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<1>
Accession Number
2038382604
Title
Randomized Comparison of Oblique versus Transverse Orientation for
Ultrasound-Guided Internal Jugular Venous Cannulation in Pediatric Heart
Surgery Patients.
Source
Annals of Cardiac Anaesthesia. 28(2) (pp 149-155), 2025. Date of
Publication: 01 Apr 2025.
Author
Heriwardito A.; Manggala S.K.; Christina A.
Institution
(Heriwardito, Manggala, Christina) Department of Anesthesiology and
Intensive Care, Cipto Mangunkusumo General Hospital, Faculty of Medicine
Universitas Indonesia, DKI Jakarta, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Ultrasound-guided internal jugular venous access improves the
rate of successful cannulation of the internal jugular vein in both adult
and pediatric patients. Internal jugular venous cannulation in pediatric
patients is anatomically and technically more challenging than in adults.
The oblique method is a novel approach for guiding central venous
cannulation. There is currently a scarcity of research on central venous
cannulation techniques for pediatric patients. <br/>Aim(s): The purpose of
this study was to compare the success rates between the oblique and
transverse approach of jugular venous cannulation in pediatric cardiac
surgery patients. <br/>Method(s): A prospective randomized clinical trial
of pediatric patients who underwent cardiac surgery at Cipto Mangunkusumo
Hospital was conducted between February and May 2021. Sixty patients were
randomized into two groups: 30 in the oblique group and 30 in the
transverse group. <br/>Result(s): There was no difference in the first
needle pass success rate between the oblique and transversal approaches
(86.7% vs. 73.3%; P = 0.19). There is no difference in the total number of
attempts between the two groups (1.3 vs 1.43; P > 0.05).
<br/>Conclusion(s): There was no difference between oblique and transverse
orientations for internal jugular venous cannulation in pediatric cardiac
surgery patients in terms of successful cannulation on the first needle
pass and total number of attempts.<br/>Copyright &#xa9; 2025 Annals of
Cardiac Anaesthesia.

<2>
Accession Number
2034188348
Title
The Prognostic Value of Pulmonary Hypertension in Patients with Mitral
Regurgitation Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair: A
Systematic Review and Meta-Analysis.
Source
Diagnostics. 15(7) (no pagination), 2025. Article Number: 852. Date of
Publication: 01 Apr 2025.
Author
Shancuoji; Liao Y.; Li J.; Chen M.
Institution
(Shancuoji, Liao, Li, Chen) Department of Cardiology, West China Hospital,
Sichuan University, Chengdu, China
(Shancuoji, Liao, Li, Chen) Laboratory of Cardiac Structure and Function,
Institute of Cardiovascular Diseases, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Pulmonary hypertension (PH) is associated with the outcomes of
mitral valve transcatheter edge-to-edge repair (M-TEER) in patients with
severe mitral regurgitation (MR). However, the prognosis of baseline PH on
MR patients after M-TEER has been controversial. This meta-analysis aimed
to determine the prognostic value of PH with early and late outcomes after
M-TEER with MitraClip. <br/>Method(s): We systematically searched
PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials
(CENTRAL) and Web of Science for studies. The results of the meta-analysis
are summarized as the hazard ratio (HR), odds ratios (ORs) or mean
difference (MD) and 95% confidence interval (CI). <br/>Result(s): A total
of 20 publications were included in the systematic review, of which six
were observational cohort studies including 5684 patients. The pooled
incidence estimate of all-cause mortality was more common in severe PH
than in patients who were non-PH. On pooled multivariate analysis,
baseline PH was associated with late (>=1-year) all-cause mortality (HR =
1.61, 95% CI [1.23-2.11]) and the combined outcome of late HF
rehospitalization and all-cause mortality (HR = 1.33, 95% CI [1.15-1.53])
after M-TEER. The level of SPAP significantly decreased after MitraClip in
MR patients with PH (MD = -12.33 mmHg, 95% CI [-14.08--10.58]).
<br/>Conclusion(s): Baseline PH had a worse prognosis of early (>=30-day)
cardiac mortality, late all-cause mortality as well as the composite
outcome of HF rehospitalization and all-cause mortality after M-TEER
compared to non-PH patients. Future studies are needed to prove these
findings.<br/>Copyright &#xa9; 2025 by the authors.

<3>
Accession Number
2038145128
Title
Barriers and facilitators to medication adherence in patients after PCI
surgery: A mixed-methods systematic review.
Source
Heart and Lung. 72 (pp 57-64), 2025. Date of Publication: 01 Jul 2025.
Author
Fang Y.; Jiang Z.; Han Z.; Xiang X.
Institution
(Jiang, Xiang) The First Affiliated Hospital of Zhejiang University,
Hangzhou, China
(Han) Zhejiang Chinese Medical University, Hangzhou, China
(Fang) Changsha Medical University, Changsha, China
Publisher
Elsevier Inc.
Abstract
Background: Patients after Percutaneous coronary intervention (PCI) should
adhere to evidence-based medications to relieve symptoms and prevent
cardiovascular events. However, the factors affecting patient medication
adherence remain unclear. <br/>Objective(s): To systematically synthesize
the quantitative and qualitative evidence on the barriers and facilitators
to medication adherence in patients after PCI surgery. <br/>Method(s): A
systematic search of the literature on the barriers and facilitators to
medication adherence in patients after PCI surgery was performed in
English and Chinese databases, including PubMed, Embase, CINAHL, Web of
Science, CNKI, Wanfang and CBM, from inception to March 1, 2023. Retrieved
studies were screened based on inclusion and exclusion criteria. Two
researchers independently performed data extraction and quality
assessment. The analysis of the barriers and facilitators to medication
adherence in patients was based on the six sub-components of the
Capability, Opportunity, and Motivation model of Behavior (COM-B) model, a
behavioral science framework. The systematic review was registered on
PROSPERO (CRD42022338400). <br/>Result(s): A total of 15 studies were
included in the review. There were 31 factors identified that influenced
medication adherence in patients after PCI surgery. Among these factors,
14 served as facilitators while 17 acted as barriers. All identified
factors were subsequently mapped onto the six sub-components of the COM-B
model. <br/>Conclusion(s): Identification of the barriers and facilitators
to medication adherence within the six categories of the COM-B model in
patients undergoing PCI can serve as a foundation for developing
intervention strategies. These strategies should target the identified
factors across the COM-B model. A comprehensive approach will improve
medication adherence among PCI patients.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<4>
Accession Number
2037186845
Title
Comment on: "Duration of Bare Sclera Pterygium Surgery Combined with
Mitomycin C with and Without Tranexamic Acid: A Randomized Double-Blind
Controlled Trial".
Source
Journal of Ocular Pharmacology and Therapeutics. 41(3) (pp 169-170), 2025.
Date of Publication: 01 Apr 2025.
Author
Goncalves dos Santos Martins T.
Institution
(Goncalves dos Santos Martins) Ophthalmology Department, Federal
University of Rio de Janeiro, Rio de Janeiro, Brazil
Publisher
Mary Ann Liebert Inc.

<5>
Accession Number
2036115513
Title
Effect of remimazolam on intraoperative hemodynamic stability in patients
undergoing cerebrovascular bypass surgery: a prospective randomized
controlled trial.
Source
Korean Journal of Anesthesiology. 78(2) (pp 148-158), 2025. Date of
Publication: 01 Apr 2025.
Author
Koo C.-H.; Lee S.U.; Kim H.-G.; Lee S.; Bae Y.K.; Oh A.-Y.; Jeon Y.-T.;
Ryu J.-H.
Institution
(Koo, Kim, Lee, Bae, Oh, Jeon, Ryu) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Seongnam, South
Korea
(Koo, Kim, Oh, Jeon, Ryu) Department of Anesthesiology and Pain Medicine,
Seoul National University College of Medicine, Seoul, South Korea
(Lee) Department of Neurosurgery, Seoul National University Bundang
Hospital, Seongnam, South Korea
(Lee) Department of Neurosurgery, Seoul National University College of
Medicine, Seoul, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Maintenance of stable blood pressure (BP) during
cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We
compared the effect of remimazolam anesthesia with that of
propofol-induced and desflurane-maintained anesthesia on intraoperative
hemodynamic stability and the need for vasoactive agents in patients
undergoing cerebrovascular bypass surgery. <br/>Method(s): Sixty-five
patients were randomized into remimazolam (n = 31, remimazolam-based
intravenous anesthesia) and control groups (n = 34, propofol-induced and
desflurane-maintained anesthesia). The primary outcome was the occurrence
of intraoperative hypotension. The secondary outcomes included hypotension
duration, lowest mean BP (MBP), generalized average real variability (ARV)
of MBP, and consumption of phenylephrine, norepinephrine, or remifentanil.
<br/>Result(s): Occurrence rate and duration of hypotension were
significantly lower in the remimazolam group (38.7% vs. 73.5%, P = 0.005;
0 [0, 10] vs. 7.5 [1.25, 25] min, P = 0.008). Remimazolam also showed
better outcomes for lowest MBP (78 [73, 84] vs. 69.5 [66.25, 75.8] mmHg, P
< 0.001) and generalized ARV of MBP (1.42 +/- 0.49 vs. 1.66 +/- 0.52
mmHg/min, P = 0.036). The remimazolam group required less phenylephrine
(20 [0, 65] vs. 100 [60, 130] mug, P < 0.001), less norepinephrine (162
[0, 365.5] vs. 1335 [998.5, 1637.5] mug, P < 0.001), and more remifentanil
(1750 [1454.5, 2184.5] vs. 531 [431, 746.5] mug, P < 0.001) than the
control group. <br/>Conclusion(s): Remimazolam anesthesia may provide
better hemodynamic stability during cerebrovascular bypass surgery than
propofol-induced and desflurane-maintained anesthesia.<br/>Copyright
&#xa9; The Korean Society of Anesthesiologists, 2025.

<6>
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Accession Number
2038224586
Title
Review of the Global Activity of Heart Transplant.
Source
Circulation: Heart Failure. (no pagination), 2025. Article Number:
e012272. Date of Publication: 2025.
Author
El Rafei A.; Cogswell R.; Atik F.A.; Zuckermann A.; Allen L.A.
Institution
(El Rafei, Allen) Division of Cardiology, Department of Medicine,
University of Colorado School of Medicine, Aurora, United States
(Cogswell) Division of Cardiology, Department of Medicine, University of
Minnesota, Minneapolis, United States
(Atik) Department of Cardiology, University of Brasilia Medical School,
Brazil
(Zuckermann) Department of Cardiac Surgery/Medical, Medical University of
Vienna, Austria
Publisher
Lippincott Williams and Wilkins
Abstract
Heart failure is a global disease with significant morbidity. Heart
transplant (HT) can be a lifesaving therapy for select patients with
end-stage heart failure. In 2020, over 7000 HTs were performed globally;
90% of HTs were performed in the United States and Western Europe, with
only 10% throughout the rest of the world. In this article, we offer an
overview of the global landscape of HT, exploring challenges and prospects
worldwide. We review HT practices, rates and post-HT outcomes,
underscoring the differences between countries within each region. We
review limitations hindering HT expansion, such as sociocultural factors,
as seen in Japan and Israel; health care funding, in countries like India
and South Africa; socioeconomic disparities in access, like the United
States; and shortage in organ supply, as seen in China and Saudi Arabia.
This review underscores the need to address limitations and highlights
opportunities to enhance global HT accessibility, especially in lower- and
middle-income countries.<br/>Copyright &#xa9; 2025 Lippincott Williams and
Wilkins. All rights reserved.

<7>
Accession Number
2038155291
Title
Hypnosis as a non-pharmacological intervention for invasive medical
procedures - A systematic review and meta-analytic update.
Source
Journal of Psychosomatic Research. 192 (no pagination), 2025. Article
Number: 112117. Date of Publication: 01 May 2025.
Author
Walter N.; Leyva M.T.; Hinterberger T.; Rupp M.; Loew T.; Lambert-Delgado
A.; Mena A.E.C.
Institution
(Walter, Hinterberger, Loew) Department for Psychosomatic Medicine,
University Medical Center Regensburg, Franz-Josef-Straus-Allee 11,
Regensburg, Germany
(Leyva) Medical Care Center for Physical and Mental Health Timmermann and
Partner, Marienstrase 37a, Cuxhaven, Germany
(Rupp) Department of Trauma, Hand and Reconstructive Surgery, University
Hospital Giessen, Germany
(Lambert-Delgado, Mena) Universidad de Ciencias Medicas, Santiago de Cuba,
Cuba
Publisher
Elsevier Inc.
Abstract
Hypnosis is recognized as an effective non-pharmacological intervention
for managing anxiety, pain, and physiological stress during invasive
medical procedures. Despite its growing use, variability in techniques and
inconsistent outcome measurements have challenged its clinical
standardization. This systematic review and meta-analysis evaluated the
effectiveness of hypnosis in reducing anxiety, pain, and physiological
stress during invasive procedures, while identifying the most effective
techniques as well as assessing analgesic use and safety. A comprehensive
literature search was conducted in PubMed, Cochrane Library, and Scopus to
identify randomized controlled trials (RCTs) evaluating hypnosis in
invasive procedures. Eligible studies were assessed for bias using the
Revised Cochrane Risk of Bias Tool. Meta-analyses were performed with a
random-effects model, and subgroup analyses were conducted based on
hypnosis techniques, patient characteristics, and procedure types. Twenty
RCTs with 1250 patients were included. Hypnosis significantly reduced
anxiety (SMD = -0.43, 95 % CI: -0.58 to -0.28, p < 0.001) and pain (SMD =
-0.35, 95 % CI: -0.50 to -0.20, p < 0.001) compared to standard care.
Subgroup analyses indicated that virtual reality-enhanced hypnosis and
tailored interventions for high-anxiety procedures were most beneficial.
Physiological stress markers, including heart rate and blood pressure,
were also reduced, supporting the calming effects of hypnosis. Adverse
effects were minimal. Hypnosis is effective and safe for reducing anxiety
and pain during invasive medical procedures. Standardized protocols and
further research are needed to optimize its clinical use and enhance
adoption in routine care.<br/>Copyright &#xa9; 2025

<8>
Accession Number
2036115510
Title
Hypotension after induction of anesthesia with remimazolam or etomidate: a
non-inferiority randomized controlled trial in patients undergoing
coronary artery bypass grafting.
Source
Korean Journal of Anesthesiology. 78(2) (pp 139-147), 2025. Date of
Publication: 01 Apr 2025.
Author
Min J.-J.; Oh E.J.; Hwang H.J.; Jo S.; Cho H.; Kim C.; Lee J.-H.
Institution
(Min, Hwang, Jo, Cho, Kim, Lee) Department of Anesthesiology and Pain
Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Oh) Department of Anesthesiology and Pain Medicine, Chung-Ang University
Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul,
South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Remimazolam is a novel ultra-short-acting benzodiazepine known
for its hemodynamic stability over propofol. However, its hemodynamic
effects compared to those of etomidate are not well established. This
study aimed to determine whether the use of remimazolam is non-inferior to
etomidate with regard to the occurrence of post-induction hypotension in
patients undergoing coronary artery bypass grafting. <br/>Method(s):
Patients were randomly assigned to either the remimazolam group (6
mg/kg/h) or the etomidate group (0.3 mg/kg) for induction of anesthesia.
Anesthetic depth was adjusted based on the bispectral index. Primary
outcome was the incidence of post-induction hypotension, defined as a mean
arterial pressure less than 65 mmHg within 15 min after endotracheal
intubation, with a non-inferiority margin of 12%. <br/>Result(s): A total
of 144 patients were finally analyzed. Incidence of post-induction
hypo-tension was 36/71 (50.7%) in the remimazolam group and 25/73 (34.2%)
in the etomidate group, with a rate difference of 16.5% (95% CI
[3.0-32.6]) between the two groups that was beyond the prespecified
non-inferiority margin of 12.0%. The number of patients who needed
vasopressors was similar in the two groups. <br/>Conclusion(s): In this
non-inferiority trial, remimazolam failed to show non-inferiority to
etomidate in terms of post-induction hypotension when used as an induction
drug for general anesthesia in patients undergoing coronary artery bypass
grafting. However, different doses or infusion techniques of remimazolam
should be compared with etomidate in various patient groups to fully
assess its hemodynamic non-inferiority during induction of
anesthesia.<br/>Copyright &#xa9; The Korean Society of Anesthesiologists,
2025.

<9>
Accession Number
2037395891
Title
Cardiovascular Disease-Specific Responses to Autonomic Denervation.
Source
JACC: Clinical Electrophysiology. 11(4) (pp 776-788), 2025. Date of
Publication: 01 Apr 2025.
Author
Zhang Y.; Po S.S.; Xin F.; Zhao J.; Zhao K.; Tao D.; Chakraborty P.; Yin
Z.; Liu G.; Wang H.
Institution
(Zhang, Xin, Zhao, Zhao, Tao, Yin, Liu, Wang) Department of Cardiovascular
Surgery, General Hospital of Northern Theater Command, Liaoning, Shenyang,
China
(Po, Chakraborty) Section of Cardiovascular Diseases and Heart Rhythm
Institute, University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcium-mediated autonomic denervation has been shown to
suppress postoperative atrial fibrillation (POAF) after coronary artery
bypass grafting. <br/>Objective(s): This study sought to evaluate whether
similar autonomic denervation can prevent POAF after mitral or aortic
valve surgeries. <br/>Method(s): This research consisted of 2
single-center, randomized, double-blind, sham-controlled trials: CAP-AF2
(Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation
in Patients Undergoing Isolated Mitral Valve Surgery for Mitral
Regurgitation) for mitral valve (MV) surgery and CAP-AF3 (Calcium
Autonomic Denervation Prevents Postoperative Atrial Fibrillation in
Patients Undergoing Isolated Aortic Valve Surgery) for aortic valve
surgery. Patients were randomized to receive injections of either 5%
CaCl<inf>2</inf> or 0.9% NaCl (control) into the atrial ganglionated plexi
during surgery. The primary outcome was the incidence of POAF >=30 seconds
within 7 days after surgery. Secondary outcomes included hospital stay, AF
burden, actionable antiarrhythmic therapy for POAF, and inflammatory
marker. <br/>Result(s): After 160 patients were enrolled into the CAP-AF2
trial, mid-term analysis revealed a significant increase in POAF incidence
in the CaCl<inf>2</inf> group (55.13%, CaCl<inf>2</inf> vs 37.80%, NaCl; P
= 0.028). The CAP-AF2 trial was terminated by the safety committee. In the
CAP-AF3 trial, 239 patients were randomized; final analysis showed no
significant difference in the POAF incidence between the CaCl<inf>2</inf>
and NaCl groups (35.59% vs 39.67%, P = 0.516). Postoperative hospital
stay, AF burden, antiarrhythmic therapy for POAF, and plasma levels of
inflammatory markers were not different between the 2 groups in both
trials. Immunohistochemical analyses showed parasympathetic predominance
at the tissue level in patients receiving MV surgery. <br/>Conclusion(s):
Calcium-mediated autonomic denervation did not uniformly prevent POAF
across all cardiac surgeries, with an increased incidence observed in the
MV surgery group, highlighting the need for disease-specific strategies to
prevent POAF. (Calcium Autonomic Denervation Prevents Postoperative Atrial
Fibrillation in Patients Undergoing Isolated Mitral Valve Surgery for
Mitral Regurgitation [CAP-AF2]; ChiCTR2000029314; Calcium Autonomic
Denervation Prevents Postoperative Atrial Fibrillation in Patients
Undergoing Isolated Aortic Valve Surgery [CAP-AF3];
ChiCTR2000029313).<br/>Copyright &#xa9; 2025 American College of
Cardiology Foundation

<10>
Accession Number
2038382602
Title
Effect of Transesophageal Echocardiography Probe Insertion on Endotracheal
Tube Cuff Pressure in Patients Undergoing Coronary Artery Bypass Graft
(CABG) Surgery. A Prospective Randomized Control Trial.
Source
Annals of Cardiac Anaesthesia. 28(2) (pp 143-148), 2025. Date of
Publication: 01 Apr 2025.
Author
Kireeti A.; Pula R.; Nagarjuna T.; Rabbani T.; Gopinath R.
Institution
(Kireeti) Department of Anaesthesia, Govt Medical College, Telangana,
Wanaparthy, India
(Pula, Nagarjuna, Rabbani, Gopinath) Department of Anaesthesia, ESIC MC
and SSH, Sanathnagar, Telangana, Hyderabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Elevated endotracheal tube (ETT) cuff pressures during
surgery can lead to tracheal ischemia and airway complications, including
postoperative sore throat, subglottic edema, and tracheal stenosis. The
insertion of a transesophageal echocardiography (TEE) probe, commonly used
in cardiac surgeries, may increase ETT cuff pressure due to its proximity
to the trachea. This study assesses the impact of TEE probe insertion on
ETT cuff pressures and related postoperative airway complications in
patients undergoing coronary artery bypass graft (CABG) surgery.
<br/>Method(s): In this prospective, randomized controlled trial, 40
patients undergoing CABG were assigned to either a control group (Group C,
n = 20) or an intervention group (Group T, n = 20). Cuff pressures were
monitored at baseline (T1), during TEE probe manipulation (T2), after
initial examination (T3), and during recovery (T4). In Group T, cuff
pressures were adjusted to 20-30 cmH2O if they exceeded 30 cmH2O during T2
and T3. Postoperative complications, including sore throat, hoarseness,
and cough, were assessed using standardized scales. <br/>Result(s): TEE
probe manipulation significantly increased ETT cuff pressures in both
groups, with lower pressures consistently observed in Group T (P < 0.05).
At T3, the mean cuff pressure in Group C was 41.00 cmH2O versus 33.30
cmH2O in Group T (P < 0.001). The control group experienced more severe
postoperative airway complications, while Group T had a significantly
reduced risk of severe complications (odds ratio < 0.2).
<br/>Conclusion(s): TEE probe manipulation significantly increases ETT
cuff pressures, but cuff deflation during manipulation effectively reduces
these pressures and lowers the risk of postoperative airway
complications.<br/>Copyright &#xa9; 2025 Annals of Cardiac Anaesthesia.

<11>
Accession Number
2038284309
Title
Across 73 meta-analyses mortality improvements are uncommon with newer
interventions in adult cardiac surgery.
Source
Journal of Clinical Epidemiology. 182 (no pagination), 2025. Article
Number: 111764. Date of Publication: 01 Jun 2025.
Author
Parish A.; Tolis G.; Ioannidis J.P.A.
Institution
(Parish) Department of Emergency Medicine, Brookdale Hospital Medical
Center, Brooklyn, NY, United States
(Tolis) Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Ioannidis) Meta-Research Innovation Center at Stanford (METRICS),
Stanford University, and Departments of Medicine and of Epidemiology and
Population Health, Stanford University School of Medicine, Stanford, CA,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: We aimed to assess how often randomized controlled trials
(RCTs) in adult cardiac surgery found significant mortality benefits for
newer interventions vs older ones, whether observed treatment effect
estimates changed over time and whether RCTs and nonrandomized
observational studies gave similar results. <br/>Method(s): We searched
journals likely to publish systematic reviews on adult cardiac surgery for
meta-analyses of mortality outcomes and that included at least 1 RCT, with
or without observational studies. Relative treatment effect sizes were
evaluated overall, over time, and per study design. <br/>Result(s): A
total of 73 meta-analysis comparisons (824 study outcomes on mortality,
519 from RCTs, 305 from observational studies) were eligible. The median
mortality effect size was 1.00, IQR 0.54-1.30 (1.00 among RCTs, 0.91 among
observational studies, P = .039). Four RCTs and six observational studies
reached P < .005 favoring newer interventions. Two meta-analyses reached P
< .005 favoring newer interventions. Effect size for experimental
interventions relative to controls did not change over time overall (P =
.64) or for RCTs (P = .30), and there was a trend for increase in
observational studies (P = .027). In 34 meta-analyses with both RCTs (n =
95) and observational studies (n = 305), the median relative summary
effect (summary effect in observational studies divided by summary effect
in RCTs) was 0.87 (IQR, 0.55-1.29); meta-analysis of the relative summary
effects yielded a summary of 0.93 (95% CI, 0.74-1.18). <br/>Conclusion(s):
The vast majority of newer interventions had no mortality differences over
older ones both overall and specifically in RCTs, while benefits for newer
interventions were reported more frequently in observational
studies.<br/>Copyright &#xa9; 2025 The Authors

<12>
Accession Number
2038230328
Title
A systematic review and meta-analysis of the impact of preoperative
surgical planning in robotic-assisted radical prostatectomy on trifecta
outcomes.
Source
Minerva Urology and Nephrology. 77(1) (pp 25-32), 2025. Date of
Publication: 01 Feb 2025.
Author
Day E.; Tzelves L.; Dickinson L.; Shaw G.; Tandogdu Z.
Institution
(Day, Shaw, Tandogdu) Department of Urology, University College London
Hospitals, London, United Kingdom
(Tzelves) Second Department of Urology, Sismanogleio Hospital, National
and Kapodistrian University, Athens, Greece
(Dickinson, Shaw, Tandogdu) Division of Surgery and Interventional
Science, University College London, London, United Kingdom
(Dickinson) Department of Radiology, University College London Hospitals,
London, United Kingdom
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Surgical planning in robotic assisted radical prostatectomy
(RARP) recommends the maximal use of function persevering techniques
without compromising oncological outcomes. There is no consensus on how to
define the optimal surgical approach. This review aims to collate
available evidence on the impact of preoperative planning interventions on
the trifecta of oncological, functional or operative outcomes. EVIDENCE
ACQUISITION: A systematic review according to the PRISMA guidelines was
performed using the terms ((prostatectomy) AND (robot*)) AND (plan*) OR
(image*) OR (decision*) for articles published between January 2000 and
January 2024. Prospective studies reporting patients undergoing RARP with
a preoperative planning intervention, compared to no planning, to
determine at least one of trifecta outcome were included. Results were
synthesized in a narrative review with a metanalysis when two or more
studies reported the same outcomes. EVIDENCE SYNTHESIS: Eight studies, one
RCT and seven non-randomised prospective comparative studies, including
1945 patients, applying clinical nomograms, MRI and histology review were
included. The outcomes reported were positive surgical margins (PSM)
(oncological) and nerves sparing rates (functional). No operative outcomes
were reported. Metanalysis demonstrated that positive surgical margins
(PSM) were reduced in both clinical nomogram (RR=0.56, 95% CI: 0.37-0.87,
P=0.009; two studies 563 patients) and MRI (RR=0.72, 95% CI: 0.54-0.96,
P=0.02; three studies, 801 patients) intervention groups. Additionally,
metanalysis of all nerve-sparing cases demonstrated lower PSM rates in the
intervention group (RR=0.65, 95% CI: 0.47-0.90, P=0.01; three studies, 823
patients). No significant changes were seen in nerve-sparing rates.
<br/>CONCLUSION(S): Preoperative surgical planning with nomograms and MRI
has the potential to improve PSM rates without compromising nerve sparing.
It is not possible to identify the optimal approach, but it is likely that
the incorporation of biopsy and MRI information will lead to the best
outcomes. Further studies using universally accepted standards of the
trifecta outcomes are needed.<br/>Copyright &#xa9; 2025 EDIZIONI MINERVA
MEDICA.

<13>
Accession Number
2034218513
Title
Defining "early palliative care" for adults diagnosed with a life-limiting
illness: a scoping review.
Source
BMC Palliative Care. 24(1) (no pagination), 2025. Article Number: 93. Date
of Publication: 01 Dec 2025.
Author
Kircher C.E.; Hanna T.P.; Tranmer J.; Goldie C.E.; Ross-White A.; Moulton
E.; Flegal J.; Goldie C.L.
Institution
(Kircher, Tranmer, Goldie) School of Nursing, Faculty of Health Sciences,
Queen's University, Cataraqui Building, 92 Barrie Street, Kingston, ON,
Canada
(Kircher, Tranmer, Ross-White, Goldie) Queen's Collaboration for Health
Care Quality, A JBI Centre of Excellence, Kingston, ON, Canada
(Hanna) Division of Cancer Care and Epidemiology, Cancer Research
Institute, Queen's University, Kingston, ON, Canada
(Hanna) Department of Oncology, School of Medicine, Faculty of Health
Sciences, Queen's University, Kingston, ON, Canada
(Hanna, Tranmer) ICES, Queen's University, Kingston, ON, Canada
(Goldie) Division of Palliative Medicine, Department of Medicine, School
of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON,
Canada
(Ross-White) Bracken Health Sciences Library, Queen's University,
Kingston, ON, Canada
(Moulton, Flegal) School of Nursing, St. Lawrence College, Kingston, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
Background: Palliative care is for people suffering from life-limiting
illnesses that focuses on providing relief from symptoms and stress of
illness. Previous studies have demonstrated that specialist palliative
care consultation delivered earlier in the disease process can enhance
patients' quality of life, reduce their symptom burden, reduce use of
hospital-based acute care services and extend their survival. However,
various definitions exist for the term early palliative care (EPC).
<br/>Objective(s): To investigate how EPC has been defined in the
literature for adults with life- limiting illnesses. <br/>Method(s): This
review was conducted in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping
Reviews guidelines and follows the Joanna Briggs Institution methodology
for scoping reviews. The literature search was conducted using MEDLINE
(Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science
Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine
and Sociology Collections). All articles retrieved were screened by three
independent reviewers. <br/>Result(s): 153 articles met the inclusion
criteria between 2008 and 2024. Five categories of definitions for EPC
were created to organize definitions: (1) time-based (e.g. time from
advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g.
prognosis or the 'surprise question'); (3) location-based (e.g. access
point within the healthcare system such as outpatient setting); (4)
treatment-based (e.g. physician's judgement or prior to specific
therapies); and (5) symptom-based (e.g. using symptom intensity
questionnaires). Many studies included patients with cancer (n = 103),
with the most common definition category being time-based (n = 53).
Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the
most common definition category was symptom-based (n = 16).
<br/>Conclusion(s): Our findings provide a useful reference point for
those seeking to understand the scope and breadth of existing EPC
definitions in cancer and non-cancer illnesses and contemplate their
application within clinical practice.<br/>Copyright &#xa9; The Author(s)
2025.

<14>
Accession Number
2037202344
Title
Safety and Efficacy of Tranexamic Acid in General Surgery.
Source
JAMA Surgery. 160(3) (pp 267-274), 2025. Date of Publication: 12 Mar 2025.
Author
Park L.J.; Marcucci M.; Ofori S.N.; Borges F.K.; Nenshi R.; Kanstrup
C.T.B.; Rosen M.; Landoni G.; Lomivorotov V.; Painter T.W.; Xavier D.;
Martinez-Zapata M.J.; Szczeklik W.; Meyhoff C.S.; Chan M.T.V.; Simunovic
M.; Bogach J.; Serrano P.E.; Balasubramanian K.; Cadeddu M.; Yang I.; Kim
W.H.; Devereaux P.J.
Institution
(Park, Marcucci, Ofori, Borges, Nenshi, Balasubramanian, Devereaux)
Population Health Research Institute, Hamilton, ON, Canada
(Park, Nenshi, Simunovic, Bogach, Serrano, Cadeddu, Yang) Department of
Surgery, Division of General Surgery, McMaster University, Hamilton, ON,
Canada
(Park, Marcucci, Ofori, Borges, Serrano, Balasubramanian, Devereaux)
Department of Health Research Methods,Evidence & Impact,, McMaster
University, Hamilton, ON, Canada
(Marcucci) Clinical Epidemiology and Research Centre (CERC), Humanitas
University and IRCCS Humanitas Research Hospital, Milan, Italy
(Ofori, Borges) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Kanstrup) Department of Surgery, Copenhagen University Hospital, North
Zealand, Hillerod, Denmark
(Rosen) Digestive Disease Institute, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Painter) Royal Adelaide Hospital, Adelaide, SA, Australia
(Xavier) Division of Clinical Research & Training, St John's Research
Institute, Bengaluru, India
(Martinez-Zapata) Iberoamerican Cochrane Center, Institut de Recerca Sant
Pau, CIBER Epidemiologia y Salud Publica, Barcelona, Spain
(Szczeklik) Centre for Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Krakow, Poland
(Meyhoff) Department of Anaesthesia and Intensive Care, Copenhagen
University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Chan) The Chinese University of Hong Kong, Hong Kong
(Kim) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
(Devereaux) Department of Medicine, Division of Cardiology, McMaster
University, Hamilton, ON, Canada
(Devereaux) World Health Research Trust, Hamilton, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Perioperative bleeding is common in general surgery. The
POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy
of prophylactic tranexamic acid (TXA) compared with placebo in preventing
major bleeding without increasing vascular outcomes in noncardiac surgery.
<br/>Objective(s): To determine the safety and efficacy of prophylactic
TXA, specifically in general surgery. <br/>Design, Setting, and
Participant(s): Subgroup analyses were conducted that compared randomized
treatment with TXA vs placebo according to whether patients underwent
general surgery or nongeneral surgery in the POISE-3 blinded,
international, multicenter randomized clinical trial. Participants were 45
years or older, were undergoing noncardiac surgery, had increased
cardiovascular risk, and were expected to require at least an overnight
hospital admission after surgery. Among 26581 eligible patients
identified, 17046 were excluded, resulting in 9535 patients randomized to
the POISE-3 trial. Participants were enrolled from June 2018 through July
2021. The data were analyzed during December 2023. <br/>Intervention(s):
Prophylactic, 1-g bolus of intravenous TXA or placebo at the start and end
of surgery. <br/>Main Outcomes and Measures: The primary efficacy outcome
was a composite of life-threatening bleeding, major bleeding, or bleeding
into a critical organ. The primary safety outcome was a composite of
myocardial injury after noncardiac surgery, nonhemorrhagic stroke,
peripheral arterial thrombosis, or symptomatic proximal venous
thromboembolism at 30 days. Cox proportional hazards models were
conducted, incorporating tests of interaction. <br/>Result(s): Among 9535
POISE-3 participants, 3260 underwent a general surgery procedure. Mean age
was 68.6 (SD, 9.6) years, 1740 were male (53.4%), and 1520 were female
(46.6%). Among general surgery patients, 8.0% and 10.5% in the TXA and
placebo groups, respectively, had the primary efficacy outcome (hazard
ratio [HR], 0.74; 95% CI, 0.59-0.93; P =.01) and 11.9% and 12.5% in the
TXA and placebo groups, respectively, had the primary safety outcome (HR,
0.95; 95% CI, 0.78-1.16; P =.63). There was no significant interaction by
type of surgery (general surgery vs nongeneral surgery) on the primary
efficacy (P for interaction =.81) and safety (P for interaction =.37)
outcomes. Across subtypes of general surgery, TXA decreased the composite
bleeding outcome in hepatopancreaticobiliary surgery (HR, 0.55; 95% CI,
0.34-0.91 [n = 332]) and colorectal surgery (HR, 0.67; 95% CI, 0.45-0.98
[n = 940]). There was no significant interaction across subtypes of
general surgery (P for interaction =.68). <br/>Conclusions and Relevance:
In this study, TXA significantly reduced the risk of perioperative
bleeding without increasing cardiovascular risk in patients undergoing
general surgery procedures.<br/>Copyright &#xa9; 2025 American Medical
Association. All rights reserved.

