based CR on patients after coronary artery bypass grast
(CABG) and percutaneous coronary interventions (PCI). METHOD(S): We
searched PubMed, Embase, Cochrane Library and Web of Science from
inception to 1 December 2023 for relevant studies that evaluated the
effect of exercise-based CR on patients after CABG and PCI. Our primary
outcomes included the mortality, complications, hospital admissions and
HRQoL between patients receiving exercise-based CR and usual care. All
statistical analyses were performed using the standard statistical
procedures provided in Review Manager 5.2 and Stata 12.0. RESULT(S):
We finally indicated and included 25 randomized controlled trials (RCTs)
with 4106 participants for the present analysis. Our pooled results
indicated that, compared to usual care, exercise-based CR did not
increasing the all-cause (RR 0.84; 95% CI 0.54 - 1.31) and cardiovascular
(RR 0.98; 95% CI 0.38 - 2.54) mortality for patients after coronary artery
operation. Similarly, exercise-based CR had equal effect on coronary
artery complications for patients after coronary artery surgery, including
CABG (RR 0.60; 95% CI 0.32 - 1.15) and PCI (RR 0.92; 95% CI 0.55 - 1.54).
It was indicated that exercise-based CR significantly reduced the
incidence of myocardial infarction (MI) by half with a RR of 0.50 (95% CI
0.28 - 0.90). In addition, exercise-based CR also significantly reduced
all-cause hospital admissions with a RR of 0.74 (95% CI 0.62 - 0.88).
Compared with usual care, exercise-based CR obviously improved HRQoL of
patients after coronary artery operation evaluated with SF-36 summary
scores (SMD 0.24; 95% CI 0.11 - 0.38) and SF-36 8 domains (SMD 0.35; 95%
CI 0.24 - 0.46) respectively. CONCLUSION(S): Our analysis indicated
that exercise-based CR had significant effect on the improvement of HRQoL
of patients after coronary artery operation without increasing the
mortality or incidence of re-intervention with operation. Copyright
© 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<111>
Accession Number
2033335079
Title
Balloon-versus self-expandable transcatheter aortic valve implantation in
small aortic annuli: a meta-analysis of randomized and propensity studies.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025.
Article Number: e012873. Date of Publication: 2025.
Author
Baudo M.; Sicouri S.; Yamashita Y.; Magouliotis D.; Cabrucci F.; Carnila
S.; Ramlawi B.
Institution
(Baudo, Sicouri, Yamashita, Magouliotis, Cabrucci, Carnila, Ramlawi)
Department of Cardiac Surgery Research, Lankenau Institute for Medical
Research, Main Line Health, 100 E Lancaster Avenue, Wynnewood, PA, United
States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
Publisher
Springer
Abstract
The hemodynamic and clinical differences between balloon- (BEV) and
self-expandable valves (SEV) are critical for patients with a small aortic
annulus (SAA). This meta-analysis aims to evaluate the clinical and
hemodynamic performance of these two systems in patients with severe
aortic stenosis and SAA. A systematic review was conducted from inception
to June 2024 for randomized and propensity-score studies comparing BEV and
SEV outcomes in patients with a SAA. Reconstructed individual patient data
(IPD) from Kaplan Meier curves was pooled for overall survival and
rehospitalization for heart failure. Nine studies with 2856 patients met
our inclusion criteria: 1427 in the BEV group and 1429 in the SEV group.
SEV demonstrated superior hemodynamic performance, including improved iEOA
(Standardized Mead Difference [SMD]: 0.52, p = 0.0012), lower mean
gradients (SMD: - 0.89, p < 0.0001), and reduced PPM (Odds Ratio [OR]:
0.38, p < 0.0001) compared to BEV. BEV presented lower new pacemaker rates
compared to SEV (OR: 1.52, p = 0.0447). There were no significant
differences between SEV and BEV in terms of rates of > mild paravalvular
leaks, early stroke, and Valve Academic Research Consortium-defined
outcomes. Reconstructed IPD showed no significant differences in overall
survival (Hazard Ratio [HR]: 0.95, p = 0.584) and rehospitalization for
heart failure (HR: 1.05, p = 0.828) during follow-up. In patients with SAA
undergoing TAVI the use of BEV was associated with higher frequency of PPM
and/or pressure gradients. Similar early stroke, survival and
rehospitalization rates were reported. Pacemaker rates were higher with
SEV. Long-term follow-up studies are required, especially with
newer-generation devices. Copyright © The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

<112>
Accession Number
2037553258
Title
Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer:
The American Association for Thoracic Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Pennathur A.; Lanuti M.; Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.;
Suh R.D.; Mak R.H.; Brunelli A.; Criner G.J.; Mazzone P.J.; Walsh G.;
Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Pettiford B.;
Rocco G.; Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.;
Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Keshavarz, Wafford) The American Association for Thoracic Surgery,
Beverly, Massachusetts, United States
(Keshavarz) Department of Family Medicine, McMaster University, Ontario,
Canada
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
Publisher
W.B. Saunders
Abstract
Objectives: A significant proportion of patients with stage I non-small
cell lung cancer (NSCLC) are considered at high risk for complications or
mortality after lobectomy. The American Association for Thoracic Surgery
(AATS) previously published important considerations in determining which
patients are considered high risk. The current objective was to evaluate
treatment options and important factors to consider during treatment
selection for these high-risk patients. Method(s): The AATS Clinical
Practice Standards Committee assembled an expert panel to review treatment
options for high-risk patients with stage I NSCLC. After a systematic
search of the literature identification of lung-nodule-related factors to
consider in treatment selection, the panel developed expert consensus
statements and vignettes using a modified Delphi method. A 75% consensus
was required for approval. Result(s): The expert panel identified
sublobar resection, image-guided thermal ablation (IGTA), and stereotactic
ablative radiotherapy (SABR), which is also known as stereotactic body
radiation therapy (SBRT) or stereotactic radiosurgery (SRS), as modalities
applicable in the treatment of high-risk patients with stage I NSCLC.
Fourteen statements and 5 vignettes illustrating clinical scenarios were
formulated, revised, and ultimately approved. Conclusion(s): The
choice of which modality (sublobar resection, SABR, or IGTA) is optimal in
high-risk patients with stage I NSCLC is complex, but a surgical approach
is generally favored when deemed safe. SABR and IGTA are reasonable
options in select patients, with SABR being the likely next choice in
nonsurgical patients. If possible, obtaining a biopsy is very important
prior non-surgical treatment. A multi-disciplinary review of patient and
tumor characteristics is essential for achieving an optimal decision. The
clinical treatment decision should also take patient perspectives,
preferences, and quality of life into consideration. Copyright ©
2025 Elsevier Inc.

<113>
Accession Number
646522638
Title
The Effect of an Educational Application on The Quality of Life and
Treatment Adherence in Mothers of Children with Congenital Heart Disease
Undergoing Cardiac Surgery: A Randomized Clinical Trial.
Source
International journal of community based nursing and midwifery. 13(1) (pp
40-52), 2025. Date of Publication: 01 Jan 2025.
Author
Rajabi M.M.; Begjani J.; Negarandeh R.
Institution
(Rajabi, Begjani) Department of Pediatric Nursing and Neonatal Intensive
Care, School of Nursing and Midwifery, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Negarandeh) Nursing and Midwifery Care Research Center, School of Nursing
and Midwifery, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Abstract
Background: The primary caregivers of children with congenital heart
disease (CHD) after cardiac surgery at home are often their mothers.
Therefore, the quality of life (QoL) and treatment adherence (TA) of
mothers are crucial for the prognosis of these children. This study
evaluated the impact of a mobile educational application on the QoL and TA
in mothers of children with CHD undergoing cardiac surgery.
 Method(s): This randomized clinical trial was conducted on 72 mothers
of children with CHD referred for cardiac surgery to Children's Medical
Center Hospital, Tehran, Iran, from September 2023 to May 2024. Mothers
were randomly assigned to intervention (n=36) and control (n=36) groups.
The intervention group received the educational app upon discharge and
used it for four weeks, while the control group received standard
discharge education, which consisted of face-to-face education. Data were
collected using a demographic form, the 36-Item Short Form Health Survey
(SF-36), and the Modanloo Treatment Adherence Questionnaire at baseline
and one month post-intervention. Data were analyzed using SPSS software
version 26, with independent t-test, chi-square, and analysis of
covariance. A significance level of P<0.05 was considered. Result(s):
At baseline, no significant differences were observed between the two
groups in total score of QoL (P=0.18) and TA (P=0.70). One month
post-intervention, the intervention group showed significantly higher
total scores in QoL (P<0.001) and TA (P<0.001) compared to the control
group. Conclusion(s): Using mobile applications in home care
education can significantly enhance the QoL and TA in mothers of children
with CHD after surgery.Trial Registration Number:
IRCT20230816059164N1. Copyright: © International Journal of
Community Based Nursing and Midwifery.

<114>
[Use Link to view the full text]
Accession Number
2037430569
Title
Erratum: Effects of Serratus Anterior Plane Block on Early Recovery from
Thoracoscopic Lung Resection: A Randomized, Blinded, Placebo-controlled
Trial (Anesthesiology (2024) 141 (1065-74) DOI:
10.1097/ALN.0000000000005224).
Source
Anesthesiology. 142(3) (pp 588), 2025. Date of Publication: 01 Mar 2025.
Author
Anonymous
Publisher
Lippincott Williams and Wilkins
Abstract
In the Editor's Perspective for the article on page 1065 in the December
2024 issue, the second bullet point under "What We Already Know about This
Topic"contains an error (i.e., "post-site"instead of "port-site"). The
corrected text is below: Patients who undergo minimally invasive thoracic
surgery have multiple port-site incisions that may cause significant chest
wall pain without intraoperative and postoperative pain management. Also,
in the Intercostal Nerve Blocks section on page 1067, an error appears in
the second sentence (i.e., "injected in the fifth"should be "injected in
the third"). The corrected text is below: After the completion of the lung
resection, the surgical team followed their existing practice of
performing internal intercostal nerve blocks under thoracoscopic
visualization. The intercostal nerve blocks were standardized to 3 ml
bupivacaine 0.25% injected in the third through the eighth intercostal
spaces (six intercostal spaces) for a total volume of 18 ml and a total
dose of 45 mg. All study patients received internal intercostal nerve
blocks. The online version and PDF of the article have been
corrected. Copyright © 2025 Lippincott Williams and Wilkins. All
rights reserved.

<115>
Accession Number
646523169
Title
Neurodevelopmental Outcomes After Nitric Oxide During Cardiopulmonary
Bypass for Open Heart Surgery: A Randomized Clinical Trial.
Source
JAMA network open. 8(2) (pp e2458040), 2025. Date of Publication: 03 Feb
2025.
Author
Long D.A.; Gibbons K.S.; Horton S.B.; Johnson K.; Buckley D.H.F.; Erickson
S.; Festa M.; d'Udekem Y.; Alphonso N.; Le Marsney R.; Winlaw D.S.;
Masterson K.; van Loon K.; Young P.J.; Schibler A.; Schlapbach L.J.; Butt
W.
Institution
(Long) School of Nursing, Centre for Healthcare Transformation, Queensland
University of Technology, Brisbane, Australia
(Long, Schlapbach) Paediatric Intensive Care Unit, Queensland Children's
Hospital, Children's Health Queensland, Brisbane, Australia
(Long, Gibbons, Johnson, Le Marsney, Schlapbach) Children's Intensive Care
Research Program, Child Health Research Centre, University of Queensland,
Brisbane, Australia
(Horton) Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, VIC,
Australia
(Horton, d'Udekem, Butt) Faculty of Medicine, Department of Paediatrics,
University of Melbourne, Melbourne, VIC, Australia
(Horton, Masterson, Butt) Clinical Sciences Theme, Murdoch Children's
Research Institute, Melbourne, VIC, Australia
(Buckley) Paediatric Intensive Care Unit, Starship Children's Hospital,
Auckland, New Zealand
(Erickson) Paediatric Critical Care, Perth Children's Hospital, Western
Australia and The University of Western Australia, Crawley, Australia
(Festa) Kids Critical Care Research, Paediatric Intensive Care Unit,
Children's Hospital at Westmead, Westmead, NSW, Australia
(Festa) Sydney Children's Hospital Network, Sydney, NSW, Australia
(d'Udekem) Children's National Hospital and The George Washington
University School of Medicine and Health Sciences, Washington, District of
Columbia
(Alphonso) Cardiac Surgery, Queensland Children's Hospital, Brisbane,
Australia
(Alphonso) School of Medicine, Children's Health Clinical Unit, University
of Queensland, Brisbane, Australia
(Winlaw) Heart Centre for Children, Children's Hospital at Westmead,
Westmead, NSW, Australia
(Winlaw) Sydney Children's Hospital Network and Faculty of Medicine and
Health, University of Sydney, Sydney, NSW, Australia
(Masterson) Paediatric Intensive Care Unit, Royal Children's Hospital
Melbourne, Melbourne, VIC, Australia
(van Loon, Butt) Department of Anaesthesiology, University Medical Center
Utrecht, Wilhelmina Children's Hospital, Utrecht, Netherlands
(Young) Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Australian and New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Young, Butt) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Schibler) James Cook University, Townsville, QLD, Australia
(Schibler) Critical Care Research Group, Wesley Medical Research, St
Andrew's War Memorial Hospital, Brisbane, QLD, Australia
(Schlapbach) Department of Intensive Care and Neonatology, University
Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
(Schlapbach) Children's Research Center, University Children's Hospital
Zurich, University of Zurich, Zurich, Switzerland
(Butt) Central Clinical School, Faculty of Medicine, Monash University,
Melbourne, VIC, Australia
Abstract
Importance: Children with congenital heart defects who undergo
cardiopulmonary bypass (CPB) surgery are at risk for delayed or impaired
neurodevelopmental outcomes. Nitric oxide (NO) added to the CPB oxygenator
may reduce systemic inflammation due to CPB and improve recovery from
surgery, including improved neurodevelopmental outcomes.
 Objective(s): To investigate neurodevelopment, health-related quality
of life (HRQOL), and factors associated with impaired neurodevelopment at
12 months post surgery in infants who received CPB with NO or standard
CPB. Design, Setting, and Participant(s): This double-masked
randomized clinical trial was conducted in 6 centers in Australia, New
Zealand, and the Netherlands between July 19, 2017, and April 28, 2021,
with a preplanned prospective follow-up 12 months postrandomization
completed on August 5, 2022. The cohort included 1364 infants younger than
2 years who underwent open heart surgery with CPB for congenital heart
disease. Intervention(s): The intervention group received NO 20 ppm
into the CPB oxygenator. The control group received standard CPB.
 Main Outcomes and Measures: The primary outcome was neurodevelopment,
defined as the Ages and Stages Questionnaire, Third Edition (ASQ-3) total
score. Secondary outcomes were HRQOL and functional status as measured by
Pediatric Quality of Life Inventory and modified Pediatric Overall
Performance Category scores, respectively. Sensitivity analyses modeled
the outcome for patients lost to follow-up. Result(s): Of 1318
infants alive 12 months after randomization, follow-up was performed in
927, with 462 patients in the NO group and 465 in the standard care group
(median [IQR] age at follow-up, 16.6 [13.7-19.8] months; median [IQR] time
since randomization, 12.7 [12.1-13.9] months; 516 male [55.7%]). There
were no differences between the NO and standard care groups in ASQ-3 total
score (mean [SD], 196.6 [75.4] vs 198.7 [73.8], respectively; adjusted
mean difference, -2.24; 95% CI, -11.84 to 7.36). There were no differences
in secondary outcomes. Prematurity (gestational age <37 weeks),
univentricular lesions, congenital syndromes, and longer intensive care
unit length of stay were associated with lower ASQ-3 total scores in
adjusted multivariable analyses. Conclusions and Relevance: In this
randomized clinical trial of infants with congenital heart disease, NO
administered via the CPB oxygenator did not improve neurodevelopmental
outcomes or HRQOL 12 months after open heart surgery. Further research
should explore homogenous cohorts with higher surgical risk and
higher-dose or alternative therapies. Trial Registration: ANZCTR
Identifier: ACTRN12617000821392.

<116>
Accession Number
646517519
Title
Efficacy and Safety of Distal Radial Artery Access versus Proximal Radial
Artery Access for Cardiac Procedures: A Systematic Review and
Meta-analysis.
Source
Medical principles and practice : international journal of the Kuwait
University, Health Science Centre. (pp 1-15), 2025. Date of Publication:
04 Feb 2025.
Author
Rehman M.E.U.; Raja H.A.A.; Osama M.; Kakakhail A.; Waseem M.H.; Mukhlis
M.; Abdullah Ali M.; Abideen Z.U.; Shoaib M.; Din Z.U.; Tahir A.; Hassan
M.Z.U.; Mazhar U.; Haider S.T.; Saeed S.; Nashwan A.J.
Abstract
OBJECTIVE: Cardiac catheterization using the distal radial artery access
(DRA), at the level of the anatomical snuff box post radial artery
bifurcation, may be linked to a lower rate of arterial occlusion and
better hemostasis. In this meta-analysis, we compare DRA versus proximal
radial artery access (PRA) in cardiac catheterization or angiography.
 METHOD(S): A detailed literature search was performed on PubMed,
Cochrane, Embase and Clinicaltrials.gov from inception till June 2024.
Risk ratios (RR) and mean differences (MD) were pooled for categorical and
continuous outcomes, respectively. Random effects meta-analysis was
undertaken on Revman. RESULT(S): Our meta-analyses include 21
randomized controlled trials with 9,539 patients (DRA 4,761, PRA 4,778).
DRA significantly reduced 24-hour radial artery occlusion (RAO) rates (RR
0.30, 95% CI 0.23 to 0.40, p <= 0.00001), and time to hemostasis (minutes)
(MD -44.46, 95% CI -50.64 to -38.92, p < 0.00001), whereas PRA was
significantly superior in terms of the puncture success rate (RR 0.96, 95%
CI 0.93 to 0.99, p < 0.01), the crossover rate (RR 2.89, 95% CI 2.02 to
4.15, p < 0.00001, and puncture attempts (MD 0.69, 95% CI 0.37 to 1.00, p
= 0.00001). CONCLUSION(S): DRA was associated with a lower risk of
occlusion and lower time to hemostasis, but required a greater number of
puncture attempts and had lower success rate. Further research is required
to elucidate the most optimal approach. Copyright The Author(s).
Published by S. Karger AG, Basel.

<117>
Accession Number
2035135389
Title
TCT-323 Evaluating the Efficacy of Coronary Sinus Aspiration During
Coronary Angioplasty to Attenuate the Risk of Contrast-Induced Acute
Kidney Injury in Predisposed Patients.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B78-B79), 2024. Date of Publication: 29 Oct 2024.
Author
Verma S.; Ansari A.H.; Kumar R.
Institution
(Verma, Kumar) Vardhman Mahavir Medical College and Safdarjung Hospital,
New Delhi, Delhi, India, India
(Ansari) Safdarjung Hospital, New Delhi, Delhi, India, India
Publisher
Elsevier Inc.
Abstract
Background: Cardiac intervention requires iodinated contrast media (CM),
posing a risk of contrast-induced nephropathy (CIN), responsible for 12%
of hospital-acquired acute kidney injury (AKI). Preventive techniques like
coronary sinus aspiration (CSA) are being developed to reduce contrast
exposure, particularly in high-risk patients. Method(s): Study Type:
Hospital-based interventional study. Study Design: Single-blinded
randomized controlled trial. Study Period: 18 months. Sample Size
Calculation: 33 patients per group. Ethical Consideration: Ethical
clearance was obtained from the institutional ethical board. Methodology:
In the CSA group, CS cannulation was done via right or left femoral vein
using an Abott SwartzTM Braided Transeptal Guiding Introducer- SL0 (8.0
French) sheath over steerable decapolar catheter. Result(s): Baseline
characteristics were well matched. The mean CS cannulation time was 9.9
+/- 5.7 minutes with mean cannulation fluoroscopy time being 6.8 +/-3.7
minutes. Time for clearance of contrast from CS was 9.8 +/-2.5 seconds.
The total volume of injected contrast (VIC) in the case group is 65.2
+/-23 mL while in the control group is 75.6 +/- 25.1 mL, with no
statistically significant difference between the 2 groups (P = 0.6). The
mean volume of coronary sinus aspirate (VCSA) was 102.2 +/-24.9 mL while
the mean VCSA per injection was 10.5 +/- 1.7 mL. The mean estimated volume
of aspirated contrast (EVAC) in our study was 18.7 +/- 7.1 mL and the mean
fraction of evacuated contrast (FAC) was 28.9 +/- 5.1%. The primary
endpoint was met: In the case group, 15.2% (5/33) while in the control
group, 39.4% (13/33) developed CIN. CSA resulted in a 24.2% absolute risk
reduction and a 61.4% relative risk reduction (unadjusted) in the case
group. There was one procedure-related complication, a CS perforation in
an elderly woman undergoing PCI to LAD, managed with pericardiocentesis.
 Conclusion(s): Hereby, we demonstrate that CSA is a safe and
practical technique and in high-risk patients undergoing coronary
angioplasty it reduces the volume of the given contrast by almost
one-third and attenuates the risk of CIN. To the best of our knowledge,
this is the first such study done in the Indian subcontinent but further
studies are needed to support our findings. Categories: OTHER: Renal
Insufficiency and Contrast Nephropathy. Copyright © 2024

<118>
Accession Number
2037502347
Title
700.58 Comparative Outcomes of Percutaneous Coronary Intervention Versus
Conservative Management in Patients Undergoing Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S100), 2025. Date of Publication: 24 Feb
2025.
Author
Ktenopoulos N.; Apostolos A.; Simopoulou C.; Katsaros O.; Kachrimanidis
I.; Theodoropoulou T.; Drakopoulou M.; Karanasos A.; Latsios G.; Synetos
A.; Aggeli K.; Tsioufis C.; Toutouzas K.
Institution
(Ktenopoulos, Apostolos, Simopoulou, Katsaros, Kachrimanidis,
Theodoropoulou, Drakopoulou, Latsios, Synetos, Aggeli, Tsioufis,
Toutouzas) National and Kapodistrian University of Athens, Hippokration
General Hospital of Athens, Athens, Greece
(Karanasos) Department of Cardiology, Patras University Hospital, Patras,
Greece, Patras, Greece
Publisher
Elsevier Inc.
Abstract
Background: The optimal approach to managing significant coronary artery
disease (CAD) in patients undergoing transcatheter aortic valve
implantation (TAVI) remains uncertain. Despite limited comparative data,
guidelines recommend percutaneous coronary intervention (PCI) for CAD in
proximal segments. This systematic review and meta-analysis aimed to
evaluate the outcomes of PCI versus no-PCI strategies, post-TAVI.
 Method(s): A systematic search of three major databases was conducted
to identify two-arm studies comparing outcomes in patients undergoing TAVI
with and without prior PCI. Primary endpoints included 30-day and up to
1-year mortality rates, while secondary endpoints were 30-day stroke,
myocardial infarction (MI), and major bleeding rates. Risk ratios (RR)
with 95% confidence intervals (CIs) were calculated, and pooled effects
were estimated using a random-effects Mantel-Haenszel model.
 Result(s): A total of 16 studies comprising 10,513 patients
undergoing TAVI were included in this analysis. Of these, 1,894 patients
(32% males, mean age 81.6+/-6.3 years) underwent PCI prior to TAVI, while
3,258 patients (29% males, mean age 81.6+/-6.3 years) didn't. Pre-TAVI PCI
was not associated with an increased risk of 30-day (RR: 1.03, 95% CI:
0.75-1.40) or up to 1-year mortality (RR: 0.90, 95% CI: 0.67-1.21).
Similarly, no significant differences were observed in 30-day stroke (RR:
0.84, 95% CI: 0.38-1.83), MI (RR: 0.63, 95% CI: 0.20-1.99), or major
bleeding (RR: 0.52, 95% CI: 0.27-1.01). Conclusion(s): This analysis
indicates that PCI prior to TAVI does not significantly affect 30-day or
up to 1-year mortality compared to no-PCI strategies. Similarly, risks of
30-day stroke, MI, and major bleeding were comparable. These findings
highlight the need for large-scale trials to determine the optimal
revascularization strategies. [Formula presented] Copyright ©
2025

<119>
Accession Number
2037501950
Title
400.23 Comparative Outcomes of CABG Versus Intravascular Imaging-Guided
PCI For Left Main Coronary Artery Disease: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S65), 2025. Date of Publication: 24 Feb 2025.
Author
Cilingiroglu M.; Iliescu C.; Marmagkiolis K.; Inanc I.
Institution
(Cilingiroglu, Iliescu, Marmagkiolis, Inanc) UT Houston MD Anderson Cancer
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Left main coronary artery disease (LMCAD) is associated with a
high risk of adverse cardiovascular events. The standard treatment options
include Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary
Intervention (PCI). In recent years, intravascular imaging (IVUS or OCT)
has enhanced the precision of PCI. This meta-analysis compares the
clinical outcomes of CABG and intravascular imaging-guided PCI for LMCAD
to determine the optimal revascularization strategy. Method(s): We
conducted a comprehensive search of PubMed, Embase, and Cochrane databases
for studies published up to June 2024. Inclusion criteria were randomized
controlled trials (RCTs) and observational studies comparing CABG and
intravascular imaging-guided PCI in patients with LMCAD. The primary
outcomes were all-cause mortality, myocardial infarction (MI), repeat
revascularization, and major adverse cardiac events (MACE). Two reviewers
independently extracted data and assessed study quality. Result(s):
CABG showed a lower all-cause mortality rate (4.5%) compared to
intravascular imaging-guided PCI (6.2%). The incidence of MI was slightly
higher in the PCI group (5.5%) compared to the CABG group (4.0%). Repeat
revascularization rates were significantly higher in the PCI group (8.0%)
compared to the CABG group (3.5%). MACE rates were comparable between the
two groups, with 9.5% in the PCI group and 8.0% in the CABG group.
 Conclusion(s): In conclusion, this meta-analysis suggests that CABG
may be associated with better long-term outcomes compared to intravascular
imaging-guided PCI for patients with LMCAD, particularly in terms of
all-cause mortality and repeat revascularization. Both revascularization
strategies offer significant benefits, and the choice should be
individualized based on patient characteristics and
preferences. Copyright © 2025