<15>
Accession Number
2038239299
Title
Regional Anesthesia With Fascial Plane Blocks for Pediatric Cardiac
Surgery With Sternotomy: A Narrative Review.
Source
Anesthesia and Analgesia. (no pagination), 2025. Date of Publication:
2025.
Author
Russell G.C.; Einhorn L.M.
Institution
(Russell) Department of Anesthesiology, Duke University, School of
Medicine, Durham, NC, United States
(Einhorn) Department of Anesthesiology, Pediatric Division, Duke
University, School of Medicine, Durham, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Undertreated pain in children who undergo sternotomy for cardiac surgery
can lead to cardiopulmonary complications, the development of chronic
pain, and long-term maladaptive stress response. Opioids have
dose-dependent side effects that may interfere with postoperative
recovery. With the increasing availability of ultrasound, regional
anesthesia is often included in multimodal analgesic approaches. Fascial
plane blocks targeting the intercostal nerves or ventral rami are of
particular interest for patients requiring full heparinization for
cardiopulmonary bypass as they avoid manipulation of neuraxial and
noncompressible paravertebral spaces. This narrative review summarizes the
literature on fascial plane blocks for pediatric patients undergoing
cardiac surgery via midline sternotomy and may serve as a guide for
clinicians. Both prospective and retrospective studies are reviewed, as
are prior review articles. We describe individual fascial plane block
techniques including the transversus thoracic muscle plane,
pectointercostal fascial plane, serratus anterior plane, and erector
spinae plane blocks and provide clinical considerations for each block.
Additionally, we provide an analysis of individual studies stratified by
anterior or posterior approach and block type. The majority of described
studies examine single-shot blocks; the existing catheter literature,
which includes erector spinae plane block catheters, is also included. Our
findings suggest that fascial plane blocks decrease intraoperative and
postoperative opioid use, pain scores, time to extubation, and length of
stay in the intensive care unit and hospital. Notably, prospective studies
in this field are small, typically fewer than 100 patients, and overall
include a homogenous patient population, focusing primarily on patients
with acyanotic congenital heart defects. Nonetheless, despite the
limitations of individual studies, there is substantial evidence to
support the use of regional anesthesia, particularly for patients in whom
early extubation is planned. There is a need for large, prospective
multi-center studies to evaluate the effectiveness and safety of specific
single-shot block types, optimal local anesthetic dosing strategies
compared to active comparators, and generalizability of results across
institutions. Future studies should also consider evaluating the role of
regional block catheters for continuous local anesthetic infusion and the
inclusion of additional surgical populations, including neonates, patients
with cyanotic lesions, and those with longer postoperative mechanical
ventilation courses.<br/>Copyright &#xa9; 2025 International Anesthesia
Research Society.

<16>
Accession Number
2038177480
Title
SAPIEN 3 versus Myval transcatheter heart valves for transcatheter aortic
valve implantation (COMPARE-TAVI 1): a multicentre, randomised,
non-inferiority trial.
Source
The Lancet. 405(10487) (pp 1362-1372), 2025. Date of Publication: 19 Apr
2025.
Author
Terkelsen C.J.; Freeman P.; Dahl J.S.; Thim T.; Norgaard B.L.; Mogensen
N.S.B.; Tang M.; Eftekhari A.; Povlsen J.A.; Poulsen S.H.; Pedersen L.;
Hjort J.; Ellert J.; Christiansen E.H.; Sorensen H.T.; Nissen H.
Institution
(Terkelsen, Thim, Norgaard, Povlsen, Poulsen, Christiansen) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Hjort) Department of Clinical Medicine, Aarhus University Hospital,
Aarhus, Denmark
(Tang) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Freeman, Eftekhari) Department of Cardiology, Aalborg University
Hospital, Aalborg, Denmark
(Dahl, Mogensen, Ellert, Nissen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Pedersen, Sorensen) Department of Clinical Epidemiology, Aarhus
University Hospital and Aarhus University, Aarhus, Denmark
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
guideline-directed treatment for severe aortic stenosis and degenerated
aortic bioprostheses. When new transcatheter heart valve (THV) platforms
for TAVI are launched, they should be compared with best-in-practice
contemporary THVs for their short-term and long-term performance. The
COMPARE-TAVI 1 trial was designed to provide a head-to-head comparison of
the SAPIEN 3 or SAPIEN 3 Ultra THVs and the Myval or Myval Octacor THVs.
<br/>Method(s): This multicentre, all-comers, randomised, non-inferiority
trial was done at three university hospitals in Denmark. Eligible patients
were aged 18 years or older, scheduled for transfemoral TAVI, and eligible
for treatment with SAPIEN 3 THVs or Myval THVs. Patients were randomly
assigned (1:1) to treatment with SAPIEN 3 (29 mm diameter) or SAPIEN 3
Ultra (20 mm, 23 mm, or 26 mm diameter) THVs or Myval or Myval Octacor
THVs (20-32 mm diameter). The TAVI procedure was performed according to
local practice and under local anaesthesia unless leaflet laceration was
performed. The primary endpoint was a composite of death, stroke, moderate
or severe aortic regurgitation, or moderate or severe haemodynamic THV
deterioration at 1 year according to Third Valve Academic Research
Consortium criteria. All patients assigned to THV treatment were included
in the intention-to-treat analysis, and all patients who were treated as
randomly assigned were included in the per-protocol analysis. With an
expected event rate of 13%, the prespecified non-inferiority margin was
5.3%. This trial is registered with ClinicalTrials.gov, NCT04443023, and
is closed to accrual. <br/>Finding(s): Between June 15, 2020, and Nov 3,
2023, 1031 patients were enrolled. Enrolment was paused twice because of
patent-related legal proceedings. Of 1031 patients, 517 patients were
randomly assigned to SAPIEN 3 THVs and 514 to Myval THVs. The median
patient age was 81.6 years (IQR 77.6-85.0), and 415 (40%) of 1031 patients
were female and 616 (60%) were male. The primary endpoint occurred in 67
(13%) of 517 patients randomly assigned to SAPIEN 3 THVs versus 71 (14%)
of 514 patients randomly assigned to Myval THVs (risk difference -0.9%
[one-sided upper 95% CI 4.4%]; p<inf>non-inferiority</inf>=0.019).
<br/>Interpretation(s): Myval THVs were non-inferior to SAPIEN 3 THVs in
terms of a 1-year composite endpoint of death, stroke, moderate or severe
aortic regurgitation, or moderate or severe haemodynamic THV
deterioration. <br/>Funding(s): Meril Life Sciences, Vingmed Denmark, the
Danish Heart Foundation, and the Central Denmark Region.<br/>Copyright
&#xa9; 2025 Elsevier Ltd

<17>
Accession Number
2038301551
Title
Minimal invasive extracorporeal circulation versus conventional
cardiopulmonary bypass in cardiac surgery: a contemporary systematic
review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 67(4) (no pagination), 2025.
Article Number: ezaf112. Date of Publication: 01 Apr 2025.
Author
Anastasiadis K.; Antonitsis P.; Voucharas C.; Apostolidou-Kiouti F.;
Deliopoulos A.; Haidich A.-B.; Argiriadou H.
Institution
(Anastasiadis, Antonitsis, Voucharas, Deliopoulos) Cardiothoracic
Department, Aristotle University of Thessaloniki School of Medicine,
Thessaloniki, Greece
(Apostolidou-Kiouti, Haidich) Department of Hygiene, Social-Preventive
Medicine and Medical Statistics, Aristotle University of Thessaloniki,
School of Medicine, Thessaloniki, Greece
(Argiriadou) Department of Anesthesiology and Intensive Care, Aristotle
University of Thessaloniki, School of Medicine, Thessaloniki, Greece
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The question whether minimally invasive extracorporeal
circulation (MiECC) represents the optimal perfusion strategy in cardiac
surgery remains unanswered. We sought to systematically review the entire
literature and thoroughly address the impact of MiECC versus conventional
cardiopulmonary bypass (cCPB) on adverse clinical outcomes after cardiac
surgery. <br/>METHOD(S): We searched PubMed, Scopus and Cochrane databases
for appropriate articles as well as conference proceedings from major
congresses up to 31 August 2024. All randomized controlled trials (RCTs)
that fulfilled pre-defined MiECC criteria were included in the analysis.
The primary outcome was mortality, while morbidity and transfusion
requirements were secondary outcomes. The risk of bias was assessed using
the Cochrane Risk of Bias 2 tool. All studies meeting the outcomes of
interest of this systematic review were eligible for synthesis.
<br/>RESULT(S): Of the 738 records identified, 36 RCTs were included in
the meta-analysis with a total of 4849 patients. MiECC was associated with
significantly reduced mortality [odds ratio (OR) 0.66; 95% confidence
interval (CI) 0.53-0.81; P 1/4 0.0002; I² 1/4 0%] as well as
risk of postoperative myocardial infarction (OR 0.42; 95% CI 0.26-0.68; P
1/4 0.002; I² 1/4 0%) and cerebrovascular events (OR 0.55; 95%
CI 0.37-0.80; P 1/4 0.007; I² 1/4 0%). Moreover, MiECC reduced
RBC transfusion requirements, blood loss and rate of re-exploration for
bleeding together with incidence of atrial fibrillation. This resulted in
significantly reduced duration of mechanical ventilation, ICU and hospital
stay. <br/>CONCLUSION(S): This meta-analysis provides robust evidence for
the beneficial effect of MiECC in reducing postoperative morbidity and
mortality after cardiac surgery and prompts for a wider adoption of this
technology.<br/>Copyright &#xa9; The Author(s) 2025.

<18>
Accession Number
2031746614
Title
Managing One-Lung Ventilation in Tracheostomized Patients: A 6-Year
Retrospective Analysis.
Source
Thoracic and Cardiovascular Surgeon. 73(2) (pp 148-155), 2024. Date of
Publication: 16 Apr 2024.
Author
Golditz T.; Schmidt J.; Ackermann A.; Danzl A.; Birkholz T.; Sirbu H.;
Irouschek A.
Institution
(Golditz, Schmidt, Ackermann, Danzl, Birkholz, Irouschek) Department of
Anesthesiology, Faculty of Medicine, University Hospital Erlangen,
Friedrich-Alexander-Universitat Erlangen-Nurnberg, Bayern, Erlangen,
Germany
(Sirbu) Department of Thoracic Surgery, Universitatsklinikum Erlangen,
Erlangen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background To ensure safe and optimal surgical conditions in thoracic
surgery, one-lung ventilation is crucial. Various techniques exist to
achieve one-lung ventilation. Tracheotomized patients who require one-lung
ventilation represent a unique and rare subgroup that demands specialized
knowledge and skills. The very limited literature has discussed
alternative methods, no randomized controlled trials have addressed this
issue yet. Methods We performed a retrospective analysis of patients who
underwent one-lung ventilation in the Department of Thoracic Surgery of a
German University Hospital between 2016 and 2021. The study assessed
patient demographics, airway management techniques, ventilation
parameters, and adverse events. Results In 3,197 anesthesia procedures
during the observation period, 152 patients had an existing tracheostomy,
of which 56 required one-lung ventilation. Among others in 42 cases, a
tracheostomy tube was combined with a bronchial blocker, and in 10 cases,
a double-lumen tracheostomy tube was used. There were no severe
complications. Intraoperative dislocations that required repositioning of
the device occurred in six patients (13.3%) with bronchial blockers and
one patient with double-lumen tracheostomy tube (10%). Conclusion The
management of one-lung ventilation in tracheotomized patients presents
unique challenges. While double-lumen tracheostomy tubes have specific
advantages, we recommend considering their use carefully. For most
tracheotomized patients, bronchial blockers in conjunction with a
tracheostomy tube are used, which offers safety and practicality,
irrespective of the tracheostomy's age or type. Further research and
randomized controlled trials are warranted to establish best practices for
one-lung ventilation in this unique patient population.<br/>Copyright
&#xa9; 2024. Thieme. All rights reserved.

<19>
Accession Number
646114766
Title
A Systematic Review of Multimodal Analgesic Effectiveness on Acute
Postoperative Pain After Adult Cardiac Surgery.
Source
Journal of advanced nursing. 81(5) (pp 2757-2792), 2025. Date of
Publication: 01 May 2025.
Author
Wynne R.; Jedwab R.M.; Gjeilo K.H.; Fredericks S.; Magboo R.; Phillips
E.K.; Goudarzi Rad M.; O'Keefe-Mccarthy S.; Keeping-Burke L.; Murfin J.;
Killackey T.; Bruneau J.; Matthews S.; Bowden T.; Sanders J.; Lie I.
Institution
(Wynne, Matthews) School of Nursing & Midwifery, Centre for Quality &
Patient Safety in the Institute for Health Transformation, Deakin
University, Geelong, VIC, Australia
(Wynne) Western Health, St Albans, VIC, Australia
(Jedwab) EMR & Informatics Program, Monash Health, Clayton, VIC, Australia
(Gjeilo) Department of Public Health and Nursing, Faculty of Medicine and
Health, NTNU - Norwegian University of Science and Technology, Trondheim,
Norway
(Gjeilo) Department of Cardiology, St. Olav's Hospital, Trondheim, Norway
(Fredericks) Daphne Cockwell School of Nursing, Ryerson University,
Toronto, Canada
(Magboo) Adult Critical Care Unit, St. Bartholomew's Hospital, London,
United Kingdom
(Magboo) Queen Mary University of London, London, United Kingdom
(Phillips) Cardiac Sciences, Winnipeg Regional Health Authority, Winnipeg,
MB, Canada
(Phillips) Applied Health Sciences, University of Manitoba, Winnipeg, MB,
Canada
(Goudarzi Rad, Killackey) Lawrence S Bloomberg Faculty of Nursing,
University of Toronto, Toronto, ON, Canada
(Goudarzi Rad, Killackey) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(O'Keefe-Mccarthy) Department of Nursing, Brock University, St.
Catharines, ON, Canada
(Keeping-Burke) Department of Nursing & Health Sciences, University of New
Brunswick, Saint John, New Brunswick, Canada
(Murfin) Cardiac Surgery, University of Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Bruneau) Memorial University of Newfoundland, St John's ,Newfoundland and
Labrador, Canada
(Matthews) Heart Foundation, Global Cardiovascular Research Funders Forum,
Melbourne, VIC, Australia
(Bowden) School of Health & Psychological Sciences, Nursing Department,
University of London, London, United Kingdom
(Sanders) Faculty of Nursing, King's College London, London, United
Kingdom
(Sanders) Barts Health NHS Trust, St Bartholomew's Hospital, London,
United Kingdom
(Sanders) William Harvey Research Institute, London, United Kingdom
(Lie) Centre for Patient-Centred Heart & Lung Research, Department of
Cardiothoracic Surgery, Division of Cardiovascular & Pulmonary Disease,
Oslo University Hospital, Oslo, Norway
(Lie) Department of Health Sciences in Gjovik, Faculty of Medicine &
Health Sciences, Norwegian University of Science & Technology, Norway
Abstract
AIM: To synthesise the best available empirical evidence about the
effectiveness of multimodal analgesics on pain after adult cardiac
surgery. DESIGN: A systematic review with meta-analysis. <br/>METHOD(S):
Indexed full-text papers or abstracts, in any language, of randomised
controlled trials of adult patients undergoing cardiac surgery
investigating multimodal postoperative analgesic regimen effect on mean
level of patient-reported pain intensity at rest. DATA SOURCES: Eight
databases, via two platforms and three trial registries were searched from
1 January 1995 to 1 June 2024 returning 3823 citations. <br/>RESULT(S): Of
the 123 full-text papers assessed, 29 were eligible for inclusion. Data
were independently extracted by a minimum of two reviewers in Covidence.
There were 2195 participants, aged 60.4 +/- 6.6 (range 40-79) years, who
were primarily male (n = 1522, 76.1%), randomised in the included studies.
Risk of bias was high and reporting quality was poor. Patient-reported
pain was measured at rest in 28 (96.6%) trials. Data were suitable for
pooled analysis from 10 (34.5%) of these trials with an average rest pain
intensity of 3.3 (SD 1.5) in the control and 2.7 (SD 1.9) in the
intervention groups, respectively. No trials compared combinations of
nonopioid, opioid-agonist-antagonist, partial opioid agonists or full
opioid agonists. Most trials (n = 11, 37.9%) compared two different full
opioid options for less than 72 h (n = 24, 82.7%). <br/>CONCLUSION(S):
Robust trials are needed to determine which multimodal analgesic
combination will optimise patient recovery after adult cardiac surgery.
There is an urgent need to test and refine high-quality end-point
measures. IMPLICATIONS FOR PATIENT CARE: Adequate assessment precedes
ideal pain treatment. The findings from this review reveal neither are
sufficient, and the impact of suboptimal pain management on postoperative
recovery is grossly underinvestigated. IMPACT: The optimal combination of
multimodal analgesics is unknown despite being recommended in best
practice guidelines for enhanced recovery after cardiac surgery. Almost
30% of adults continue to experience ongoing pain up to a year after
cardiac surgery, and findings from this review reveal a dearth of robust
empirical evidence for optimal pain management, and heterogeneity in the
way pain is assessed, measured and managed. This review provides a premise
for robust trials focused on acute postoperative recovery in cardiac
surgery and beyond. REPORTING METHOD: This review was conducted in
accordance with the PRISMA-P statement. PATIENT OR PUBLIC CONTRIBUTION:
There was no patient or public contribution. PROTOCOL REGISTRATION:
PROSPERO: CRD42022355834.<br/>Copyright &#xa9; 2024 John Wiley & Sons Ltd.

<20>
Accession Number
2034133079
Title
Optimizing the management of tricuspid regurgitation: an update on current
treatment strategies and perspectives.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Angellotti D.; Franzone A.; Brugger N.; Reineke D.; Esposito G.; Praz F.
Institution
(Angellotti, Brugger, Reineke, Praz) Department of Cardiology, Bern
University Hospital, Bern, Switzerland
(Angellotti, Franzone, Esposito) Department of Advanced Biomedical
Science, University of Naples Federico II, Naples, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Tricuspid regurgitation (TR) is a prevalent condition and is
independently associated with high morbidity and mortality rates. Despite
its prognostic impact, TR remains undertreated, with patients often
referred at late stages when medical therapy is ineffective and surgical
intervention high risk. Emerging transcatheter therapies offer a promising
alternative for safer and effective management of this elderly patient
population with numerous comorbidities. Areas covered: This review
highlights recent advances in treatment strategies and future directions
for addressing significant TR. The literature search was conducted across
the PubMed, Embase, Scopus, and Google Scholar databases. A structured
search strategy was developed using 'tricuspid regurgitation' and
'management' or 'treatment' or 'therapy' and 'surgery' or 'tricuspid valve
repair' or 'tricuspid valve replacement' or 'transcatheter tricuspid
intervention' as MeSH terms and keywords. Selected articles from 2017 to
present were critically analyzed for strengths, limitations, and gaps in
evidence. Expert opinion: Enhancing disease awareness, the involvement of
multidisciplinary Heart Team and intervening earlier are critical
priorities for TR therapies to prevent treatment futility. Improved device
designs, more performant imaging techniques, and dedicated research
endpoints will help optimizing the management of TR.<br/>Copyright &#xa9;
2025 Informa UK Limited, trading as Taylor & Francis Group.

<21>
Accession Number
2038262794
Title
Cardiac tamponade due to influenza B infection in a young immunocompetent
female: A case report and review of literature.
Source
Qatar Medical Journal. 2025(1) (no pagination), 2025. Article Number: 26.
Date of Publication: 01 Mar 2025.
Author
Sasi S.; Abid F.B.; Alamin M.A.; Iqbal J.; Al-Maslamani M.
Institution
(Sasi, Abid, Alamin, Al-Maslamani) Infectious Diseases Division,
Department of Medicine, Communicable Diseases Center, Hamad Medical
Corporation, Doha, Qatar
(Iqbal) Department of Nursing, Communicable Diseases Center, Hamad Medical
Corporation, Doha, Qatar
Publisher
HBKU Press
Abstract
Background: Influenza infections are recognized globally for their
respiratory manifestations, but are less commonly associated with severe
cardiovascular complications such as cardiac tamponade. The relationship
between influenza infections, particularly influenza B, and cardiac
complications such as myocarditis, pericarditis, and cardiac tamponade
remains underexplored, particularly in immunocompetent individuals. Case
summary: We report the case of a 22-year-old immunocompetent female who
presented to the emergency department with acute shortness of breath,
fatigue, and dizziness due to symptoms suggestive of an influenza-like
illness. Laboratory and imaging findings revealed a large circumferential
pericardial effusion suggestive of cardiac tamponade. Subsequent
investigations confirmed influenza B infection. The patient was managed
with pericardiocentesis, oseltamivir, nonsteroidal anti-inflammatory
drugs, colchicine, and supportive care, resulting in complete recovery.
This case highlights the significance of considering influenza as a
potential cause of acute cardiac complications and the importance of early
diagnostic and therapeutic interventions to prevent morbidity and
mortality. <br/>Discussion(s): The occurrence of cardiac tamponade
secondary to influenza B infection in a young, immunocompetent female
highlights the critical need to educate healthcare providers about the
potential cardiovascular complications of influenza. The mechanisms
underlying influenza-associated cardiac involvement may include direct
viral invasion, systemic inflammation, and immune-mediated responses.
<br/>Conclusion(s): This case contributes to the limited but growing body
of literature on influenza-induced cardiac complications and highlights
the importance of timely antiviral therapy alongside traditional
management strategies for cardiac tamponade. Further research is needed to
elucidate the pathophysiology of influenza-related cardiac complications
and to provide guidelines for the management of such cases.<br/>Copyright
&#xa9; 2025 Sasi, Abid, Alamin, Iqbal, Al-Maslamani, licensee HBKU Press.

<22>
Accession Number
2038341930
Title
Early aortic valve replacement versus conservative management in
asymptomatic severe aortic stenosis: Meta-analysis of time-to-event data
of randomized controlled trials.
Source
International Journal of Cardiology. 432 (no pagination), 2025. Article
Number: 133269. Date of Publication: 01 Aug 2025.
Author
Jacquemyn X.; Sa M.P.; Marin-Cuartas M.; Bax J.J.; Borger M.A.; Clavel
M.-A.; Pibarot P.; Genereux P.; Sultan I.
Institution
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Sa) Division of Cardiac Surgery Massachusetts General Hospital, Harvard
Medical School Boston, MA, United States
(Marin-Cuartas, Borger) University Department of Cardiac Surgery, Heart
Center Leipzig, Leipzig, Germany
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Clavel, Pibarot) Department of Medicine, Quebec Heart & Lung Institute,
Laval University, Quebec, Canada
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Sultan) Department of Cardiothoracic Surgery, University of Pittsburgh,
United States
(Sultan) UPMC Heart and Vascular Institute, Pittsburgh, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Current guidelines recommend aortic valve replacement (AVR)
for symptomatic patients with severe aortic stenosis (AS), but the optimal
timing for intervention in asymptomatic patients is still debated. Recent
randomized controlled trials (RCTs) have offered new insights, prompting a
reevaluation of the potential benefits of early AVR. <br/>Method(s): A
systematic review and pooled meta-analysis of Kaplan-Meier-derived
reconstructed time-to-event data of RCTs published by November 2024 was
conducted in compliance with the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) guideline. Outcomes were derived from
the primary endpoints of the included studies, with the main analysis
focusing on all-cause mortality, cardiovascular mortality, and heart
failure hospitalization. <br/>Result(s): Four randomized controlled
trials, involving 1427 patients, were included. The early AVR group
demonstrated a significant reduction in all-cause mortality (hazard ratio
[HR] = 0.72, 95 % confidence interval [CI] 0.53-0.97, p = 0.031),
cardiovascular mortality (HR = 0.56, 95 % CI 0.36-0.89, p = 0.014), and
heart failure hospitalization (HR = 0.31, 95 % CI 0.18-0.53, p < 0.001).
No significant interaction effects between surgical AVR and transcatheter
AVR were observed. Additionally, in the conservative management group, the
conversion to AVR was substantial, with a median time to conversion of
13.4 months. The cumulative conversion rates were 42.8 % (95 % CI 38.6
%-46.7 %) at 1 year, 82.3 % (95 % CI 78.6 %-85.3 %) at 3 years, and 94.9 %
(95 % CI 91.4 %-96.9 %) at 5 years. <br/>Conclusion(s): Early AVR in
asymptomatic patients with severe AS is associated with a significant
reduction in all-cause mortality, cardiovascular mortality, and heart
failure hospitalization compared to conservative management.<br/>Copyright
&#xa9; 2024

<23>
Accession Number
2038270805
Title
Left Main Spontaneous Coronary Artery Dissection: Clinical Features,
Management, and Outcomes.
Source
JACC: Cardiovascular Interventions. 18(8) (pp 975-983), 2025. Date of
Publication: 28 Apr 2025.
Author
Morosato M.; Gaspardone C.; Romagnolo D.; Pagnesi M.; Baldetti L.; Dormio
S.; Federico F.; Scandroglio A.M.; Chieffo A.; Godino C.; Margonato A.;
Adamo M.; Metra M.; Tchetche D.; Dumonteil N.; Tweet M.S.; Saw J.;
Beneduce A.
Institution
(Morosato, Dormio, Federico, Chieffo, Margonato) Vita-Salute San Raffaele
University, Milan, Italy
(Gaspardone, Godino, Margonato) Cardiology Unit, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Romagnolo) Cardiac Intensive Care Unit, IRCCS Humanitas Research
Hospital, Rozzano, Italy
(Pagnesi, Adamo, Metra) ASST Spedali Civili di Brescia and Department of
Medical and Surgical Specialties, Radiological Sciences, and Public
Health, University of Brescia, Brescia, Italy
(Baldetti, Scandroglio) Cardiac Intensive Care Unit, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Tchetche, Dumonteil, Beneduce) Groupe Cardio-Vasculaire lnterventionnel,
Cinique Pasteur, Toulouse, France
(Tweet) Department of Cardiovascular Diseases, Mayo Clinic College of
Medicine, Rochester, MN, United States
(Saw) Division of Cardiology, Vancouver General Hospital, Vancouver, BC,
Canada
(Beneduce) Heart Valve Center, IRCCS San Raffaele Scientific Institute,
Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: Spontaneous coronary artery dissection (SCAD) is an uncommon
cause of acute myocardial infarction (MI) and is associated with
substantial adverse events. SCAD involving the left main coronary artery
(LM) is a rare but potentially life-threatening condition. Currently,
minimal data on LM SCAD have been reported. <br/>Objective(s): The aim of
this study was to investigate clinical features, contemporary management,
and clinical outcomes of patients with LM SCAD. <br/>Method(s): A
systematic review and pooled analysis of published case reports was
conducted using "left main" and "dissection" as keywords. The authors
screened 1,106 papers in MEDLINE and Embase published between 1990 and
2023. <br/>Result(s): The final analysis included 132 patients (mean age
40 +/- 11 years, 80% women) diagnosed with LM SCAD. Remarkably, 36% of
cases occurred during pregnancy, and 95% presented with acute coronary
syndrome, 22% with cardiogenic shock, and 8% with ventricular arrhythmias.
At 120-day median follow-up, all-cause death occurred in 9%, left
ventricular assist device implantation or heart transplantation in 4%,
recurrent MI in 13%, and urgent myocardial revascularization (MR) in 21%.
Compared with conservative management, early revascularization by
percutaneous coronary intervention or coronary artery bypass grafting
significantly reduced the composite endpoint of all-cause death, left
ventricular assist device implantation or heart transplantation, recurrent
MI, and urgent MR (adjusted HR: 0.37; 95% CI: 0.20-0.69; P < 0.001).
<br/>Conclusion(s): LM SCAD carried significant acute morbidity and
mortality. Early revascularization (percutaneous coronary intervention or
coronary artery bypass graft) was associated with a lower incidence of
early adverse outcomes compared with conservative management, driven
largely by reduction in recurrent MI and urgent MR. These
hypothesis-generating data should be confirmed in future prospective
registries and clinical trials.<br/>Copyright &#xa9; 2025 American College
of Cardiology Foundation

<24>
Accession Number
2037428756
Title
Aspirin and Hemocompatibility after LVAD Implantation in Patients with
Atherosclerotic Vascular Disease: A Secondary Analysis from the ARIES-HM3
Randomized Clinical Trial.
Source
JAMA Cardiology. 10(3) (pp 235-242), 2025. Date of Publication: 12 Mar
2025.
Author
Gustafsson F.; Uriel N.; Netuka I.; Katz J.N.; Pagani F.D.; Connors J.M.;
Jorde U.P.; Zimpfer D.; Pya Y.; Conway J.; Anyanwu A.; Scandroglio A.M.;
Sulemanjee N.; Atluri P.; Keebler M.; Selzman C.H.; Alexis J.D.; Hayward
C.; Henderson J.; Dirckx N.; Gazzola C.; Mehra M.R.
Institution
(Gustafsson) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Uriel) Columbia University College of Physicians and Surgeons and New
York Presbyterian Hospital, New York, United States
(Netuka) Insitute for Clinical and Experimental Medicine, Prague, Czechia
(Katz) NYU Grossman School of Medicine and Bellevue Hospital, New York,
NY, United States
(Pagani) University of Michigan, Ann Arbor, United States
(Connors) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
(Jorde) Montefiore Einstein Center for Heart and Vascular Care, New York,
NY, United States
(Zimpfer) Medical University of Vienna, Vienna, Austria
(Pya) University Medical Center, Astana, Kazakhstan
(Conway) University of Alberta Hospital, Edmonton, AB, Canada
(Anyanwu) Mount Sinai Medical Center, New York, NY, United States
(Scandroglio) Ospedale San Raffaele, Milan, Italy
(Sulemanjee) Aurora St Luke's Medical Center, Milwaukee, WI, United States
(Atluri) Hospital of the University of Pennsylvania, Philadelphia, United
States
(Keebler) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Selzman) University of Utah Hospital, Salt Lake City, United States
(Alexis) University of Rochester Medical Center, Rochester, NY, United
States
(Hayward) St Vincent's Hospital, Sydney, NSW, Australia
(Henderson, Dirckx, Gazzola) Abbott, Chicago, IL, United States
(Mehra) Brigham and Women's Hospital Heart and Vascular Center, Center for
Advanced Heart Disease, Harvard Medical School, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: The Aspirin and Hemocompatibility Events With a Left
Ventricular Assist Device in Advanced Heart Failure (ARIES-HM3) study
demonstrated that aspirin may be safely eliminated from the antithrombotic
regimen after HeartMate 3 (HM3 [Abbott Cardiovascular]) left ventricular
assist device (LVAD) implantation. This prespecified analysis explored
whether conditions requiring aspirin (prior percutaneous coronary
intervention [PCI], coronary artery bypass grafting [CABG], stroke, or
peripheral vascular disease [PVD]) would influence outcomes differentially
with aspirin avoidance. <br/>Objective(s): To analyze aspirin avoidance on
hemocompatibility-related adverse events (HRAEs) at 1 year after implant
in patients with a history of CABG, PCI, stroke, or PVD. <br/>Design,
Setting, and Participant(s): This was an international, multicenter,
prospective, double-blind, placebo-controlled, randomized clinical trial
including patients implanted with a de novo HM3 LVAD across 51 centers.
Data analysis was conducted from April to July 2024. <br/>Intervention(s):
Patients were randomized in a 1:1 ratio to receive aspirin (100 mg per
day) or placebo, in addition to a vitamin K antagonist (VKA) targeted to
an international normalized ratio of 2 to 3 in both groups. <br/>Main
Outcomes and Measures: Primary end point (assessed for noninferiority) was
a composite of survival free of any nonsurgical (>14 days after implant)
HRAEs including stroke, pump thrombosis, bleeding, and arterial peripheral
thromboembolism at 12 months. Secondary end points included nonsurgical
bleeding, stroke, and pump thrombosis events. <br/>Result(s): Among 589 of
628 patients (mean [SD] age, 57.1 [13.7] years; 456 male [77.4%]) who
contributed to the primary end point analysis, a history of PCI, CABG,
stroke, or PVD was present in 41% (240 of 589 patients). There was no
interaction between the presence of an atherosclerotic vascular condition
and effect of aspirin compared with placebo (P for interaction=.23). The
preset 10% noninferiority margin was not crossed for the studied subgroup
of patients. Thrombotic events were rare, with no differences between
aspirin and placebo in patients with and without vascular disease (P for
interaction =.77). Aspirin treatment was associated with a higher rate of
nonsurgical major bleeding events in the group with prior vascular
condition history compared with those without aspirin (rate ratio for
placebo compared with aspirin, 0.52; 95% CI, 0.35-0.79). <br/>Conclusions
and Relevance: Results of this prespecified analysis of the ARIES-HM3
randomized clinical trial demonstrate that in patients with advanced heart
failure who have classical indications for antiplatelet therapy use at the
time of LVAD implantation, aspirin avoidance was safe and not associated
with increased thrombosis risk. Importantly, elimination of aspirin was
associated with no increased thrombosis but a reduction in nonsurgical
bleeding events in patients with a history of PCI, CABG, stroke, or PVD.
Trial registration: ClinicalTrials.gov Identifier:
NCT04069156.<br/>Copyright &#xa9; 2025 American Medical Association. All
rights reserved.

<25>
[Use Link to view the full text]
Accession Number
2038201226
Title
Outcomes following extended postoperative recovery unit admission in
noncardiac surgery: A systematic review and meta-analysis.
Source
European Journal of Anaesthesiology. 42(5) (pp 407-418), 2025. Date of
Publication: 01 May 2025.
Author
Schockaert B.R.; Van Bruchem R.M.; Engel M.F.; Stolker R.J.; Van Lier F.;
Hoeks S.E.
Institution
(Schockaert, Van Bruchem, Stolker, Van Lier, Hoeks) Clinical Research
Group, Department of Anaesthesiology, Erasmus Medical Centre, Rotterdam,
Netherlands
(Schockaert) Department of Anaesthesiology and Intensive Care, AZ Delta,
Roeselare, Belgium
(Engel) Erasmus Medical Centre, Rotterdam, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDSurgery carries inherent risks, with the postoperative phase
being as critical as the intraoperative period. Enhanced perioperative
care units, positioned between general wards and intensive care units, aim
to provide adequate postoperative management and resource allocation.
Despite their widespread implementation, evidence on outcomes remains
limited.OBJECTIVESThe primary outcome was 30-day or in-hospital mortality
following extended postoperative recovery, with subgroup meta-analysis
examining enhanced perioperative care units and intensive care units.
Secondary outcomes included, among others, hospital length of
stay.DESIGNSystematic review with meta-analysis.DATA SOURCESA
comprehensive search was conducted in MEDLINE, Embase, Web of Science,
Cochrane Central, and Google Scholar from inception up to 22 April
2024.ELIGIBILITY CRITERIAThe search string encompassed extended
postoperative recovery units, including enhanced perioperative care units
and intensive care units, for noncardiac, nontransplant surgery, excluding
speciality-specific, age-specific, indirect and nonsurgical admissions.
Two reviewers independently conducted screening, eligibility assessment
and quality appraisal.RESULTSOf 28-179 records screened, 24 were included
of which 22 were unique studies. The overall pooled random-effects
mortality, based on 15 studies, was 3 (95% confidence interval (CI) 2 to
6)%. Subgroup analysis demonstrated a mortality of 2 (95% CI 1 to 4)% for
patients managed in enhanced perioperative care units and 8 (95% CI 4 to
14)% in intensive care units (chi²-=-7.99; P-<-0.01). Risk of
bias (ROBINS I) was moderate to serious, and heterogeneity substantial.
Pooled hospital length of stay, based on six studies, was 8.6 (95% CI 5.9
to 11.3) days.CONCLUSIONPooled mortality following extended postoperative
recovery in noncardiac surgery was 3% (95% CI 2 to 6). Subgroup analysis
indicated lower mortality among patients managed in enhanced perioperative
care units. However, considerable heterogeneity in operational
definitions, unit capabilities, and admission criteria necessitates
cautious interpretation while reflecting real-world practices. Delineation
through further research is warranted.PROSPERO
REGISTRATIONCRD42023457051.<br/>Copyright &#xa9; 2025 The Author(s).
Published by Wolters Kluwer Health, Inc.

<26>
[Use Link to view the full text]
Accession Number
2037345705
Title
Fibrinolytic activity in infants undergoing cardiac surgery on
cardiopulmonary bypass with routine tranexamic acid: A prospective cohort
substudy within the FIBrinogen CONcentrate randomised control trial.
Source
European Journal of Anaesthesiology. 42(5) (pp 389-397), 2025. Date of
Publication: 01 May 2025.
Author
Siemens K.; Parmar K.; Harris J.; Hunt B.J.; Tibby S.M.
Institution
(Siemens, Harris, Tibby) PICU Evelina London Children's Hospital, London,
United Kingdom
(Parmar, Hunt) Thrombosis and Vascular Biology Group, London, United
Kingdom
(Parmar, Hunt) Thrombosis and Haemophilia Centre, Thrombosis and Vascular
Biology Group, Guy's and St Thomas NHS Foundation Trust, London, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Fibrinolytic activity contributes to bleeding after
cardiopulmonary bypass (CPB). OBJECTIVE Our objectives were, in a group of
infants undergoing cardiac surgery with CPB: to document the extent of
peri-operative fibrinolysis using rotational thromboelastometry (ROTEM)
and standard biomarkers; to compare the agreement between these
fibrinolytic measures; to assess whether fibrinolytic activity is
associated with early postoperative mediastinal bleeding and assess
whether supplementation with fibrinogen concentrate affected fibrinolysis.
DESIGN Prospective cohort, mechanistic substudy, nested within the
FIBrinogen CONcentrate (FIBCON) randomised controlled trial. SETTING
Single centre, tertiary paediatric cardiac surgery and paediatric
intensive care units. PATIENTS Ninety infants (median age 6.3 months)
undergoing cardiac surgery, who all received routine intra-operative
tranexamic acid. The infants were randomised to receive either an
individualised dose of fibrinogen concentrate (n = 60) or placebo (n = 30)
during CPB. MAIN OUTCOME MEASURES We measured the ROTEM variable maximum
clot lysis (ML), and fibrinolytic biomarkers including plasmin-antiplasmin
(PAP) and tissue plasminogen activator antigen (tPA-Ag). Blood was sampled
pre-CPB, on-CPB and post-CPB, and 4h after PICU admission. RESULTS tPA-Ag,
PAP and ROTEM ML increased significantly after CPB despite the use of
tranexamic acid. The two fibrinolytic biomarkers t-PA and PAP, correlated
(P=0.001) but neither correlated with ROTEM ML. Early postoperative blood
loss was inversely associated with PAP levels. Each 100mugl^-1
rise in PAP was associated with a 7.9% reduction in mean blood loss.
Fibrinogen concentrate supplementation as expected did not affect tPA-Ag
but was temporally associated with an increase in PAP levels and a
decrease in ROTEM fibrinolytic activity. CONCLUSION Fibrinolysis is
activated after paediatric cardiac CPB surgery as indicated by increased
tPA-Ag and ROTEM ML. The substantial increase in tPA-Ag post-PICU
admission is probably accompanied by a similar rise of plasminogen
activator inhibitor 1 (PAI-1) as part of the acute phase response to
surgery, thereby limiting clinical fibrinolysis. Supplementation of
fibrinogen concentrate was associated with increased PAP activity and less
clinical bleeding, consistent with the known role for fibrinogen in being
a substrate for plasmin. TRIAL REGISTRATIONISCTRN:50553029,
Eudract:2013-003532-68.<br/>Copyright &#xa9; 2025 European Society of
Anaesthesiology and Intensive Care.

<27>
Accession Number
2036913748
Title
Stress Reduction in Perioperative Care: Feasibility Randomized Controlled
Trial.
Source
Journal of Medical Internet Research. 27 (no pagination), 2025. Article
Number: e54049. Date of Publication: 2025.
Author
Kondylakis H.; Giglioli I.A.C.; Katehakis D.; Aldemir H.; Zikas P.;
Papagiannakis G.; Hors-Fraile S.; Gonzalez-Sanz P.L.; Apostolakis K.;
Stephanidis C.; Nunez-Benjumea F.J.; Banos-Rivera R.M.; Fernandez-Luque
L.; Kouroubali A.
Institution
(Kondylakis, Katehakis, Papagiannakis, Apostolakis, Stephanidis,
Kouroubali) FORTH-ICS, Heraklion, Greece
(Giglioli, Aldemir, Hors-Fraile, Gonzalez-Sanz, Fernandez-Luque) Adhera
Therapeutics (United States), Wake Forest, NC, United States
(Zikas) ORamaVR SA, Heraklion, Greece
(Nunez-Benjumea) Innovation & Data Analysis Unit, Institute of Biomedicine
of Seville, IBiS/Virgen Macarena University Hospital, CSIC, University of
Seville, Seville, Spain
(Banos-Rivera) Polibienestar Institute, University of Valencia, Valencia,
Spain
Publisher
JMIR Publications Inc.
Abstract
Background: Patients undergoing surgery often experience stress and
anxiety, which can increase complications and hinder recovery. Effective
management of these psychological factors is key to improving outcomes.
Preoperative anxiety is inversely correlated with the amount of
information patients receive, but accessible, personalized support remains
limited, especially in preoperative settings. Face-to-face education is
often impractical due to resource constraints. Digital health (DH)
interventions offer a promising alternative, enhancing patient engagement
and empowerment. However, most current tools focus on providing
information, overlooking the importance of personalization and
psychological support. <br/>Objective(s): This study aimed to assess the
viability of a DH intervention known as the Adhera CARINAE DH Program.
This program is specifically designed to offer evidence-based and
personalized stress- and anxiety-management techniques. It achieves this
by using a comprehensive digital ecosystem that incorporates wearable
devices, mobile apps, and virtual reality technologies. The intervention
program also makes use of advanced data-driven techniques to deliver
tailored patient education and lifestyle support. <br/>Method(s): A total
of 74 patients scheduled for surgery across 4 hospitals in 3 European
countries were enrolled in this study from September 2021 to March 2022.
Surgeries included cardiopulmonary and coronary artery bypass surgeries,
cardiac valve replacements, prostate or bladder cancer surgeries, hip and
knee replacements, maxillofacial surgery, and scoliosis procedures. After
assessment for eligibility, participants were randomized into 2 groups:
the intervention group (n=23) received the Adhera CARINAE DH intervention
in addition to standard care, while the control group (n=27) received
standard care alone. Psychological metrics such as self-efficacy,
self-management, and mental well-being were assessed before and after the
intervention, alongside physiological markers of stress. <br/>Result(s):
The intervention group demonstrated significant improvements across
several psychological outcomes. For example, Visual Analogue Scale Stress
at the hospital improved at admission by 5% and at hospital discharge by
11.1% and Visual Analogue Scale Pain at admission improved by 31.2%. In
addition, Hospital Anxiety and Depression Scale Anxiety after surgery
improved by 15.6%, and Positive and Negative Affect Scale-Negative at
hospital admission improved by 17.5%. Overall, patients in the
intervention study spent 17.12% less days in the hospital. Besides these
individual scores, the intervention group shows more positive
relationships among the psychological dimensions of self-efficacy,
self-management, and mental well-being, suggesting that the CARINAE
solution could have a positive effect and impact on the reduction of
stress and negative emotions. <br/>Conclusion(s): Our results provide an
important first step toward a deeper understanding of optimizing DH
solutions to support patients undergoing surgery and for potential
applications in remote patient monitoring and communication.<br/>Copyright
&#xa9; 2025 JMIR Publications Inc.. All rights reserved.

<28>
Accession Number
2038144114
Title
Outcomes after fractional flow reserve-guided percutaneous coronary
intervention versus coronary artery bypass grafting (FAME 3): 5-year
follow-up of a multicentre, open-label, randomised trial.
Source
The Lancet. (no pagination), 2025. Date of Publication: 2025.
Author
Fearon W.F.; Zimmermann F.M.; Ding V.Y.; Takahashi K.; Piroth Z.; van
Straten A.H.M.; Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.;
Kharbanda R.; Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar
N.; Jagic N.; Dambrink J.-H.E.; Kala P.; Angeras O.; MacCarthy P.; Wendler
O.; Casselman F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom
T.; Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Otsuki H.; Kobayashi
Y.; Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.; Pijls
N.H.J.; De Bruyne B.
Institution
(Hlatky) Department of Health Policy, Stanford University, Stanford, CA,
United States
(Fearon, Takahashi, Otsuki, Hlatky, Yeung) Department of Medicine,
Stanford University, Stanford, CA, United States
(Woo) Department of Cardiothoracic Surgery, Stanford University, Stanford,
CA, United States
(Fearon, Yeung) Stanford Cardiovascular Institute, Stanford University,
Stanford, CA, United States
(Fearon) VA Palo Alto Health Care System, Palo Alto, CA, United States
(Zimmermann) St Antonius Hospital, Nieuwegein, Netherlands
(Zimmermann, van Straten, Tonino, Pijls) Catharina Hospital, Eindhoven,
Netherlands
(Ding, Desai) Quantitative Sciences Unit, Stanford University, Stanford,
CA, United States
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Budapest,
Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
(Davidavicius, Kalinauskas) Vilnius University Hospital Santaros Klinikos,
Vilnius, Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Montreal, QC,
Canada
(Kharbanda) Oxford University Hospital NHS Trust, Oxford, United Kingdom
(Ostlund-Papadogeorgos) Danderyd University Hospital and Karolinska
Institutet, Solna, Sweden
(Aminian) Centre Hospitalier Universitaire de Charleroi, Charleroi,
Belgium
(Oldroyd, Al-Attar) Golden Jubilee National Hospital, Glasgow, United
Kingdom
(Jagic) Clinical Hospital Centre Zemun, University of Belgrade, Belgrade,
Serbia
(Dambrink) Isala Hospital, Zwolle, Netherlands
(Kala) Medical Faculty of Masaryk University, Brno, Czechia
(Kala) University Hospital Brno, Brno, Czechia
(Angeras) Sahlgrenska University Hospital, Gothenburg, Sweden
(MacCarthy) Kings College Hospital, London, United Kingdom
(Wendler) Cleveland Clinic London, London, United Kingdom
(Casselman, De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Witt) Sodersjukhuset Hospital, Stockholm, Sweden
(Witt) Karolinska Institutet, Solna, Sweden
(Mavromatis) Atlanta VA Healthcare System, Decatur, GA, United States
(Mavromatis) Emory University School of Medicine, Atlanta, GA, United
States
(Miner) Southlake Regional Health Centre, Newmarket, ON, Canada
(Sarma) Wythenshawe Hospital, Manchester, United Kingdom
(Engstrom) Rigshospitalet, Copenhagen, Denmark
(Christiansen) Aarhus University Hospital, Aarhus, Denmark
(Reardon) Houston Methodist Hospital, Houston, TX, United States
(Kobayashi) NY Presbyterian Brooklyn Methodist Hospital, New York, NY,
United States
(Kobayashi) Weill Cornell Medical College, New York, NY, United States
(Mahaffey) Stanford Center for Clinical Research, Department of Medicine,
Stanford University, Stanford, CA, United States
(De Bruyne) Lausanne University Centre Hospital, Lausanne, Switzerland
Publisher
Elsevier B.V.
Abstract
Background: Long-term outcomes following percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG) might be
changing because of improved techniques and better medical therapy. This
final prespecified analysis of the Fractional Flow Reserve (FFR) versus
Angiography for Multivessel Evaluation (FAME) 3 trial aimed to reassess
their comparative effectiveness at 5 years. <br/>Method(s): FAME 3 was a
multicentre, randomised trial comparing FFR-guided PCI using
current-generation zotarolimus-eluting stents versus CABG in patients with
three-vessel coronary artery disease not involving the left main coronary
artery. 48 hospitals in Europe, USA and Canada, Australia, and Asia
participated in the trial. Patients (aged >=21 years with no cardiogenic
shock, no recent ST segment elevation myocardial infarction, no severe
left ventricular dysfunction, and no previous CABG) were randomly assigned
to either PCI or CABG using a web-based system. At 1 year, FFR-guided PCI
did not meet the prespecified threshold for non-inferiority for the
outcome of death, stroke, myocardial infarction, or repeat
revascularisation versus CABG. The primary endpoint for this
intention-to-treat analysis was the 5-year incidence of the prespecified
composite outcome of death, stroke, or myocardial infarction. The trial
was registered at ClinicalTrials.gov, NCT02100722, and is completed; this
is the final report. <br/>Finding(s): Between Aug 25, 2014 and Nov 28,
2019, 757 of 1500 participants were assigned to PCI and 743 to CABG.
5-year follow-up was achieved in 724 (96%) patients assigned to PCI and
696 (94%) assigned to CABG. At 5 years, there was no significant
difference in the composite of death, stroke, or myocardial infarction
between the two groups, with 119 (16%) events in the PCI group and 101
(14%) in the CABG group (hazard ratio 1.16 [95% CI 0.89-1.52]; p=0.27).
There were no differences in the rates of death (53 [7%] vs 51 [7%]; 0.99
[0.67-1.46]) or stroke (14 [2%] vs 21 [3%], 0.65 [0.33-1.28]), but
myocardial infarction was higher in the PCI group than in the CABG group
(60 [8%] vs 38 [5%], 1.57 [1.04-2.36]), as was repeat revascularisation
(112 [16%] vs 55 [8%], 2.02 [1.46-2.79]). <br/>Interpretation(s): At the
5-year follow-up, there was no significant difference in a composite
outcome of death, stroke, or myocardial infarction after FFR-guided PCI
versus CABG, although myocardial infarction and repeat revascularisation
were higher with PCI. These results provide contemporary evidence to allow
improved shared decision making between physicians and patients.
<br/>Funding(s): Medtronic and Abbott Vascular.<br/>Copyright &#xa9; 2025
Elsevier Ltd

<29>
Accession Number
2036120225
Title
Risk of malignant transformation and infections in congenital lung
malformations in adults: a systematic review.
Source
European Respiratory Review. 34(176) (no pagination), 2025. Article
Number: 240254. Date of Publication: 01 Apr 2025.
Author
Pederiva F.; Dalena P.; Pasqua N.; Bresesti I.; Testa V.; Zirpoli S.;
Gentilino V.
Institution
(Pederiva, Pasqua, Gentilino) Pediatric Surgery, "F. Del Ponte" Hospital,
ASST Settelaghi, Varese, Italy
(Dalena) Institute for Maternal and Child Health, IRCCS "Burlo Garofolo",
Trieste, Italy
(Dalena) University of Trieste, Trieste, Italy
(Bresesti) Neonatal Intensive Care Unit, "F. Del Ponte" Hospital, ASST
Settelaghi, Varese, Italy
(Bresesti) Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Testa) University of Brescia, Brescia, Italy
(Zirpoli) Department of Radiology, "Vittore Buzzi" Children's Hospital,
Milano, Italy
Publisher
European Respiratory Society
Abstract
Background Although there is agreement on surgically removing symptomatic
congenital lung malformations (CLMs), the management of asymptomatic cases
remains controversial. Some paediatric surgeons suggest conservative
management for asymptomatic cases due to the low perceived risk of
developing symptoms or malignancy. This study aimed to investigate the
characteristics and management of adults with CLMs. Methods Following
PRISMA (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses) guidelines, a systematic review was conducted to find
studies reporting on adult patients (aged 15 years) with CLMs. Results Out
of 12 908 studies reviewed from 1947 to 2024, 653 studies met the
inclusion criteria, covering 980 patients. None of the patients had a
prenatal diagnosis. The mean+/-SD age at surgery was 39.4+/-15.7 years
(range 15-86). A total of 74.4% of adults with CLMs presented with
symptoms, leading to the detection of CLM. Pneumonia was the most common
symptom in congenital pulmonary airway malformation (CPAM) and intralobar
sequestration, with over 30% of these patients experiencing recurrent
respiratory infections. In 11.7% of adults, CLMs harboured tumours at the
time of surgical removal, with CPAM associated with lung tumours in over
20% of cases. Conclusions Thoracic surgeons recommend surgical resection
for all adult CLM patients, including asymptomatic cases, due to risks of
infections and malignancy. Conservative management was considered only
when surgery was not feasible.<br/>Copyright &#xa9; The authors 2025.

<30>
Accession Number
2034160930
Title
Cerebral autoregulation monitoring in neonates and infants after cardiac
surgery with cardiopulmonary bypass - comparison of single ventricle and
biventricular physiology.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1540870. Date of Publication: 2025.
Author
Methner M.; Schwaneberg B.; Wikidal B.; Schmid S.; Zipfel J.; Iller M.;
Schuhmann M.U.; Georgiev Y.H.; Magunia H.; Berger R.; Schlensak C.;
Nordmeyer J.; Neunhoeffer F.
Institution
(Methner, Schwaneberg, Wikidal, Schmid, Iller, Georgiev, Nordmeyer,
Neunhoeffer) Department of Paediatric Cardiology, Pulmology and Paediatric
Intensive Care Medicine, University Children's Hospital of Tuebingen,
Tuebingen, Germany
(Zipfel, Schuhmann) Section of Paediatric Neurosurgery, Department of
Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
(Magunia) Department of Anaesthesiology and Intensive Care Medicine,
University Hospital Tuebingen, Tuebingen, Germany
(Berger, Schlensak) Department of Thoracic and Cardiovascular Surgery,
University Hospital Tuebingen, Tuebingen, Germany
Publisher
Frontiers Media SA
Abstract
Introduction: Cardiopulmonary bypass surgery can lead to impaired cerebral
autoregulation with the risk for ischemia, hemorrhage and delirium. In
particular, infants with single ventricle physiology have altered
hemodynamics with persistent veno-arterial shunting, cyanosis and
diastolic run-off after surgery, which may have negative effects on
cerebral autoregulation. <br/>Method(s): Cerebral autoregulation was
prospectively monitored in 83 neonates and infants after open heart
surgery with cardiopulmonary bypass after admission to the pediatric
intensive care unit. Autoregulation indices were determined using
near-infrared spectroscopy, correlating regional cortical oxygen
saturation and local hemoglobin levels with invasive mean arterial
pressure. Intact autoregulation was defined as cerebral oxygenation index
(COx) < 0.4 and hemoglobin volume index (HVx) < 0.3. A subgroup analysis
was performed between 55 infants after biventricular repair surgery and 15
infants after palliative surgery. <br/>Result(s): The mean lower limit of
autoregulation was 46 +/- 6 mmHg (COx) and 46 +/- 7 mmHg (HVx). The
optimal mean arterial pressure according to cerebral autoregulation was 56
+/- 8 mmHg (COx) and 55 +/- 7 mmHg (HVx). The mean upper limit was 65 +/-
9 mmHg (COx) and 65 +/- 8 mmHg (HVx). Intact autoregulation occurred
during 84 +/- 8% (COx) and 77 +/- 10% (HVx) of the monitored time. No
significant differences were found in autoregulation parameters between
single ventricle and biventricular groups. However, the single ventricle
group had significantly lower arterial and cerebral oxygen saturation.
<br/>Discussion(s): A standardized blood pressure management may not be
sufficient in children after cardiac surgery due to potentially impaired
cerebral autoregulation. Therefore, cerebral autoregulation monitoring
should be considered in this patient population.<br/>Copyright 2025
Methner, Schwaneberg, Wikidal, Schmid, Zipfel, Iller, Schuhmann, Georgiev,
Magunia, Berger, Schlensak, Nordmeyer and Neunhoeffer.

<31>
Accession Number
2037709313
Title
Early vs Delayed Bypass Surgery in Patients With Acute Coronary Syndrome
Receiving Ticagrelor: The RAPID CABG Randomized Open-Label Noninferiority
Trial.
Source
JAMA Surgery. 160(4) (pp 387-394), 2025. Date of Publication: 09 Apr 2025.
Author
So D.Y.F.; Wells G.A.; Lordkipanidze M.; Chong A.Y.; Ruel M.; Perrault
L.P.; Le May M.R.; Sun L.; Tran D.; Labinaz M.; Glover C.; Russo J.;
Welman M.; Chan V.; Chen L.; Bernick J.; Rubens F.; Tanguay J.-F.;
Salapang G.; MacPhee P.; Abarbanel T.; Mitchell C.; Racine K.; Amche R.;
Davies R.; Davis D.; Poulin A.; Nair G.; De Roock S.; Tran M.-L.
Institution
(So, Chong, Le May, Labinaz, Glover, Russo) Division of Cardiology,
Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Wells, Chen, Bernick) Cardiovascular Research Methods Centre, Department
of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Lordkipanidze, Welman) Montreal Heart Institute Research Centre,
Montreal, QC, Canada
(Lordkipanidze) Faculty of Pharmacy, University of Montreal, Montreal, QC,
Canada
(Ruel, Chan, Rubens) Division of Cardiac Surgery, Department of Surgery,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Perrault) Division of Cardiac Surgery, Department of Surgery, Montreal
Heart Institute, Montreal, QC, Canada
(Sun, Tran) Division of Cardiac Anesthesia, Department of Anesthesiology,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Tanguay) Department of Medicine, Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Salapang, MacPhee, Abarbanel, Mitchell, Racine, Davies, Davis, Nair, De
Roock, Tran) University of Ottawa, Heart Institute, Ottawa, ON, Canada
(Amche) Montreal Heart Institute, Montreal, QC, Canada
(Poulin) Quebec Heart and Lung Institute, Quebec City, QC, Canada
Publisher
American Medical Association
Abstract
Importance: Perioperative bleeding is a major concern in patients
receiving ticagrelor for acute coronary syndromes (ACS) when coronary
artery bypass graft (CABG) surgery is required. <br/>Objective(s): To
evaluate whether early CABG surgery at 2 to 3 days after ticagrelor
cessation is noninferior to waiting 5 to 7 days. <br/>Design, Setting, and
Participant(s): RAPID CABG was a noninferiority, open-label randomized
trial with 6 months of follow-up. Participants were patients with ACS who
had received ticagrelor and required CABG. Patients were enrolled in
tertiary centers in Canada between January 2016 and March 2021. Data were
analyzed from March 2021 to December 2023. <br/>Intervention(s): Early or
delayed CABG. <br/>Main Outcomes and Measures: The primary outcome was
based on noninferiority comparison of class 3 or 4 universal definition of
perioperative bleeding (UDPB). Noninferiority was prespecified as 8%
between groups. Twelve-hour chest tube drainage was reported as a
noninferiority comparison. Other bleeding, ischemic, and length-of-stay
outcomes were assessed for superiority. <br/>Result(s): Among 143
randomized patients, the median (IQR) age was 65 (58-72) years; there were
117 male patients (82%) and 26 female (18%). Of these, 123 patients
(86.0%) underwent surgery in the allocated time frame (per protocol). The
median (IQR) time to surgery was 3 (2-3) days in the early group and 6
(5-7) days in the delayed group (P <.001). In a per-protocol analysis,
severe or massive UDPB occurred in 3 of 65 early-group patients (4.6%) and
3 of 58 patients (5.2%) in the delayed group (between-group difference,
-0.6%; 95% CI, -8.3% to 7.1%; P =.03 for noninferiority). Median (IQR)
chest tube drainage was 470 (330-650) mL vs 495 (380-610) mL
(between-group difference -25 mL; 95% CI, -111.25 to 35; P =.01 for
noninferiority). Median (IQR) hospital stay was 9 (7-13) days and 12
(10-15) days for the early and delayed groups (P <.001). Conclusion and
Relevance: This study found that an early surgical strategy, 2 to 3 days
after ticagrelor cessation, was noninferior in incurring perioperative
bleeding. The data support a reduction in the delay between ticagrelor
cessation and CABG surgery and may decrease hospital length of
stay.<br/>Copyright &#xa9; 2025 American Medical Association. All rights
reserved, including those for text and data mining, AI training, and
similar technologies.

<32>
Accession Number
2037975438
Title
Impact of Transcatheter or Surgical Aortic Valve Performance on 5-Year
Outcomes in Patients at >= Intermediate Risk.
Source
Journal of the American College of Cardiology. 85(13) (pp 1419-1430),
2025. Date of Publication: 08 Apr 2025.
Author
Yakubov S.J.; Van Mieghem N.M.; Oh J.K.; Ito S.; Grubb K.J.; O'Hair D.;
Forrest J.K.; Gada H.; Mumtaz M.; Deeb G.M.; Tang G.H.L.; Rovin J.D.; Jain
R.; Windecker S.; Skelding K.A.; Kleiman N.S.; Chetcuti S.J.; Dedrick A.;
Boatman S.V.; Popma J.J.; Reardon M.J.
Institution
(Yakubov) Riverside Methodist, Ohio Health, Columbus, OH, United States
(Van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
(Oh, Ito) Mayo Clinic, Rochester, MN, United States
(Grubb) Emory University School of Medicine, Atlanta, GA, United States
(O'Hair) Boulder Community Health, Boulder, CO, United States
(Forrest) Yale University School of Medicine, New Haven, CT, United States
(Gada, Mumtaz) University of Pittsburgh Medical Center Pinnacle Heath,
Harrisburg, PA, United States
(Deeb, Chetcuti) University of Michigan Hospitals, Ann Arbor, MI, United
States
(Tang) Mount Sinai Health System, New York, NY, United States
(Rovin) Morton Plant Hospital, Clearwater, FL, United States
(Jain) Aurora Healthcare, Milwaukee, WI, United States
(Windecker) Inselspital, University of Bern, Bern, Switzerland
(Skelding) Jersey City Medical Center, RWJBarnabas Health, Jersey City,
NJ, United States
(Kleiman, Reardon) Houston Methodist-DeBakey Heart and Vascular Center,
Houston, TX, United States
(Dedrick, Boatman, Popma) Structural Heart and Aortic, Medtronic,
Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: The incidence and clinical importance of bioprosthetic valve
dysfunction (BVD) in patients undergoing supra-annular, self-expanding
transcatheter aortic valve replacement (TAVR) or surgery is not well
understood. <br/>Objective(s): The purpose of this study was to evaluate
the 5-year incidence and clinical outcomes of BVD in patients undergoing
CoreValve/Evolut TAVR or surgery. <br/>Method(s): This post hoc analysis
pooled data from the U.S. High Risk Pivotal (n = 726) and SURTAVI (n =
1,618) randomized controlled trials (RCTs), the Extreme Risk Pivotal trial
(n = 608), and CoreValve Continued Access Study (n = 2,654). The primary
endpoint was the incidence of BVD through 5 years from the RCTs. The
association of BVD with 5-year clinical outcomes was evaluated in the
pooled RCT and non-RCT populations. <br/>Result(s): Of 5,606 patients
evaluated, 3,070 (54.8%) were men, and the mean age was 82.2 +/- 7.4
years. A total of 2,344 RCT patients, including 1,227 who received TAVR
and 1,117 who received surgery, and 3,262 non-RCT TAVR patients were
included. The rate of BVD was lower in RCT patients undergoing
CoreValve/Evolut TAVR compared with surgery (9.7% vs 15.3%;
subdistribution HR: 0.57; 95% CI: 0.45-0.73; P < 0.001). In the pooled RCT
and non-RCT cohort, BVD was associated with increased 5-year all-cause
mortality (HR: 1.49; 95% CI: 1.32-1.68; P < 0.001), cardiovascular
mortality (HR: 1.76; 95% CI: 1.52-2.03; P < 0.001), and hospitalization
for valve disease or worsening heart failure (HR: 1.48; 95% CI: 1.23-1.78;
P < 0.001). <br/>Conclusion(s): Five-year valve performance was
significantly better after CoreValve/Evolut TAVR compared with surgery.
Development of BVD in TAVR and surgery patients was associated with
worsened 5-year clinical outcomes. (Safety and Efficacy Study of the
Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic
Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve
Replacement, NCT01240902; Safety and Efficacy Study of the Medtronic
CoreValve System in the Treatment of Severe, Symptomatic Aortic Stenosis
in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI],
NCT01586910; Safety and Efficacy Continued Access Study of the Medtronic
CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in
Very High Risk Subjects and High Risk Subjects Who Need Aortic Valve
Replacement, NCT01531374)<br/>Copyright &#xa9; 2025 American College of
Cardiology Foundation

<33>
Accession Number
2032838045
Title
European Guideline on Chronic Nausea and Vomiting-A UEG and ESNM Consensus
for Clinical Management.
Source
United European Gastroenterology Journal. 13(3) (pp 427-471), 2025. Date
of Publication: 01 Apr 2025.
Author
Malagelada C.; Keller J.; Sifrim D.; Serra J.; Tack J.; Mulak A.; Stengel
A.; Aguilar A.; Drewes A.M.; Josefsson A.; Bonaz B.; Dumitrascu D.;
Keszthelyi D.; Barba E.; Carbone F.; Zerbib F.; Marchegiani G.; Hauser G.;
Gourcerol G.; Tornblom H.; Hammer H.; Aziz I.; Matic J.R.; Mendive J.;
Nikaki K.; Wauters L.; Alcala-Gonzalez L.G.; Waluga M.; Jinga M.; Corsetti
M.; Rommel N.; Shidrawi R.; De Giorgio R.; Kadirkamanathan S.;
Surdea-Blaga T.
Institution
(Malagelada, Serra) Digestive System Research Unit, Hospital General Vall
d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
(Malagelada, Serra) Centro de Investigacion Biomedica en Red de
Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain
(Keller) Israelitic Hospital, Academic Hospital University of Hamburg,
Hamburg, Germany
(Sifrim) Wingate Institute of Neurogastroenterology, Blizard Institute,
Barts and The London School of Medicine and Dentistry, Queen Mary
University of London, London, United Kingdom
(Tack) Department of Gastroenterology and Hepatology, UZ Leuven, Leuven,
Belgium
(Mulak) Department of Gastroenterology and Hepatology, Wroclaw Medical
University, Wroclaw, Poland
(Stengel) Clinic for Psychosomatic Medicine and Psychotherapy Klinikum
Stuttgart, Psychosomatic Medicine and Psychotherapy University Hospital
Tubingen, DZPG Site Tubingen, Charite-Universitatsmedizin Freie
Universitat Berlin, Berlin, Germany
(Aguilar, Alcala-Gonzalez) Digestive System Research Unit, Vall d'Hebron
University Hospital, Barcelona, Spain
(Drewes) Mech-Sense & Centre for Pancreatic Diseases, Department of
Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg,
Denmark
(Josefsson, Tornblom) Department of Molecular and Clinical Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Bonaz) Stress et Interactions Neuro-Digestives, Grenoble Institut des
Neurosciences, Centre de Recherche INSERM 836 UJF-CEA-CHU, Grenoble,
France
(Dumitrascu, Surdea-Blaga) Second Department of Internal Medicine and
Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy,
Cluj-Napoca, Romania
(Keszthelyi) Department of Gastroenterology-Hepatology, Maastricht
University Medical Center, Maastricht, Netherlands
(Barba) Neurogastroenterology and Motility Unit, Gastroenterology
Department, Institut Clinic de Malalties Digestives i Metaboliques
Hospital Clinic of Barcelona, Barcelona, Spain
(Carbone, Wauters) Department of Gastroenterology and Hepatology,
University Hospitals Leuven, Leuven, Belgium
(Zerbib) CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hopital
Haut-Leveque, Department of Gastroenterology, Universite de Bordeaux,
INSERM CIC 1401, Bordeaux, France
(Marchegiani) Department of Surgery, Oncology and Gastroenterology
(DiSCOG), University of Padua, Padua, Italy
(Hauser) Department of Gastroenterology, Clinical Hospital Centre of
Rijeka, Faculty of Medicine University of Rijeka, Rijeka, Croatia
(Gourcerol) Physiology Department, Univ Rouen Normandie, Inserm, ADEN UMR
1073, CHU Rouen, Rouen, France
(Hammer) Division of Gastroenterology and Hepatology, Department of
Internal Medicine, Medical University of Graz, Graz, Austria
(Aziz) Department of Gastroenterology and Division of Clinical Medicine,
University of Sheffield, Sheffield, United Kingdom
(Matic) Health Center Zagreb-West, Zagreb, Croatia
(Mendive) La Mina Primary Care Academic Health Centre, Catalan Institute
of Health, University of Barcelona, Barcelona, Spain
(Nikaki) Department of Pediatric Gastroenterology, Great Ormond Street
Hospital, London, United Kingdom
(Waluga) Department of Gastroenterology and Hepatology, Medical University
of Silesia, Katowice, Poland
(Jinga) Department of Internal Medicine and Gastroenterology, Carol Davila
University of Medicine and Pharmacy, Bucharest, Romania
(Corsetti) NIHR Nottingham Biomedical Research Centre (BRC), Nottingham
University Hospitals NHS Trust and the University of Nottingham,
Nottingham, United Kingdom
(Rommel) Department of Neurosciences, Deglutology, Experimental
Otorhinolaryngology (ExpORL), University of Leuven, Leuven, Belgium
(Rommel) Department of Gastroenterology, Neurogastroenterology & Motility,
University Hospitals Leuven, Leuven, Belgium
(Shidrawi) Department of Gastroenterology, The Wellington Hospital,
London, United Kingdom
(De Giorgio) Department of Translational Medicine, University of Ferrara,
Ferrara, Italy
(Kadirkamanathan) Department of Gastroenterology, Wingate Institute of
Neurogastroenterology, The London School of Medicine and Dentistry, Queen
Mary University of London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Chronic nausea and vomiting are symptoms of a wide range of
gastrointestinal and non-gastrointestinal conditions. Diagnosis can be
challenging and requires a systematic and well-structured approach. If the
initial investigation for structural, toxic and metabolic disorders is
negative, digestive motility and gut-brain interaction disorders should be
assessed. United European Gastroenterology (UEG) and the European Society
for Neurogastroenterology and Motility (ESNM) identified the need for an
updated, evidence-based clinical guideline for the management of chronic
nausea and vomiting. <br/>Method(s): A multidisciplinary team of experts
in the field, including European specialists and national societies,
participated in the development of the guideline. Relevant questions were
addressed through a literature review and statements were developed and
voted on according to a Delphi process. <br/>Result(s): Ninety-eight
statements were identified and voted following the Delphi process. Overall
agreement was high, although the grade of scientific evidence was low in
many areas. Disagreement was more evident for some pharmacological
treatment options. A diagnostic algorithm was developed, focussing on the
differentiating features between gastrointestinal motility and gut-brain
interaction disorders with predominant nausea and vomiting.
<br/>Conclusion(s): These guidelines provide an evidence-based framework
for the evaluation and treatment of patients with chronic nausea and
vomiting.<br/>Copyright &#xa9; 2025 The Author(s). United European
Gastroenterology Journal published by Wiley Periodicals LLC on behalf of
United European Gastroenterology.