<120>
Accession Number
2037501910
Title
700.54 Comparative Outcomes of TAVR Vs. SAVR for Patients With Prior CABG:
A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S98-S99), 2025. Date of Publication: 24 Feb
2025.
Author
Qureshi M.A.; Haseeb S.; Ahmed O.; Bakht D.; Amir M.; Saeed S.; Srivastava
K.; Yasin Z.; Bai S.; Tariq H.; Shahid A.; Othman H.
Institution
(Qureshi, Ahmed, Srivastava, Yasin, Bai, Tariq, Othman) Henry Ford Jackson
Hospital, Jackson, MI, United States
(Haseeb) Northwell Health, Long Island, NY, United States
(Bakht, Amir) King Edward Medical University, Lahore, Pakistan
(Saeed) Mount Auburn Hospital, Boston, MA, United States
(Shahid) Allama Iqbal Medical College, Lahore, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) and Surgical
Aortic Valve Replacement (SAVR) are treatments for severe aortic stenosis,
especially in patients with a history of Coronary Artery Bypass Grafting
(CABG). This meta-analysis compares the short and long-term outcomes of
TAVR and SAVR, focusing on post-operative atrial fibrillation (AF),
pacemaker implantation, and 1-year cardiovascular (CV) mortality, stroke,
and major vascular complications. Method(s): A systematic review and
meta-analysis were conducted per PRISMA guidelines, including studies
comparing TAVR and SAVR outcomes in CABG patients. Primary outcomes were
post-operative AF, pacemaker implantation, and 1-year CV mortality,
stroke, and major vascular complications. Odds ratios (OR) with 95%
confidence intervals (CI) were calculated using a random-effects model.
Heterogeneity was assessed with the I2 statistic, and a p-value
of <0.05 was considered significant. Result(s): Post-Operative AF: 3
studies (854 patients) showed a significantly lower incidence of AF in the
TAVR group (OR: 0.15, 95% CI: 0.09-0.27, P < 0.00001).Pacemaker
Implantation: 10 studies (15,790 patients) showed TAVR was associated with
a higher risk of pacemaker implantation (OR: 2.41, 95% CI: 1.49-3.89, P =
0.0003).1-Year Outcomes: 5 studies (8,627 patients) showed no significant
difference between TAVR and SAVR for 1-year CV mortality (OR: 0.84, P =
0.51), stroke (OR: 0.94, P = 0.80), or major vascular complications (OR:
1.72, P = 0.12). Conclusion(s): TAVR offers a lower incidence of
post-operative AF but a higher risk of pacemaker implantation compared to
SAVR. For 1-year CV mortality, stroke, and major vascular complications,
TAVR and SAVR show comparable outcomes. Further studies with larger sample
sizes are needed to confirm these findings and better understand long-term
outcomes [Formula presented] Copyright © 2025

<121>
Accession Number
2037501971
Title
700.11 Early Outcomes With Three TAVI Valves (Myval, Sapien, and Evolut
Series) in Women - Substury of Landmark Trial.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S88), 2025. Date of Publication: 24 Feb 2025.
Author
Tobe A.; Serruys P.W.; Amat-Santos I.J.; van Royen N.; Hudec M.; Ielasi
A.; Montorfano M.; Webster M.; Toutouzas K.; Teiger E.; Bedogni F.;
Voskuil M.; Pan M.; Angeras O.; Kim W.-K.; Rothe J.; Kristic I.; Peral V.;
Abdel-Wahab M.; Thakkar A.; Chandra U.; Morice M.-C.; Soliman O.; Onuma
Y.; Baumbach A.
Institution
(Tobe, Serruys, Soliman, Onuma) University of Galway, Galway, Ireland
(Amat-Santos) Centro de Investigacion Biomedica en red - Enfermedades
Cardiovasculares, Madrid, Spain
(van Royen) Radboud University Hospital, Nijmegen, Netherlands
(Hudec) Middle-Slovak Institute Of Cardiovascular Diseases, Banska
Bystrica, Slovakia, Slovakia
(Ielasi) IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
(Montorfano) Vita-Salute San Raffaele University, Milan, Netherlands
(Webster) Auckland City Hospital, Auckland, New Zealand, New Zealand
(Toutouzas) Hippokration Hospital, Athens, Greece
(Teiger) Henri-Mondor University Hospital, Creteil, France
(Bedogni) San Donato Hospital, Milan, Italy
(Voskuil) University Medical Center Utrecht, Utrecht, Netherlands
(Pan) University of Cordoba, Cordoba, Spain, Spain
(Angeras) Sahlgrenska University Hospital, Gothenburg, Sweden
(Kim) University of Giessen and Marburg, Giessen, Germany
(Rothe) University Medical Center Freiburg, Freiburg, Germany
(Kristic) University Hospital of Split, Split, Croatia
(Peral) Son Espases University Hospital, Palma, Spain
(Abdel-Wahab) University Hospital Leipzig, Leipzig, Germany
(Thakkar, Chandra) Meril Life Sciences Pvt. Ltd., Vapi, India
(Morice) Cardiovascular European Research Center, Paris, France
(Baumbach) Queen Mary University of London and Barts Heart Centre, London,
United Kingdom, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Nearly 50% of severe aortic stenosis (AS) patients undergoing
transcatheter aortic valve replacement (TAVR) are women, yet they are
under-represented in clinical trials. SMART trial reported that in women
with small annulus area, self-expanding transcatheter heart valve (THV)
showed better hemodynamic outcomes than balloon-expandable THV. In the
LANDMARK trial comparing three types of THVs, outcomes in women were
investigated. Method(s): In a multicenter, non-inferiority LANDMARK
trial (n=768), 369 women with severe AS were randomized to Myval THV
series(n=193), Sapien THV series (n=86), and Evolut THV series (n=90). The
primary endpoint at 30 days was a composite of all-cause death, all
stroke, bleeding (types 3 and 4), acute kidney injury (stages 2-4), major
vascular complications, moderate or severe prosthetic valve regurgitation
(PVR), and new permanent pacemaker implantation as per the Valve Academic
Research Consortium-3 consensus. Result(s): Mean age (Myval: 81,
Sapien: 81.7, and Evolut 79.8 years old) and median Society of Thoracic
Surgeons scores (3.1%, 3.5%, 3.1%) were comparable in three arms. More
than 50% of women had small aortic annuli (55.4%, 60.5%, 54.4%). In the
Myval arm, 49% of patients received intermediate sizes (21.5, 24.5 and
27.5 mm). At 30 days, Myval had a lower aortic valve mean pressure
gradient (MPG, Myval: 8.7mmHg; Sapien: 11.1mmHg, p<0.001) and a higher
effective orifice area (EOA) compared to Sapien (1.88cm2,
1.61cm2, p<0.001), while having a higher MPG (Evolut: 5.4mmHg,
p<0.001) and lower EOA than Evolut (2.37cm2, p<0.001). Myval
was non-inferior to Sapien (Myval: 19% vs Sapien: 20%, Risk difference
[95%Cl]: -0.6 [NA, 9.6], p<inf>noninferiority</inf>=0.01) and Evolut (19%
vs 30%; risk difference [95%CI]: -10.9% [NA, 0.1],
p<inf>noninferiority</inf><0.0001) for the primary endpoint. There was no
statistically significant difference between Myval versus Sapien for
itemized events of the primary composite endpoint, whereas there were
lower rates of moderate-severe PVR (Myval 2% vs. Evolut 9%, p=0.01) and
major vascular complications (2% vs. 7%, p=0.03) in Myval than Evolut.
 Conclusion(s): In the women subset of the LANDMARK trial, Myval had a
lower aortic valve mean pressure gradient and a higher effective orifice
area than Sapien, whereas superior hemodynamics of Evolut to Myval entails
a significantly higher risk of PVR at 30 days. TAVI with the Myval series
in women patients with severe AS is non-inferior to both the Sapien and
Evolut series for the primary composite endpoint at 30 days. Copyright
© 2025

<122>
Accession Number
2037501385
Title
700.81 Meta-Analysis: Comparison of Mitraclip, Pascal, Tendyne, and
Surgical Mitral Valve Repair/Replacement for Treatment of Severe
Symptomatic Functional Mitral Regurgitation.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S111-S112), 2025. Date of Publication: 24 Feb
2025.
Author
Cilingiroglu M.; iliescu C.; inanc I.
Institution
(Cilingiroglu, iliescu, inanc) UT Houston MD Anderson Cancer Center,
Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Functional mitral regurgitation (FMR) is a common and
challenging condition to manage in patients with heart failure. Various
interventions, including MitraClip, Pascal, Tendyne, and surgical mitral
valve repair/replacement (SMVR), have been developed to treat severe
symptomatic FMR. This meta-analysis aims to compare the clinical outcomes,
procedural success, and complication rates of these treatments.
 Method(s): A systematic search was conducted in PubMed, Embase, and
the Cochrane Library to identify studies comparing MitraClip, Pascal,
Tendyne, and SMVR in patients with severe symptomatic FMR. Outcomes
assessed included all-cause mortality, heart failure hospitalization,
improvement in New York Heart Association (NYHA) functional class, mitral
regurgitation (MR) grade reduction, and procedural complications. Data
were extracted and analyzed using random-effects models to calculate
pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence
intervals (CIs). Result(s): Fourteen studies with a total of 7,392
patients were included. Tendyne was associated with the highest procedural
success rate (OR 1.35, 95% CI 1.12-1.62, p=0.002) and significant MR grade
reduction (MD -1.5, 95% CI -1.8 to -1.2, p<0.001) compared to the other
modalities. SMVR had the lowest all-cause mortality at 1-year follow-up
(OR 0.75, 95% CI 0.60-0.95, p=0.02). MitraClip and Pascal were associated
with significant improvement in NYHA functional class (MD -0.8, 95% CI
-1.1 to -0.5, p<0.001). Complication rates were highest with SMVR (OR
1.55, 95% CI 1.30-1.85, p<0.001) compared to percutaneous interventions.
 Conclusion(s): Tendyne and SMVR offer distinct advantages in
procedural success and long-term survival, respectively, for patients with
severe symptomatic FMR. MitraClip and Pascal provide significant
symptomatic improvement with lower complication rates. The choice of
intervention should be individualized based on patient-specific factors
and clinical judgment. Copyright © 2025

<123>
Accession Number
2037502321
Title
700.45 Oral Anticoagulants Versus Antiplatelets Therapy for Patients
Undergoing Left Atrial Appendage Closure: A Systematic Review and
Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S104), 2025. Date of Publication: 24 Feb
2025.
Author
Qadeer A.; Haider M.Z.; Khawar M.; Maryam S.; Komel A.; Aisha A.; Naveed
M.A.; Hasnain H.; Ashraf M.A.; Shafique N.; Aamir M.; Sharma U.; Kirchoff
R.W.
Institution
(Qadeer, Sharma, Kirchoff) Mayo clinic Hospital, Phoenix, AZ, United
States
(Haider) West Virginia University, Morgantown, WV, United States
(Khawar) King Edward Medical University, Lahore, Pakistan
(Maryam, Komel, Aisha, Hasnain, Ashraf) Nishtar Medical University,
Multan, Pakistan
(Naveed) Dow University of Health Sciences, Karachi, Pakistan
(Shafique) Advent Health, Orlando, FL, United States
(Aamir) Lehigh Valley Health Network, Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Oral anticoagulants, including Warfarin and Direct oral
anticoagulants, are commonly used for anticoagulation in patients
undergoing left atrial appendage closure (LAAC). However, their safety and
efficacy remain uncertain compared to antiplatelet therapy.
 Method(s): A comprehensive literature search was conducted across
multiple databases (EMBASE, OVID, Scopus, PubMed, ClinicalTrials.gov, and
Web of Science). We extracted baseline characteristics and evaluated
outcomes. Odds ratios (OR) with 95% confidence intervals (CI) were
calculated. Statistical significance was assigned at p<0.05.
 Result(s): Twenty studies with 8,394 patients were analyzed. OACs
were associated with a lower incidence of device-related thrombosis (OR:
0.52, 95% CI: 0.32-0.85, p = 0.009), overall mortality (OR: 0.40, 95% CI:
0.23-0.67, p = 0.0006), and major bleeding (OR: 0.65, 95% CI: 0.46-0.92, p
= 0.02) as compared to antiplatelet therapy (APT). However, DOACs had no
difference in the incidence of overall bleeding and ischemic stroke when
compared to APT. Study heterogeneity was low to moderate (I2 =
0%-54%). Conclusion(s): OACs are associated with a decreased risk of
device-related thrombosis and overall mortality in patients undergoing
left atrial appendage closure compared to DAPT. However, randomized trials
are needed to further evaluate the efficacy and adverse effects associated
with OAC and APT. [Formula presented] Copyright © 2025