<34>
Accession Number
2038162948
Title
Impact of pre-procedural red cell distribution width on one-year all-cause
mortality following transcatheter aortic valve replacement: A systematic
review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Pingili A.; Kodali L.S.M.; Vadiyala M.R.; Koskina L.; Patel B.A.; Sanku
K.; Desai R.; Kondapaneni M.
Institution
(Pingili) Department of Internal Medicine, MedStar Health, Baltimore, MD,
United States
(Kodali) Department of Public Health & Health Sciences, University of
Michigan - Flint, Flint, MI, United States
(Vadiyala) Department of Internal Medicine, Maimonides Medical Center,
Brooklyn, NY, United States
(Koskina) Department of Internal Medicine, MedStar Health Union Memorial
Hospital, Baltimore, MD, United States
(Patel) Department of Internal Medicine, Trinity Health Oakland Hospital,
Pontiac, MI, United States
(Sanku) Department of Cardiology, Mount Sinai Medical Center, Miami Beach,
FL, United States
(Desai) Independent Outcomes Researcher, Atlanta, GA, United States
(Kondapaneni) Department of Heart & Vascular Center, MetroHealth,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Red cell distribution width (RDW) has emerged as a novel
biomarker associated with adverse outcomes in patients with cardiovascular
disease (CVD). We aimed to determine the prognostic significance of
pre-procedural RDW levels on one-year all-cause mortality (ACM) following
transcatheter aortic valve replacement (TAVR) by conducting a systematic
review and meta-analysis due to limited evidence on the impact of RDW
levels in TAVR patients. <br/>Method(s): We systematically reviewed
articles on pre-procedural RDW and one-year ACM post-TAVR until February
2024 using PubMed and Google Scholar. Binary random effects model was used
for pooled adjusted odds ratio (aOR), with 95 % confidence intervals (CI)
and I2 statistics for heterogeneity. <br/>Result(s): A total of 7 studies
with 3273 patients aged between 70-90 years and 45 % males were analyzed.
High pre-procedural RDW was an independent predictor of one-year ACM (aOR
1.60, 95%CI 1.13-2.27, p < 0.01). This association is even more prominent
when aged > 80 years vs. <80 years (aOR 1.64, 95 % CI 1.17-2.31, p < 0.01
vs. aOR 1.46, 95 % CI 0.49-4.32, p < 0.01). Leave-one-out sensitivity
analysis validated the robustness of our meta-analysis.
<br/>Conclusion(s): Our study indicated that elevated baseline RDW is an
independent predictor of one-year ACM post-TAVR. Further studies are
needed to validate the importance of RDW as a marker of post-TAVR
outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<35>
Accession Number
2038162929
Title
Fractional Flow Reserve Versus Angiography-Guided Revascularisation in
Patients With Severe Aortic Stenosis: A Systematic Review.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Mridha N.; Zaka A.; Raffel C.; Murdoch D.; Walters D.
Institution
(Mridha, Raffel, Murdoch, Walters) The Prince Charles Hospital, Brisbane,
QLD, Australia
(Mridha, Raffel, Murdoch, Walters) The University of Queensland, School of
Medicine, Brisbane, QLD, Australia
(Mridha, Zaka) Griffith University, School of Medicine, Gold Coast, QLD,
Australia
(Zaka) Bond University, School of Medicine, Gold Coast, QLD, Australia
(Raffel) Queensland University of Technology, Brisbane, QLD, Australia
Publisher
Elsevier Ltd
Abstract
Background: Aortic stenosis (AS) and coronary artery disease usually
coexist in older adults. Although fractional flow reserve (FFR) is the
gold standard for demonstrating functionally significant coronary artery
stenoses, its efficacy in patients with severe AS awaiting transcatheter
aortic valve implantation is unclear. This systematic review assesses the
clinical outcomes between FFR- and angiography-guided coronary
revascularisation in patients with severe AS. <br/>Method(s): This review
conformed to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. PubMed, Ovid MEDLINE, Web of Science,
and Cochrane databases were searched until 12 March 2024. Eligible studies
included randomised controlled trials or observational studies including
patients with severe AS with concurrent coronary disease comparing FFR-
with angiography-guided percutaneous coronary intervention. Primary
outcomes were all-cause mortality and myocardial infarction. Secondary
outcomes were composite major adverse cardiovascular events.
<br/>Result(s): Five retrospective cohort studies were identified,
including 1,927 patients. The average follow-up was 34.7 months.
FFR-guided cohorts exhibited higher incidence rates for all-cause
mortality (17.4% vs 15.6%), myocardial infarction (4.4% vs 3.3%), and
major adverse cardiovascular events (21.8% vs 18.5%) than the
angiography-guided cohorts. A total of 32.8% the angiography-guided cohort
and 33.1% from the FFR-guided cohort underwent percutaneous coronary
intervention. Due to insufficient power and inconsistency of the available
data (including heterogenous patient selection criteria, differences in
procedural protocols, anatomical distribution of stented lesions,
non-uniform reporting of measured outcomes), a meta-analysis for the
primary and secondary outcomes was not conducted. The methodological
quality of the included studies was found to be of fair quality according
to the Newcastle-Ottawa checklist. <br/>Conclusion(s): Despite the
recognised usefulness of FFR in the assessment of coronary artery disease,
its clinical efficacy in patients with severe AS undergoing transcatheter
aortic valve implantation remains uncertain amidst inconclusive
observational data. Large-scale randomised controlled trials are
required.<br/>Copyright &#xa9; 2024 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<36>
Accession Number
2036653034
Title
Editor's Choice - Outcomes of Endovascular Repair Confined to the
Ascending Thoracic Aorta: A Systematic Review and Meta-Analysis.
Source
European Journal of Vascular and Endovascular Surgery. 69(4) (pp 531-544),
2025. Date of Publication: 01 Apr 2025.
Author
de Kort J.F.; Mandigers T.J.; Bissacco D.; Domanin M.; Piffaretti G.;
Twine C.P.; Wanhainen A.; van Herwaarden J.A.; Trimarchi S.; de Vincentiis
C.
Institution
(de Kort, Mandigers, Domanin, Trimarchi) Cardio Thoracic Vascular
Department, Section of Vascular Surgery, Fondazione IRCCS Ca Granda
Ospedale Maggiore Policlinico, Milan, Italy
(de Kort, Mandigers, van Herwaarden) Department of Vascular Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
(Bissacco, Domanin, Trimarchi) Department of Clinical Sciences and
Community Health, Universita degli Studi di Milano, Milan, Italy
(Piffaretti) Department of Medicine and Surgery, Vascular Surgery,
University of Insubria School of Medicine, Varese University Hospital,
Varese, Italy
(Twine) Southmead Hospital, North Bristol NHS Trust, and University of
Bristol Medical School, Bristol, United Kingdom
(Wanhainen) Section of Vascular Surgery, Department of Surgical Sciences,
Uppsala University, Uppsala, Sweden
(Wanhainen) Department of Surgical and Peri-operative Sciences, Surgery,
Umea University, Umea, Sweden
(de Vincentiis) Cardiac Surgery Unit, Cardiac Surgery Division, Department
of Cardiovascular Disease E. Malan, IRCCS Policlinico S. Donato, Milan,
Italy
Publisher
W.B. Saunders Ltd
Abstract
Objective: High risk, inoperable patients with ascending aortic disease
are increasingly managed with thoracic endovascular aortic repair (TEVAR).
The aim of this study was to assess the available literature on TEVAR
confined to the ascending aorta (a-TEVAR), describing study and patient
characteristics, procedural and stent graft details, and outcomes. Data
sources: This was a systematic review and meta-analysis. MEDLINE, Web of
Science, and Scopus were systematically searched for eligible studies
reporting on outcomes after a-TEVAR (PROSPERO ID: CRD42023440826).
Eligible studies reported outcomes after a-TEVAR without adjunctive
supra-aortic vessel treatment. Review Methods: The Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was
followed. The ROBINS-I and Joanna Briggs Institute Critical Appraisal
Checklist were used as quality assessment tools. A Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) evidence
certainty analysis was performed for the main outcomes. The main outcome
was death. A proportional meta-analysis was performed with a mean and 95%
confidence interval (CI) for the main outcomes. All articles were included
up to 1 January 2024. <br/>Result(s): Ninety four studies were included
(19 cohort studies, 75 case reports or series), reporting on 259 patients
(57.8% male). The mean age was 69.1 (95% CI 65.0 - 73.1) years and mean
follow up 19.6 (95% CI 14.5 - 24.6) months. The most common comorbidity
was prior cardiac or thoracic surgery (n = 191). The most frequent
indications for a-TEVAR (52.1% urgent a-TEVAR) were type A aortic
dissection (43.6%) and pseudoaneurysm (38.6%). The most commonly deployed
stent grafts were Gore (44.5%), Cook (23.5%), and Medtronic (17.0%). The
in hospital mortality rate was 7.3% (95% CI 4.7 - 11.2%), 30 day mortality
rate 7.7% (95% CI 5.1 - 11.6%), and overall mortality rate 17.0% (95% CI
12.9 - 22.0%) during follow up. GRADE showed very low evidence certainty
for all outcomes. Eighty eight complications were reported and there was a
re-operation rate of 13.1% (95% CI 9.5 - 17.8%). In hospital and 30 day
mortality rates for type A dissection were 12.4% (95% CI 7.5 - 19.7%) (n =
14) and 13.3% (95% CI 8.2 - 20.8%) (n = 15), respectively, and for
pseudoaneurysm 4.0% (95% CI 1.6 - 9.8%) (n = 4) and 4.0% (95% CI 1.6 -
9.8) (n = 4), respectively. <br/>Conclusion(s): Despite heterogeneous
literature and very low GRADE evidence certainty, a-TEVAR seems
technically feasible in high risk patients. In addition, there is need for
a consensus on when and how to use a-TEVAR and a need for a specific
endograft for use in the ascending aorta.<br/>Copyright &#xa9; 2024
European Society for Vascular Surgery

<37>
[Use Link to view the full text]
Accession Number
2038232846
Title
Early Intervention Versus Conservative Management for Asymptomatic Severe
Aortic Stenosis: An Updated Meta-Analysis of Randomized Controlled Trials.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000910. Date of Publication: 2025.
Author
Ahmed M.; Hashmi T.M.; Shafiq A.; Ahmed R.; Naveed A.; Akhtar N.; Jain H.;
Neppala S.; Ali S.; Alam M.; Jenkins N.; Ahmed F.; Ripley D.P.; Mamas M.A.
Institution
(Ahmed, Hashmi) Rawalpindi Medical University, Rawalpindi, Pakistan
(Shafiq, Naveed) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Akhtar) Nishtar Medical University, Multan, Pakistan
(Jain) All India Institute of Medical Sciences, Jodhpur, India
(Neppala) Division of Cardiology, UT Health Science Center, San Antonio,
TX, United States
(Ali) Department of Cardiology, Louisiana State University, Shreveport,
LA, United States
(Alam) Department of Interventional Cardiology, Baylor College of
Medicine, Houston, TX, United States
(Jenkins) Department of Cardiology, Sunderland Royal Hospital, Sunderland,
United Kingdom
(Ahmed) Division of Cardiology, Duke University Hospital, Durham, NC,
United States
(Ripley) Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne,
United Kingdom
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
The timely management of asymptomatic severe aortic stenosis (AS) presents
an important clinical dilemma. This meta-analysis aims to investigate
whether early intervention can lead to improved clinical outcomes compared
with conservative management in asymptomatic severe AS. We conducted a
literature search of major databases to identify randomized controlled
trials that compared an early intervention (either early surgical aortic
valve replacement or early transcatheter aortic valve replacement) with
conservative management in patients with asymptomatic severe AS. Data for
clinical outcomes were extracted, and risk ratios (RRs) were calculated
for all end points with corresponding 95% confidence intervals (CIs). The
meta-analysis included 4 randomized controlled trials with 1427 patients.
Compared with conservative management, early intervention was associated
with no significant difference in all-cause [RR, 0.52 (95% CI, 0.23-1.19)]
or cardiovascular death [RR, 0.41 (95% CI, 0.10-1.64)]. A statistically
significant reduction was observed in the risk of stroke [RR, 0.60 (95%
CI, 0.38-0.94)] and unplanned hospitalizations [RR, 0.49 (95% CI,
0.40-0.60)] with an early intervention. The risk of myocardial infarction
remained comparable [RR, 0.67 (95% CI, 0.13-3.54)]. Early intervention can
be a suitable treatment option for patients with asymptomatic severe AS
who prefer proactive management of their condition.<br/>Copyright &#xa9;
2025 Wolters Kluwer Health, Inc. All rights reserved.

<38>
Accession Number
2038148654
Title
Intraoperative phrenic nerve stimulation to prevent diaphragm fiber
weakness during thoracic surgery.
Source
PLoS ONE. 20(4 April) (no pagination), 2025. Article Number: e0320936.
Date of Publication: 01 Apr 2025.
Author
Bresciani G.; Beaver T.; Martin A.D.; van der Pijl R.; Mankowski R.;
Leeuwenburgh C.; Ottenheijm C.A.C.; Martin T.; Arnaoutakis G.; Ahmed S.;
Mariani V.M.; Xue W.; Smith B.K.; Ferreira L.F.
Institution
(Bresciani, Mariani, Ferreira) Department of Applied Physiology and
Kinesiology, University of Florida, Gainesville, FL, United States
(Beaver, Martin, Arnaoutakis) Department of Surgery, University of
Florida, Gainesville, FL, United States
(Martin, Ahmed, Smith) Department of Physical Therapy, University of
Florida, Gainesville, FL, United States
(van der Pijl, Ottenheijm) Department of Cellular and Molecular Medicine,
University of Arizona, Tucson, AZ, United States
(Mankowski, Leeuwenburgh) Department of Physiology and Aging, University
of Florida, Gainesville, FL, United States
(Xue) Department of Biostatistics, University of Florida, Gainesville, FL,
United States
(Ferreira) Department of Orthopaedic Surgery, Duke University, School of
Medicine, Durham, NC, United States
(Ferreira) Division of Physical Therapy, Duke University, School of
Medicine, Durham, NC, United States
Publisher
Public Library of Science
Abstract
Thoracic surgery rapidly induces weakness in human diaphragm fibers. The
dysfunction is thought to arise from combined effects of the surgical
procedures and inactivity. This project tested whether brief bouts of
intraoperative hemidiaphragm stimulation would mitigate slow and fast
fiber loss of force in the human diaphragm. We reasoned that maintenance
of diaphragm activity with brief bouts of intraoperative phrenic
stimulation would mitigate diaphragm fiber weakness and myofilament
protein derangements caused by thoracic surgery. Nineteen adults (9
females, age 59 +/- 12 years) with normal inspiratory strength or
spirometry consented to participate. Unilateral phrenic twitch stimulation
(twitch duration 1.5 ms, frequency 0.5 Hz, current 2x the motor threshold,
max 25 mA) was applied for one minute, every 30 minutes during
cardiothoracic surgery. Thirty minutes following the last stimulation
bout, biopsies were obtained from the hemidiaphragms for single fiber
force mechanics and quantitation of myofilament proteins (abundance and
phosphorylation) and compared by a linear mixed model and paired t-test,
respectively. Subjects underwent 6 +/- 2 hemidiaphragm stimulations at 17
+/- 6 mA, during 278 +/- 68 minutes of surgery. Longer-duration surgeries
were associated with a progressive decline in diaphragm fiber force (p <
0.001). In slow-twitch fibers, phrenic stimulation increased absolute
force (+25%, p < 0.0001), cross-sectional area (+16%, p < 0.0001) and
specific force (+7%, p < 0.0005). Stimulation did not alter contractile
function of fast-twitch fibers, calcium-sensitivity in either fiber type,
and abundance and phosphorylation of myofilament proteins. In adults
without preoperative weakness or lung dysfunction, unilateral phrenic
stimulation mitigated diaphragm slow fiber weakness caused by thoracic
surgery, but had no effect on myofilament protein abundance or
phosphorylation.<br/>Copyright &#xa9; 2025 Bresciani et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<39>
Accession Number
2038161427
Title
Risk, rate or rhythm control for new onset supraventricular arrhythmia
during septic shock: Protocol for the CAFS multicentre, parallel-group,
open-label trial.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e090404. Date of
Publication: 01 Apr 2025.
Author
Labbe V.; Desnos C.; Preau S.; Doyen D.; Contou D.; Bagate F.; Souweine
B.; Pey V.; Bertrand P.-M.; Muller G.; Boissier F.; Asfar P.; Bonnet N.;
Joffre J.; Sy O.; Dres M.; Annoni F.; Monnet X.; Carreira S.; Vivier E.;
Serck N.; Wiart A.; Voicu S.; Heming N.; Le Breton C.; Chevrel G.;
Chemouni F.; Piagnerelli M.; Haentjens L.; Fartoukh M.; Taccone F.; Durand
D.; Monthieux G.; Berard L.; Rousseau A.; Mekontso Dessap A.
Institution
(Labbe, Annoni, Taccone, Durand) Department of Intensive Care, Universite
Libre de Bruxelles, Hopital Universitaire de Bruxelles, Brussels,
Anderlecht, Belgium
(Labbe, Bagate, Monnet, Fartoukh, Mekontso Dessap) Institut Mondor de
Recherche Biomedicale, Groupe de Recherche Clinique CARMAS, Cardiovascular
and Respiratory Manifestations of Acute Lung Injury and Sepsis, Universite
Paris-Est Creteil Val de Marne, Ile-de-France, Creteil, France
(Desnos, Fartoukh) Service de Medecine Intensive Reanimation, Centre
Hospitalier Universitaire Tenon, Sorbonne Universite, Assistance Publique
- Hopitaux de Paris, Ile-de-France, Paris, France
(Preau) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Lille, Hauts-de-France, Lille, France
(Preau) Unite 1167, Institut Pasteur de Lille, Institut National de la
Sante et de la Recherche Medicale, Lille University, Lille, France
(Doyen) Medecine Intensive Reanimation, Centre Hospitalier Universitaire
Nice, Provence-Alpes-Cote-d'Azur, Nice, France
(Doyen) Laboratoire de PhysioMedecine Moleculaire LP2M, CNRS-UNS, UMR
7370, Equipe Pathophysiologie du Transport Ionique, Universite Cote
d'Azur, Provence-Alpes-Cote d'Azur, Nice, France
(Contou) Service de Reanimation Polyvalente, Centre Hospitalier Victor
Dupouy, Argenteuil, France
(Bagate, Mekontso Dessap) Service de Medecine Intensive Reanimation,
Hopitaux Universitaires Henri Mondor, Universite Paris Est Creteil,
Assistance Publique - Hopitaux de Paris, Ile-de-France, Creteil, France
(Souweine) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Clermont-Ferrand, Clermont-Ferrand, France
(Pey) Service de Reanimation Polyvalente Rangueil, Hopital de Rangueil,
Occitanie, Toulouse, France
(Bertrand) Intensive Care Unit, Centre Hospitalier de Cannes, Cannes,
France
(Muller) Medecine Intensive Reanimation, Centre Hospitalier Universitaire
Orleans, Centre-Val de Loire, Orleans, France
(Muller) MR INSERM, 1327 ISCHEMIA, Universite de Tours, Centre-Val de
Loire, Tours, France
(Muller) Clin. Research in Intensive Care and Sepsis-Trial Group for
Global Evaluation and Research in Sepsis, French Clinical Research
Infrastructure Network (F-CRIN) Research Network, Orleans, France
(Boissier) Medical Intensive Care Unit, Centre Hospitalier Universitaire
de Poitiers, Nouvelle-Acquitaine, Poitiers, France
(Boissier) Centre d'Investigation Clinique 1402, Investigations of Sleep
Acute Lung Injury, & Ventilation Group, Institut National de la Sante et
de la Recherche Medicale, Universite de Poitiers, Nouvelle-Aquitaine,
Poitiers, France
(Asfar) Departement de Medecine Intensive-Reanimation, Centre Hospitalier
Universitaire Angers, Pays de la Loire, Angers, France
(Bonnet) Service de Reanimation Medico-Chirurgicale, Centre Hospitalier
Universitaire Avicenne, Universite Sorbonne Paris Nord, Assistance
Publique - Hopitaux de Paris, Ile-de-France, Bobigny, France
(Joffre) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Saint Antoine, Sorbonne Universite, Assistance Publique -
Hopitaux de Paris, Ile-de-France, Paris, France
(Sy) Service de Medecine Intensive Reanimation, Centre Hospitalier Melun,
Melun, France
(Dres) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Pitie-Salpetriere, Sorbonne Universite, Assistance Publique
- Hopitaux de Paris, Paris, France
(Monnet) Service de Medecine Intensive Reanimation, Hopital de Bicetre,
DMU 4 CORREVE, Assistance Publique - Hopitaux de Paris, Ile-de-France, Le
Kremlin-Bicetre, France
(Monnet) Inserm UMR S_999, FHU SEPSIS, Universite Paris-Saclay,
Ile-de-France, Gif-sur-Yvette, France
(Carreira) Service d'Anesthesie-Reanimation Polyvalente, Hopital Saint
Camille, Bry-sur-Marne, France
(Vivier) Service de Reanimation Polyvalente, Centre Hospitalier Saint
Joseph Saint Luc, Auvergne-Rhone-Alpes, Lyon, France
(Serck) Service des Soins Intensifs, Clinique Saint-Pierre Ottignies,
Ottignies, Belgium
(Wiart) Service des Soins Intensifs, Centre Hospitalier de Wallonie
Picarde (CHwapi), Tournai, Belgium
(Voicu) Service de Reanimation Medicale et Toxicologique, Centre
Hospitalier Universitaire Lariboisiere, Universite Paris Cite, Assistance
Publique - Hopitaux de Paris, Ile-de-France, Paris, France
(Heming) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Raymond Poincare, Universite Versailles Saint
Quentin-Universite Paris Saclay, Assistance Publique - Hopitaux de Paris,
Ile-de-France, Garches, France
(Heming) Laboratoire d'Infection et Inflammation, Unite 1173, Faculte de
Medecine Simone Veil, Institut National de la Sante et de la Recherche
Medicale, Universite Versaillles Saint Quentin, University Paris Saclay,
Ile-de-France, Garches, France
(Le Breton) Service de Medecine Intensive Reanimation, Centre Hospitalier
Universitaire Louis Mourier, DMU ESPRIT, Universite Paris Cite, Assistance
Publique - Hopitaux de Paris, Ile-de-France, Colombes, France
(Chevrel) Service de Reanimation, Centre Hospitalier Sud Francilien,
Ile-de-France, Corbeil-Essonnes, France
(Chemouni) Service de Medecine Intensive Reanimation, Centre Hospitalier
Marne-La-Vallee, Ile-de-France, Jossigny, France
(Piagnerelli) Service des Soins Intensifs, Centre Hospitalier
Universitaire Charleroi, Wallonie, Charleroi, Belgium
(Haentjens) Service des Soins Intensifs, Centre Hospitalier Universitaire
Ambroise Pare, Wallonie, Mons, Belgium
(Monthieux, Berard, Rousseau) Department of Clinical Pharmacology and
Clinical Research Platform Paris-East (URCEST CRC-CRB), Centre Hospitaleir
Universitaire Saint-Antoine, Assistance Publique - Hopitaux de Paris,
Ile-de-France, Paris, France
(Mekontso Dessap) Institut Mondor de Recherche Biomedicale, Institut
National de la Sante et de la Recherche Medicale, Universite Paris-Est
Creteil Val de Marne, Ile-de-France, Creteil, France
Publisher
BMJ Publishing Group
Abstract
Introduction New-onset supraventricular arrhythmia (NOSVA) is the most
common arrhythmia in patients with septic shock and is associated with
haemodynamic alterations and increased mortality rates. With no data
available from randomised trials, clinical practice for patient management
varies widely. In this setting, rate control or rhythm control could be
beneficial in limiting the duration of shock and preventing evolution to
multiorgan dysfunction. Methods and analysis The Control Atrial
Fibrillation in Septic shock (CAFS) study is a binational (French and
Belgium), multicentre, parallel-group, open-label, randomised controlled
superiority trial to compare the efficacy and safety of three management
strategies in patients with NOSVA during septic shock. The expected
duration of patient enrolment is 42 months, starting from November 2021.
Patients will be randomised to receive either risk control (magnesium and
control of risk factors for NOSVA), rate control (risk control and low
dose of amiodarone) or rhythm control (risk control and cardioversion
using high dose of amiodarone with external electrical shock if NOSVA
persists) for 7 days. Patients with a history of SVA, NOSVA lasting more
than 48 hours, recent cardiac surgery or a contraindication to amiodarone
will not be included. We plan to recruit 240 patients. Patients will be
randomised on a 1:1:1 basis and stratified by centre. The primary endpoint
is a hierarchical criterion at day 28 including all-cause mortality and
the duration of septic shock defined as time from randomisation to
successful weaning of vasopressors. Secondary outcomes include: individual
components of the primary endpoint; arterial lactate clearance at day 3;
efficacy at controlling cardiac rhythm at day 7; proportion of patients
free from organ dysfunction at day 7; ventricular arrhythmia, conduction
disorders, thrombotic events, major bleeding events and acute hepatitis
related to amiodarone at day 28; intensive care unit and hospital lengths
of stay at day 28. Ethics and dissemination The study has been approved by
the French (Comite Sud-Ouest et Outre-Mer II, France, registration number
2019-A02624-53) and Belgian (Comite ethique de l'hopital Erasme, Belgium,
registration number CCB B4062023000179) ethics committees. Patients will
be included after obtaining signed informed consent. The results will be
submitted for publication in peer-reviewed journals. Trial registration
number NCT04844801.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<40>
Accession Number
2038191203
Title
Anaesthetic Management of a Patient with Heterotaxy Syndrome for Emergency
Mechanical Thrombectomy.
Source
Neurology India. 73(2) (pp 358-360), 2025. Date of Publication: 01 Mar
2025.
Author
Madhusudhan S.; Sethuraman M.; Vimala S.
Institution
(Madhusudhan) Department of Anesthesiology, St Johns Medical College,
Bangalore, India
(Sethuraman, Vimala) Department of Neuroanesthesia, Sree Chitra Thirunal
Institute for Medical Sciences and Technology, Kerala, Trivandrum, India
Publisher
Wolters Kluwer Medknow Publications

<41>
Accession Number
2034096032
Title
Comparison between single bolus dose administration and continuous
infusion of remimazolam for general anesthesia induction in non-cardiac
surgery: a single-center prospective randomized controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 150. Date
of Publication: 01 Dec 2025.
Author
Ikeda T.; Miyoshi H.; Kido K.; Sumii A.; Otsuki S.; Kato T.; Nakamura R.;
Narasaki S.; Tsutsumi Y.M.
Institution
(Ikeda, Miyoshi, Kido, Sumii, Otsuki, Kato, Nakamura, Narasaki, Tsutsumi)
Department of Anesthesiology and Critical Care, Hiroshima University,
Hiroshima, Japan
(Miyoshi) Department of Anesthesiology and Critical Care Institution,
Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Remimazolam is a short-acting benzodiazepine anesthetic
recommended for continuous infusion during anesthesia induction. However,
the safety and efficacy of single bolus dose administration remain under
investigation. This study compared continuous infusion with single bolus
dose administration and assessed the safety of a single bolus dose
administration. <br/>Method(s): The participants were randomly assigned
into three groups based on the method of remimazolam administration the
day before surgery: (1) continuous infusion group (continuous infusion at
12 mg/kg/h), (2) single bolus dose administration of 0.1 group (single
administration of 0.1 mg/kg), or (3) single bolus dose administration of
0.2 group (single administration of 0.2 mg/kg). The time between drug
administration and loss of consciousness was determined, and hemodynamic
monitoring was performed. <br/>Result(s): 67 patients (continuous infusion
group (n = 22), single bolus dose administration of 0.1 group (n = 22),
and single bolus dose administration of 0.2 group (n = 23)) were included
in the study. The different times to loss of consciousness were 88.2 +/-
16.2 s, 59.5 +/- 31.5 s, and 42.6 +/- 11.4 s in the continuous infusion
group, single bolus dose administration of 0.1 group, and single bolus
dose administration of 0.2 group, respectively. No significant differences
were observed in the incidence of adverse events between the groups. The
results are presented as mean +/- standard deviation (SD).
<br/>Conclusion(s): Single-dose remimazolam is a safe method for
anesthesia induction, resulting in shorter time to loss of consciousness
compared with continuous infusion, while maintaining a similar incidence
of adverse events. Trial registration: jRCTs061230049, registered on
17/08/2023.<br/>Copyright &#xa9; The Author(s) 2025.

<42>
Accession Number
2031490449
Title
Risk factors for interstitial lung disease in patients with non-small cell
lung cancer with epidermal growth factor receptor-tyrosine kinase
inhibitors: A systematic review and meta-analysis.
Source
Respiratory Investigation. 62(3) (pp 481-487), 2024. Date of Publication:
01 May 2024.
Author
Fukuda Y.; Uchida Y.; Ando K.; Manabe R.; Tanaka A.; Sagara H.
Institution
(Fukuda) Department of Medicine, Division of Respiratory Medicine,
Yamanashi Red Cross Hospital, 6663-1 Funatsu, Fujikawaguchiko-machi,
Yamanashi, Japan
(Fukuda, Uchida, Ando, Manabe, Tanaka, Sagara) Department of Medicine,
Division of Respiratory Medicine and Allergology, Showa University School
of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
(Ando) Division of Internal Medicine, Showa University Dental Hospital
Medical Clinic, 2-1-1, Kitasenzoku, Ota-ku, Tokyo, Japan
(Ando) Department of Perioperative Medicine, Division of General Medicine,
Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku,
Tokyo, Japan
Publisher
Elsevier B.V.
Abstract
Background: The use of epidermal growth factor receptor-tyrosine kinase
inhibitors (EGFR-TKIs) can potentially result in interstitial lung disease
(ILD), which can substantially impact a patient's quality of life,
subsequently leading to the interruption or discontinuation of EGRF-TKI
treatment. Clinicians, therefore, need to thoroughly assess patients to
determine if they are at risk for ILD. <br/>Method(s): We searched for
observational study in the following databases: MEDLINE via the PubMed,
CENTRAL, and IchushiWeb. The primary outcome was risk factors for the
development of ILD, while the secondary outcome was risk factors for the
severity of ILD. Of the 1602 studies returned, we selected 11 for
meta-analysis, performed using a random-effects model. <br/>Result(s):
Risk factors for developing ILD were sex (odds ratio (OR), 1.87; 95%
confidence interval (CI), 1.08-3.22; I² = 0%; P = 0.02),
smoking history (OR, 2.13; 95% CI, 1.51-3.00; I² = 3 4%; P =
0.0001), and history of ILD (OR = 5.95; 95% CI, 3.34-10.59; I²
= 67%; P = 0.0009). Age, previous thoracic surgery or radiotherapy,
performance status, histological type of lung cancer, and treatment line
were not statistically significant risk factors for ILD. Risk factors
identified in one study were serum albumin level, history of nivolumab
use, radiographic residual lung volume, and history of pulmonary
infection. <br/>Conclusion(s): We identified risk factors for developing
ILD in patients with non-small cell lung cancer treated with
EGFR-TKIs.<br/>Copyright &#xa9; 2024 The Japanese Respiratory Society

<43>
Accession Number
2034097496
Title
Home-Based Rehabilitation After Transcatheter Aortic Valve Replacement
(REHAB-TAVR): A Pilot Randomized Controlled Trial.
Source
Journal of the American Geriatrics Society. (no pagination), 2025. Date
of Publication: 2025.
Author
Shi S.M.; Rapley F.-A.; Margulis H.; Laham R.J.; Guibone K.; Percy E.;
Kaneko T.; Wang K.-Y.; Kim D.H.
Institution
(Shi, Wang, Kim) Frailty Research Center, Hinda and Arthur Marcus
Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States
(Shi, Wang, Kim) Division of Gerontology, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Shi, Laham, Wang, Kim) Harvard Medical School, Boston, MA, United States
(Rapley) Clinical Research Center, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Margulis) Rehabilitation Services, Hebrew SeniorLife, Boston, MA, United
States
(Laham, Guibone) Division of Cardiology, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Percy) Division of Cardiac Surgery, Department of Surgery, University of
British Columbia, Vancouver, Canada
(Kaneko) Department of Surgery, Washington University School of Medicine,
St. Louis, MO, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The benefit of early cardiac rehabilitation after
transcatheter aortic valve replacement (TAVR) is not well established.
This pilot study evaluated the feasibility and short-term effects of a
home-based exercise program, with or without cognitive-behavioral
intervention (CBI). <br/>Method(s): We randomized 51 patients (mean age,
83.9 years; 19 women) to a home-based exercise program with CBI (Group A;
n = 18) or without CBI (Group B; n = 15), or telephone-based education
control (Group C; n = 18). The exercise program focusing on balance,
flexibility, strength, and endurance began within 7 days post-discharge
and was delivered once weekly by a physical therapist for 8 weeks. CBI
included discussions on exercise benefits and barriers, goal setting,
detailed exercise planning, and a weekly cash adherence incentive. The
primary outcome was a disability score (range: 0-22; higher scores
indicate greater disability) at 8 weeks. Secondary outcomes included the
Short Physical Performance Battery (SPPB) (range: 0-12; higher scores
indicate better function), self-efficacy, and outcome expectation scores.
Feasibility outcomes included adherence and drop-out rates.
<br/>Result(s): Fifteen participants (83.3%) in Group A, 10 (58.8%) in
Group B, and 10 (52.6%) in Group C completed >= 5 of the eight assigned
weekly sessions (p = 0.196). Two participants in each group were lost to
follow-up. At 8 weeks, the home-based exercise groups (Group A and B
combined) demonstrated lower disability scores (mean [SE]: 2.6 [0.3] vs.
4.5 [0.5]; p = 0.042) and higher SPPB scores (9.5 [0.6] vs. 6.5 [0.8]; p =
0.003) compared with the education group (Group C). Group A had lower
disability scores than Group B (2.1 [0.4] vs. 3.4 [0.5]; p = 0.047), with
no differences in self-efficacy and outcome expectation scores.
<br/>Conclusion(s): An early, home-based, multi-domain exercise program
appears feasible and may prevent disability and improve physical function
in older adults after TAVR. Adding CBI, including a modest cash incentive,
showed trends toward improved adherence and reduced disability. Trial
Registration: NCT02805309.<br/>Copyright &#xa9; 2025 The American
Geriatrics Society.

<44>
Accession Number
2034072902
Title
The Composite Number Needed to Treat for Semaglutide in Populations with
Overweight or Obesity and Established Cardiovascular Disease Without
Diabetes.
Source
Advances in Therapy. 42(5) (pp 2513-2525), 2025. Article Number: 102782.
Date of Publication: 01 May 2025.
Author
Lubker C.; Bhavsar J.; Duque do Vale R.; Emerson S.S.; Nortoft E.; Plutzky
J.; Roberts G.; Tarp J.M.; Lincoff A.M.
Institution
(Lubker, Duque do Vale, Nortoft, Tarp) Novo Nordisk A/S, Soborg, Denmark
(Bhavsar) Novo Nordisk Inc., Plainsboro, NJ, United States
(Emerson) Department of Biostatistics, University of Washington, Seattle,
WA, United States
(Plutzky) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, United States
(Roberts) Health Economics and Outcomes Research Ltd, Cardiff, United
Kingdom
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland Clinic Lerner College of Medicine of Case Western Reserve
University, Cleveland, OH, United States
Publisher
Adis
Abstract
Introduction: Number needed to treat (NNT), an outcome measure derived
from the estimated risk results of clinical trials, is widely used to
demonstrate value to stakeholders by identifying how many patients require
treatment to avoid one event of interest. However, NNTs calculated for
primary trial endpoints may underestimate a treatment's value by not
considering other outcomes. In this secondary analysis of data from the
SELECT cardiovascular (CV) outcomes trial, we aimed to determine the NNT
for semaglutide for major adverse cardiovascular events (MACE), in
addition to NNTs when other clinically and payer-relevant outcomes are
included. <br/>Method(s): This study is a secondary analysis of data from
the randomized, double-blind SELECT trial (ClinicalTrials.gov NCT03574597)
of once-weekly subcutaneous administration of semaglutide compared with
placebo in 17,604 patients with overweight or obesity and with established
cardiovascular disease (CVD) (39.8 months mean follow-up). The outcomes
were NNT<inf>3P-MACE</inf> (based upon the trial's composite primary
endpoint of death from cardiovascular causes, non-fatal myocardial
infarction, non-fatal stroke), NNT<inf>EXTENDED</inf> (inclusive of
NNT<inf>3P-MACE</inf>, hospitalization for any cause, coronary
revascularization, and non-CV death), and NNT<inf>CKM</inf> (inclusive of
NNT<inf>EXTENDED</inf>, glycated hemoglobin level [HbA<inf>1c</inf>] >=
6.5%, and a 5-point nephropathy composite). <br/>Result(s): The relative
risk reductions observed for the events comprising the NNTs were 20%
(NNT<inf>3P-MACE</inf>), 20% (NNT<inf>EXTENDED</inf>), and 41%
(NNT<inf>CKM</inf>). At 1 and 4 years post initiation of semaglutide,
NNT<inf>3P-MACE</inf> was 125 and 58, NNT<inf>EXTENDED</inf> was 49 and
25, and NNT<inf>CKM</inf> was 20 and 11, respectively. <br/>Conclusion(s):
When clinically and payer-relevant outcomes from the SELECT trial are
included in calculations of NNT, semaglutide was associated with greater
risk reductions and lower estimates of NNT than for the primary endpoint
alone. Our findings suggest that including the broader effects of
semaglutide beyond the primary trial endpoint recognizes additional value
to stakeholders.<br/>Copyright &#xa9; The Author(s) 2025.

<45>
Accession Number
2031568089
Title
Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation.
Source
Thoracic and Cardiovascular Surgeon. 73(2) (pp 111-116), 2024. Date of
Publication: 03 May 2024.
Author
Kaneyuki D.; Jordan A.M.; Rosen J.L.; Macmillan T.R.; Morris R.J.;
Tchantchaleishvili V.
Institution
(Kaneyuki, Jordan, Rosen, Macmillan, Morris, Tchantchaleishvili) Division
of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia,
PA, United States
Publisher
Georg Thieme Verlag
Abstract
Background Severe tricuspid regurgitation (TR) adversely affects long-term
survival; however, isolated tricuspid valve (TV) surgery has been rarely
performed due to high operative mortality. In addition, the previous
literature included heterogeneous TR etiologies. Therefore, we aimed to
elucidate early and long-term outcomes of isolated TV surgery for
functional TR. Methods An electronic search was performed to identify all
relevant studies. Baseline characteristics, perioperative variables, and
clinical outcomes were extracted and pooled for meta-analysis. Results
This meta-analysis included seven studies. Pooled analyses showed that 68%
(35, 89) of patients had preoperative atrial fibrillation or flutter, and
58% (11, 94) had a history of left-sided valve surgery. Seventy-three
percent (65, 80) of patients had at least one physical exam finding of
right-sided heart failure, and 57% (44, 69) were in New York Heart
Association class III or IV. TV replacement was more common than repair.
In TV replacement, bioprosthetic valve (39%, 13, 74) was more common than
mechanical prosthesis (22%, 18, 26). The early mortality rate was 7%.
Twenty percent of patients required a permanent pacemaker postoperatively.
The overall 1- and 5-year survival rates were 84.5 and 69.1%,
respectively. Conclusion More than half of the patients who underwent
isolated TV surgery for functional TR had undergone left-sided valve
surgery and had significant heart failure symptoms at the time of surgery.
Further studies on the surgical indication for concomitant TV surgery at
the time of left-sided valve surgery and the appropriate timing of surgery
for isolated functional TR are needed to improve survival.<br/>Copyright
&#xa9; 2024. Thieme. All rights reserved.

<46>
Accession Number
2029622548
Title
Hybrid Cardiac Rehabilitation Program in a Low-Resource Setting: A
Randomized Clinical Trial.
Source
JAMA Network Open. 7(1) (no pagination), 2024. Article Number: e2350301.
Date of Publication: 09 Jan 2024.
Author
Seron P.; Oliveros M.J.; Marzuca-Nassr G.N.; Morales G.; Roman C.; Munoz
S.R.; Galvez M.; Latin G.; Marileo T.; Molina J.P.; Navarro R.; Sepulveda
P.; Lanas F.; Saavedra N.; Ulloa C.; Grace S.L.; Gomez D.; Arancibia M.J.;
Stavros I.; Munoz F.; Arias Y.; Ferrada O.; Gonzalez C.; Verdejo H.;
Segovia M.J.; Adaros K.; Aburto C.; Buzeta F.; Valencia E.; Tomas Ramos
J.; Osorio M.; Diaz F.; Aravena S.; Gatta S.; Figueroa J.L.; Hermosilla
D.; Diaz I.; Maldonado N.; Navarro-Raninao R.; Olea V.; Aravena R.;
Sanchez P.; Morales K.; Saldias M.; Contreras M.M.
Institution
(Seron, Oliveros, Marzuca-Nassr, Sepulveda, Ulloa) Facultad de Medicina,
Departamento de Ciencias de la Rehabilitacion, Universidad de la Frontera,
Temuco, Chile
(Seron, Oliveros, Lanas) Centro de Excelencia CIGES, Universidad de la
Frontera, Temuco, Chile
(Morales, Munoz) Facultad de Medicina, Departamento de Salud Publica,
Universidad de la Frontera, Temuco, Chile
(Roman) Facultad de Medicina, Escuela de Kinesiologia, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Galvez) Unidad de Kinesiologia, Complejo Hospitalario San Jose, Santiago,
Chile
(Latin) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico,
Hospital San Borja Arriaran, Santiago, Chile
(Marileo) Unidad de Rehabilitacion Cardiaca, Hospital Regional de
Antofagasta, Antofagasta, Chile
(Molina) Servicio de Medicina Fisica y Rehabilitacion, Hospital San Juan
de Dios, Santiago, Chile
(Navarro) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico
Universidad de Chile, Santiago, Chile
(Lanas) Facultad de Medicina, Departamento de Medicina Interna,
Universidad de la Frontera, Temuco, Chile
(Saavedra) Facultad de Medicina, Departamento de Ciencias Basicas,
Universidad de la Frontera, Temuco, Chile
(Grace) York University, University Health Network, University of Toronto,
Toronto, ON, Canada
(Gomez, Arancibia, Aravena, Sanchez, Morales, Saldias, Contreras)
Universidad de la Frontera Temuco, Region de la Araucania, Chile
(Stavros, Munoz, Arias, Ferrada, Gonzalez, Verdejo, Segovia, Adaros,
Aburto, Buzeta) Hospital de Antofagasta Antofagasta, Region de
Antofagasta, Chile
(Valencia, Tomas Ramos, Osorio, Diaz) Hospital Clinico Universidad de
Chile Santiago, Region Metropolitana, Chile
(Aravena, Gatta, Figueroa, Hermosilla) Hospital San Borja Arriaran
Santiago, Region Metropolitana, Chile
(Diaz, Maldonado, Navarro-Raninao) Hospital San Jose Santiago, Region
Metropolitana, Chile
(Olea) Hospital San Juan de Dios Santiago, Region Metropolitana, Chile
Publisher
American Medical Association
Abstract
Importance: While effective, cardiovascular rehabilitation (CR) as
traditionally delivered is not well implemented in lower-resource
settings. <br/>Objective(s): To test the noninferiority of hybrid CR
compared with traditional CR in terms of cardiovascular events.
<br/>Design, Setting, and Participant(s): This pragmatic, multicenter,
parallel arm, open-label randomized clinical trial (the Hybrid Cardiac
Rehabilitation Trial [HYCARET]) with blinded outcome assessment was
conducted at 6 referral centers in Chile. Adults aged 18 years or older
who had a cardiovascular event or procedure, no contraindications to
exercise, and access to a mobile telephone were eligible and recruited
between April 1, 2019, and March 15, 2020, with follow-up until July 29,
2021. <br/>Intervention(s): Participants were randomized 1:1 in permuted
blocks to the experimental arm, which received 10 center-based supervised
exercise sessions plus counseling in 4 to 6 weeks and then were supported
at home via telephone calls and text messages through weeks 8 to 12, or
the control arm, which received the standard CR of 18 to 22 sessions with
exercises and education in 8 to 12 weeks. <br/>Main Outcomes and Measures:
The primary outcome was cardiovascular events or mortality. Secondary
outcomes were quality of life, return to work, and lifestyle behaviors
measured with validated questionnaires; muscle strength and functional
capacity, measured through physical tests; and program adherence and
exercise-related adverse events, assessed using checklists.
<br/>Result(s): A total of 191 participants were included (mean [SD] age,
58.74 [9.80] years; 145 [75.92%] male); 93 were assigned to hybrid CR and
98 to standard CR. At 1 year, events had occurred in 5 unique participants
in the hybrid CR group (5.38%) and 9 in the standard CR group (9.18%). In
the intention-to-treat analysis, the hybrid CR group had 3.80% (95% CI,
-11.13% to 3.52%) fewer cardiovascular events than the standard CR group,
and relative risk was 0.59 (95% CI, 0.20-1.68) for the primary outcome. In
the per-protocol analysis at different levels of adherence to the
intervention, all 95% CIs crossed the noninferiority boundary (eg, 20%
adherence: absolute risk difference, -0.35% [95% CI, -7.56% to 6.85%]; 80%
adherence: absolute risk difference, 3.30% [95% CI, -3.70% to 10.31%]). No
between-group differences were found for secondary outcomes except
adherence to supervised CR sessions (79.14% [736 of 930 supervised
sessions] in the hybrid CR group vs 61.46% [1201 of 1954 sessions] in the
standard CR group). <br/>Conclusions and Relevance: The results suggest
that a hybrid CR program is noninferior to standard center-based CR in a
low-resource setting, primarily in terms of recurrent cardiovascular
events and potentially in terms of intermediate outcomes. Hybrid CR may
induce superior adherence to supervised exercise. Clinical factors and
patient preferences should inform CR model allocation.<br/>Copyright
&#xa9; 2024 American Medical Association. All rights reserved.

<47>
Accession Number
2032206244
Title
Chlorthalidone vs Hydrochlorothiazide for Hypertension Treatment After
Myocardial Infarction or Stroke A Secondary Analysis of a Randomized
Clinical Trial.
Source
JAMA Network Open. 7(5) (no pagination), 2024. Article Number: e2411081.
Date of Publication: 14 May 2024.
Author
Ishani A.; Hau C.; Cushman W.C.; Leatherman S.M.; Lew R.A.; Glassman P.A.;
Taylor A.A.; Ferguson R.E.
Institution
(Ishani) Minneapolis VA Healthcare System, Minneapolis, MN, United States
(Ishani) Department of Medicine, University of Minnesota, Minneapolis,
United States
(Hau, Leatherman, Lew, Ferguson) Cooperative Studies Program Coordinating
Center, VA Boston Healthcare System, Boston, MA, United States
(Cushman) Medical Service, Memphis VA Medical Center, Memphis, TN, United
States
(Cushman) Department of Preventive Medicine, University of Tennessee
Health Science Center, Memphis, United States
(Leatherman, Lew) Department of Biostatistics, Boston University School of
Public Health, Boston, MA, United States
(Glassman) Pharmacy Benefits Management Services, Department of Veterans
Affairs, Washington, DC, United States
(Glassman) VA Greater Los Angeles Healthcare System, Los Angeles, CA,
United States
(Glassman) David Geffen School of Medicine, UCLA, Los Angeles, CA, United
States
(Taylor) Michael E. DeBakey VA Medical Center, Houston, TX, United States
(Taylor) Department of Medicine, Baylor College of Medicine, Houston, TX,
United States
(Ferguson) Department of Medicine, Boston University Chobanian & Avedisian
School of Medicine, Boston, MA, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Patients with prior myocardial infarction (MI) or stroke have a
greater risk of recurrent cardiovascular (CV) events. OBJECTIVE To
evaluate the association of chlorthalidone (CTD) vs hydrochlorothiazide
(HCTZ) with CV outcomes and noncancer deaths in participants with and
without prior MI or stroke. DESIGN, SETTING, AND PARTICIPANTS This was a
prespecified secondary analysis of the Diuretic Comparison Project (DCP),
a pragmatic randomized clinical trial conducted within 72 participating
Veterans Affairs health care systems from June 2016 to June 2021, in which
patients aged 65 years or older with hypertension taking HCTZ at baseline
were randomized to continue HCTZ or switch to CTD at pharmacologically
comparable doses. This secondary analysis was performed from January 3,
2023, to February 29, 2024. EXPOSURES Pharmacologically comparable daily
dose of HCTZ or CTD and history of MI or stroke. MAIN OUTCOMES AND
MEASURES Outcome ascertainment was performed from randomization to the end
of the study. The primary outcome consisted of a composite of stroke, MI,
urgent coronary revascularization because of unstable angina, acute heart
failure hospitalization, or noncancer death. Additional outcomes included
achieved blood pressure and hypokalemia (potassium level <3.1 mEq/L; to
convert to mmol/L, multiply by 1.0). RESULTS The DCP randomized 13 523
participants to CTD or HCTZ, with a mean (SD) study duration of 2.4 (1.4)
years. At baseline, median age was 72 years (IQR, 69-75 years), and 96.8%
were male. Treatment effect was evaluated in subgroups of participants
with (n = 1455) and without (n = 12 068) prior MI or stroke at baseline.
There was a significant adjusted interaction between treatment group and
history of MI or stroke. Participants with prior MI or stroke randomized
to CTD had a lower risk of the primary outcome than those receiving HCTZ
(105 of 733 [14.3%] vs 140 of 722 [19.4%]; hazard ratio [HR], 0.73; 95%
CI, 0.57-0.94; P =.01) compared with participants without prior MI or
stroke, among whom incidence of the primary outcome was slightly higher in
the CTD arm compared with the HCTZ arm (597 of 6023 [9.9%] vs 535 of 6045
[8.9%]; HR, 1.12; 95% CI, 1.00-1.26; P =.054) (P =.01 for interaction).
The incidence of a nadir potassium level less than 3.1 mEq/L and
hospitalization for hypokalemia differed among those with and without
prior MI or stroke when comparing those randomized to CTD vs HCTZ, with a
difference only among those without prior MI or stroke (potassium level
<3.1 mEq/L: prior MI or stroke, 43 of 733 [5.9%] vs 37 of 722 [5.1%] [P
=.57]; no prior MI or stroke, 292 of 6023 [4.9%] vs 206 of 6045 [3.4%] [P
<.001]; hospitalization for hypokalemia: prior MI or stroke, 14 of 733
[1.9%] vs 16 of 722 [2.2%] [P =.72]; no prior MI or stroke: 84 of 6023
[1.4%] vs 57 of 6045 [0.9%] [P =.02]). CONCLUSIONS AND RELEVANCE Results
of this secondary analysis of the DCP trial suggest that CTD may be
associated with reduced major adverse CV events and noncancer deaths in
patients with prior MI or stroke compared with HCTZ.<br/>Copyright &#xa9;
2024 American Medical Association. All rights reserved.

<48>
Accession Number
2028162240
Title
A Controlled Trial Comparing One-Year Hemodynamics of Two Bovine
Pericardial Valves.
Source
Thoracic and Cardiovascular Surgeon. 73(2) (pp 132-140), 2023. Date of
Publication: 05 Dec 2023.
Author
Sohn S.H.; Kang Y.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kang, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul National University,
College of Medicine, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Bundang Hospital, Seoul National University, College
of Medicine, Seongnam, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background This randomized controlled trial was designed to compare 1-year
hemodynamic performances and clinical outcomes after aortic valve
replacement (AVR) using a recently introduced (the AVALUS group) and
worldwide used (the CEPME group) bovine pericardial bioprostheses. Methods
Patients were screened to enroll 70 patients in each group based on a
noninferiority design. The primary endpoint of the trial was the mean
pressure gradient across the aortic valve (AVMPG) at 1 year after surgery.
One-year echocardiographic data were obtained from 92.1% (129 of 140
patients) of the study patients. Results There were no differences in
baseline characteristics, including sex and body surface area (1.64 +/-
0.18 vs. 1.65 +/- 0.15 m 2) between the groups. The AVMPG on 1-year
echocardiography was 14.0 +/- 4.3 and 13.9 +/- 5.1 mmHg in the AVALUS and
CEPME groups, respectively (the p-value for noninferiority was 0.0004). In
the subgroup analyses for the respective size of the prostheses, AVMPG of
the 19-mm prostheses was significantly lower in the AVALUS group than in
the CEPME group (14.0 +/- 4.3 vs. 20.0 +/- 4.7 mmHg, p = 0.012), whereas
those of the other sizes were not significantly different between the two
groups. There were no significant differences in the effective orifice
area (1.49 +/- 0.40 vs. 1.53 +/- 0.38 cm 2, p = 0.500) or effective
orifice area index (0.91 +/- 0.22 vs 0.93 +/- 0.23 cm 2 /m 2, p = 0.570)
in all the patients, or in the subgroup analysis for the 19-mm prosthesis.
There were no differences in the 1-year clinical outcomes between the two
groups. Conclusion The 1-year hemodynamic and clinical outcomes of the
AVALUS group were noninferior to those of the CEPME group
(NCT03796442).<br/>Copyright &#xa9; 2023. Thieme. All rights reserved.

<49>
Accession Number
2028974367
Title
Low-Value Surgical Procedures in Low- and Middle-Income Countries: A
Systematic Scoping Review.
Source
JAMA Network Open. 6(11) (no pagination), 2023. Article Number: e2342215.
Date of Publication: 07 Nov 2023.
Author
Albarqouni L.; Abukmail E.; Mohammedali M.; Elejla S.; Abuelazm M.;
Shaikhkhalil H.; Pathirana T.; Palagama S.; Effa E.; Ochodo E.;
Rugengamanzi E.; Alsabaa Y.; Ingabire A.; Riwa F.; Goraya B.; Bakhit M.;
Clark J.; Arab-Zozani M.; Alves Da Silva S.; Pramesh C.S.; Vanderpuye V.;
Lang E.; Korenstein D.; Born K.; Tabiri S.; Ademuyiwa A.; Nabhan A.;
Moynihan R.
Institution
(Albarqouni, Abukmail, Ingabire, Riwa, Bakhit, Clark, Moynihan) Institute
for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine,
Bond University, Gold Coast, Australia
(Mohammedali) Medicine and Health Sciences Faculty, Department of
Medicine, An-Najah National University, Nablus, Palestine
(Elejla, Shaikhkhalil) Faculty of Medicine, Islamic University of Gaza,
Gaza, Palestine
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Pathirana, Palagama) School of Medicine and Dentistry, Griffith
University, Sunshine Coast, Australia
(Effa) Department of Internal Medicine, Faculty of Clinical Sciences,
College of Medical Sciences, University of Calabar, Calabar, Nigeria
(Ochodo) Centre for Global Health Research, Kenya Medical Research
Institute, Kisumu, Kenya
(Ochodo) Centre for Evidence-Based Health Care, Department of Global
Health, Faculty of Medicine and Health Sciences, Stellenbosch University,
Stellenbosch, South Africa
(Rugengamanzi) Department of Clinical Oncology, Muhimbili University of
Health and Allied Sciences, Dar es Salaam, Tanzania
(Alsabaa) Faculty of Medicine, Al-Azhar University of Gaza, Gaza,
Palestine
(Goraya) Princess Margaret Cancer Centre, Toronto, ON, Canada
(Arab-Zozani) Social Determinants of Health Research Center, Birjand
University of Medical Sciences, Birjand, Iran, Islamic Republic of
(Alves Da Silva) Department of Epidemiology, HCor Hospital, Sao Paulo,
Brazil
(Pramesh) Tata Memorial Centre, Homi Bhabha National Institute, Mumbai,
India
(Vanderpuye) National Centre for Radiotherapy Oncology and Nuclear
Medicine, Korle Bu Teaching Hospital, Accra, Ghana
(Lang) Department of Emergency Medicine, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Korenstein) Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Born) Institute of Health Policy Management and Evaluation, Dalla Lana
School of Public Health, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Tabiri) Department of Surgery, University for Development Studies, School
of Medicine and Tamale Teaching Hospital, Tamale, Ghana
(Ademuyiwa) Paediatric Surgery Unit, Department of Surgery, Faculty of
Clinical Sciences, College of Medicine of the University of Lagos, Lagos
University Teaching Hospital, Idi Araba, Lagos, Nigeria
(Nabhan) Department of Obstetrics and Gynecology, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
Publisher
American Medical Association
Abstract
Importance: Overuse of surgical procedures is increasing around the world
and harms both individuals and health care systems by using resources that
could otherwise be allocated to addressing the underuse of effective
health care interventions. In low- and middle-income countries (LMICs),
there is some limited country-specific evidence showing that overuse of
surgical procedures is increasing, at least for certain procedures.
<br/>Objective(s): To assess factors associated with, extent and
consequences of, and potential solutions for low-value surgical procedures
in LMICs. Evidence Review: We searched 4 electronic databases (PubMed,
Embase, PsycINFO, and Global Index Medicus) for studies published from
database inception until April 27, 2022, with no restrictions on date or
language. A combination of MeSH terms and free-text words about the
overuse of surgical procedures was used. Studies examining the problem of
overuse of surgical procedures in LMICs were included and categorized by
major focus: the extent of overuse, associated factors, consequences, and
solutions. <br/>Finding(s): Of 4276 unique records identified, 133 studies
across 63 countries were included, reporting on more than 9.1 million
surgical procedures (median per study, 894 [IQR, 97-4259]) and with more
than 11.4 million participants (median per study, 989 [IQR, 257-6857]).
Fourteen studies (10.5%) were multinational. Of the 119 studies (89.5%)
originating from single countries, 69 (58.0%) were from
upper-middle-income countries and 30 (25.2%) were from East Asia and the
Pacific. Of the 42 studies (31.6%) reporting extent of overuse of surgical
procedures, most (36 [85.7%]) reported on unnecessary cesarean delivery,
with estimated rates in LMICs ranging from 12% to 81%. Evidence on other
surgical procedures was limited and included abdominal and percutaneous
cardiovascular surgical procedures. Consequences of low-value surgical
procedures included harms and costs, such as an estimated US $3.29 billion
annual cost of unnecessary cesarean deliveries in China. Associated
factors included private financing, and solutions included social media
campaigns and multifaceted interventions such as audits, feedback, and
reminders. <br/>Conclusions and Relevance: This systematic review found
growing evidence of overuse of surgical procedures in LMICs, which may
generate significant harm and waste of limited resources; the majority of
studies reporting overuse were about unnecessary cesarean delivery.
Therefore, a better understanding of the problems in other surgical
procedures and a robust evaluation of solutions are needed.<br/>Copyright
&#xa9; 2023 Albarqouni L et al.

<50>
Accession Number
2038262487
Title
Sevoflurane vs. Propofol Anaesthesia and the Risk of Perioperative Acute
Kidney Injury.
Source
Journal of the College of Physicians and Surgeons Pakistan. 35(4) (pp
480-485), 2025. Date of Publication: 01 Apr 2025.
Author
Li M.; You W.; Chi X.; Nie M.; Xie A.
Institution
(Li) Department of Anaesthesiology, The Affiliated Hospital of Qingdao
University, Qingdao, China
(You) Department of Proctology, The Affiliated Hospital of Qingdao
University, Qingdao, China
(Chi) Department of Geriatrics, The Affiliated Hospital of Qingdao
University, Qingdao, China
(Nie) Department of Anaesthesiology, Qingdao University Medical College
Affiliated Yantai Yuhuangding Hospital, Yantai, China
(Xie) Department of Neurology, The Affiliated Hospital of Qingdao
University, Qingdao, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Sevoflurane has been suggested to lower the incidence of acute kidney
injury (AKI) after heart surgery compared to intravenous anaesthetics.
However, recent studies indicated opposite results. Therefore, this
meta-analysis was conducted on randomised controlled trials (RCTs) to
determine if sevoflurane decreases the risk of AKI compared to propofol.
Relevant RCTs were identified from PubMed, EMBASE databases, and reference
lists of reviews and related articles till June 6, 2023. Review Manager
was used for statistical analysis. In this study, 10 RCTs were included.
Compared with propofol, sevoflurane increased the incidence of AKI (odds
ratio [OR], 2.74; 95% confidence interval [CI], 1.62-4.65; p = 0.0002;
I² = 13%) and prolonged the length of intensive care unit
(standard mean difference [SMD], 0.29; 95% CI, 0.06-0.53; p = 0.01;
I² = 0%) and hospital stays (mean difference [MD], 1.62; 95%
CI, 0.59-2.64; p = 0.002; I² = 0%). Based on current evidence,
sevoflurane was linked to an increased risk of perioperative AKI compared
to propofol. To verify the results, more high-quality RCTs are
necessary.<br/>Copyright &#xa9; 2025 College of Physicians and Surgeons
Pakistan. All rights reserved.

<51>
Accession Number
2038309880
Title
Favorable impact of FFR<inf>CT</inf> on myocardial revascularization
outcomes: Results from an observational real-world registry.
Source
International Journal of Cardiology. 431 (no pagination), 2025. Article
Number: 133245. Date of Publication: 15 Jul 2025.
Author
Lammens J.; Motoc A.; Tanaka K.; Belsack D.; Vandeloo B.; Lochy S.;
Schoors D.; Van Loo I.; De Potter T.; Michiels V.; Tsugu T.; Van Dalem A.;
Thorrez Y.; Magne J.; De Mey J.; Cosyns B.; Argacha J.-F.
Institution
(Lammens, Motoc, Vandeloo, Lochy, Schoors, De Potter, Michiels, Cosyns,
Argacha) Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije
Universiteit Brussel, Brussels, Belgium
(Tanaka, Belsack, Tsugu, De Mey) Department of Radiology, Universitair
Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Van Loo) Department of Cardiac Surgery, Universitair Ziekenhuis Brussel,
Vrije Universiteit Brussel, Brussels, Belgium
(Van Dalem) Department of Clinical Biology, Universitair Ziekenhuis
Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Thorrez) Department of Information Technologies, Universitair Ziekenhuis
Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Magne) Department of Cardiology, Dupuytren University Hospital 2,
Limoges, France
(Magne) INSERM U1094 and IRD, Limoges University, Limoges, France
Publisher
Elsevier Ireland Ltd
Abstract
Background: Coronary computed tomography angiography (CCTA)-derived
fractional flow reserve (FFR<inf>CT</inf>) strategy significantly
decreases unnecessary invasive coronary angiography and refines the
appropriateness of revascularization decision. The present study aimed to
evaluate how FFR<inf>CT</inf> guided - strategy impacts outcomes
postrevascularization. <br/>Method(s): We included patients with suspected
obstructive coronary artery disease (OCAD in a registry from 2013 to 2021.
FFR<inf>CT</inf> entered Heart-Team decision from 2017. Propensity score
adjusted Cox - and logistic - regression analyzed FFR<inf>CT</inf>'s
impact on post- revascularization major adverse cardiovascular events
(MACE) and myocardial injury (PMI). <br/>Result(s): Among 7541 patients,
1601 had suspected OCAD. 559 patients underwent revascularization: 69.0 %
PCI, 29.7 % CABG and 1.2 % both. 252(45.1 %) patients underwent
FFR<inf>CT</inf>. Over 4.4 +/- 2.2 years, 137(24.5 %) patients experienced
MACE. FFR<inf>CT</inf> was associated with a trend toward reduced MACE (HR
0.736, 95 % CI 0.513-1.055, p = 0.095) and significantly reduced all-cause
mortality (HR 0.476, 95 % CI 0.230-0.985, p = 0.046). In the post-2017
cohort (413 patients, follow-up 3.7 +/- 1.5 years), FFR<inf>CT</inf>
significantly reduced MACE (HR 0.610, 95 % CI 0.390-0.954, P = 0.030) and
all-cause mortality (HR 0.285, 95 % CI 0.104-0.779, P = 0.014). In CABG
patients, FFR<inf>CT</inf> was associated with lower PMI incidence (5.3 %
vs. 15.6 %, p = 0.044). Multivariable analysis revealed no significant
association between FFR<inf>CT</inf> use and PMI. <br/>Conclusion(s):
Revascularization decision-making with FFR<inf>CT</inf> translates into
better post-revascularization outcomes, primarily by reducing MACE through
lower mortality. There was no clear impact on PMI. These findings suggests
that FFR<inf>CT</inf>'s value lies indeed in improving patient selection
for revascularization, but warrants further confirmation in randomized
clinical trials.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<52>
Accession Number
2034084567
Title
Surgical and postoperative management of congenital heart disease: a
systematic review of observational studies.
Source
Langenbeck's Archives of Surgery. 410(1) (no pagination), 2025. Article
Number: 113. Date of Publication: 01 Dec 2025.
Author
Ghasemi Shayan R.; Fatollahzadeh Dizaji M.; Sajjadian F.
Institution
(Ghasemi Shayan, Sajjadian) Radiology Department, Paramedical Faculty,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Fatollahzadeh Dizaji) Islamic Azad University, Tabriz, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Congenital heart disease (CHD) remains a critical concern in
pediatric and adult cardiovascular care, requiring continuous advancements
in surgical techniques and perioperative strategies. While survival rates
have improved, challenges persist in optimizing long-term
neurodevelopmental outcomes, addressing disparities in healthcare access,
and overcoming systemic barriers to implementing best practices. This
systematic review integrates recent evidence on predictive factors,
perioperative innovations, and economic challenges affecting CHD
management. <br/>Method(s): A systematic review was conducted, analyzing
data from 27 observational studies, including retrospective and
prospective cohort studies, as well as case reports, sourced from diverse
geographic and clinical settings. Studies were selected based on strict
inclusion criteria, emphasizing clear surgical outcomes, perioperative
advancements, and neurodevelopmental follow-up. Data were extracted and
synthesized to identify key trends in CHD surgery, anesthetic management,
and long-term patient care. <br/>Result(s): Key findings include: *
Neurodevelopmental Outcomes: Long-term follow-up studies identified
associations between prolonged ICU stays, intraoperative cerebral
oxygenation deficits, and developmental delays. Hearing loss was reported
in 21.6% of post-surgical patients, significantly impacting cognitive and
language abilities. * Predictive Factors for Postoperative Outcomes:
Hemoglobin saturation, lactate levels, and platelet counts were
statistically associated with adverse postoperative outcomes (p < 0.05),
reinforcing the need for preoperative risk stratification. * Fast-Track
Extubation and Resource Optimization: Early extubation protocols reduced
ICU stays by an average of 20%, with a 15% decrease in postoperative
complications. However, financial disincentives and inadequate
reimbursement models limited their widespread adoption, particularly in
low-resource settings. * Tailored Anesthetic Techniques: Individualized
anesthesia strategies, including neuroprotective approaches and blood
conservation techniques, improved outcomes in high-risk CHD populations,
reducing complication rates by up to 10%. * Global Disparities in CHD
Care: Studies from low-income countries revealed significantly higher
rates of malnutrition, delayed surgical interventions, and postoperative
complications. These disparities highlight the urgent need for global
policy reforms to improve healthcare equity in CHD management.
<br/>Conclusion(s): This review highlights the necessity of integrating
predictive analytics, multidisciplinary approaches, and healthcare system
reforms to enhance CHD management. While advancements in surgical
techniques and perioperative care yield promising outcomes, persistent
challenges-including healthcare disparities, financial constraints, and
long-term neurodevelopmental risks-require targeted interventions. Future
research should focus on personalized care models, global health policy
adjustments, and innovative technologies to optimize CHD patient
outcomes.<br/>Copyright &#xa9; The Author(s) 2025.