<124>
Accession Number
2037504951
Title
900.05 Transcaval Access For Transcatheter Aortic Valve Replacement: A
Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S116-S117), 2025. Date of Publication: 24 Feb
2025.
Author
Otmani Z.; Awad A.A.; Alzawahreh A.; Khalefa B.B.; Elsayed H.A.; Mohamed
Amin O.H.; Almansi A.; Awad A.K.
Institution
(Otmani) Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou,
Algeria, Algeria
(Awad) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Alzawahreh) Faculty of Medicine, The Hashemite University, Zarqa, Jordan
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Elsayed, Mohamed Amin) Faculty of Medicine, Zagazig University, Zagazig,
Egypt
(Almansi) Prince Hamza Hospital, Amman, Jordan
(Awad) Thoracic and Cardiovascular Surgery Department Heart, Vascular &
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Transfemoral access is considered the standard route for
transcatheter aortic valve replacement (TAVR). However, in some cases,
this access route is contraindicated. To address these limitations,
alternative access routes such as transaxillary are emerging as first-line
approaches, while the transcaval approach remains an uncertain pathway.
Our Meta-analysis aimed to evaluate the safety of the transcaval approach
compared to other access routes for TAVR. Method(s): We searched five
databases such as PubMed, SCOPUS, WOS, Cochrane Library, and Embase for
any study that reports transcaval access alone or compares it to any
alternative access in TAVR patients. We used Risk ratio (RR) for
dichotomous outcomes, and Mean Difference (MD) for continuous outcomes
with a 95% confidence interval. Result(s): Eleven studies with 1003
patients were included in our meta analysis. For pairwise analysis,
transcaval showed non-statistically significant difference over
alternatives in terms of intra-hospital, 30 days, and long-term all-cause
mortality with a RR of 0.08 (95% CI -0.83 to 0.99, P= 0.86), 0.11 (95% CI
-0.48 to 0.7, P= 0.71), and 1.08 (95% CI -0.50 to 2.66, P= 0.18),
respectively. Furthermore, in our single-arm analysis, transcaval access
has a low pooled 30-day all-cause mortality rate of 7% (95% CI 5-10) and
long-term mortality of 21% (95% CI 2-77). The mean difference in length of
stay in the hospital after the operation was 4.88 (95% CI 4.45 to 5.31),
and the major bleeding rate was 14% (95% CI 8-23). Conclusion(s):
Transcaval access for TAVR is a safe and a feasible method that can be
considered as a new alternative access when the trans-femoral access is
contraindicated. [Formula presented] Copyright © 2025

<125>
Accession Number
2037501621
Title
900.03 A Meta-Analysis of Dual Perclose Proglide Versus Hybrid Angio-Seal
+ Proglide Closure Techniques for Femoral Access Hemostasis After
Percutaneous Cardiovascular Procedures.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S118), 2025. Date of Publication: 24 Feb
2025.
Author
Banga A.; Rathore S.S.; Niharika Janga L.S.; Patino C.; Saeed M.; Ying X.;
Manandhar R.; Xu D.; Mautong H.; Scimeca G.; Guillen R.H.
Institution
(Banga, Niharika Janga, Patino, Saeed, Ying, Manandhar, Xu, Scimeca,
Guillen) Mount Auburn Hospital, Harvard Medical School, Cambridge, MA,
United States
(Rathore) Dr. Sampurnanand Medical College, Jodhpur, India
(Mautong) Cook County Hospital, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background: Vascular complications and hemorrhage increase morbidity and
mortality following percutaneous cardiovascular interventions, such as
transcatheter aortic valve replacements (TAVR) and percutaneous
endovascular aneurysm repair (pEVAR), frequently due to the failure of
vascular closure devices (VCD). We compared an isolated Dual Perclose
Proglide (DPP) suture-based strategy to a Hybrid Angio-Seal+Proglide (ASP)
Closure technique for femoral access hemostasis after TAVR and pEVAR.
 Method(s): We conducted a comprehensive literature review of
randomized controlled trials (RCTs) and observational studies utilizing
PubMed, Embase, Cochrane Library, ScienceDirect, and ClinicalTrial.gov. We
computed the Relative Risk (RR) and 95% Confidence Interval (CI) for
specific outcomes, including vascular complications, bleeding, and VCD
failure, employing random effects models to present overall impact sizes.
 Result(s): A total of four studies, including one RCT and three
observational studies, with 596 patients (DPP: 266; ASP: 330) were
analyzed. The DPP-based suture strategy showed a higher but statistically
non-significant relative risk of vascular complications (RR = 1.43, 95% CI
0.99 to 2.07, p = 0.06), bleeding (RR = 1.25, 95% CI 0.58 to 2.68, p =
0.57), and VCD failure (RR = 2.15, 95% CI 0.51 to 8.98, p = 0.30) than the
hybrid ASP technique (Figure). Conclusion(s): The implementation of
the hybrid ASP approach for achieving femoral access hemostasis following
TAVR or pEVAR does not yield a statistically significant improvement in
postprocedural patient outcomes regarding vascular problems, hemorrhage,
and VCD failures. [Formula presented] Copyright © 2025

<126>
Accession Number
2037501370
Title
700.75 Impact of Transcatheter Mitral Valve Repair on Quality of Life and
Clinical Outcomes in Patients With Secondary Mitral Regurgitation With or
Without Heart Failure: A Systematic Review and Meta-analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S111), 2025. Date of Publication: 24 Feb
2025.
Author
Obi O.S.; Lajczak P.; Nweze U.; Asonye P.
Institution
(Obi) New York Institute of Technology College of Osteopathic Medicine,
Old Westbury, NY, United States
(Lajczak) Medical University of Silesia, Zabrze, Poland
(Nweze) University of Massachusetts Global, Musco School of Nursing and
Health Sciences, Aliso Viejo, CA, United States
(Asonye) University of Illinois at Chicago College of Pharmacy, Chicago,
IL, United States
Publisher
Elsevier Inc.
Abstract
Background: It remains unclear whether transcatheter mitral valve repair
(TMVR) enhances quality of life (QoL) and clinical outcomes in patients
with heart failure and secondary mitral regurgitation. Method(s):
PubMed, Embase and Cochrane databases were systematically searched for
randomized controlled trails (RCTs) and observational studies comparing
TMVR versus control or medical therapy for secondary mitral regurgitation
with or without heart failure with primary outcome of all-cause mortality.
We pooled odds ratio (OR) and mean difference (MD) along with their 95%
confidence interval (CIs). Result(s): We included 3 RCTs and 6
observational studies consisting of 3,435 patients of which 1,743 (50.7%)
patients with secondary mitral regurgitation had transcatheter mitral
valve repair and 1,692 (49.3%) patients had medical therapy or control.
The mean age of the included patients was 72.6 +/- 11.1 years and 74.5%
were males. The pooled analysis showed that TMVR significantly reduced the
incidence of all-cause mortality (OR = 0.71; 95% CI [0.52; 0.96]; p =
0.028), cardiovascular death (OR = 0.63; 95% CI [0.43; 0.93]; p = 0.018),
unplanned mitraclip implantation (OR = 0.19; 95% CI [0.08; 0.44]; p <
0.001), mitral regurgitation (OR = 17.79; 95% CI [9.57; 33.06]; p < 0.001)
and all unplanned TMVR (OR = 0.16; 95% CI [0.09; 0.27]; p < 0.001).
Similarly, TMVR significantly improved mean change from baseline to 12
months kansas city cardiomyopathy questionnaire overall summary (KCCQ-OS)
score (MD = 17.16; 95% CI [11.04; 23.28]; p < 0.01), New York Heart
Association (NYHA) functional class I or II heart failure (OR = 2.19; 95%
CI [1.59; 3.00]; p < 0.001) and mean change in 6-minute walk distance
(6MWD) (MD = 37.94; 95% CI [33.54; 42.34]; p < 0.01). However, there were
no significant differences for mitral valve surgery (OR = 0.33; 95% CI
[0.10; 1.09]; p = 0.069), ICD or CRT-D implantation (OR = 1.03; 95% CI
[0.50; 2.12]; p = 0.941), heart transplantation (OR = 0.65; 95% CI [0.19;
2.15]; p = 0.478), death from non-cardiovascular causes (OR = 0.69; 95% CI
[0.41; 1.15]; p = 0.155), LVAD implantation (OR = 0.55; 95% CI [0.26;
1.17]; p = 0.123), strokes (OR = 1.16; 95% CI [0.49; 2.73]; p = 0.734),
LVEF (MD = -3.13; 95% CI [-7.84; 1.58]; p = 0.19), CABG (OR = 0.21; 95% CI
[0.01; 4.29]; p = 0.307), PCI (OR = 0.85; 95% CI [0.43; 1.71]; p = 0.654)
and hospitalization for heart failure (OR = 0.50; 95% CI [0.23; 1.08]; p =
0.078). Conclusion(s): The use of TMVr significantly reduced the
incidence of all-cause mortality as well as improved KCCQ-OS score, NYHA
functional class I or II heart failure and mean change in
6MWD. Copyright © 2025

<127>
Accession Number
2037502006
Title
700.53 Comparison of Dual Chamber Pacemaker Implantation Versus Single
Chamber Wireless Pacemaker Implantation Following TAVR Procedures.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S98), 2025. Date of Publication: 24 Feb 2025.
Author
Cilingiroglu M.; Iliescu C.; Marmagkiolis K.; Inanc I.
Institution
(Cilingiroglu, Iliescu, Marmagkiolis, Inanc) UT Houston MD Anderson Cancer
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a minimally
invasive procedure for treating severe symptomatic aortic stenosis.
Post-procedural conduction abnormalities are common, often necessitating
pacemaker implantation. This meta-analysis aims to compare the efficacy
and safety of dual chamber pacemaker (DCP) implantation versus single
chamber wireless pacemaker (SCP) implantation following TAVR.
 Method(s): A systematic search was conducted in PubMed, Embase, and
the Cochrane Library to identify studies comparing DCP and SCP
implantation in patients undergoing TAVR. Outcomes assessed included
all-cause mortality, device-related complications, quality of life (QoL)
improvement, and lead-related issues. Data were extracted and analyzed
using random-effects models to calculate pooled odds ratios (ORs) and mean
differences (MDs) with 95% confidence intervals (CIs). Result(s): Ten
studies with a total of 3,120 patients were included. DCP was associated
with lower all-cause mortality at 1-year follow-up (OR 0.75, 95% CI
0.60-0.94, p=0.01). SCP showed a significant reduction in lead-related
complications (OR 0.45, 95% CI 0.30-0.67, p<0.001) and device-related
infections (OR 0.58, 95% CI 0.40-0.84, p=0.004). QoL improvement was
comparable between the two groups (MD 0.10, 95% CI -0.05 to 0.25, p=0.19).
 Conclusion(s): DCP implantation post-TAVR is associated with lower
all-cause mortality, while SCP implantation reduces lead-related
complications and device-related infections. Both modalities offer similar
improvements in QoL. The choice of pacemaker should be individualized
based on patient-specific factors and clinical judgment. Copyright
© 2025

<128>
Accession Number
2037514673
Title
Bioprosthetic Valve Fracture for Transcatheter Aortic Valve-in-Valve
Replacement: A Systematic Literature Review.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Chopko T.C.; Afoke J.N.; Khan F.W.; Rowse P.G.
Institution
(Chopko) Department of Surgery, Mayo Clinic, Rochester, Minnesota, United
States
(Afoke, Khan, Rowse) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve-in-valve replacement presents a viable,
minimally invasive approach to replacing degraded bioprosthetic surgical
valves. The major drawback of this technique is poor hemodynamics in the
form of patient-prosthesis mismatch and high transvalvular gradients. This
is commonly attributable to the reduced valvular diameter from the
transcatheter heart valve fixed inside the degraded bioprosthesis.
Maximizing this diameter by bioprosthetic valve fracture occurs through a
noncompliant, high-pressure balloon to splay the degraded valve outward.
Despite its novelty, this has demonstrated improved hemodynamic outcomes
and optimal valvular expansion with slightly increased operative risk. In
this review, we highlight the technique of bioprosthetic valve fracture,
types of suitable balloons and valves, timing in relation to
valve-in-valve implantation, safety and efficacy, implications, and future
directions. Copyright © 2025 The Authors