<53>
Accession Number
2038208169
Title
Prevalence of postoperative neurocognitive disorders in older non-cardiac
surgical patients: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 103 (no pagination), 2025. Article Number:
111830. Date of Publication: 01 Apr 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, ON, Canada
(Thangavelu, Yan, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: The growing number of older persons undergoing surgery
are at a higher risk of neurocognitive disorder due to multimorbidity and
age-related changes. Previous reviews estimated postoperative
neurocognitive disorder or cognitive dysfunction (POCD) prevalence without
accounting for the sample size or study quality. The prevalence of POCD in
this population requires further investigation. This systematic review and
meta-analysis applies systematic weighting to estimate the pooled
prevalence of POCD in older non-cardiac surgical patients. <br/>Design(s):
Systematic review and meta-analysis. <br/>Setting(s): MEDLINE, MEDLINE
ePub, Embase, Cochrane Central Register of Controlled Trials and Cochrane
Database of Systematic Reviews for relevant articles. <br/>Patient(s):
Non-cardiac surgical patients aged >=60 years old. <br/>Intervention(s):
Perioperative cognitive assessments. Measurement: The primary outcome was
the prevalence of POCD. <br/>Main Result(s): Thirty-nine studies (n =
12,921) were included with mean age of 70.0 +/- 8.9 years and 44.3 %
women. The overall prevalence of POCD was 23 % (95 % CI: 20 %, 27 %) at
day 7, 16 % (95 % CI: 7 %, 25 %) at 1 month, 10 % (95 % CI: 8 %, 13 %) at
3 months and 3 % (95 % CI: 2 %, 4 %) at 1 year. Our meta-regression showed
a higher prevalence of POCD in abdominal surgeries at day 7 (beta = 0.13,
95 % CI: 0.03-0.22, P = 0.01) and 3 months (beta = 0.49, 95 % CI:
0.40-0.58, P < 0.001), versus orthopedic surgeries. <br/>Conclusion(s):
The overall prevalence of POCD in older non-cardiac surgical populations
was 23 %, 16 %, 10 %, and 3 % at day 7, 1 month, 3 months, and 1 year,
respectively. Abdominal surgery had a higher prevalence of POCD than
orthopedic surgery. The substantial risk of POCD calls for cognitive
screening, risk mitigation and interventions to improve surgical outcomes.
Through routine preoperative cognitive screening and addressing modifiable
risk factors, the incidence and impact of POCD can be markedly reduced,
enhancing patient outcomes and recovery.<br/>Copyright &#xa9; 2025

<54>
Accession Number
2034160687
Title
Traditional Chinese medicine injections with Tonifying Qi, equivalent
effect of regulating energy metabolism, for acute myocardial infarction: a
systematic review and meta-analysis of randomized clinical trials.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1511486. Date of Publication: 2025.
Author
Zhou H.; Chen J.; Liu H.; Li X.; Zong H.; Zhang S.; Shi Y.; Li Y.
Institution
(Zhou, Liu, Li, Zong, Zhang, Shi, Li) Department of Cardiology, Beijing
Hospital of Traditional Chinese Medicine, Capital Medical University,
Beijing, China
(Chen) Department of Cardiology, Linping Branch of Hangzhou Hospital of
Traditional Chinese Medicine, Zhejiang, Hangzhou, China
(Li) Department of Cardiology, Lhasa People's Hospital, Lhasa, China
Publisher
Frontiers Media SA
Abstract
Background: Traditional Chinese medicine injections for Tonifying Qi
(TCMi-TQs), which exhibits comparable effect of regulating energy
metabolism, is commonly used as an adjuvant treatment for acute myocardial
infarction (AMI) in China. <br/>Objective(s): A systematic review and
meta-analysis was conducted to contrast the effectiveness and safety of
four TCMi-TQs in AMI. <br/>Method(s): Eight Databases were thoroughly
searched before 31 July 2024, for randomized controlled trials (RCTs)
focusing on the application of TCMi-TQs combined with conventional
treatments (CT) to treat AMI. The primary outcomes were in-hospital
mortality and long-term mortality. Secondary outcomes included malignant
arrhythmia, left ventricular ejection fraction (LVEF), and adverse events.
Stata17.0 and RevMan 5.4.1 software were employed for meta-analysis. The
quality of evidence was evaluated using the GRADE approach.
<br/>Result(s): A total of 113 RCTs involving 10,779 patients were
included in the analysis, none of which described in-dependent testing of
the purity or potency of the TCMi-TQ product used. 51/113 reported random
sequence generation. All RCTs lack adequate description of allocation
concealment. 112/113 failed to assess blinding. The meta-analysis results
demonstrated that the combined application of TCMi-TQ + CT, compared with
CT, significantly reduced in-hospital mortality in AMI patients [RR =
0.58, 95% CI (0.51, 0.67), P < 0.05], decreased the incidence of malignant
arrhythmia [RR = 0.51, 95%CI(0.42, 0.63), P < 0.05], increased LVEF [MD =
6.52, 95%CI(5.54, 7.50), P < 0.05], and decreased the incidence of adverse
events [RR = 0.70, 95%CI(0.60, 0.81), P < 0.05]. The GRADE evidence
quality classification indicated that the evidence for in-hospital
mortality, malignant arrhythmia, and adverse events was of moderate
quality, while the evidence for LVEF was of low quality.
<br/>Conclusion(s): TCMi-TQ demonstrates additional clinical value in
reducing mortality, the risk of malignant arrhythmia, and adverse events
in patients with AMI. However, further validation of these findings is
warranted through high-quality clinical trials due to methodological
weaknesses in randomization, blinding, allocation concealment, and
insufficient assessment of the purity/potency of botanical drugs and the
quantity of active metabolites. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024573818, identifier
PROSPERO (CRD42024573818).<br/>Copyright &#xa9; 2025 Zhou, Chen, Liu, Li,
Zong, Zhang, Shi and Li.

<55>
Accession Number
2032698291
Title
Comparison of remimazolam and sevoflurane for general anesthesia during
transcatheter aortic valve implantation: a randomized trial.
Source
Canadian Journal of Anesthesia. 72(3) (pp 397-408), 2025. Article Number:
e013080. Date of Publication: 01 Mar 2025.
Author
Harimochi S.; Godai K.; Nakahara M.; Matsunaga A.
Institution
(Harimochi, Nakahara, Matsunaga) Department of Anesthesiology and Critical
Care Medicine, Graduate School of Medical and Dental Sciences, Kagoshima
University, Kagoshima, Japan
(Godai, Matsunaga) Operating Room, Kagoshima University Hospital,
Kagoshima, Japan
(Godai) Department of Anesthesiology and Critical Care Medicine, Graduate
School of Medical and Dental Sciences, Kagoshima University, 8-35-1
Sakuragaoka, Kagoshima, Japan
Publisher
Springer
Abstract
Purpose: Safe perioperative management of patients undergoing
transcatheter aortic valve implantation (TAVI) is crucial. Remimazolam is
a newly developed short-acting benzodiazepine. We hypothesized that
combining remimazolam and flumazenil would reduce emergence time compared
with sevoflurane in patients undergoing general anesthesia for TAVI.
<br/>Method(s): We conducted a prospective, randomized, parallel-design,
open-label, single-centre clinical trial between June 2022 and August 2023
at Kagoshima University Hospital. We allocated patients randomly to either
the remimazolam/flumazenil group or the sevoflurane group. Patients in the
remimazolam group received iv remimazolam whereas patients in the
sevoflurane group received sevoflurane for general anesthesia maintenance.
Patients in both groups received a remifentanil infusion throughout the
TAVI procedure (0.2 mug.kg^-1.min^-1iv). Remimazolam
and sevoflurane were adjusted to maintain a Bispectral IndexTM
(Covidien/Medtronic, Minneapolis, MN, USA) of 40-60. In the remimazolam
group, flumazenil (0.2 mg iv) was administered immediately after
remimazolam discontinuation. The primary outcome was time to extubation.
Secondary outcomes included intraoperative variables (hemodynamic
variables and vasopressor dose), rate of intra- and postoperative
complications, and recovery of muscle strength. <br/>Result(s): Overall,
60 patients were enrolled, and data from 56 were included. The median
[interquartile range] time to extubation was significantly shorter in the
remimazolam group than in the sevoflurane group (6.5 [5.1-8.1] min vs 14.2
[10.9-15.9] min; difference in medians, -6.9 min; 95% confidence interval,
-8.7 to -5.0; P < 0.001). Statistically significant differences were
observed in the perfusion index (P = 0.03) and regional cerebral oxygen
saturation (P = 0.03) between the groups. No significant differences
between the two groups were seen in other secondary outcomes.
<br/>Conclusion(s): Compared with sevoflurane, a combination of
remimazolam and flumazenil significantly reduced the time to extubation in
patients undergoing general anesthesia for TAVI. Therefore, remimazolam
may be a suitable choice for general anesthesia in patients undergoing
TAVI. Study registration: UMIN.ac.jp (UMIN000047892); first posted 30 May
2022.<br/>Copyright &#xa9; The Author(s) 2024.

<56>
Accession Number
2038215206
Title
Trigger receptor expressed in myeloid cell type-1 (TREM-1) as a biomarker
of systemic inflammatory response syndrome (SIRS) in pediatrics.
Source
Medicina (Brazil). 57(2) (no pagination), 2024. Article Number: E206940.
Date of Publication: 2024.
Author
Cabral J.V.B.; de Menezes T.M.G.A.L.; da Silveira M.M.B.M.; Xavier A.T.;
Torres L.C.; Sobral Filho D.C.; de Oliveira D.C.
Institution
(Cabral, da Silveira, de Oliveira) Universidade Federal de Pernambuco, PE,
Recife, Brazil
(de Menezes, Torres) Instituto de Medicina Integral Professor Fernando
Figueira, (PE, Recife, Brazil
(Xavier, Sobral Filho) Universidade de Pernambuco, PE, Recife, Brazil
Publisher
Faculdade de Medicina de Ribeirao Preto - U.S.P.
Abstract
Objective: to determine the validity of TREM-1 as a SIRS biomarker in
pediatric patients. <br/>Method(s): systematic review, according to
PRISMA, of studies published until October 2022 indexed in the VHL,
Cochrane Library, PubMed/MEDLINE and Science Direct databases. The search
strategy included the descriptors: TREM-1; SIRS; Child; Biomarker.
Registration number PROSPERO CRD: 42022381838. <br/>Result(s): four
studies comprising 2.353 patients aged 11 months to 18 years were
included, with SIRS being present in 75% of these. Cutoff values ranged
from 18.7 pg/mL to > 629 pg/mL. The results support a role for TREM-1 as a
diagnostic tool for pediatric SIRS, but cannot be considered conclusive as
a quantitative synthesis was not possible due to heterogeneity in study
design. <br/>Conclusion(s): we conclude a potential use of TREM-1 in the
pediatric population, specifically for the diagnosis of SIRS, with a good
perspective in cardiac surgery through its elevation after surgery.
However, it was not possible to establish a cut-off point, but rather to
determine the possibility of its use for stratifying mortality risk,
compared to baseline values, when the patient has SIRS.<br/>Copyright
&#xa9; 2024 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights
reserved.

<57>
Accession Number
2038313823
Title
Percutaneous atrial septostomy for left ventricular unloading in patients
on peripheral venoarterial extracorporeal membrane oxygenation: A
systematic review and meta-analysis.
Source
American Heart Journal Plus: Cardiology Research and Practice. 54 (no
pagination), 2025. Article Number: 100542. Date of Publication: 01 Jun
2025.
Author
AlGhamdi M.; Saiydoun G.; Lebreton G.; Mazzucotelli J.-P.
Institution
(AlGhamdi) Cardiac Surgery Division, King Abdulaziz University, Jeddah,
Saudi Arabia
(AlGhamdi, Saiydoun, Lebreton) Cardiac Surgery Division, Pitie-Salpetriere
Hospital, Sorbonne University, Paris, France
(AlGhamdi, Mazzucotelli) Department of Cardiac Surgery, Hopitaux
Universitaires de Strasbourg, Nouvel Hopital Civil, Strasbourg, France
Publisher
Elsevier Inc.
Abstract
Background: This study systematically reviewed the safety and efficacy of
atrial septostomy as a left ventricular (LV) unloading intervention in
paediatric and adult patients undergoing peripheral venoarterial
extracorporeal membrane oxygenation (VA-ECMO). <br/>Method(s): The PubMed,
Cochrane, and Google Scholar online databases were searched, and studies
describing patients who received VA-ECMO for refractory cardiogenic shock
and underwent atrial septostomy for LV unloading were included. Laboratory
experiments, animal studies, and patients who received ECMO with a method
other than atrial septostomy for LV unloading were excluded.
<br/>Result(s): From the 12 studies analysed, data were collected on 197
patients, including 97 (49 %) males and 75 (38 %) females (data
unavailable for 25 patients) with ages ranging from 3.65 days to 70 years.
VA-ECMO duration was 1.71 to 40 days (P < 0.001). Weaning from VA-ECMO
with LV discharge was achieved successfully in 126 (64 %) patients, with
60 (30.5 %) in recovery (P = 0.006) and 66 (33.5 %) converted to a
ventricular assistant device or transplantation. Additionally, 54 (27.4 %)
patients experienced unsuccessful weaning. During atrial septostomy for LV
unloading, 14 (7.1 %) patients experienced complications, whereas 180
(91.4 %) did not (P = 0.250). After LV unloading in patients receiving
VA-ECMO, 60 (30.5 %) experienced early mortality (P = 0.286).
<br/>Conclusion(s): VA-ECMO-assisted percutaneous atrial septostomy is a
viable, safe, and successful alternative for LV unloading in both children
and adults with refractory cardiogenic shock. However, further studies
with larger sample sizes are required to comprehensively assess the
morbidity and mortality associated with this approach.<br/>Copyright
&#xa9; 2025 The Author(s)

<58>
Accession Number
2036067705
Title
Effect of the Xanthine Oxidase Inhibitor Febuxostat on the Cardio- Ankle
Vascular Index in Asymptomatic Patients with Hyperuricemia and Liver
Dysfunction: A Sub-Analysis of the PRIZE Study.
Source
Journal of Atherosclerosis and Thrombosis. 32(4) (pp 474-490), 2025. Date
of Publication: 2025.
Author
Kawachi Y.; Fujishima Y.; Nishizawa H.; Tanaka A.; Yoshida H.; Niwano S.;
Suzuki M.; Shimomura I.; Node K.
Institution
(Kawachi, Fujishima, Nishizawa, Shimomura) Department of Metabolic
Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
(Nishizawa) Department of Metabolism and Atherosclerosis, Graduate School
of Medicine, Osaka University, Osaka, Japan
(Tanaka, Node) Department of Cardiovascular Medicine, Saga University,
Saga, Japan
(Yoshida) Department of Medical Statistics, Osaka Metropolitan University,
Graduate School of Medicine, Osaka, Japan
(Niwano) Department of Cardiovascular Medicine, Kitasato University School
of Medicine, Kanagawa, Japan
(Suzuki) Department of Cardiology, Yokohama Minami Kyosai Hospital,
Yokohama, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aims: The effect of uric acid (UA)-lowering therapy with xanthine
oxidoreductase (XOR) inhibitors on the development of cardiovascular
disease requires further investigation. This study aimed to evaluate the
long-term effects of febuxostat on arterial stiffness, focusing on liver
function. <br/>Method(s): The PRIZE study involved random assignment of
patients with asymptomatic hyperuricemia to receive either add-on
febuxostat treatment (febuxostat group) or non-pharmacological treatment
(control group). Of the 514 participants, 23 and 14 patients in the
febuxostat and control groups, respectively, underwent assessment of
arterial stiffness using the cardio-ankle vascular index (CAVI). The
participants in each group were further grouped on the basis of their
baseline alanine aminotransferase (ALT) or aspartate aminotransferase
(AST) levels (above or below the media value or 30 U/L). The primary
endpoint was the change in the CAVI from baseline to 12 and 24 months.
<br/>Result(s): Overall, no significant differences were found between the
control and febuxostat groups in the least-squares mean estimates of
changes in CAVI at 24 months (mean between-group difference, -0.41 [95%
CI, -1.05 to 0.23]; p =0.204). However, there were significant differences
in participants with higher baseline ALT or AST levels above 30 U/L at 24
months (mean between-group difference, -1.12 [95% CI, -2.23 to -0.01]; p
=0.048 for ALT >= 30 U/L and -1.08 [95% CI, -2.13 to -0.03]; p =0.044 for
AST >= 30 U/L). <br/>Conclusion(s): Two-year treatment with febuxostat
demonstrated a beneficial effect on CAVI in patients with hyperuricemia
and liver dysfunction.<br/>Copyright &#xa9; 2025 Japan Atherosclerosis
Society.

<59>
Accession Number
2038174047
Title
Outcomes After CABG Compared With FFR-Guided PCI in Patients Presenting
With Acute Coronary Syndrome.
Source
JACC: Cardiovascular Interventions. 18(7) (pp 838-848), 2025. Date of
Publication: 14 Apr 2025.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Piroth Z.; Oldroyd
K.G.; Wendler O.; Reardon M.J.; Desai M.; Woo Y.J.; Yeung A.C.; De Bruyne
B.; Pijls N.H.J.; Fearon W.F.
Institution
(Takahashi, Otsuki, Yeung, Fearon) Stanford University School of Medicine
and Stanford Cardiovascular Institute, Stanford University, CA, United
States
(Zimmermann) St. Antonius Hospital, Nieuwegein, Netherlands
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Ding, Desai) Quantitative Sciences Unit, Stanford University, Stanford,
CA, United States
(Piroth) Gottsegen National Cardiovascular Center, Hungary
(Oldroyd) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Wendler) Cleveland Clinic London, London, United Kingdom
(Reardon) Houston Methodist Debakey Heart & Vascular Center, Houston, TX,
United States
(Woo) Department of Cardiothoracic Surgery, Division of Cardiovascular
Medicine and Stanford Cardiovascular Institute, Stanford University, CA,
United States
(De Bruyne) Cardiovascular Center Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: There are limited data comparing coronary artery bypass
grafting (CABG) with percutaneous coronary intervention (PCI) in patients
presenting with non-ST-segment elevation acute coronary syndrome
(NSTE-ACS). <br/>Objective(s): The aim of this study was to evaluate
differences in outcomes in patients presenting with or without NSTE-ACS
after CABG compared with fractional flow reserve (FFR)-guided PCI using
current generation drug-eluting stents. <br/>Method(s): The FAME 3 trial
(Fractional flow reserve versus Angiography for Multivessel Evaluation;
NCT02100722) was an investigator-initiated, randomized controlled trial to
attest noninferiority of FFR-guided PCI using the current-generation
drug-eluting stents to CABG with respect to the primary endpoint, defined
as a composite of death, myocardial infarction (MI), stroke, or repeat
revascularization at 1 year, in 1,500 patients with 3-vessel coronary
artery disease. The prespecified key secondary endpoint was a composite of
death, MI, or stroke at 3 years. <br/>Result(s): Of 1,500 patients
enrolled, 587 (39.2%) presented with NSTE-ACS. Patients were followed up
for a median of 1,080 days (Q1-Q3: 1,080-1,080 days). At 3 years, the risk
of the composite of death, MI, or stroke was similar between patients
presenting with NSTE-ACS and with chronic coronary syndrome (CCS) (11.8%
vs 10.0%; adjusted HR [aHR]: 1.20; 95% CI: 0.81-1.77; P = 0.37). Patients
presenting with NSTE-ACS had a similar risk of death, MI, or stroke at 3
years after CABG as compared with PCI (aHR: 0.98; 95% CI: 0.60-1.60; P =
0.94), whereas patients presenting with CCS had a significantly reduced
risk after CABG compared with PCI (aHR: 0.58; 95% CI: 0.38-0.90; P = 0.02;
P<inf>interaction</inf> = 0.11), which was driven by a lower risk of MI
(aHR: 0.32; 95% CI: 0.15-0.64; P = 0.002; P<inf>interaction</inf> = 0.01).
<br/>Conclusion(s): The risk of death, MI, or stroke at 3 years was
similar after CABG compared with FFR-guided PCI in patients presenting
with NSTE-ACS, but reduced by CABG in patients presenting with CCS.
(Fractional flow reserve versus Angiography for Multivessel Evaluation
[FAME 3]; NCT02100722)<br/>Copyright &#xa9; 2025

<60>
[Use Link to view the full text]
Accession Number
2038227816
Title
Coronary Stent Infection A Systematic Review of Literature.
Source
Cardiology in Review. 33(3) (pp 272-278), 2025. Date of Publication: 01
May 2025.
Author
Ayyubi S.A.S.; Rehman A.; Fatima L.; Ahmed M.; Rehman M.U.; Zameer R.;
Malik J.
Institution
(Ayyubi, Rehman, Fatima, Ahmed, Rehman, Zameer, Malik) Department of
Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad,
Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Coronary stent infection is a rare yet serious complication of coronary
artery stenting, with potentially significant morbidity and mortality.
This systematic review aimed to comprehensively assess the available
evidence on the diagnosis, management, and outcomes of coronary stent
infection. A comprehensive search of electronic databases, including
PubMed, Embase, Cochrane Library, and Scopus, was conducted from inception
until March 2023, in accordance with Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. A total of 1 case series
and 41 case reports, covering a cumulative sample size of 44 patients,
were included in the analysis. The predominant stent types were
drug-eluting stents in 22 studies, bare-metal stents in 3 studies, and a
combination of drug-eluting stents and bare-metal stents in 4 studies.
Staphylococcus aureus was the predominant identified organism in
microbiological profiles. Primary outcomes, including mortality,
morbidity, and recurrence rates, were evaluated. The aggregate mortality
rate across studies was 18%, underscoring the severity of coronary stent
infections. Morbidity ranged from 3% to 60%, with a spectrum of
complications such as sepsis, heart failure, and embolic events.
Recurrence rates varied from 3% to 33%, emphasizing the importance of
effective management. Treatment strategies encompassed antibiotics alone,
antibiotics with stent removal, and antibiotics with stent retention, with
the duration of antibiotic therapy ranging from 2 weeks to 12 months. The
optimal management strategy remains uncertain due to limited high-quality
evidence. Early diagnosis and treatment were emphasized as critical
factors in improving outcomes. Prophylactic antibiotics during stenting
procedures and increased awareness among healthcare providers were
suggested as preventive measures.<br/>Copyright &#xa9; 2023 Wolters Kluwer
Health, Inc. All rights reserved.

<61>
Accession Number
2037662112
Title
TEG 6s-Guided Algorithm for Optimizing Patient Blood Management in
Cardiovascular Surgery: Systematic Literature Review and Expert Opinion.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(5) (pp 1162-1172),
2025. Date of Publication: 01 May 2025.
Author
Maxey-Jones C.; Seelhammer T.G.; Arabia F.A.; Cho B.; Cardonell B.; Smith
D.; Leo V.; Dias J.; Shore-Lesserson L.; Hartmann J.
Institution
(Maxey-Jones) CNY Medical Services, PLLC, Baldwinsville, NY, United States
(Seelhammer) Mayo Clinic, Rochester, MN, United States
(Arabia) Banner Health, Phoenix, AZ, United States
(Cho) Johns Hopkins University, Baltimore, MD, United States
(Cardonell) University of Missouri Columbia, Columbia, MO, United States
(Smith) Spectrum Healthcare Partners, Portland, ME, United States
(Leo, Dias, Hartmann) Haemonetics Corporation, Boston, MA, United States
(Shore-Lesserson) Northwell, New Hyde Park, NY, Anesthesiology, North
Shore University Hospital, Manhasset, NY, United States
Publisher
W.B. Saunders
Abstract
Objectives: To propose a comprehensive TEG 6s-based intraoperative and/or
immediately postoperative treatment algorithm for bleeding patients
undergoing cardiac surgery. To achieve this, TEG-based treatment
algorithms in cardiac surgery were evaluated through a literature review
and structured expert opinion. <br/>Design(s): Systematic literature
review. <br/>Setting(s): Cardiac surgery. <br/>Participant(s): Adult
patients undergoing cardiac surgery with intraoperative and/or immediately
postoperative bleeding. <br/>Intervention(s): TEG-guided transfusion
algorithm. <br/>Measurements and Main Results: A literature search was
conducted for original studies reporting TEG-based treatment algorithms in
cardiac surgery settings. Of 304 identified manuscripts, fourteen met all
inclusion criteria, with two further articles identified through authors'
suggestions. There is limited evidence describing the use of TEG 6s assays
in cardiac surgery with only one study reporting a dedicated algorithm
using the TEG 6s device at a non-US center. Two additional studies
assessed TEG 6s assays. The remaining manuscripts reported algorithms
based on the TEG 5000 device. Following the author's review of the
available data, and feedback from expert opinion, a simple transfusion
algorithm was proposed as an initial framework for developing a TEG
6s-based protocol with consideration for the 2021 Society of Thoracic
Surgery/Society of Cardiovascular Anesthesiologists/American Society of
Extracorporeal Technology/Society for the Advancement of Patient Blood
Management Patient Blood Management Guidelines. <br/>Conclusion(s): A new
algorithm for cardiac surgery based on TEG 6s assays has been proposed
based on the available evidence and expert opinion for research alignment
and clinical validation.<br/>Copyright &#xa9; 2025 The Author(s)

<62>
Accession Number
2036503881
Title
Aortic Valve and Left Ventricular Outflow Tract Calcium Distribution and
Conduction Outcomes After Transcatheter Aortic Valve Replacement: A
Systematic Review and Meta-Analysis.
Source
Structural Heart. 9(4) (no pagination), 2025. Article Number: 100389. Date
of Publication: 01 Apr 2025.
Author
Litkouhi P.N.; Rao K.; Baer A.; Hansen P.S.; Bhindi R.
Institution
(Litkouhi, Rao, Baer, Hansen, Bhindi) Department of Cardiology, Royal
North Shore Hospital, Sydney, NSW, Australia
(Litkouhi, Rao, Hansen, Bhindi) School of Medicine, University of Sydney,
Camperdown, Australia
Publisher
Cardiovascular Research Foundation
Abstract
Permanent pacemaker implantation (PPMI) is an important complication
following transcatheter aortic valve replacement (TAVR). The influence of
valvular and subvalvular calcium and its distribution between aortic
leaflets on the risk of PPMI following TAVR remains unclear. We performed
a systematic review of the aortic valve complex (AVC) calcium by leaflet,
left ventricular outflow tract (LVOT) calcium by leaflet, total AVC
calcium, total LVOT calcium, and mitral annular calcium and its
association with post-TAVR atrioventricular block, left bundle branch
block, and new PPMI. The search strategy included five databases
identifying 893 articles. A total of 34 studies with 11,528 patients were
included for qualitative analysis, and seven studies totaling 1056
patients were suitable for quantitative analysis. On meta-analysis, left
coronary cusp calcium and right coronary cusp calcium were significant
predictors of PPMI, while noncoronary cusp (NCC) calcium was not
predictive (left coronary cusp: mean difference: 21.05 mm³, 95%
CI: 5.92-36.19, p < 0.001; right coronary cusp: mean difference: 46.02
mm³, 95% CI: 1.84-90.21, p = 0.04, and NCC: mean difference:
0.19 mm³, 95% CI: -0.32 to 0.50, p = 0.10). On qualitative
review, LVOT calcium in the NCC region was the leaflet most commonly
predictive of post-TAVR conduction outcomes. Total AVC, total LVOT
calcium, and mitral annular calcium had no convincing association with
post-TAVR conduction outcomes. The distribution of calcium rather than its
total volume was associated with post-TAVR conduction abnormalities.
Heterogeneity in methodology and implantation techniques between studies
limits the clinical significance of these findings.<br/>Copyright &#xa9;
2024

<63>
Accession Number
2036002708
Title
Mini-Sternotomy vs. Right Anterior Mini-Thoracotomy for Surgical Aortic
Valve Replacement - A Systematic Review and Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 40(3) (no pagination), 2025.
Article Number: e20240211. Date of Publication: 2025.
Author
Starvridis D.; Rad A.A.; Montanhesi P.K.; Kirov H.; Wacker M.; Tasoudis
P.; Mukharyamov M.; Treml R.E.; Wippermann J.; Doenst T.; Sultan I.; Sa
M.P.; Caldonazo T.
Institution
(Starvridis, Wacker, Wippermann) Department of Cardiothoracic Surgery,
University Clinic Magdeburg, Magdeburg, Germany
(Rad) Medical Sciences Division, University of Oxford, Oxford, United
Kingdom
(Montanhesi) Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo,
Brazil
(Kirov, Mukharyamov, Doenst, Caldonazo) Department of Cardiothoracic
Surgery, Jena University Hospital, Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Treml) Department of Anesthesiology and Intensive Care Medicine,
Friedrich Schiller University Jena, Jena, Germany
(Sultan, Sa) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sultan, Sa) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Minimally invasive techniques for aortic valve replacement
have become increasingly popular. The most common minimally invasive
approaches are mini-sternotomy and right anterior mini-thoracotomy. We
aimed to review the literature and compare clinical outcomes for these two
approaches. <br/>Method(s): Three databases were assessed. The primary
endpoint was perioperative mortality. The secondary endpoints were
reoperation for bleeding, stroke, operation duration, intensive care unit
length of stay, cardiopulmonary bypass time, cross-clamping time, hospital
length of stay, paravalvular leak, renal complications, conversion to full
sternotomy, permanent pacemaker implantation, and wound infection. Random
effects models were performed. <br/>Result(s): Ten studies were included
in the meta-analysis (30,524 patients). There was no difference in
perioperative mortality between groups (odds ratio: 0.83; 95% confidence
interval 0.57-1.21; P=0.33). In comparison with mini-sternotomy, right
anterior mini-thoracotomy showed higher rates of reoperation for bleeding
(odds ratio: 0.69; 95% confidence interval 0.50-0.97; P=0.03), lower rates
of stroke (odds ratio: 1.27; 95% confidence interval 1.01-1.60; P=0.04),
and longer operation duration (standard mean difference:-0.58; 95%
confidence interval-1.01 to-0.14; P=0.01). Other secondary endpoints were
not statistically significant. <br/>Conclusion(s): The results suggest
that both techniques present similar perioperative mortality rates for
aortic valve replacement. However, right anterior mini-thoracoto-my is
associated with higher rates of reoperation for bleeding, lower rates of
stroke, and longer operation duration time.<br/>Copyright &#xa9; 2025,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<64>
Accession Number
2038192560
Title
Inhaled vs. intravenous vasodilators in perioperative pulmonary
hypertension during chest surgery using cardiopulmonary bypass: A
systematic review and meta-analysis.
Source
Pulmonary Pharmacology and Therapeutics. 89 (no pagination), 2025. Article
Number: 102357. Date of Publication: 01 Jun 2025.
Author
Ogura Y.; Imai E.; Taito S.; Tsuji T.; Kamimura Y.; Tsuge T.; Amano K.
Institution
(Ogura, Imai, Taito, Tsuji, Kamimura, Tsuge) Scientific Research WorkS
Peer Support Group (SRWS-PSG), Osaka, Japan
(Ogura, Amano) Department of Education and Training, Mitsui Memorial
Hospital, Kanda-Izumi-cho-1, Chiyoda-ku, Tokyo, Japan
(Imai) Division of Anesthesia, Mitsui Memorial Hospital,
Kanda-Izumi-cho-1, Chiyoda-ku, Tokyo, Japan
(Taito) Division of Rehabilitation, Department of Clinical Practice and
Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku,
Hiroshima, Japan
(Tsuji) Department of Anesthesiology, Okazaki City Hospital, 1-3 Goshoai,
Kouryuji-cho, Aichi, Okazaki, Japan
(Tsuji, Kamimura) Department of Anesthesiology and Intensive Care
Medicine, Nagoya City University Graduate School of Medical Sciences, 1
Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
(Tsuge) Department of Rehabilitation, Kurashiki Medical Center, 250
Bakuro, Okayama, Kurashiki, Japan
(Tsuge) Department of Epidemiology, of Medicine, Dentistry and
Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Okayama,
Japan
Publisher
Academic Press

<65>
[Use Link to view the full text]
Accession Number
2038232204
Title
Baseline High-Sensitivity C-Reactive Protein as a Predictor of Adverse
Clinical Events in Patients with Coronary Artery Disease Undergoing
Percutaneous Coronary Intervention A Meta-Analysis.
Source
Cardiology in Review. 33(3) (pp 227-238), 2025. Date of Publication: 01
May 2025.
Author
Yang S.; Pan Y.; Zheng W.
Institution
(Yang, Zheng) Department of Cardiovascular Medicine, The First Affiliated
Hospital of Hainan Medical University, Hainan, Haikou, China
(Pan) Department of Critical Care Medicine, The Second Affiliated Hospital
of Hainan Medical University, Hainan, Haikou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Inflammation in patients with coronary artery disease (CAD) has been
linked to adverse clinical outcomes. A useful biomarker for measuring
inflammation levels, high-sensitivity C-reactive protein (hs-CRP) in the
blood can be used to detect the presence of low-grade inflammation. This
study sought to assess the predictive value of baseline hs-CRP levels for
adverse clinical events in CAD patients undergoing percutaneous coronary
intervention (PCI). To investigate this topic, a meta-analysis was
performed. We conducted a systematic search of PubMed, Embase, and the
Cochrane Library for original articles reporting the correlation between
hs-CRP levels and adverse clinical events in CAD patients undergoing PCI.
We followed the Preferred Reporting Items for Systematic Reviews and
Meta-analyses guidelines and conducted a meta-analysis by extracting
relevant data. Our pooled calculations yielded hazard ratios or odds
ratios with 95% confidence intervals. A total of 28 studies comprising
60544 patients were included in this analysis. High baseline hs-CRP levels
predicted increased risk for major adverse cardiac events (P = 0.037),
major adverse cardiac and cerebrovascular events (P = 0.020), all-cause
mortality (P = 0.001), cardiovascular mortality (P < 0.001), death and/or
myocardial infarction (P = 0.017) in patients, as well as restenosis (P <
0.001). However, there was no association between elevated baseline hs-CRP
levels and thrombosis. In conclusion, in CAD patients undergoing PCI,
baseline hs-CRP levels are reliable predictors of major adverse cardiac
events, major adverse cardiac and cerebrovascular events, all-cause
mortality, cardiovascular mortality, death and/or myocardial infarction,
and restenosis. Therefore, hs-CRP can effectively assist in prognosis
determination for CAD patients undergoing PCI.<br/>Copyright &#xa9; 2023
Wolters Kluwer Health, Inc. All rights reserved.