<129>
Accession Number
2037501383
Title
300.24 Meta-Analysis Investigating the Risk Factors for Developing Acute
Kidney Injury After Heart Transplantation.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S57-S58), 2025. Date of Publication: 24 Feb
2025.
Author
Khawar M.; Sehar A.; Qadeer A.; Shahzad M.; Farooq H.; Hadeed Khawar M.M.;
Mubashir M.M.; Mour G.K.; Haider M.Z.; Kirchoff R.W.; Aamir M.
Institution
(Khawar, Sehar, Shahzad, Farooq, Mubashir) King Edward Medical University,
Lahore, Pakistan
(Qadeer, Mour, Kirchoff) Mayo clinic Hospital, Phoenix, AZ, United States
(Hadeed Khawar) Services Institute of Medical Sciences, Lahore, Pakistan
(Haider) West Virginia University, Morgantown, WV, United States
(Aamir) Lehigh Valley Health Network, Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Acute kidney injury (AKI) is a severe complication after heart
transplantation, leading to increased morbidity, mortality, and healthcare
costs. Identifying modifiable risk factors is crucial to improve outcomes
and guide clinical care. Method(s): Searches were conducted in
MEDLINE, Google Scholar, ScienceDirect, ClinicalTrials.gov, and Cochrane
databases until September 1. Included studies were retrospective cohorts
and observational studies. Statistical analysis using RevMan 5.4 reported
outcomes as odds ratios (OR) and mean differences (MD) with 95% confidence
intervals (CI). Result(s): Thirteen studies with 3330 heart
transplant patients reported an AKI incidence of 41.3% (1376/3330).
Significant risk factors included older age (p = 0.04), higher BMI (p =
0.0007), pre-existing CKD (p < 0.00001), COPD (p = 0.02), diabetes (p =
0.001), prolonged bypass time (p = 0.002), ECMO (p = 0.008), mechanical
ventilation (p = 0.003), and prior surgery (p = 0.02). Non-significant
factors included creatinine (p = 0.05), eGFR (p = 0.22), ischemic time (p
= 0.06), hypertension (p = 0.13), IABP (p = 0.14), smoking (p = 0.20),
male sex (p = 0.55), valvular disease (p = 0.24), inotropes (p = 0.78),
cardiomyopathy (p = 0.79), LVAD (p = 0.83), PAD (p = 0.81), and CAD (p =
0.93). Conclusion(s): Modifiable factors such as BMI, diabetes, and
bypass duration offer targets to lower AKI risk. Perioperative management
focused on these risks could improve outcomes. Future research should
refine preventive strategies in transplant care. [Formula
presented] Copyright © 2025

<130>
Accession Number
2037539974
Title
Emerging Implications of Elevated Lipoprotein(a) Levels in Coronary Artery
Bypass Graft Surgery: A Narrative Review.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Patel S.K.; Badross M.S.; Dhingra N.K.; Moroney M.; Casey J.H.; Ali Hassan
S.M.; Khan T.S.; Hess D.A.; Koschinsky M.L.; Teoh H.; Verma S.
Institution
(Patel, Dhingra, Ali Hassan, Verma) Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Badross) UCD School of Medicine, University College Dublin, Dublin,
Ireland
(Dhingra, Ali Hassan, Teoh, Verma) Division of Cardiac Surgery, St.
Michael's Hospital of Unity Health Toronto, Li Ka Shing Knowledge
Institute, Toronto, ON, Canada
(Dhingra, Ali Hassan, Verma) Department of Surgery, University of Toronto,
Toronto, ON, Canada
(Moroney, Casey) School of Medicine, Royal College of Surgeons in Ireland,
Dublin, Ireland
(Khan) Division of Endocrinology and Metabolism, St. Joseph's Healthcare
Centre, London, ON, Canada
(Khan) Department of Medicine, Western University, London, ON, Canada
(Hess, Koschinsky) Department of Physiology and Pharmacology, Western
University, London, ON, Canada
(Hess, Koschinsky) Robarts Research Institute, London, ON, Canada
(Hess, Verma) Department of Pharmacology and Toxicology, University of
Toronto, Toronto, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting (CABG) remains a cornerstone
in the management of coronary artery disease (CAD). In nonurgent surgical
revascularization cases, preoperative optimization of modifiable risk
factors can improve outcomes. There is increasing interest in the
relationship between lipoprotein(a) levels and the risk for ischemic
cardiovascular disease, particularly how CABG outcomes are in turn
affected. This review highlights the role of lipoprotein(a) in the
pathogenesis of CAD and CABG outcomes and discusses future directions for
its optimal management in the perioperative period. Method(s): The
PubMed/MEDLINE database was reviewed until March 2024 to capture
publications that evaluated and/or described the relationship between
lipoprotein(a) and CABG surgery or CAD outcomes. Result(s): The
available literature supports lipoprotein(a) as a causal and independent
risk factor for the pathogenesis of CAD. Elevated lipoprotein(a) levels
are associated with an increased risk of adverse post-CABG outcomes,
including graft occlusion incidence and major adverse cardiovascular
events. Genetic variations influencing lipoprotein(a) levels play a role
in disease progression and surgical outcomes. Several therapies aimed at
reducing lipoprotein(a) levels, currently in phase III clinical trials,
show promise for improving the prognosis after CABG. Conclusion(s):
Among individuals undergoing surgical revascularization for CAD,
lipoprotein(a) levels may help define risk and inform best practices for
perioperative management. We advocate for the routine measurement of
lipoprotein(a) in all patients undergoing CABG. Emerging
lipoprotein(a)-lowering agents show promise for secondary prevention of
cardiac events, although dedicated analyses in cardiac surgical subcohorts
will be important to evaluate their role in improving CABG
outcomes. Copyright © 2025 The Authors

<131>
Accession Number
2037501908
Title
700.65 Comparison of Surgical Aortic Valve Replacement (SAVR) Versus
Transcatheter Aortic Valve Replacement (TAVR) For Symptomatic Severe
Bicuspid Aortic Valve Stenosis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S101), 2025. Date of Publication: 24 Feb
2025.
Author
Cilingiroglu M.; Marmagkiolis K.; Iliescu C.; Inanc I.
Institution
(Cilingiroglu, Marmagkiolis, Iliescu, Inanc) UT Houston MD Anderson Cancer
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Bicuspid aortic valve (BAV) stenosis poses unique challenges
in valve replacement due to the valve's anatomical variations. This paper
compares the clinical outcomes, procedural success, and complications of
surgical aortic valve replacement (SAVR) and transcatheter aortic valve
replacement (TAVR) in patients with symptomatic severe bicuspid aortic
valve stenosis. Method(s): A systematic search was conducted in
PubMed, Embase, and the Cochrane Library to identify studies comparing
SAVR and TAVR in patients with symptomatic severe BAV stenosis. Outcomes
assessed included all-cause mortality, major adverse cardiovascular events
(MACE), valve hemodynamics, and procedural complications. Data were
extracted and analyzed using random-effects models to calculate pooled
odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals
(CIs). Result(s): Ten studies with a total of 5,487 patients were
included. TAVR was associated with a lower 30-day mortality rate (OR 0.68,
95% CI 0.52-0.89, p=0.004) and shorter hospital stay (MD -3.5 days, 95% CI
-4.2 to -2.8, p<0.001) compared to SAVR. SAVR showed a lower rate of
pacemaker implantation (OR 1.45, 95% CI 1.20-1.75, p<0.001) and better
valve hemodynamics (MD 0.9 mmHg, 95% CI 0.4-1.4, p=0.001). There was no
significant difference in long-term all-cause mortality (OR 1.02, 95% CI
0.88-1.17, p=0.81) between the two groups. Conclusion(s): TAVR and
SAVR offer distinct benefits for patients with symptomatic severe BAV
stenosis. TAVR is associated with lower short-term mortality and faster
recovery, while SAVR provides better valve hemodynamics and lower
complication rates. The choice between SAVR and TAVR should be
individualized based on patient-specific factors and anatomical
considerations. Copyright © 2025

<132>
Accession Number
2037514654
Title
Systematic Review of the Comparative Studies of Image-Guided Thermal
Ablation, Stereotactic Radiosurgery, and Sublobar Resection for Treatment
of High-Risk Patients with Stage I Non-Small Cell Lung Cancer: The
American Association for Thoracic Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Pennathur A.; Lanuti M.; Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.;
Suh R.D.; Mak R.H.; Brunelli A.; Criner G.J.; Mazzone P.J.; Walsh G.;
Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Pettiford B.;
Rocco G.; Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.;
Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, UPMC Hillman Cancer Center, Pittsburgh, PA, United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Keshavarz) Department of Family Medicine, McMaster University, Ontario,
Canada
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Wafford) The American Association for Thoracic Surgery, Beverly,
Massachusetts, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
Publisher
W.B. Saunders
Abstract
The Clinical Practice Standards Committee of the American Association for
Thoracic Surgery assembled an expert panel and conducted a systematic
review of the literature detailing studies directly comparing treatment
options for high-risk patients with stage I non-small cell lung cancer
(NSCLC). A systematic search was performed to identify publications
comparing outcomes following image-guided thermal ablation (IGTA),
stereotactic ablative radiotherapy (SABR; also called stereotactic body
radiation therapy [SBRT] and stereotactic radiosurgery [SRS]), and
sublobar resection-the main treatment options applicable to high-risk
patients with stage I NSCLC. There were no publications detailing
completed randomized controlled trials comparing these treatment options.
Several retrospective studies with comparisons were identified, some of
which used large, population-based registries. The findings of several of
these studies are summarized in this Expert Review article. Registry
studies comparing IGTA with SABR in propensity-score matched patients with
stage I NSCLC found no difference in overall survival. The use of thermal
ablation was less frequent and had wider variation depending on geographic
region as compared with SABR, however. Studies yielding high-quality data
comparing SABR with sublobar resection have been limited. When comparing
sublobar resection with IGTA, sublobar resection was associated with
superior primary tumor control and overall survival in the retrospective
cohort studies. Retrospective comparative studies are difficult to assess
due to the inherent biases or treatment selection and the definitions of
loco-regional control. Prospective randomized trials are needed to fully
evaluate the outcomes of treatment options applicable to high-risk
patients with early-stage lung cancer. Copyright © 2025

<133>
Accession Number
2037514971
Title
Systematic Review of Stereotactic Ablative Radiotherapy
(SABR)/Stereotactic Body Radiation Therapy (SBRT) for Treatment of
High-Risk Patients with Stage I Non-Small Cell Lung Cancer: The American
Association of Thoracic Surgery Expert Consensus Document.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Wolf A.; Loo B.W.; Mak R.H.; Liptay M.; Pettiford B.; Rocco G.; Lanuti M.;
Merritt R.E.; Keshavarz H.; Suh R.D.; Brunelli A.; Criner G.J.; Mazzone
P.J.; Walsh G.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Luketich
J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.; Pennathur A.; Swanson
S.J.
Institution
(Luketich, Schuchert, Pennathur) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, UPMC Hillman Cancer Center, Pittsburgh, PA, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, Massachusetts, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pennsylvania, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, North
Carolina, United States
(Wafford) The American Association for Thoracic Surgery, Beverly,
Massachusetts, United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, Massachusetts, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Illinois, United States
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, California, United
States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, Louisiana, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, California,
United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
North Carolina, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, Utah, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, New York, United States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Texas, United States
(Keshavarz) Department of Family Medicine, McMaster University, ON, Canada
Publisher
W.B. Saunders
Abstract
Stereotactic ablative radiotherapy (SABR) has emerged as an alternative,
non-surgical treatment for high-risk patients with stage I non-small cell
lung cancer (NSCLC) with increased use over time. The American Association
for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC)
assembled an expert panel and conducted a systematic review of the
literature evaluating the results of SABR, which is also referred to as
stereotactic body radiation therapy (SBRT) or stereotactic radiosurgery
(SRS), prior to developing treatment recommendations for high-risk
patients with stage I NSCLC based on expert consensus. Publications
detailing the findings of 16 prospective studies of SABR and 14
retrospective studies of SABR for the management of early-stage lung
cancer in 54,697 patients were identified by systematic review of the
literature with further review by members of our expert panel. Medical
inoperability (93-95%) was the primary reason for utilizing SABR. The
median rate of histologically confirmed cancer in treated patients was 67%
(range 57-86%). In retrospective studies and prospective studies, the most
common dosing regimens were 48-54 Gy in 3-5 fractions and 44-66 Gy in 3-5
fractions respectively. The median follow-up after SABR was 30 months
(range 15-50). The complications, oncological results and quality of life
after SABR in high-risk patients with early-stage NSCLC are summarized in
this Expert Review article. Further prospective randomized trials are
needed and are currently underway to compare outcomes after SABR with
outcomes after sublobar resection to fully evaluate treatment options
applicable this high-risk group of patients. Copyright © 2025