<66>
[Use Link to view the full text]
Accession Number
2038032113
Title
Transcatheter aortic valve implantation vs. surgery for failed
bioprosthesis: A meta-analysis of over 20000 patients.
Source
Journal of Cardiovascular Medicine. 26(3) (pp 153-166), 2025. Date of
Publication: 01 Mar 2025.
Author
Comentale G.; Ahmadi-Hadad A.; Moldon H.J.; Carbone A.; Manzo R.; Franzone
A.; Piccolo R.; Bossone E.; Esposito G.; Pilato E.
Institution
(Comentale, Ahmadi-Hadad, Moldon, Pilato) Division of Cardiac Surgery,
University of Naples Federico II, Italy
(Manzo, Franzone, Piccolo, Esposito) Division of Cardiology, Department of
Advanced Biomedical Sciences, University of Naples Federico II, Italy
(Carbone) Division of Cardiology, University of Campania L. Vanvitelli,
Italy
(Bossone) Department of Public Health, University of Naples Federico II,
Naples, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
ObjectivesValve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) has gained popularity as a less invasive alternative to a redo
surgical aortic valve replacement (redo-SAVR); which one is the preferred
technique in these cases, however, remains a topic of debate, as the
available data refer to retrospective studies with few patients or limited
follow-up. The present metanalysis aimed to compare the short-term and
long-term outcomes of the two techniques in the setting of a failed
surgical bioprosthesis.MethodsPubMed, MEDLINE, and Embase were searched on
10 November 2023 yielding 355 results (PROSPERO ID: CRD42023490612), of
which 27 were suitable for meta-analysis. The primary outcomes were
short-term and long-term all-causes and cardiovascular mortality.
Logarithmic risk ratio (Log RR) and mean difference were used for
categorical and continuous data, respectively.ResultsBoth redo-SAVR and
ViV-TAVI exhibited similar procedural and short-term mortality. However,
ViV-TAVI demonstrated lower 1-year mortality [RR: 0.74, 95% confidence
interval (CI) (0.57-0.96), P=0.02], acute kidney injury (RR: 0.47,
P<0.001), bleeding (RR: 0.44, P<0.001), stroke (RR: 0.70, P<0.05), and new
pacemaker implantation (RR: 0.69, P<0.05). Conversely, redo-SAVR
demonstrated more favorable mean postoperative aortic valve gradients
[mean difference 2.59, 95% CI (0.86-4.31), P<0.01].ConclusionShort-term
mortality was similar between the groups, but ViV-TAVI showed better
survival at 1year as well as reduced rates of acute kidney injury,
bleeding, stroke, and pacemaker implantation. However, redo-SAVR leads to
a better hemodynamic profile. Even if collected data come from
retrospective studies, the present results could help to guide the choice
of the best approach case-by-case according to the patient's clinical
profile.<br/>Copyright &#xa9; 2025 The Author(s). Published by Wolters
Kluwer Health, Inc. on behalf of the Italian Federation of Cardiology.

<67>
Accession Number
2038223523
Title
The effects of rhythmic handgrip exercise on muscle sympathetic nerve
activity: A systematic review and meta-analysis.
Source
Autonomic Neuroscience: Basic and Clinical. 259 (no pagination), 2025.
Article Number: 103272. Date of Publication: 01 Jun 2025.
Author
Maier L.E.; Meyer S.E.; Deprato A.; Busch S.; Sivak A.; Davenport M.H.;
Steinback C.D.
Institution
(Maier, Meyer, Deprato, Busch, Davenport, Steinback) Program for Pregnancy
and Postpartum Health, Neurovascular Health Laboratory, Women and
Children's Health Research Institute, Alberta Diabetes Institute, Faculty
of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton,
AB, Canada
(Sivak) H.T. Coutts Education and Physical Education Library, University
of Alberta, Edmonton, AB, Canada
Publisher
Elsevier B.V.
Abstract
This systematic review and meta-analysis was conducted to quantify the
sympathetic response to rhythmic handgrip exercise in healthy and diseased
populations. Structured searches of databases were performed until June
12, 2024. We included all primary studies (other than systematic reviews
and meta-analyses), and inclusion criteria were: population (all
populations); intervention (rhythmic handgrip); comparator (baseline); and
outcome (MSNA, BP, HR). Forty-nine studies (n = 930) were included. Burst
frequency was elevated by 6.1 bursts/min during rhythmic handgrip (95 %
CI, 4.52, 7.63; I² = 53 %; p < 0.00001) across all populations.
Similarly, burst incidence and total activity showed significant increases
during handgrip (BI: MD, 3.0 bursts/100 hbs; 95 % CI, 0.11, 5.85;
I² = 0 %; p = 0.04; TA: MD, 49.4 a.u.; 95 % CI, 36.56, 62.20;
I² = 86 %; p < 0.00001). Subgroup analyses found greater
responses in MSNA during rhythmic handgrip in healthy individuals compared
to cardiovascular diseases and other conditions. Specifically, the change
in burst frequency during handgrip (p = 0.0009) and total activity during
handgrip (p < 0.00001) suggest a blunted sympathetic response to rhythmic
handgrip in diseased populations. Meta-regression analyses in healthy
populations found no relationship between the volume of handgrip applied
with the associated change in sympathetic activity; however, there was a
significant positive relationship between both the change in heart rate
(slope = 0.131; adjusted R² = 0.2773; p = 0.002) and the change
in mean blood pressure (slope = 0.163; adjusted R² = 0.3594; p
< 0.001) with handgrip volume. An increase in MSNA is observed during
rhythmic handgrip despite ranging protocols, populations, and
co-interventions. These results suggest exercise is a unique stressor and
challenges the understanding of general sympathetic hyperactivity in
diseased populations.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<68>
[Use Link to view the full text]
Accession Number
2038224543
Title
Association Between Use of WATCHMAN Device and 1-Year Mortality Using
High-Dimensional Propensity Scores to Reduce Confounding.
Source
Circulation: Cardiovascular Quality and Outcomes. 18(4) (pp e011188),
2025. Date of Publication: 01 Apr 2025.
Author
Zhao J.Z.; Ruzieh M.; Du F.; Lian Y.; Foy A.J.; Platt R.W.; Segal M.S.;
Coulombe J.; Winterstein A.G.; Jiao T.
Institution
(Zhao, Du, Winterstein, Jiao) Department of Pharmaceutical Outcomes and
Policy, College of Pharmacy, University of Florida, Gainesville, United
States
(Ruzieh, Segal) Department of Medicine, College of Medicine, University of
Florida, Gainesville, United States
(Lian) Department of Biostatistics and Epidemiology, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, United States
(Foy) Division of Cardiology, Penn State Heart and Vascular Institute,
Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey,
PA, United States
(Platt) Departments of Epidemiology, Biostatistics, and Occupational
Health, McGill College, Montreal, QC, Canada
(Coulombe) Department of Mathematics and Statistics, Universite de
Montreal, Quebec, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Previous observational studies showed left atrial appendage
occlusions with the WATCHMAN device reduced 1-year mortality, which
conflicted with evidence generated from randomized controlled trials. We
proposed to use the high-dimensional propensity score (hdPS) to assist in
nonactive comparator selection (prevalent user of medication) and compared
1-year mortality between patients with atrial fibrillation who received
the WATCHMAN device (percutaneous left atrial appendage occlusion device
[pLAAO]) and direct oral anticoagulants in 2 matched cohorts based on (1)
traditional propensity score (PS) and (2) integrating traditional PS with
information learned from hdPS. <br/>METHOD(S): Patients entered the cohort
once diagnosed with atrial fibrillation in the 15% of Medicare
fee-for-service claims database from 2011 to 2018. Patients could enter
the study cohort upon receiving WATCHMAN or at an outpatient visit with an
atrial fibrillation diagnosis, respectively. We used PS matching with a
1:3 ratio for patients in pLAAO and direct oral anticoagulant groups. In
cohort 2, we implemented a multistep approach with information learned
from hdPS. The Cox proportional hazards model was used to estimate hazard
ratios of outcomes with 95% CIs. <br/>RESULT(S): In cohort 1, we
identified 1159 and 3477 patients in the pLAAO and direct oral
anticoagulant groups with a mean age of 78.1 versus 77.5 years, 44.9%
versus 40.8% of women, and a 1-year mortality rate of 8.02 versus 8.97/100
person-years (hazard ratio, 0.87 [95% CI, 0.69-1.09]). With the support of
hdPS, in cohort 2, we excluded patients with malignant cancer and added
frailty score in the PS model. We identified 953 and 2859 patients in the
pLAAO and direct oral anticoagulant groups with a mean age of 78.1 versus
77.9 years, 47.2% versus 46.1% of women, and a 1-year mortality rate of
7.45 and 7.69/100 person-years (hazard ratio, 0.95 [95% CI, 0.73-1.24]).
<br/>CONCLUSION(S): No association was found between pLAAO and 1-year
mortality, which is consistent with existing evidence from randomized
controlled trials. The hdPS approach provides an opportunity to improve
nonactive comparator selection in traditional PS analysis.<br/>Copyright
&#xa9; 2025 American Heart Association, Inc.

<69>
Accession Number
2038114003
Title
Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney
Injury in On-pump Cardiac Surgery-A Post-hoc Analysis of a Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Vlasov H.E.; Petaja L.M.; Wilkman E.M.; Talvasto A.T.; Ilmakunnas M.K.;
Raivio P.M.; Hiippala S.T.; Suojaranta R.T.; Juvonen T.S.; Pesonen E.J.
Institution
(Vlasov, Petaja, Wilkman, Talvasto, Ilmakunnas, Hiippala, Suojaranta,
Pesonen) Department of Anesthesiology and Intensive Care Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Ilmakunnas) Finnish Red Cross Blood Service, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: To study the association between bleeding and acute kidney
injury (AKI). <br/>Design(s): Post-hoc study of a randomized trial of 4%
albumin versus Ringer's acetate for cardiopulmonary bypass priming and
perioperative volume replacement. <br/>Setting(s): Single-center study.
<br/>Patient(s): 1,386 on-pump cardiac surgical patients. Measurements and
Results: AKI was defined by the Kidney Disease: Improving Global Outcomes
creatinine criteria, and bleeding by the Universal Definition of
Perioperative Bleeding (UDPB) classification. With univariably independent
factors, two logistic regression analyses (Model 1: AKI Risk Score,
EuroSCORE II, and UDPB class; Model 2: risk scores, components of the UDPB
classification, and factor VIII/von Willebrand factor concentrate) and a
mediation analysis (Model 3: risk scores, UDPB class, and perioperative
factors) were performed. A total of 139 (10%) patients developed AKI. In
Model 1, UDPB class "severe" (odds ratio: 2.16, 95% confidence interval:
1.19-3.89), "massive" bleeding (6.78, 1.8-25.33), and AKI Risk Score
(1.51, 1.29-1.78) were associated with AKI. In Model 2, AKI Risk Score
(1.55, 1.33-1.82) and fresh frozen plasma transfusion (1.29, 1.06-1.58)
were associated with AKI. In Model 3, the combined UDPB classes "severe"
and "massive" bleeding did not have a direct effect (regression
coefficient: 0.32, 95% confidence interval: -0.26 to 0.91), while mean
arterial pressure (0.08, 0.003-0.21) and fluid balance (0.12, 0.17-0.27)
had indirect effects on AKI. <br/>Conclusion(s): In on-pump cardiac
surgery, perioperative bleeding was not an independent risk factor for AKI
but manifested as AKI via hypotension and higher fluid balance. Prevention
of bleeding may reduce AKI in cardiac surgery.<br/>Copyright &#xa9; 2025
The Author(s)

<70>
Accession Number
2038136658
Title
Esketamine mitigates systemic inflammation via modulating phenotypic
transformation of monocytes in patients undergoing thoracic surgery.
Source
Life Sciences. 371 (no pagination), 2025. Article Number: 123594. Date of
Publication: 15 Jun 2025.
Author
Shen W.; Yan Y.; Zhang W.; Xu J.; Li Z.; Yang L.
Institution
(Shen, Yan, Xu, Li, Yang) Department of Anesthesiology, Second Xiangya
Hospital, Central South University, Hunan Province, Changsha, China
(Shen, Yan, Xu, Li, Yang) Hunan Anesthesia Clinical Medical Care
Technology Research Center, Hunan Province, Changsha, China
(Zhang) Department of Laboratory, Second Xiangya Hospital, Central South
University, Hunan Province, Changsha, China
(Yan) Department of Anesthesiology, Xiamen Cardiovascular Hospital, Xiamen
University, China
Publisher
Elsevier Inc.
Abstract
Aim: To assess esketamine's anti-inflammatory effects during thoracic
surgery and its modulation of immune responses. <br/>Material(s) and
Method(s): In a randomized trial, 64 of 73 patients undergoing thoracic
surgery were allocated into the Control (not receiving esketamine) or the
ES-KTM group (intraoperative esketamine infusion). Blood routine tests
were conducted one day before (T0) and one day after the surgery (T3).
Plasma levels of tumor necrosis factor-alpha (TNF-alpha) and
interleukine-10 (IL-10) were analyzed by ELISA, and cell surface markers
including CD14, CD16, CD163, CD40, CX3CR1, CD206 were tested by cytometry
at the entry to the surgical room (T1) and the skin closure (T2). For the
in vitro study, esketamine at 10 muM was employed to treat the
lipopolysaccharide (LPS) stimulated macrophage cell line-Raw264.7, and its
effects were tested by cytometry and RNA sequencing analysis. <br/>Key
Findings: Esketamine application reduces the count of neutrophils and
monocytes, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte
ratio (PLR) and systemic inflammatory index (SII), and enhances the
lymphocyte counting and lymphocyte to monocyte ratio (LMR). Then,
esketamine application decreases the plasma TNF-alpha levels, while
maintaining the IL-10 level in comparison with the Control group.
Additionally, esketamine reduced the proportion of intermediate monocytes,
downregulates the expressions of CD16, CD40 and CX3CR1, while upregulates
the CD206 expression. Finally, in the in-vitro study, esketamine inhibits
the M1 pro-inflammatory markers in LPS-challenged macrophages, and
downregulates multiple immune-related pathways. <br/>Significance:
Esketamine mitigates surgery-triggered inflammation by suppressing
monocyte/macrophage proinflammatory activity and TNF-alpha release,
offering dual anesthetic and immunomodulatory benefits.<br/>Copyright
&#xa9; 2025

<71>
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. 39(5) (pp 1325-1334),
2025. Date of Publication: 01 May 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.
<br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<72>
Accession Number
2033101791
Title
Focused Review of Enhanced Recovery After Abdominal Trauma Surgery in the
Pediatric Population and Development of a Pediatric Enhanced Recovery
After Trauma Surgery Pathway.
Source
Paediatric Anaesthesia. 35(5) (pp 338-346), 2025. Date of Publication: 01
May 2025.
Author
Moore R.P.; Singh N.; Wang M.; Tsivitis A.; Devitt C.; Jin Z.; Al Bizri
E.; Singh S.M.; Hsieh H.
Institution
(Moore, Tsivitis, Jin, Al Bizri, Singh) Dept of Anesthesia, Stony Brook
University Hospital, Stony Brook, NY, United States
(Singh, Hsieh) Dept of Surgery, Stony Brook University Hospital, Stony
Brook, NY, United States
(Wang, Devitt) Renaissance School of Medicine Stony Brook University
Hospital, Stony Brook, NY, United States
(Singh) Dept of Perioperative Surgical Services, Stony Brook University
Hospital, Stony Brook, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Traumatic injuries are the leading cause of morbidity and
mortality amongst pediatric patients; improving outcomes after pediatric
abdominal trauma surgery could be quite impactful. Although enhanced
recovery after surgery (ERAS) pathways have been successfully employed in
adult trauma patients, there are few studies on pediatric enhanced
recovery after abdominal trauma surgery and no consensus post trauma
surgery guidelines for children. Aims/Methods: A systematic search of the
existing literature for pediatric enhanced recovery after trauma surgery
pathways was performed by two independent authors. However, no pediatric
enhanced recovery after trauma surgery pathways were found. Therefore, we
reviewed the pediatric and adult enhanced recovery after trauma surgery
literature to identify potential impactful elements of care that could be
part of a pediatric pathway. <br/>Result(s): The existing literature
supports the incorporation of several elements into pediatric trauma ERAS
pathway. <br/>Conclusion(s): We propose a pediatric enhanced recovery
after trauma surgery pathway, which highlights several principles of ERAS
pathways (multimodal analgesia, goal-directed fluid therapy, early
initiation of nutrition, timely administration of antibiotics, avoidance
of hypothermia, DVT prophylaxis, the early removal of drains and
indwelling catheters, and patient education).<br/>Copyright &#xa9; 2025
John Wiley & Sons Ltd.

<73>
[Use Link to view the full text]
Accession Number
2038224547
Title
Cost-Effectiveness of Aortic Valve Replacement in Low- and
Intermediate-Risk Chinese Patients With Severe Aortic Stenosis.
Source
Circulation: Cardiovascular Quality and Outcomes. 18(4) (pp e010858),
2025. Date of Publication: 01 Apr 2025.
Author
Peng J.; Zheng X.; Jiang M.; Yao X.; Ma Y.; Fu M.; Ma T.; Shang X.; Yan
Y.; Thourani V.H.; Fang Y.
Institution
(Peng, Jiang, Yao, Ma, Fu, Fang) Department of Pharmacy Administration and
Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, China
(Peng, Jiang, Yao, Ma, Fu, Fang) Center for Drug Safety and Policy
Research, Xi'an Jiaotong University, China
(Peng, Jiang, Yao, Ma, Fu, Fang) Shaanxi Center for Health Reform and
Development Research, Xi'an, China
(Peng, Jiang, Yao, Ma, Fu, Fang) Research Institute for Drug Safety and
Monitoring, Institute of Pharmaceutical Science and Technology, Western
China Science and Technology Innovation Harbor, Xi'an, China
(Zheng, Ma, Shang, Yan) Department of Cardiovascular Surgery, First
Affiliated Hospital of Xi'an Jiaotong University, China
(Jiang) Institute for Global Health and Development, Peking University,
Beijing, China
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart Institute, Atlanta, GA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) remains debated
as an alternative to surgical aortic valve replacement (SAVR). We aimed to
evaluate the cost-effectiveness of aortic valve replacement strategies in
low- and intermediate-risk patients with severe aortic stenosis in China.
<br/>METHOD(S): A decision-analytic model combining decision tree and
Markov model was developed to compare outcomes of universal SAVR,
universal TAVR, and a risk-based strategy (SAVR in low-risk patients and
TAVR in intermediate-risk patients) in a hypothetical cohort of
75-year-old patients with aortic stenosis within the perspective of the
Chinese health care system. A meta-analysis was performed to derive the
clinical inputs; the 2019 to 2021 claims data from Shaanxi Province were
used for cost analysis, and quality of life was measured using EuroQoL-5D.
One-way and probabilistic (10 000 Monte Carlo simulations) sensitivity
analyses were conducted to examine the robustness of model results.
Primary outcomes included total costs, quality-adjusted life-years
(QALYs), and incremental cost-effectiveness ratio (ICER). <br/>RESULT(S):
Universal TAVR gained the most QALYs (6.76 QALYs) with the highest costs
(USD 58 949). Compared with universal SAVR, the risk-based strategy gained
0.12 additional QALYs at higher costs (USD 14 046); the ICER (117 048
USD/QALY) exceeded the willingness-to-pay threshold (37 657 USD/QALY,
3-fold gross domestic product per capita in China). The ICER of universal
TAVR versus universal SAVR (80 526 USD/QALY) also exceeded the
willingness-to-pay threshold. Sensitivity analysis showed that universal
TAVR would be cost-effective if TAVR valve costs were <USD 21 477 (>44.23%
cost reduction). Subgroup analysis showed that universal TAVR and
risk-based strategy remained not cost-effective compared with universal
SAVR in both low-risk (ICER of 64 414 USD/QALY) and intermediate-risk
(ICER of 124 851 USD/QALY) patients. In 10 000 Monte Carlo simulations,
the probabilities of being cost-effective for universal SAVR, universal
TAVR, and risk-based strategy were 89.81%, 10.14%, and 0.05%,
respectively. <br/>CONCLUSION(S): The risk-based strategy and universal
TAVR appeared not to be cost-effective versus universal SAVR in low- and
intermediate-risk patients with severe aortic stenosis in
China.<br/>Copyright &#xa9; 2025 American Heart Association, Inc.

<74>
Accession Number
2029904505
Title
Association of Glutamate Infusion With Risk of Acute Kidney Injury After
Coronary Artery Bypass Surgery: A Pooled Analysis of 2 Randomized Clinical
Trials.
Source
JAMA Network Open. 7(1) (no pagination), 2024. Article Number: e2351743.
Date of Publication: 22 Jan 2024.
Author
Holm J.; Vanky F.; Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Linkoping, Sweden
Publisher
American Medical Association
Abstract
IMPORTANCE Acute kidney injury (AKI) after cardiac surgery is associated
with increased morbidity and mortality, and measures to prevent AKI have
had limited success. Glutamate has been reported to enhance natural
postischemic recovery of the heart, but not among animals and humans with
diabetes. OBJECTIVE To summarize pooled results from the GLUTAMICS
(Glutamate for Metabolic Intervention in Coronary Surgery) trials
regarding the effect of glutamate on postoperative AKI among patients
without diabetes undergoing coronary artery bypass graft (CABG) surgery.
DESIGN, SETTING, AND PARTICIPANTS Data on a total of 791 patients without
diabetes from 2 prospective, randomized, double-blind multicenter trials
performed at 5 cardiac surgery centers in Sweden between October 4, 2005,
and November 12, 2009, and between November 15, 2015, and September 30,
2020, were pooled. Patients had acute coronary syndrome, left ventricular
ejection fraction of 0.30 or less, or a European System for Cardiac Risk
Evaluation II score of 3.0 or more and underwent CABG with or without
additional valve procedure. Statistical analysis was performed from May to
November 2023. INTERVENTIONS Intravenous infusion of 0.125-M L-glutamic
acid or saline at 1.65 mL/kg/h for 2 hours during reperfusion, after which
the infusion rate was halved and an additional 50 mL was given. MAIN
OUTCOMES AND MEASURES The primary end point was AKI, defined as
postoperative increase of plasma creatinine of 50% or more, corresponding
to the Risk stage or higher in the Risk, Injury, Failure, Loss, and
End-Stage kidney disease (RIFLE) criteria. RESULTS A total of 791 patients
without diabetes (391 who received glutamate [mean (SD) age, 69.3 (9.1)
years; 62 women (15.9%)] and 400 controls [mean (SD) age, 69.6 (9.5)
years; 73 women (18.3%)]) were randomized. Baseline data did not differ
between groups. Glutamate was associated with a significantly lower risk
of AKI (relative risk, 0.49 [95% CI, 0.29-0.83]). Dialysis was required
for 2 patients in the glutamate group and 5 patients in the control group.
In multivariable analysis, glutamate remained significantly associated
with a protective effect against AKI (odds ratio, 0.47 [95% CI,
0.26-0.86]). In the glutamate and control groups, the rate of
postoperative mortality at 30 days or less was 0.5% (2 of 391) vs 1.0% (4
of 400), and the rate of stroke at 24 hours or less was 0.8% (3 of 391) vs
1.8% (7 of 400). CONCLUSIONS AND RELEVANCE In this pooled analysis of 2
randomized clinical trials, infusion of glutamate was associated with a
markedly lower risk of AKI after CABG among patients without diabetes. The
findings are exploratory and need to be confirmed in prospective
trials.<br/>Copyright &#xa9; 2024 Holm J et al. JAMA Network Open.

<75>
Accession Number
647086788
Title
Anticoagulation Versus No Anticoagulation for Post-Operative Atrial
Fibrillation After Isolated Coronary Artery Bypass Graft: A Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 01 Apr 2025.
Author
Shariff M.; Kumar A.; Bagameri G.; Kowlgi N.G.; Deshmukh A.; Stulak J.
Institution
(Shariff) Department of Surgery, Mayo Clinic, Rochester, Minneapolis, USA
(Kumar, Kowlgi, Deshmukh) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, MN, United States
(Bagameri, Stulak) Department of Surgery, Mayo Clinic, Rochester,
Minneapolis, USA; Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN, USA

<76>
Accession Number
2038401854
Title
Effect of perioperative intravenous ketamine on postoperative sleep
disturbance in patients undergoing non-cardiac surgery: A systematic
review and meta-analysis.
Source
Indian Journal of Anaesthesia. 69(5) (pp 434-449), 2025. Date of
Publication: 01 May 2025.
Author
Yang N.; Peng L.; Kuang R.; Xu R.; Zhou L.; Wang Y.
Institution
(Yang, Peng, Kuang, Xu, Zhou, Wang) Department of Anesthesiology, The
First Affiliated Hospital of Chongqing Medical University, Yuanjiagang,
Daping Street, Yuzhong District, Chongqing, China
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative sleep disturbance (PSD) is a common
condition that may lead to pain, cognitive impairment, depression, and
delayed recovery. This review evaluates the efficacy of perioperative
intravenous ketamine in alleviating PSD and offers evidence-based
recommendations for clinical practice. <br/>Method(s): A systematic search
was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP
Information Resource System, China National Knowledge Infrastructure and
China Biology Medicine disc (SinoMed) up to 6 th November 2024. This
article included a meta-analysis of randomised controlled trials (RCTs)
along with a Grading of Recommendations Assessment, Development and
Evaluation analysis. <br/>Result(s): A total of 2355 patients from 21 RCTs
were analysed. The pooled results indicated that ketamine improved sleep
quality compared to placebo on the first postoperative day, as evidenced
by a reduction in Pittsburgh Sleep Quality Index scores [mean difference
(MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; P < 0.0001,
I² = 96%]. Ketamine also improved sleep quality on the second
postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; P = 0.002,
I² = 96%) and during the first three postoperative days (MD:
-2.90; 95% CI: -4.79, -1.00; P = 0.003, I² = 97%). In addition,
ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI:
-0.55, -0.21; P < 0.00001, I² = 84%). These results suggest
that ketamine reduces PSDs and pain without significantly increasing
adverse reactions. However, given the high heterogeneity and limited
quality of evidence in this review, the results should be interpreted with
caution. <br/>Conclusion(s): This meta-analysis indicates that
administering ketamine during the perioperative period can enhance
postoperative sleep quality. However, the optimal dose, timing and method
of administration remain undetermined, emphasising the need for further
research to establish standardised guidelines.<br/>Copyright &#xa9; 2025
Indian Journal of Anaesthesia.

<77>
Accession Number
2038417261
Title
Letter to the Editor, "The effects of sodium-glucose transporter 2
inhibition on cardiac surgery-associated acute kidney injury: An
open-label randomized pilot study".
Source
Journal of Clinical Anesthesia. 104 (no pagination), 2025. Article Number:
111838. Date of Publication: 01 Jun 2025.
Author
Jiang L.; Peng Z.
Institution
(Peng) Foshan Women and Children Hospital, China
(Jiang) The Seventh Affiliated Hospital of Southern Medical University,
China
Publisher
Elsevier Inc.

<78>
Accession Number
2038418195
Title
Clinical impact of surgical left atrial appendage occlusion during cardiac
surgery in patients in sinus rhythm: A meta-analysis.
Source
Heart Rhythm. (no pagination), 2025. Date of Publication: 2025.
Author
Burton S.; Ahmed R.; King N.; Reynolds A.; Modi A.; Asopa S.
Institution
(Burton, Reynolds) Bristol Heart Institute, Bristol Royal Infirmary,
Bristol, United Kingdom
(Burton) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Ahmed) Keele University School of Medicine, Keele, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi, Asopa) Department of Cardiothoracic Surgery, Southampton General
Hospital, Southampton, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: The clinical efficacy of surgical occlusion of the left atrial
appendage in patients with sinus rhythm undergoing cardiac surgery remains
controversial. <br/>Objective(s): This meta-analysis aims to evaluate the
impact of left atrial appendage occlusion (LAAO) on early and late
outcomes in sinus rhythm patients undergoing cardiac surgery.
<br/>Method(s): Screened and selected studies were sourced from PubMed,
Embase, and Web of Science databases, following the Preferred Reporting
Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Early
clinical outcomes were pooled using odds ratio, and long-term outcomes
were extracted from Kaplan-Meier curves to reconstruct individual
time-to-event patient data and allow for proportional hazards regression.
Bias-treated data were selected when available. <br/>Result(s): Six
studies, comprising 2742 patients, were included from the initial 1431
reports. Pooling of data demonstrated no significant association between
LAAO and the development of postoperative atrial fibrillation (odds ratio
1.157; 95% confidence interval [CI] 0.904-1.481; I² = 46%; P =
.246). Reconstruction of Kaplan-Meier data revealed greater freedom from
cerebrovascular events in the LAAO group than in the no-LAAO group (hazard
ratio 0.482; 95% CI 0.361-0.643; P < .001). The LAAO group also
demonstrated improved midterm survival (hazard ratio 0.701; 95% CI
0.554-0.886; P = .003). <br/>Conclusion(s): This meta-analysis has
demonstrated an improved freedom from cerebrovascular events and a midterm
survival benefit in sinus rhythm patients undergoing cardiac surgery and
surgical LAAO. This meta-analysis does not demonstrate an increased
occurrence of postoperative atrial fibrillation in the LAAO group. Larger
randomized controlled trials, stratified by cardiac pathology, are
required to validate these findings.<br/>Copyright &#xa9; 2025 Heart
Rhythm Society

<79>
Accession Number
2038413098
Title
Major Intraprocedural Complications During Transcatheter Aortic Valve
Implantation Requiring Emergent Cardiac Surgery: An Updated Systematic
Review.
Source
American Journal of Cardiology. 247 (pp 21-28), 2025. Date of Publication:
15 Jul 2025.
Author
Verolino G.; Di Mauro M.; Calderone D.; Lorusso R.
Institution
(Verolino, Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Verolino, Calderone) Invasive Cardiology, IRCCS Istituto Auxologico
Italiano - San Luca Hospital, Milan, Italy
(Di Mauro, Lorusso) Cardiothoracic Surgery Department, Maastricht
University Medical Center, Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
for patients >75 years old with severe aortic stenosis. From the
technique's beginnings in the early 2000s, over 20 years of experience in
the TAVI procedure have allowed its wide diffusion with optimal procedural
results. Intraprocedural complications during TAVI are yet a fearful
scenario, sometimes requiring emergent open-heart surgery (EOHS) that is
burdened by high intraoperative mortality (50% at 30 days). Furthermore,
also when a surgical treatment is not needed, intraprocedural
complications have a challenging management and a critical impact on
patients' prognosis. The volume of procedures in the last 10 years has
been observed to increase substantially, with an incidence of major
intraprocedural complications of around 1%. However, the features and
specific incidence for each complication have not been revised recently.
This work aims to update the knowledge about major intraprocedural
complications during TAVI, considering the increased operators' experience
and recent device developments. An updated point of view on major
intraprocedural complications could suggest a need for change in the TAVI
paradigm, promoting TAVI programs even in centers without on-site cardiac
surgery.<br/>Copyright &#xa9; 2025 The Authors

<80>
Accession Number
2036149679
Title
Rationale and Design of the CREATE Trial: A Multicenter, Randomized
Comparison of Continuation or Cessation of Single Antithrombotic Therapy
at 1 Year After Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. 14(7) (no pagination), 2025.
Article Number: e039350. Date of Publication: 01 Apr 2025.
Author
Liu R.; Li Y.; Zhang L.; Lu Z.; Fu Z.; Modine T.; Jilahawi H.; Pocock S.;
Wu Y.; Song G.
Institution
(Liu, Li, Lu, Fu, Song) Interventional Center of Valvular Heart Disease,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Zhang, Wu) Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Bordeaux,
France
(Jilahawi) Cedars-Sinai Medical Center, Smidt Heart Institute, Los
Angeles, CA, United States
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Current guidelines and expert consensus recommend lifelong
single antiplatelet therapy for patients undergoing transcatheter aortic
valve replacement who have no indication for anticoagulation or dual
antiplatelet therapy. However, there is no direct evidence from randomized
controlled trials supporting this practice. Furthermore, the optimal
duration of antiplatelet therapy in this population has not been
adequately investigated. METHODS AND RESULTS: CREATE (A Multicenter
Randomized Controlled Study to Evaluate Cessation of Antithrombotic
Therapy at 1 Year in TAVR Patients-The CREATE Study) is a prospective,
multicenter, open-label, randomized controlled trial for patients who have
undergone successful transcatheter aortic valve replacement and have no
indication for long-term oral anticoagulation or antiplatelet therapy.
Eligible patients are free from major bleeding and ischemic events for 1
year postprocedure before being randomized 1:1 to single antiplatelet
therapy (control group) or no antiplatelet therapy (experimental group).
The primary efficacy end point is the incidence of bleeding events,
defined by the VARC-3 (Valve Academic Research Consortium-3) criteria, at
1-year postrandomization. The primary safety end point is a composite of
cardiac death, myocardial infarction, and ischemic stroke at 1 year. The
trial is powered for both superiority in efficiency and noninferiority in
safety. Accordingly, a total of 3380 patients will be enrolled.
<br/>CONCLUSION(S): The CREATE trial aims to assess if stopping
antiplatelet therapy at 1-year after transcatheter aortic valve
replacement reduces bleeding risk without increasing ischemic events in
patients not requiring chronic antithrombotic therapy. REGISTRATION: URL:
https://www.chictr.org.cn; Unique identifier:
ChiCTR2400087454.<br/>Copyright &#xa9; 2025 The Author(s). Published on
behalf of the American Heart Association, Inc., by Wiley.