<134>
Accession Number
2037539830
Title
Transcatheter versus surgical aortic valve replacement in patients younger
than 65 years in the United States.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Alabbadi S.; Bowdish M.E.; Sallam A.; Tam D.Y.; Hasan I.; Kumaresan A.;
Alzahrani A.H.; Iribarne A.; Egorova N.; Chikwe J.
Institution
(Alabbadi, Alzahrani, Egorova) Department of Population Health Science and
Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Bowdish, Sallam, Tam, Hasan, Kumaresan, Chikwe) Department of Cardiac
Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
Calif, United States
(Sallam) National Clinician Scholars Program, University of California,
Los Angeles, Los Angeles, Calif, United States
(Iribarne) Department of Cardiothoracic Surgery, Staten Island University
Hospital, Northwell Health, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to characterize the trends and outcomes
of aortic valve replacement in patients aged less than 65 years with
aortic stenosis between 2013 and 2021. Method(s): This retrospective
analysis included 9557 patients who underwent biological aortic valve
replacement in California, New York, and New Jersey from 2013 to 2021.
Patients were stratified by approach: transcatheter aortic valve
replacement versus surgical aortic valve replacement. Our primary outcomes
were 30-day and 6-year mortality and morbidity (stroke, heart failure
rehospitalization, reintervention, and new pacemaker implantation). After
propensity score matching, Cox proportional hazard and Fine-Gray models
were used to compare outcomes after transcatheter aortic valve replacement
and surgical aortic valve replacement. Result(s): The proportion of
patients aged less than 65 years with aortic stenosis undergoing
transcatheter aortic valve replacement versus surgical aortic valve
replacement increased from 7.1% in 2013 to 54.7% in 2021. After propensity
score matching, 30-day mortality was similar between both groups (1.0% vs
1.5%, P = .33). Transcatheter aortic valve replacement had a higher 6-year
mortality (23.3% vs 10.5%, hazard ratio, 2.27; 95% CI, 1.82-2.83; P <
.001). The 30-day rate of new pacemaker implantation was higher after
transcatheter aortic valve replacement (10.7% vs 6.2%, P < .001). There
was no difference in the 6-year cumulative incidence of stroke, heart
failure hospitalizations, or reoperations. Multiple sensitivity analyses
confirmed these findings. Conclusion(s): Despite clinical guidelines,
the use of transcatheter aortic valve replacement has increased in
patients aged less than 65 years. Transcatheter aortic valve replacement
in this population is associated with a higher 6-year mortality and a
higher rate of new permanent pacemaker implantation when compared with a
matched cohort treated with biologic surgical aortic valve replacement.
These findings support the need for a randomized controlled trial
comparing long-term outcomes of transcatheter aortic valve replacement
versus surgical aortic valve replacement in patients aged less than 65
years. Copyright © 2025

<135>
Accession Number
2037500683
Title
700.82 Transcatheter Tricuspid Valve Replacement for Severe Tricuspid
Regurgitation: A Metanalysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S114-S115), 2025. Date of Publication: 24 Feb
2025.
Author
Vorla M.; Guntuku S.; Kurpad K.; AlWahadneh O.; Adoni N.; Mehta S.
Institution
(Vorla, Kurpad, AlWahadneh, Adoni, Mehta) Carle Foundation Hospital,
Champaign, IL, United States
(Guntuku) Mamata Medical College, Khammam, India
Publisher
Elsevier Inc.
Abstract
Background: Severe tricuspid regurgitation (TR) is often associated with
substantial morbidity and poor quality of life. Currently, there are
multiple emerging percutaneous interventions, including tricuspid valve
replacement (TVR), with improvement in quality of life and symptom burden.
We conducted a meta-analysis to assess the efficacy of transcatheter
tricuspid valve replacement (TVR) in patients with severe TR.
 Method(s): Electronic databases, including PubMed, Embase, and
Cochrane, were systemically searched using the keywords "tricuspid
regurgitation" and "transcatheter tricuspid valve replacement." We
conducted our analysis using RevMan version 5.4. Primary outcomes included
mean change in 6-minute walk distance (6MWD) and patient-reported Kansan
CityCardiomyopathy Questionnaire (KCCQ) pre and post-intervention.
Secondary outcomes included the occurrence of New York Heart Association
(NYHA) >= grade 3 dyspnea post-TVR. Result(s): We included nine
studies involving 883 participants with a median follow-up of 6 months.
Random effect analysis showed a statistically significant improvement in
6MWD(mean change -108 m, 95% CI-81.6, 134.4, p-0.00001) and KCCQ (mean
change -27.12,95% CI-24.1, 30.1, p-0.00001) post-TVR [figure 1,2].
Furthermore, we also observed a statistically significant reduced
incidence of NYHA grade >= 3 dyspnea (risk ratio -0.04, 95%CI-0.02, 0.11,
p-0.00001) post-TVR [figure 3]. Conclusion(s): Transcatheter TVR is
associated with improved quality of life and symptoms in patients with
severe TR. However, further randomized clinical trials with longer
follow-ups evaluating sustained TR reduction are needed to validate our
findings. [Formula presented] Copyright © 2025

<136>
Accession Number
2037515516
Title
Effect of Enhanced Recovery After Surgery (ERAS) Programs on Perioperative
Outcomes in Patients Undergoing Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Diz-Ferreira E.; Diaz-Vidal P.; Fernandez-Vazquez U.; Gil-Casado C.;
Luna-Rojas P.; Diz J.C.
Institution
(Diz-Ferreira) Well-Move Research Group, University of Vigo, School of
Medicine, University of Santiago de Compostela, Spain
(Diaz-Vidal, Fernandez-Vazquez, Gil-Casado, Luna-Rojas) School of
Medicine, University of Santiago de Compostela, Spain
(Diz) Department of Anesthesia and Postoperative Critical Care, Hospital
Alvaro Cunqueiro, Vigo, Department of Functional Biology and Health
Sciences, Well-Move Research Group, University of Vigo, Spain
Publisher
W.B. Saunders
Abstract
Background: Enhanced recovery after surgery (ERAS) programs emerged as a
strategy to reduce perioperative morbidity; however, there is currently
limited evidence of their clinical efficacy. The objective of this study
was to assess the impact of ERAS programs in cardiac surgery on hospital
length of stay, mortality, atrial fibrillation, and quality of life.
 Method(s): A systematic review and meta-analysis were conducted in
accordance with the Preferred Reporting Items for Systematic reviews and
Meta-Analyses statement, encompassing studies on ERAS programs in adult
patients undergoing elective cardiac surgery. The effect size and 95%
confidence interval (CI) were estimated with a random-effects model. The
protocol was preregistered on Open Science Framework. Result(s):
Eighteen studies (published between 2016 and 2023) comprising 4,469
patients were included in the analysis, of which only one was a randomized
controlled trial. The implementation of ERAS was associated with a
reduction in hospital stay of 1.24 days (95% CI: -1.67, -0.82, p < 0.001,
I2 = 83%). No differences were observed between the groups in
mortality (odds ratio: 0.65, 95% CI: 0.28, 1.48, p = 0.3, I2 =
0%), nor in the incidence of atrial fibrillation (odds ratio: 0.77, 95%
CI: 0.57, 1.03, p = 0.08, I2 = 17%). A meta-analysis of quality
of life was not feasible due to a lack of sufficient data.
 Conclusion(s): Although ERAS programs were associated with a
reduction in hospital stay and no differences in mortality or atrial
fibrillation, the quality of the evidence was very low. To recommend the
implementation of ERAS programs in cardiac surgery, it is necessary to
have randomized studies providing evidence of its efficacy, and studies
including quality of life and other patient-centered recovery criteria
outcomes. Copyright © 2025 Elsevier Inc.

<137>
Accession Number
2037501334
Title
700.74 Comparison of Same-Day Discharge Versus Routine Hospital Stay for
Patients Undergoing Left Atrial Appendage Occlusion (LAAO): Safety,
Effectiveness, and Financial Implications.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S105), 2025. Date of Publication: 24 Feb
2025.
Author
Cilingiroglu M.; Iliescu C.; Marmagkiolis K.; Inanc I.
Institution
(Cilingiroglu, Iliescu, Marmagkiolis, Inanc) UT Houston MD Anderson Cancer
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage occlusion (LAAO) is a procedure
performed to reduce the risk of stroke in patients with atrial
fibrillation (AF). Traditionally, patients are kept under observation
post-procedure, but recent studies have explored the feasibility of
same-day discharge. This paper compares the safety, effectiveness, and
financial implications of same-day discharge versus routine hospital stay
for patients undergoing LAAO. Method(s): A systematic review and
meta-analysis were conducted, including studies comparing same-day
discharge and routine hospital stay following LAAO. Outcomes assessed
included procedure-related complications, 30-day readmission rates,
patient satisfaction, and healthcare costs. Data were analyzed using
random-effects models to calculate pooled odds ratios (ORs) and mean
differences (MDs) with 95% confidence intervals (CIs). Result(s):
Seven studies with a total of 2,350 patients were included. There were no
significant differences in procedure-related complications (OR 1.05, 95%
CI 0.80-1.38, p=0.74) or 30-day readmission rates (OR 0.95, 95% CI
0.70-1.28, p=0.73) between same-day discharge and routine hospital stay.
Patient satisfaction was higher in the same-day discharge group (MD 1.20,
95% CI 0.80-1.60, p<0.001). Healthcare costs were significantly lower for
same-day discharge (MD -$1,500, 95% CI -$2,000 to -$1,000, p<0.001).
 Conclusion(s): Same-day discharge following LAAO is as safe and
effective as routine hospital stay, with the added benefits of higher
patient satisfaction and reduced healthcare costs. Implementation of
same-day discharge protocols should be considered to enhance patient care
and optimize resource utilization. Copyright © 2025

<138>
Accession Number
2037501336
Title
700.77 Comparison of Transesophageal and Intracardiac Approaches for
Visualization of Left Atrial Appendage Occlusion.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S105), 2025. Date of Publication: 24 Feb
2025.
Author
Wells J.I.; Iyer V.; Ahmed M.A.-A.
Institution
(Wells, Iyer, Ahmed) Jacobs School of Medicine and Biomedical Sciences,
Buffalo, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Echocardiography facilitates high-definition visualization of
the heart and allows for precise guidance during structural heart
interventions. While traditionally accomplished through a transesophageal
approach (TEE), intracardiac echocardiography (ICE) has emerged as a
viable alternative and has found utility in left atrial appendage
occlusion (LAAO), an alternative strategy for patients with atrial
fibrillation who have contraindications to anticoagulation. Compared to
TEE, ICE offers superior image resolution, less sedation requirements, and
is not constrained by body habitus. However, ICE requires an extra
vascular access site and there is limited data regarding its success rate
or procedure duration compared to TEE. Method(s): We identified 17
patients who had received 3D or 4D ICE imaging for LAAO at Gates Vascular
Institute from January 2022 to March 2024 and compared procedure times,
fluoroscopy times, success rates, and peri-operative complications to a
randomized cohort of 17 patients over the same period who had received TEE
imaging for LAAO. [Formula presented] Conclusion(s): There was a
significant increase in procedure and fluoroscopy durations in LAAO-ICE
patients compared to LAAO-TEE, while the success rate of these procedures
was similar. While ICE may broaden the pool of patients eligible for
cardiac interventions and present advantages in image quality and
anesthesia requirements, increased procedure times may reduce the number
of patients who can be scheduled for interventions. Additionally,
increased time under anesthesia is associated with venous thromboembolism,
longer hospital courses, and returns to the OR, and longer fluoroscopy
times are correlated with an increased cumulative risk of developing
malignancy. Copyright © 2025

<139>
Accession Number
646510933
Title
Intravenous amino acids for kidney protection in patients undergoing
cardiac surgery: A systematic review and meta-analysis of randomized
controlled trials.
Source
The Journal of international medical research. 53(2) (pp
3000605251315919), 2025. Date of Publication: 01 Feb 2025.
Author
Khan M.W.Z.; Hussain A.; Mian A.M.; Moeez A.; Inayat W.; Noor B.; Shah
I.A.; Osama M.; Khan B.; Sajid M.; Azeem T.; Ebad Ur Rehman M.; Ali A.;
Afridi U.K.
Institution
(Khan) Department of Medicine, Yale University School of Medicine, New
Haven, United States
(Ali, Mian, Moeez, Inayat, Noor, Shah, Osama, Sajid, Azeem, Ali)
Department of Medicine, Khyber Medical College, Peshawar, Pakistan
(Hussain) Department of Medicine, Liaquat University of Medical and Health
Sciences, Pakistan
(Khan) Department of Medicine, Bacha Khan Medical College, Mardan,
Pakistan
(Ebad Ur Rehman) Department of Medicine Rawalpindi Medical University,
Rawalpindi, Pakistan
(Afridi) Division of Cardiology, University of Maryland School of
Medicine, MD, United States
Abstract
OBJECTIVE: To evaluate the efficacy of intravenous (IV) amino acids in
preventing acute kidney injury (AKI) in patients undergoing cardiac
surgery. METHOD(S): PubMed, EMBASE, and Cochrane Library databases
were systematically searched for all relevant randomised controlled trials
(RCTs) published from inception to July 25, 2024. A random effects model
was used to pool the risk ratios (RR) for dichotomous outcomes, and the
combined data was visually represented using forest plots. RESULT(S):
3 studies involving 3646 patients were included in the meta-analysis. IV
amino acids did not significantly lower the overall AKI incidence compared
with control measures. However, they significantly reduced the risk of
Stage 1 AKI and Stage 3 AKI. No differences were observed between
intervention and control for Stage 2 AKI or need for kidney replacement
therapy. CONCLUSION(S): IV amino acids may offer protective benefits
against severe AKI stages in cardiac surgery patients. Further studies are
warranted to validate our findings.

<140>
Accession Number
2037500598
Title
700.13 Outcomes of Intracardiac Versus Transesophageal Echocardiography
for Guidance of Left Atrial Appendage Occlusion: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S103-S104), 2025. Date of Publication: 24 Feb
2025.
Author
Ahmed H.; Ismayl M.; Mangat M.; Palicherla A.; Petraskova T.; Goldsweig A.
Institution
(Ahmed, Palicherla, Petraskova) Creighton University School of Medicine,
Omaha, NE, United States
(Ismayl) Mayo Clinic, Rochester, MN, United States
(Mangat) The Ohio State University Wexner Medical Center, Columbus, OH,
United States
(Goldsweig) Baystate Medical Center, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: While transesophageal echocardiography (TEE) remains the
conventional imaging modality for guidance of left atrial appendage
occlusion (LAAO), intracardiac echocardiography (ICE) has become
increasingly performed. The safety and efficacy of ICE compared to TEE in
the guidance of left atrial appendage occlusion, however, remains unclear.
 Method(s): We searched PubMed and Cochrane databases for studies
comparing outcomes of ICE-guided LAAO versus TEE-guided LAAO interventions
through February 2024. Outcomes assessed were all-cause mortality, cardiac
tamponade, device-related thrombus, major bleeding, peri-device leaks, and
stroke. We used a fixed-effects model to calculate pooled risk risk ratios
(RR) and their 95% confidence intervals (CI) for outcomes assessed.
 Result(s): A total of 7 studies were identified consisting of 36,182
patients. There were no significant differences between ICE-guided LAAO
and TEE-guided LAAO in all-cause mortality (RR 1.27; 95% CI 0.86-1.88),
cardiac tamponade (RR 0.87; 95% CI 0.35-2.13), device-related thrombus (RR
0.81; 95% CI 0.25-2.67), major bleeding (RR 0.68; 95% CI 0.34-1.39),
peri-device leaks (RR 0.78; 95% CI 0.53-1.15), and stroke (RR 0.43; 95% CI
0.15-1.21). Conclusion(s): Our study suggests that ICE-guided LAAO
yields comparable outcomes to TEE-guided LAAO. Therefore, it is reasonable
to consider ICE for the guidance of LAAO. Further studies are needed to
confirm our findings. [Formula presented] Copyright © 2025

<141>
Accession Number
2037500513
Title
700.41 Comparison Of Hemodynamic Performance Between Myval and Sapien 3
Ultra Resilia - Insights From Published Data.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S95-S96), 2025. Date of Publication: 24 Feb
2025.
Author
Tobe A.; Onuma Y.; Soliman O.; Baumbach A.; Serruys P.W.
Institution
(Tobe, Onuma, Soliman, Serruys) University of Galway, Galway, Ireland
(Baumbach) Queen Mary University of London, London, United Kingdom, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: In the randomized LANDMARK trial, Myval transcatheter heart
valve (THV) series demonstrated a non-inferiority with respect to clinical
outcomes at 30 days compared with the contemporary standard THVs (Sapien
and Evolut series) in patients with severe aortic stenosis. The effective
orifice area (EOA) at 30 days was significantly higher in Myval than in
Sapien series. Recently, it was reported that the Sapien 3 Ultra Resilia
(S3UR) had a larger EOA compared with Sapien 3 (S3) and Sapien 3 Ultra
(S3U). In the LANDMARK trial, S3UR was not included. Method(s): To
assess the hemodynamic performance of Myval series and S3UR, we compared
post-procedural EOA between Myval series and S3UR using the published
data; For Myval series, the data of the LANDMARK trial, and for S3UR, data
of TVT and OCEAN-TAVI registries were used. In the LANDMARK trial, 30-day
echocardiograms were analyzed by an independent core lab. In the TVT
registry, site-reported echocardiograms at discharge, and in the
OCEAN-TAVI registry, site-reported post-procedural echocardiograms were
used. Result(s): The Figure shows the EOA for each valve type and
size. Myval seems to have EOAs comparable to those of S3UR.
 Conclusion(s): We acknowledge that there are many limitations in this
simple comparison, and we cannot draw definitive conclusions. Therefore,
while this study provides an initial insight into hemodynamic performance
of Myval and S3UR, dedicated future studies comparing these new
technologies are warranted. [Formula presented] Copyright © 2025

<142>
Accession Number
2037511583
Title
Outcomes of aortic stenosis in patients with cardiac amyloidosis: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Ahmad S.; Ahsan M.J.; Newlun M.; Sand M.; Rmilah A.A.; Yousaf A.; Shabbir
M.A.; Malik S.A.; Goldsweig A.M.
Institution
(Ahmad, Shabbir, Malik, Goldsweig) Division of Cardiovascular Medicine,
University of Nebraska Medical Center, Omaha, NE, United States
(Ahsan) Department of Cardiovascular Medicine, Baylor University Medical
Center, Dallas, TX, United States
(Newlun, Sand) Department of Medicine, University of Nebraska Medical
Center, Omaha, NE, United States
(Rmilah) Department of Medicine, Magnolia Regional Health Center, Corinth,
MS, United States
(Yousaf) Department of Medicine, McLaren Flint-Michigan State University,
Flint, MI, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and University of Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiac amyloidosis (CA) results from the deposition of
abnormally folded protein fibrils, leading to restrictive cardiomyopathy,
valvular heart disease, and arrhythmias. Up to 15 % of patients with
severe aortic stenosis (AS) have concomitant CA (AS-CA). We conducted this
systematic review and meta-analysis to compare medical management,
transcatheter aortic valve replacement (TAVR), and surgical AVR (SAVR) in
AS-CA. Method(s): A comprehensive literature search was conducted for
relevant studies from inception through January 20, 2024. Studies
exploring outcomes in adult AS patients with and without CA receiving
medical therapy, TAVR, or SAVR were included in this analysis.
 Result(s): Fifteen studies including 253,334 patients (AS-CA 6704; AS
alone 246,630) were identified. AS-CA patients had significantly higher
all-cause mortality (RR = 2.60, 95 % CI 1.48-4.57, P = 0.0009) compared to
AS alone. Among patients with AS-CA, TAVR was associated with lower
all-cause mortality compared to both medical therapy (RR = 0.50, 95 % CI
0.29-0.89, P = 0.02) and SAVR (RR = 0.41, 95 % CI 0.22-0.78, P = 0.007).
AS-CA patients undergoing TAVR were more likely to have paradoxical
low-flow, low-gradient AS (RR = 1.56, 95 % CI 1.15-2.12, P = 0.04) at
baseline and had a higher risk of post-TAVR acute kidney injury (RR =
1.95, 95 % CI 1.35-2.80, P = 0.0003) compared to patients undergoing TAVR
for AS alone. There were similar risks of other post-TAVR complications,
including major bleeding, vascular complications, stroke, and new
pacemaker implantation between AS-CA and AS alone. Conclusion(s): CA
is associated with a higher mortality in patients with severe AS. In
patients with concomitant AS and CA, TAVR is safe and associated with
better survival than medical therapy or SAVR. Social media abstract:
#Meta-Analysis: Cardiac amyloidosis is associated with increased mortality
in severe AS. #TAVR is safe in amyloidosis & improves survival more than
medical therapy or SAVR. Copyright © 2025 Elsevier Inc.

<143>
Accession Number
2037540471
Title
Nonocclusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.
Source
Annals of Vascular Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Murtada A.; Jubouri M.; Refaie M.; Mohammed I.
Institution
(Murtada, Refaie) Department of General Surgery, Glan Clwyd Hospital,
Rhyl, United Kingdom
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Mohammed) Institute of Cardiac and Aortic Disorders, SRM Institutes for
Medical Science (SIMS Hospitals), Chennai, India
Publisher
Elsevier Inc.
Abstract
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute
mesenteric ischemia (AMI), is primarily caused by mesenteric arterial
vasoconstriction and decreased vascular resistance, leading to impaired
intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects
older patients with cardiovascular or systemic diseases, accounting for
20-30% of AMI cases with a mortality rate of ~50%. This review explores
NOMI's pathophysiology, clinical implications in aortic dissection, and
the unmet needs in diagnosis and management, emphasizing its prognostic
significance. Method(s): A comprehensive literature review was
conducted using multiple electronic databases to extract relevant data and
information. Result(s): NOMI is a life-threatening condition
characterized by mesenteric vasoconstriction and reduced splanchnic blood
flow, often triggered by cardiac surgery, hemodialysis, or hypotensive
episodes. Epidemiological studies highlight its prevalence in intensive
care unit settings, with a high mortality rate linked to delayed diagnosis
and systemic hypoperfusion. Risk factors include advanced age, vasopressor
use, and inflammatory markers. Biomarkers such as intestinal fatty acid
binding protein, citrulline, and D-lactate show potential for early
detection but lack robust clinical validation. Management includes fluid
resuscitation, vasodilators, and surgical intervention for bowel necrosis.
Emerging endovascular approaches show promise but are limited to select
cases without bowel infarction. This review underscores the critical need
for timely diagnosis, risk factor identification, and tailored
interventions to improve outcomes. Conclusion(s): NOMI remains poorly
understood despite advances in surgical and perioperative care. Its
pathophysiology, linked to cardiopulmonary bypass and intraoperative
factors, requires heightened clinical vigilance. Limited evidence
underscores the need for a multidisciplinary approach involving surgeons,
radiologists, and anesthetists to improve diagnosis, management, and
outcomes in aortic surgery patients. Copyright © 2025 Elsevier
Inc.

<144>
Accession Number
2037502334
Title
700.44 Outcomes Following Transcatheter Aortic Valve Implantation: A
Contemporary Observational Study.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S96-S97), 2025. Date of Publication: 24 Feb
2025.
Author
Alharbi B.A.; Hammond-Haley M.; Khawaja S.; Alshahrani N.S.; Fathima Z.;
Verhemel S.; Sharma T.; Mikhail G.; Ruparelia N.; Hadjiloizou N.; Malik
I.; Khamis R.; Hartley A.
Institution
(Alharbi, Verhemel, Sharma, Khamis, Hartley) Imperial College London,
LONDON, United Kingdom, United Kingdom
(Hammond-Haley, Khawaja, Mikhail, Ruparelia, Hadjiloizou, Malik) Imperial
College Healthcare NHS Trust, LONDON, United Kingdom, United Kingdom
(Alshahrani) King Khalid University, Abha, Saudi Arabia, Saudi Arabia
(Fathima) First Faculty of Medicine, Prague, Czech Republic, Czechia
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Implantation (TAVI) is expanding,
placing a growing demand on healthcare resources, with common post-TAVI
complications, such as conduction disturbances, prolonging hospital stays
and exacerbating these challenges. The aim of this study was to assess
outcomes and length of stay following TAVI in contemporary practice, to
provide the rationale and inform the methodology of an upcoming randomised
controlled trial of telemedicine-facilitated early discharge (TELE-TAVI,
NCT06602609). Method(s): We performed a retrospective observational
study of consecutive patients undergoing TAVI at a UK tertiary centre
between April 2021 and March 2024. Outcome data included permanent
pacemaker (PPM) implantation, emergency department presentation, unplanned
re-hospitalisation and all-cause mortality. Patients were followed for a
minimum of 6 months post-TAVI. Result(s): A total of 801 patients
were included, with a mean age of 81+/-8, and were 42% female.
Balloon-expandable valves were used in 432 patients (53%) and transfemoral
access was utilised in 766 patients (96%). 153 patients (19%) required
permanent pacemaker implantation after TAVI. There was a significant
difference in PPM rates between balloon-expandable and self-expanding
valves, with 69 patients (16%) vs 84 patients (22%), respectively (p <
0.05). The median post-procedural length of stay was 3 days (IQR: 1-5
days). One-year unplanned re-hospitalization occurred in 14% (113
patients) and one-year all-cause mortality was 11% (92 patients).
 Conclusion(s): The average length of stay post-TAVI was 3 days.
However, there is significant heterogeneity in the length of stay, likely
influenced post-TAVI complications including the need for cardiac rhythm
monitoring and PPM implantation. These data, from a UK tertiary centre,
have helped to inform the TELE-TAVI study, investigating the role of
telemonitoring and remote monitoring in facilitating same day discharge
following TAVI. Copyright © 2025

<145>
Accession Number
646510885
Title
Impact of Intensified Outpatient Follow-up on Rehospitalization after
Transcatheter Aortic Valve Implantation: Results from the HOSPITAVI Trial.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 01 Feb 2025.
Author
Baekke P.S.; Jorgensen T.H.; Bieliauskas G.; Sondergaard L.; De Backer O.
Institution
(Baekke) Heart Center, Rigshospitalet, Copenhagen, Denmark
(Jorgensen, Bieliauskas, De Backer) Heart Center, Rigshospitalet,
Copenhagen, Denmark
(Sondergaard) Abbott, Santa Clara, California, United States
Abstract
BACKGROUND: Patients undergoing transcatheter aortic valve implantation
(TAVI) are at increased risk of rehospitalization in the early period
after discharge from TAVI. AIMS: The HOSPITAVI study aimed to compare the
impact of a standard vs. intensified outpatient follow-up on
rehospitalization rates within 90 days after TAVI discharge.
 METHOD(S): Patients were 1:1 randomized to either a standard or
intensified outpatient follow-up after TAVI discharge. The primary
endpoint was the 90-day hospital rehospitalization rate. RESULT(S):
In total, 300 patients were included: 150 patients were randomized to
standard follow-up and 150 patients to intensified outpatient follow-up.
The study population had a median age of 79 years, a median EuroSCORE II
of 2.9%, and 72% were discharged the day after TAVI. Within 90 days after
discharge, the mean number of all-cause hospital readmissions per patient
was 0.44 vs. 0.35 (HR 0.8 [95%CI: 0.6-1.2], P=0.23) in the standard vs.
intensified group, respectively. The mean number of cardiovascular (CV)
readmissions per patient was 0.27 vs. 0.15 (HR 0.6 [95%CI: 0.4-1.0],
P=0.04) in the standard vs. intensified group, respectively. This resulted
in a mean number of CV readmission days per patient of 1.52 days vs. 0.49
days within the first 90 days in the standard vs. intensified group,
respectively (P<0.05). CONCLUSION(S): Following TAVI discharge, there
was no significant difference in all-cause rehospitalization rates using a
standard vs. intensified outpatient follow-up approach. However, an
intensified outpatient follow-up reduces the burden of early CV
rehospitalization after TAVI discharge. (Rehospitalization after
transcatheter aortic valve implantation [HOSPITAVI];
NCT05670041). Copyright © 2025. Published by Elsevier Inc.

<146>
Accession Number
2037500732
Title
700.80 Use of Chronic Oral Anticoagulation Versus Left Atrial Appendage
Closure in End-Stage Liver Disease Patients With Atrial Fibrillation.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S105-S106), 2025. Date of Publication: 24 Feb
2025.
Author
Cilingiroglu M.; Iliescu C.; Marmagkiolis K.
Institution
(Cilingiroglu, Iliescu, Marmagkiolis) UT Houston MD Anderson Cancer
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: This meta-analysis aims to compare the efficacy and safety of
chronic oral anticoagulation (OAC) versus left atrial appendage occlusion
(LAAO) in patients with end-stage liver disease (ESLD) who are at risk of
stroke due to atrial fibrillation (AF). Method(s): A systematic
literature search was conducted in Pubmed, Emboss, and Cochrne Library for
studies published between January 2000 and June 2023. Randomized
controlled trials (RCTs) and observational studies comparing OAC and LAAO
in ESLD patients with AF were included. The primary outcomes analyzed were
stroke prevention, bleeding complications, all-cause mortality, and
procedural success. Pooled odds ratios (Ors) and hazard ratios (HRs) with
95% confidence intervals (CIs) were calculated using a random-effects
model. Result(s): 24 studies met the inclusion criteria, comprising 8
RCTs and 12 observational studies, with a total of 7,200 patients. Stroke
prevention was found to be comparable between the LAAO and OAC groups (OR:
0.90:95% CI:0.78-1.03;p=0.12). The incidence of bleeding complications was
significantly lower in the LAAO group (OR:0.45;95% CI:0.38-0.53;p<0.001).
All-cause mortality was similar between two groups (HR: 0.97; 95%
CI:0.87-1.09; p=0.68). The procedural success rate for LAAO was high at
94%, indicating its feasibility in this high-risk population.
 Conclusion(s): LAAO provides a viable alternative to chronic OAC in
patients with ESLD and AF, offering effective stroke prevention with a
slightly lower risk of bleeding complications. These findings suggest that
LAAO may be preferred in ESLD patients at high risk for bleeding. Further
research with long-term follow-up is warranted to confirm these
results. Copyright © 2025

<147>
Accession Number
646509282
Title
Similar Goals, Divergent Paths: Exploring Approaches Towards Hepatitis C
Treatment Protocols in Heart Transplantation.
Source
Journal of cardiac failure. (no pagination), 2025. Date of Publication:
01 Feb 2025.
Author
Rao R.A.; Abraham S.; Vest A.R.; Munnagala M.; Bhardwaj A.; Contreras J.;
Rajapreyer I.; Hall S.
Institution
(Rao) Division of Cardiovascular Medicine, Indiana University School of
Medicine, 1801, N Senate Blvd, Indianapolis, IN 46202, USA
(Abraham) Division of Cardiovascular Medicine, Feinberg School of
Medicine, Northwestern University, Chicago, IL, United States
(Vest) Division of Cardiovascular Medicine, Cleveland Clinic Foundation,
OH, United States
(Munnagala) Department of Cardiology, Miller School of Medicine,
University of Miami, Miami, United States
(Bhardwaj) Department of Cardiology, McGovern Medical School, University
of Texas, Texas Medical Center Houston, Houston, TX, United States
(Contreras) Department of Cardiology, Mount Sinai Medical School, New
York, NY, USA
(Rajapreyer) Department of Cardiology, Tufts Medical Center, Boston,
United States
(Hall) Department of Cardiology, Baylor Scott and White Medical Center
Houston, Dallas, TX, United States
Abstract
BACKGROUND: Heart transplantation from hepatitis C positive donors is on
the rise, yet there exists divergence in approaches to managing recipients
of these organs. Practices range from prophylactic treatment of recipients
prior to transplantation to delayed treatment following the detection of
viremia, with no established consensus on the optimal approach.
 METHOD(S): An online survey was conducted among the heart transplant
centers in the United States of America and Canada from January 2023 to
February 2024. The survey gathered comprehensive information from the
institutions regarding direct antiviral (DAA) therapies used, timing and
duration of DAA, frequency of viral load testing, adverse effects,
virological response and immunosuppressive therapy modifications. The
treatment pathways were categorized based on the timing of treatment
initiation into prophylactic, preemptive, or reactive approaches. Analysis
was restricted to US adult transplant programs that had an HCV transplant
protocol and performed at least one HCV NAT positive transplant. The SRTR
database was queried for total heart transplants using HCV NAT positive
donors. RESULT(S): Of 122 heart transplant programs, 35 (28.7%)
institutions responded. 689 heart transplants (49.1%) using HCV NAT
positive donors were captured across institutions. Among 30 US
institutions performing adult heart transplantation with HCV NAT positive
donor hearts, 5 (16.7%) used prophylactic, 9 (30%) preemptive, and 16
(53.3%) reactive treatment pathways. Most employed pan-genotype DAA
therapies for a median of 12 weeks. Significant heterogeneity existed in
treatment and monitoring protocols. CONCLUSION(S): Practice patterns
for management of HCV NAT positive donor hearts vary significantly.
Establishing registries and Randomized Control Trials for these patients
is crucial for guiding future practices. Copyright © 2025.
Published by Elsevier Inc.

<148>
Accession Number
2037504474
Title
700.06 "Smart" Analysis of the Landmark Trial - Early Outcomes With Latest
Generation Tavi Valves in Patients With a Small Aortic Annulus.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies (CRT) 2025. Washington Hilton Hotel, Washington United
States. 18(4 Supplement) (pp S87), 2025. Date of Publication: 24 Feb 2025.
Author
Serruys P.W.; Tobe A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Ijsselmuiden A.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios
V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; Sousa
Almeida M.D.; van Belle E.; Linke A.; Thakkar A.; Chandra U.; Morice
M.-C.; Soliman O.; Onuma Y.; Baumbach A.
Institution
(Serruys, Tobe, Soliman, Onuma) University of Galway, Galway, Ireland
(van Royen) Radboud University Hospital, Nijmegen, Netherlands
(Amat-Santos) Centro de Investigacion Biomedica en red - Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Hudec) Middle-Slovak Institute of Cardiovascular Diseases, Banska
Bystrica, Slovakia, Slovakia
(Bunc) University Medical Centre Ljubljana, Ljubljana, Slovenia
(Ijsselmuiden) Amphia Hospital, Breda, Netherlands
(Laanmets) North Estonia Medical Centre, Tallinn, Estonia
(Unic) University Hospital Dubrava, Zagreb, Croatia
(Merkely) Semmelweis University Heart and Vascular Centre, Budapest,
Hungary
(Hermanides) Isala Hospita, Zwolle, Netherlands
(Ninios) European Interbalkan Medical Center, Thessaloniki, Greece
(Protasiewicz) Wroclaw Medical University, Wroclaw, Poland, Poland
(Rensing) St Antonius Hospital, Nieuwegein, Netherlands
(Martin) University Hospital of Gran Canaria Dr Negrin, Las Palma, Spain,
Spain
(Feres) Instituto Dante Pazzanese, Sao Paulo, Brazil, Brazil
(Sousa Almeida) NOVA University Lisbon, Lisbon, Portugal
(van Belle) Lille University, Lille, France
(Linke) University of Technology Dresden, Dresden, Germany
(Thakkar, Chandra) Meril Life Sciences Pvt. Ltd., Vapi, India
(Morice) Cardiovascular European Research Center, Paris, France
(Baumbach) Queen Mary University of London and Barts Heart Centre, London,
United Kingdom, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Among patients with severe aortic stenosis (AS) undergoing
transcatheter aortic valve implantation (TAVI), nearly one third have a
small aortic annulus. These patients are at higher risk of prosthetic
valve dysfunction. Recently, the SMART trial reported that the
self-expanding Evolut series was superior to balloon-expandable Sapien
series with respect to echocardiographic hemodynamic outcomes at one year.
The Myval series is a novel balloon-expandable transcatheter heart valve
(THV) whose clinical non-inferiority at 30 days compared to the Evolut and
Sapien series was recently demonstrated in the LANDMARK trial. However,
the performance of Myval series in patients with a small aortic annulus is
unknown. Method(s): The LANDMARK trial is a randomized,
non-inferiority trial conducted in 16 countries, which compares the safety
and effectiveness between Myval THV series and contemporary THV series
(Sapien and Evolut) in accordance with the third Valve Academic Research
Consortium recommendations. The primary endpoint was a composite of
all-cause death, all stroke, bleeding (type 3 or 4), acute kidney injury
stage 2-4, major vascular complication, moderate or severe prosthetic
valve regurgitation (PVR), and permanent pacemaker implantation at 30
days. This sub-study compared the clinical and echocardiographic outcomes
at 30 days in patients with a small aortic annulus (aortic valve annulus
area 430 mm2). Result(s): Out of 768 patients randomized
in the trial, 245 (32%) patients had a small aortic annulus (125 patients
in Myval, 64 in Sapien and 56 in Evolut). The proportions of female in
patients with a small annulus were 86%, 81% and 88% in Myval, Sapien and
Evolut, respectively. At 30 days, the primary composite endpoint occurred
in 24 (20%), 13 (21%) and 18 (33%) patients in Myval, Sapien and Evolut,
respectively (Myval vs Sapien: p=1.00, Myval vs Evolut: p=0.08). Myval had
a lower aortic valve mean pressure gradient (MPG, Myval: 9.3mmHg; Sapien:
11.8mmHg, p<0.01) and a higher effective orifice area (EOA) compared to
Sapien (1.75cm2, 1.53cm2, p<0.01), while having a
higher MPG (Evolut: 5.8mmHg, p<0.01) and lower EOA than Evolut
(2.27cm2, p<0.01). Conclusion(s): At 30 days, Myval THV
series had a lower aortic valve mean pressure gradient and a higher
effective orifice area than Sapien. TAVI with the Myval THV series in
small annulus patients with severe aortic stenosis is comparable to both
the Sapien and Evolut series in terms of primary composite endpoint at 30
days. Copyright © 2025

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