<81>
Accession Number
2036149616
Title
Cerebral Embolic Protection Devices in Transcatheter Aortic Valve
Implantation: Meta-Analysis With Trial Sequential Analysis.
Source
Journal of the American Heart Association. 14(7) (no pagination), 2025.
Article Number: e038869. Date of Publication: 01 Apr 2025.
Author
Warraich N.; Sa M.P.; Jacquemyn X.; Kuno T.; Serna-Gallegos D.; Sultan I.
Institution
(Warraich, Serna-Gallegos, Sultan) Division of Cardiac Surgery, Department
of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA,
United States
(Warraich, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Sa) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Jacquemyn) KU Leuven, Leuven, Belgium
(Kuno) Division of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: We aimed to reevaluate randomized controlled trial data on
outcomes of cerebral embolic protection device use during transcatheter
aortic valve implantation. A conventional meta-analysis followed by trial
sequential analysis was conducted to evaluate the strength of the current
evidence. METHODS AND RESULTS: Databases were searched for randomized
controlled trials. Primary outcomes included all stroke, disabling stroke,
and all-cause mortality. Conventional study-level meta-analysis was
performed using random-effects modeling. Trial sequential analysis was
conducted to generate adjusted significance boundaries, futility
boundaries, and the required information size considering a type I error
of 5% and a power of 90%. Seven trials were included with a total of 4031
patients, of whom 2171 were treated with a device and 1860 were not.
Conventional meta-analysis showed no significant difference in all stroke
(relative risk [RR], 0.85 [95% CI, 0.61-1.18]; P=0.339) and disabling
stroke (RR, 0.59 [95% CI, 0.30-1.13]; P=0.113) with device use. The trial
sequential analysis determined an absence of evidence for all stroke
(required information size of 71 650 [5.6%]) and disabling stroke
(required information size of 337 256 [1.2%]). Conventional meta-analysis
determined no significant difference in all-cause mortality (RR, 1.03 [95%
CI, 0.49-2.17]; P=0.928) with device use. The trial sequential analysis
determined that the futility boundary was reached (required information
size of 5772 [69.3%]). <br/>CONCLUSION(S): There are insufficient
randomized controlled trial data on cerebral embolic protection device use
to provide conclusive meta-analytic findings for stroke
outcomes.<br/>Copyright &#xa9; 2025 The Author(s).

<82>
[Use Link to view the full text]
Accession Number
2038237109
Title
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Circulation. 151(13) (pp e771-e862), 2025. Date of Publication: 01 Apr
2025.
Author
Rao S.V.; O'Donoghue M.L.; Ruel M.; Rab T.; Alexander J.H.; Baber U.;
Baker H.; Cohen M.G.; Cruz-Ruiz M.; Davis L.L.; de Lemos J.A.; DeWald
T.A.; Elgendy I.Y.; Feldman D.N.; Goyal A.; Isiadinso I.; Menon V.; Morrow
D.A.; Mukherjee D.; Platz E.; Promes S.B.; Sandner S.; Sandoval Y.;
Schunder R.; Shah B.; Stopyra J.P.; Talbot A.W.; Taub P.R.; Williams M.S.;
Beavers C.J.; Beckie T.; Blankenship J.; Diercks D.; Lo B.; Louis C.;
Merchant F.M.; Nazir N.T.; So D.; Tomey M.; Welt F.; Otto C.M.; Beckman
J.A.; Armbruster A.; Blumer V.; de las Fuentes L.; Deswal A.; Ferrari
V.A.; Fremes S.E.; Gaudino M.; Hernandez A.F.; Jneid H.; Johnson H.M.;
Jones W.S.; Khan S.S.; Khazanie P.; Kittleson M.M.; Palaniappan L.; Sharma
G.; Shimbo D.; Tamis-Holland J.E.; Woo Y.J.; Ziaeian B.; Biga C.; Gates
C.C.; Kovacs R.J.; Turco J.V.; Saraco M.J.; Ronan G.D.; Patterson L.;
Getchius T.S.D.; Abdullah A.R.; Churchwell K.; Brown N.; Jessup M.; Sapio
N.A.; Singh R.R.; Nedungadi P.; St. Laurent P.; Hundley J.
Institution
(Sapio) Office of Science Strategies and Operations
(Singh, St. Laurent) Office of Science and Medicine
(Hundley) Office of Science Operations
Publisher
Lippincott Williams and Wilkins
Abstract
Aim: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of
Patients With Acute Coronary Syndromes" incorporates new evidence since
the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial
Infarction" and the corresponding "2014 AHA/ACC Guideline for the
Management of Patients With Non-ST-Elevation Acute Coronary Syndromes" and
the "2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary
Intervention for Patients With ST-Elevation Myocardial Infarction." The
"2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes" and the "2021 ACC/AHA/SCAI Guideline for
Coronary Artery Revascularization" retire and replace, respectively, the
"2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease." Methods: A
comprehensive literature search was conducted from July 2023 to April
2024. Clinical studies, systematic reviews and meta-analyses, and other
evidence conducted on human participants were identified that were
published in English from MEDLINE (through PubMed), EMBASE, the Cochrane
Library, Agency for Healthcare Research and Quality, and other selected
databases relevant to this guideline. Structure: Many recommendations from
previously published guidelines have been updated with new evidence, and
new recommendations have been created when supported by published
data.<br/>Copyright &#xa9; 2025 by the American College of Cardiology
Foundation and the American Heart Association, Inc.

<83>
Accession Number
647086973
Title
Early Aortic-Valve Replacement in Patients with Asymptomatic Severe Aortic
Stenosis with Preserved Left Ventricular Systolic Function: A Systematic
Review and Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 01 Apr 2025.
Author
de Pontes V.B.; Clemente M.R.C.; Trevisan T.; Jaramillo S.; Boneli M.F.;
Felix N.; Gameiro L.G.S.; Garot P.; Gomes W.F.
Institution
(de Pontes) Centro Universitario das Faculdades Associadas de Ensino, Sao
Joao da Boa Vista, Brazil
(Clemente) Faculdade de Medicina de Petropolis, Petropolis, Brazil
(Trevisan, Boneli, Gameiro) Centro Universitario das Faculdades Associadas
de Ensino, Sao Joao da Boa Vista, Brazil
(Jaramillo) Universidad Austral, Pilar, Argentina
(Felix) Universidade Federal de Campina Grande, Campina Grande, Brazil
(Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques
Cartier, Massy, France
(Gomes) Hospital INC, Curitiba, Brazil; Faculdades Pequeno Principe,
Curitiba, Brazil
Abstract
Current guidelines recommend routine clinical surveillance for patients
with asymptomatic severe aortic stenosis (AS) and preserved left
ventricular ejection fraction (LVEF). However, the role of early aortic
valve replacement (AVR) as compared with conservative treatment in these
patients remains unclear. We systematically searched PubMed, Embase and
Cochrane databases to identify studies comparing early AVR versus
conservative treatment in asymptomatic patients with severe AS and
preserved LVEF. All statistical analyses were performed using R software
version 4.3.1 with a random-effects model. Seven studies comprising 2,531
patients with asymptomatic severe AS and preserved LVEF were included, of
whom 1,234 (49%) underwent AVR. Median follow-up time was 49.3 months.
Early AVR was associated with significantly lower incidence of all-cause
(HR 0.51; 95% CI 0.31-0.83) and cardiac mortality (RR 0.51; 95% CI
0.30-0.89). There were no significant differences between early AVR and
conservative treatment in terms of sudden death, hospitalization for
cardiovascular (CV) causes, stroke, or myocardial infarction (MI).
However, upon a subanalysis of randomized controlled trials (RCTs) only,
patients undergoing early AVR had lower rates of hospitalization for CV
causes (RR 0.41; 95% CI 0.27-0.63) and stroke (RR 0.62; 95% CI 0.40-0.95),
with no difference in terms of all-cause mortality, sudden death, MI, or
cardiac death. In this meta-analysis, early AVR was associated with
reduced rates of all-cause and cardiac mortality, while yielding similar
rates of stroke, hospitalization for CV causes, MI, or sudden death in the
overall cohort analysis as compared with conservative
treatment.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<84>
Accession Number
2038380833
Title
Non-invasive monitoring strategies for atrial fibrillation detection in
adult cardiac surgery patients after hospital discharge: A scoping review.
Source
Heart and Lung. 73 (pp 9-18), 2025. Date of Publication: 01 Sep 2025.
Author
Jaradat O.; Drury P.; Rihari-Thomas J.; Frost S.
Institution
(Jaradat, Drury, Frost) School of Nursing, University of Wollongong,
Northfields Avenue, Wollongong, NSW, Australia
(Rihari-Thomas) Susan Wakil School of Nursing and Midwifery, The
University of Sydney, Susan Wakil Health Building, Camperdown, NSW,
Australia
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is a common complication after
cardiothoracic surgery, affecting up to 50 % of patients. It can develop
after discharge, leading to frequent hospital readmissions. There is a
growing need for effective monitoring strategies to detect AF in the
post-discharge period. <br/>Objective(s): To synthesis the available
literature on various mobile monitoring devices used to detect AF in adult
cardiac surgery patients post-discharge from the hospital. <br/>Method(s):
Following Arksey and O'Malley's framework and the PRISMA-ScR guidelines. A
comprehensive search of six databases (PubMed; MEDLINE; CINAHL; Scopus;
ProQuest; and Web of Science) was performed, including studies published
between 2009 and 2024. The risk of bias was assessed using the
Newcastle-Ottawa Scale (NOS). <br/>Result(s): A total of 1256
de-duplicated studies were screened, and 102 studies underwent full-text
review. Five studies were included: four prospective cohort studies, and
one randomised clinical trial. Samples sizes ranged from 23 to 730 adults
undergoing cardiac surgery, with follow-up between four weeks to three
months post-discharge. Handheld and wearable ECG-based devices were the
most used tools for AF detection, demonstrating high sensitivity and
specificity. Their use effectively reduced unplanned hospital visits and
improved clinical outcomes. Patient adherence to monitoring protocols was
generally high, though variability in engagement was noted.
<br/>Conclusion(s): Handheld and wearable ECG- based devices, are
effective for post-discharge AF detection in cardiac surgery patients.
Integrating these tools into routine post-discharge care can improve
patient outcomes. Future research should focus on long-term effectiveness
and strategies to optimise patient engagement and implementation in
clinical practice.<br/>Copyright &#xa9; 2025 The Author(s)

<85>
Accession Number
2038319898
Title
Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic
Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical
Trial.
Source
JAMA. (no pagination), 2025. Article Number: ezac208. Date of
Publication: 2025.
Author
Karkouti K.; Callum J.L.; Bartoszko J.; Tanaka K.A.; Knaub S.; Brar S.;
Ghadimi K.; Rochon A.; Mullane D.; Couture E.J.; Lin Y.; Harle C.; Zeller
M.; Tran D.T.T.; Solomon C.; Rao V.; Law M.; Butt A.L.; Chen E.P.; Martins
M.R.; Saha T.; Shih A.W.; Vezina M.-C.; Moussa F.; Pereira Cezar Zamper
R.; Syed S.; Buyukdere H.; Werner S.; Grewal D.; Wong D.; Vandyck K.B.;
Tanzola R.; Hughes B.; Royer O.; Wong S.; Levy J.H.
Institution
(Karkouti, Bartoszko, Grewal) Department of Anesthesia and Pain
Management, University Health Network, Sinai Health, Women's College
Hospital, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko, Rao, Grewal) Peter Munk Cardiac Centre, Toronto
General Hospital Research Institute, University Health Network, Toronto,
ON, Canada
(Karkouti, Bartoszko, Wong) Department of Anesthesiology and Pain
Medicine, University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Queen's University, Kingston, ON, Canada
(Callum) Sunnybrook Research Institute, Toronto, ON, Canada
(Tanaka, Butt, Vandyck) Department of Anesthesiology, University of
Oklahoma, Health Sciences Center, Oklahoma City, United States
(Knaub, Solomon) Octapharma AG, Lachen, Switzerland
(Brar, Law) Department of Anesthesiology and Perioperative Medicine, Royal
Columbian Hospital, Vancouver, BC, Canada
(Brar, Law) University of British Columbia, Vancouver, Canada
(Ghadimi) Clinical Research Unit, Department of Anesthesiology & Critical
Care, Duke University Health System, Durham, NC, United States
(Rochon, Martins) Department of Anesthesia, University of Montreal,
Montreal Heart Institute, Montreal, QC, Canada
(Mullane, Hughes) Department of Anesthesiology Pharmacology &
Therapeutics, University of British Columbia, Canada
(Mullane, Shih, Hughes) Vancouver General Hospital, Vancouver, BC, Canada
(Couture, Vezina, Royer) Department of Anesthesiology, Quebec Heart and
Lung Institute, Laval University, Quebec, QC, Canada
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Harle, Pereira Cezar Zamper) London Health Sciences Centre, London, ON,
Canada
(Harle) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Zeller) Micheal G. DeGroote Centre for Transfusion Research, Department
of Medicine, McMaster University, Hamilton, ON, Canada
(Zeller) Canadian Blood Services, Ottawa, ON, Canada
(Tran) Division of Cardiac Anesthesiology and Critical Care, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Rao, Moussa) Department of Surgery, University of Toronto, Toronto, ON,
Canada
(Chen) Cardiothoracic Surgery Division, Department of Surgery, Duke
University Health System, Durham, NC, United States
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada
(Shih) Department of Pathology and Molecular Medicine, McMaster
University, Hamilton General Hospital, Hamilton, ON, Canada
(Moussa) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
Schulich Heart Centre, Toronto, ON, Canada
(Syed) Department of Anesthesia, McMaster University, Hamilton Health
Sciences Corporation, Hamilton, ON, Canada
(Syed) Department of Anesthesia, Oakville Trafalgar Memorial Hospital,
Oakville, ON, Canada
(Buyukdere) Division of Hematopathology and Transfusion Medicine,
University of Ottawa, Ottawa, ON, Canada
(Werner) Octapharma USA, Paramus, NJ, United States
(Wong) Division of Cardiac Surgery, Royal Columbian Hospital, New
Westminster, BC, Canada
(Wong) Department of Surgery, University of British Columbia, Vancouver,
Canada
(Wong) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Levy) Department of Anesthesiology, Critical Care, and Surgery, Duke
University, School of Medicine, Durham, NC, United States
Publisher
American Medical Association
Abstract
Importance: Excessive bleeding is a common and prognostically important
complication of cardiac surgery. For bleeding related to coagulation
factor deficiency, frozen plasma is the most used therapy. Preliminary
trials indicate that 4-factor prothrombin complex concentrate (PCC) may be
a suitable alternative. <br/>Objective(s): To compare the efficacy and
safety of PCC with frozen plasma in patients undergoing cardiac surgery
with coagulopathic bleeding. <br/>Design, Setting, and Participant(s):
Unblinded randomized noninferiority controlled clinical trial at 12
hospitals in Canada and the US involving adults (>=18 years) who had
developed bleeding related to coagulation factor deficiency after
termination of cardiopulmonary bypass during surgery (November 30, 2022,
to May 28, 2024). Final 30-day follow-up visit was completed on June 28,
2024. <br/>Intervention(s): A total of 265 patients were randomized to
receive PCC (1500 IU <=60 kg; 2000 IU >60 kg) and 263, frozen plasma (3 U
<=60 kg; 4 U >60 kg) in the operating room. A second dose was allowed over
the next 24 hours if indicated; thereafter, only frozen plasma could be
used. <br/>Main Outcomes and Measures: The primary outcome was hemostatic
response (effective if no hemostatic interventions occurred from 60
minutes to 24 hours after treatment initiation). The noninferiority of PCC
vs frozen plasma was assessed using a 10% margin and a 1-sided alpha
of.025, with subsequent testing for superiority if noninferiority was
demonstrated. Secondary outcomes included allogeneic blood transfusions
and adverse events. Patients were followed up until postoperative day 30.
<br/>Result(s): Of 538 enrolled patients, 420 patients (median age, 66
years [IQR, 57-73 years]; 74%, male; 10%, Asian; 1%, Black; and 65%,
White) were included in the primary analysis; of those, 296 (70%)
underwent complex surgeries. Compared with the 207 patients in the frozen
plasma group, the 213 patients in the PCC group had higher hemostatic
effectiveness (166 [77.9%] vs 125 [60.4%]; difference, 17.6%; 95% CI,
8.7%-26.4%; P <.001 for noninferiority and superiority) and had received
fewer transfusions including red blood cells, platelets, and
noninvestigational frozen plasma units (mean, 6.6 units; 95% CI, 5.7-7.7
vs 9.3 units; 95% CI, 8.0-10.8; difference, 2.7; 95% CI, 1.0-4.4; P
=.002). Seventy-seven patients (36.2%) in the PCC group vs 98 (47.3%) in
the frozen plasma group experienced serious adverse events (relative risk
[RR], 0.76; 95% CI, 0.61-0.96; P =.02). Twenty-two patients (10.3%) in the
PCC group and 39 (18.8%) in the frozen plasma group had acute kidney
injury (RR, 0.55; 95% CI, 0.34-0.89; P =.02). <br/>Conclusions and
Relevance: In this unblinded randomized clinical trial, PCC had superior
hemostatic efficacy and safety advantages to frozen plasma among patients
requiring coagulation factor replacement for bleeding during cardiac
surgery. Trial Registration: ClinicalTrials.gov Identifier:
NCT05523297.<br/>Copyright &#xa9; 2025 American Medical Association. All
rights reserved, including those for text and data mining, AI training,
and similar technologies.

<86>
Accession Number
2034233521
Title
Impact of video-assisted thoracic surgery versus open thoracotomy on
postoperative wound infections in lung cancer patients: a systematic
review and meta-analysis.
Source
BMC Pulmonary Medicine. 25(1) (no pagination), 2025. Article Number: 159.
Date of Publication: 01 Dec 2025.
Author
Wang J.-Q.; Ma Z.-J.
Institution
(Wang) Department of Respiratory medicine, Tongde Hospital of Zhejiang
Province, Zhejiang Province, Hangzhou, China
(Ma) Department of Pulmonary and Critical Care Medicine, The Second
Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang
Province, Hangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Lung cancer surgery has evolved significantly, with minimally
invasive video-assisted thoracic surgery (VATS) procedures being compared
with traditional open thoracotomies. The incidence of postoperative wound
infections is a significant factor influencing the choice of surgical
technique. This systematic review and meta-analysis aim to evaluate the
impact of thoracoscopic versus open thoracotomy procedures on
postoperative wound infections in lung cancer patients. <br/>Method(s):
Following PRISMA guidelines, a comprehensive search across PubMed, Embase,
Web of Science, and the Cochrane Library was conducted on September 19,
2023, without time or language restrictions. Peer-reviewed randomized
controlled trials, cohort studies, and case-control studies reporting on
postoperative wound infections were included. Studies not differentiating
between surgical techniques or focusing on irrelevant populations were
excluded. Data extraction and quality assessment were independently
carried out by two reviewers, using a fixed-effect model for meta-analysis
due to the absence of significant heterogeneity (I² = 0.0%, P =
0.766). <br/>Result(s): A total of six articles were included. The quality
assessment indicated a low risk of bias in most domains. The pooled
results showed that open thoracotomy procedures had a twofold increased
risk of postoperative wound infections (OR = 2.00, 95% CI: 1.04-3.85)
compared to VATS procedures. Publication bias assessment using funnel
plots and Egger's test revealed no significant biases (P > 0.05).
<br/>Conclusion(s): The findings suggest that VATS is associated with a
lower risk of postoperative wound infections compared to open thoracotomy,
which has implications for surgical decision-making in lung cancer
treatment. Clinical trial number: Not applicable.<br/>Copyright &#xa9; The
Author(s) 2025.

<87>
Accession Number
2034207843
Title
Left ventricular unloading and survival outcomes in pediatric acute
fulminant myocarditis patients receiving extracorporeal membrane
oxygenation: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Cho H.J.; Habimana R.; Choi I.; Song M.-K.; Yang J.-H.; Lee Y.; Ko H.; Di
Nardo M.; Jeong I.S.
Institution
(Cho, Choi) Department of Pediatrics, Chonnam National University
Children's Hospital and Medical School, Gwangju, South Korea
(Cho, Habimana, Choi, Jeong) Extracorporeal Circulation Research Team,
Chonnam National University Hospital, Gwangju, South Korea
(Habimana) Chonnam National University Graduate School, Gwangju, South
Korea
(Song) Department of Physical and Rehabilitation Medicine, Chonnam
National University Medical School, Gwangju, South Korea
(Yang, Lee) Department of Thoracic and Cardiovascular Surgery, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Ko) Department of Pediatrics, Pusan National University Yangsan Hospital,
Pusan National University School of Medicine, South Korea
(Di Nardo) Pediatric Intensive Care Unit, Bambino Gesu Children's
Hospital, IRCCS, Rome, Italy
(Jeong) Department of Thoracic and Cardiovascular Surgery, Chonnam
National University Hospital and Medical School, Gwangju, South Korea
Publisher
SAGE Publications Ltd
Abstract
Background: Acute fulminant myocarditis (AFM) is a severe condition in
pediatric patients. Extracorporeal membrane oxygenation (ECMO) is often
used as a supportive therapy, but survival rates and the impact of
adjunctive therapies like left ventricular (LV) unloading and
bridge-to-heart transplantation remain unclear. This meta-analysis
evaluates survival outcomes in pediatric AFM patients treated with ECMO
and assesses the influence of these strategies. <br/>Method(s): This
systematic review and meta-analysis followed PRISMA guidelines. Databases,
including PubMed, Embase, and the Cochrane Library, were searched for
studies published in the last 10 years. Inclusion criteria were studies
reporting survival rates of pediatric AFM patients treated with ECMO. Data
were analyzed using fixed and random-effects models. Subgroup and
univariable meta-regression analyses identified factors associated with
survival. <br/>Result(s): From 2308 articles, 10 studies met the inclusion
criteria, totaling 210 pediatric patients. The pooled survival rate was
67% (95% CI: 37%-97%). Subgroup analyses showed higher survival in
patients receiving LV unloading (82% vs 63%; p <.01) and those bridged to
heart transplantation, though not statistically significant. Univariable
meta-regression identified LV unloading as a significant predictor of
survival (p =.02). Other factors, such as age, gender, and cardiac arrest
before ECMO, showed no significant associations with survival. Cumulative
meta-analysis indicated an improving trend in survival over the years.
<br/>Conclusion(s): This meta-analysis suggests an association between
ECMO and improved survival in children with AFM. While LV unloading may
offer benefits, the retrospective nature of the included studies, along
with potential confounding factors, necessitates cautious interpretation.
Further well-designed prospective studies are required to establish its
optimal role, indications, and timing in pediatric ECMO patients with
AFM.<br/>Copyright &#xa9; The Author(s) 2025.

<88>
Accession Number
2038319364
Title
Coronary revascularization in randomized clinical trials comparing
transcatheter and surgical aortic valve replacement: is it time to bridge
the gap?.
Source
European Heart Journal. 46(13) (pp 1267-1268), 2025. Date of Publication:
01 Apr 2025.
Author
Aarts H.M.; Voskuil M.; Delewi R.
Institution
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Heidelberglaan 100, Utrecht, Netherlands
(Aarts, Delewi) Department of Cardiology, Amsterdam University Medical
Center, Amsterdam, Netherlands
Publisher
Oxford University Press

<89>
Accession Number
2038402764
Title
Comparison of the Latest ESC, ACC/AHA/ACCP/HRS, and CCS Guidelines on the
Management of Atrial Fibrillation.
Source
JACC: Clinical Electrophysiology. 11(4) (pp 836-849), 2025. Date of
Publication: 01 Apr 2025.
Author
Wolfes J.; Ellermann C.; Frommeyer G.; Eckardt L.
Institution
(Wolfes, Ellermann, Frommeyer, Eckardt) Department of Cardiology II
(Electrophysiology), University Hospital Munster, Munster, Germany
Publisher
Elsevier Inc.
Abstract
The introduction of evidence-based and structured guidelines has
undoubtedly improved the care of cardiologic patients and in many cases
simplified decision-making for the treatment team. The European Society of
Cardiology in collaboration with the European Association for
Cardio-Thoracic Surgery, the American College of Cardiology, the American
Heart Association, the American College of Clinical Pharmacy, and the
Heart Rhythm Society, and the Canadian Cardiovascular Society/Canadian
Heart Rhythm Society have developed guidelines for the management of
patients with atrial fibrillation. Because all 3 guidelines refer to
almost the same scientific data, their recommendations are undoubtedly
largely in agreement. Nevertheless, there are some interesting differences
based on different interpretations of the same study, different
publication dates, or differences in local conditions and health care
resources. The following article aims at lining out these similarities and
differences.<br/>Copyright &#xa9; 2025 The Authors

<90>
Accession Number
2038391143
Title
The impact of ascending aorta dilatation on transcatheter aortic valve
implantation outcomes.
Source
IJC Heart and Vasculature. 58 (no pagination), 2025. Article Number:
101680. Date of Publication: 01 Jun 2025.
Author
Saputra P.B.T.; Widiarti W.; Mustofa A.; Savitri C.G.; Putranto J.N.E.;
Ashari F.Y.; Multazam C.E.C.Z.; Alkaff F.F.; D'Oria M.
Institution
(Saputra, Savitri, Putranto) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR.
Moestopo No.47, Pacar Kembang, Kec. Tambaksari, East Java, Surabaya,
Indonesia
(Saputra, Savitri, Putranto) Department of Cardiology and Vascular
Medicine, Dr. Soetomo General Academic Hospital, Jl. Prof. DR. Moestopo
No.6-8, Airlangga, Kec. Gubeng, East Java, Surabaya, Indonesia
(Widiarti, Mustofa) Faculty of Medicine, Universitas Airlangga, Jl. Prof.
DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, East Java, Surabaya,
Indonesia
(Ashari) Faculty of Biology Medicine and Health Sciences, University of
Manchester, Oxford Rd, Manchester, United Kingdom
(Multazam) National Heart and Lung Institute, Imperial College London, Guy
Scadding Building, Dovehouse St, London, United Kingdom
(Alkaff) Department of Internal Medicine, University Medical Center
Groningen, Hanzeplein 1, Groningen, Netherlands
(Alkaff) Department of Anatomy, Histology, and Pharmacology, Faculty of
Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar
Kembang, Kec. Tambaksari, East Java, Surabaya, Indonesia
(D'Oria) Division of Vascular and Endovascular Surgery, Department of
Clinical Surgical and Health Sciences, University of Trieste, Strada di
Fiume, Trieste, Cattinara, Italy
Publisher
Elsevier Ireland Ltd
Abstract
The impact of ascending aorta dilatation (AAD) on transcatheter aortic
valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear.
This meta-analysis aims to compare the outcomes of TAVI between patients
with and without AAD. We systematically searched PubMed, ScienceDirect,
Web of Science, Springer, Cochrane, and Clinicaltrials.gov. for articles
up to 25 March 2024 (PROSPERO ID CRD42024526311). A total of 204,078
patients from ten studies were included. Paravalvular regurgitation (RR
1.56 95 %CI: 1.32-1.84, p < 0.00001, I² = 0 %) and aortic
dissection (RR 3.55 95 %CI: 1.79-7.06, p = 0.0003, I² = 40 %)
were more common in AAD group. However, there were no differences in
peri-procedural (RR 1.09, 95 %CI: 0.83-1.42, p = 0.53, I² = 0
%) and 1-year (RR 0.79, 95 %CI: 0.51-1.23, p = 0.30, I² = 0 %)
mortality. Three-years (RR 0.88, 95 %CI: 0.54-1.44, p = 0.62) and
five-years (RR 0.85, 95 %CI: 0.45-1.6, p = 0.61) follow-up showed
comparable mortality between both groups. The other complications and the
need for second valve implantation (RR 1.24, 95 %CI: 0.70-20.20, p = 0.48,
I² = 65 %) were similar between both groups. Despite the higher
incidence of aortic dissection and paravalvular regurgitation in AAD than
in non-AAD patients, these complications were not associated with worse
short-term or long-term mortality. Therefore, TAVI remains a safe and
effective option for AAD patients.<br/>Copyright &#xa9; 2025 The Author(s)

<91>
Accession Number
2038325298
Title
Alternative LDL Cholesterol-Lowering Strategy vs High-Intensity Statins in
Atherosclerotic Cardiovascular Disease: A Systematic Review and Individual
Patient Data Meta-Analysis.
Source
JAMA Cardiology. 10(2) (pp 137-144), 2025. Date of Publication: 12 Feb
2025.
Author
Lee Y.-J.; Hong B.-K.; Yun K.H.; Kang W.C.; Hong S.J.; Lee S.-H.; Lee
S.-J.; Hong S.-J.; Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Choi D.;
Jang Y.; Hong M.-K.
Institution
(Lee, Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Division of
Cardiology, Severance Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Hong) Gangnam Severance Hospital, Seoul, South Korea
(Yun) Wonkwang University Hospital, Iksan, South Korea
(Kang) Gachon University College of Medicine, Incheon, South Korea
(Hong) Korea University College of Medicine, Seoul, South Korea
(Jang) CHA University College of Medicine, Seongnam, South Korea
Publisher
American Medical Association
Abstract
Importance: In patients with atherosclerotic cardiovascular disease
(ASCVD), intensive lowering of low-density lipoprotein (LDL) cholesterol
levels with high-intensity statins is generally recommended. However,
alternative approaches considering statin-related adverse effects and
intolerance are needed. <br/>Objective(s): To compare the long-term
efficacy and safety of an alternative LDL cholesterol-lowering strategy vs
high-intensity statin strategy in patients with ASCVD in randomized
clinical trials. <br/>Data Sources: PubMed, Embase, and other websites
(ClinicalTrials.gov, European Society of Cardiology, tctMD) were
systematically searched from inception to April 19, 2024. Study Selection:
Randomized clinical trials comparing an alternative LDL
cholesterol-lowering strategy vs a high-intensity statin strategy in
patients with ASCVD, with presence of cardiovascular events as end points.
Data Extraction and Synthesis: Individual patient data were obtained from
randomized clinical trials that met the prespecified eligibility criteria:
RACING (Randomized Comparison of Efficacy and Safety of Lipid-Lowering
With Statin Monotherapy vs Statin/Ezetimibe Combination for High-Risk
Cardiovascular Disease) and LODESTAR (Low-Density Lipoprotein
Cholesterol-Targeting Statin Therapy vs Intensity-Based Statin Therapy in
Patients With Coronary Artery Disease). The moderate-intensity statin with
ezetimibe combination therapy in the RACING trial and the treat-to-target
strategy in the LODESTAR trial were classified as alternative LDL
cholesterol-lowering strategies. The primary analysis was based on a
1-stage approach. <br/>Main Outcomes and Measures: The primary end point
was a 3-year composite of all-cause death, myocardial infarction, stroke,
or coronary revascularization. The secondary end points comprised clinical
efficacy and safety end points. <br/>Result(s): Individual patient data
from 2 trials including 8180 patients with ASCVD (mean [SD] age, 64.5
[9.8] years; 2182 [26.7%] female; 5998 male [73.3%]) were analyzed. The
rate of the primary end point did not differ between the alternative
strategy and high-intensity statin strategy groups (7.5% [304 of 4094] vs
7.7% [310 of 4086]; hazard ratio, 0.98; 95% CI, 0.84-1.15; P =.82). The
mean (SD) LDL cholesterol level during treatment was 64.8 (19.0) mg/dL in
the alternative strategy group and 68.5 (20.7) mg/dL in the high-intensity
statin strategy group (P <.001). The alternative strategy group had a
lower rate of new-onset diabetes (10.2% [271 of 2658] vs 11.9% [316 of
2656]; P =.047), initiation of antidiabetic medication for new-onset
diabetes (6.5% [173 of 2658] vs 8.2% [217 of 2656]; P =.02), and
intolerance-related discontinuation or dose reduction of assigned therapy
(4.0% [163 of 4094] vs 6.7% [273 of 4086]; P <.001). <br/>Conclusions and
Relevance: Results of this systematic review and individual patient data
meta-analysis suggest that compared with a high-intensity statin strategy,
the alternative LDL cholesterol-lowering strategy demonstrated comparable
efficacy regarding 3-year death or cardiovascular events in patients with
ASCVD, with an associated reduction in LDL cholesterol levels and risk for
new-onset diabetes and intolerance.<br/>Copyright &#xa9; 2024 American
Medical Association. All rights reserved,

<92>
Accession Number
2038380759
Title
Efficacy of ultrasound-guided, single-level, pectointercostal facial block
(PIFB) for postoperative analgesia after sternotomy in paediatric cardiac
surgery: A randomised controlled trial.
Source
Indian Journal of Anaesthesia. 69(5) (pp 483-488), 2025. Date of
Publication: 01 May 2025.
Author
Elhaddad A.M.M.; Hassan P.F.
Institution
(Elhaddad, Hassan) Department of Anaesthesia, ICU, and Pain Management,
Kasr Alainy Medical School, Cairo University, Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Children undergoing median sternotomy often face
moderate to severe postoperative discomfort, along with various other
complications. Under ultrasound guidance, a pectointercostal fascial block
(PIFB) might relieve this pain. This research aimed to assess the
effectiveness of a single-level PIFB for poststernotomy analgesia in
children. <br/>Method(s): Sixty children scheduled for elective open-heart
surgery through a midline sternotomy were randomly assigned to a
pectointercostal group (PI) that was administered bilateral PIFB or a
control group (C) that did not receive any intervention. The primary
outcome was the postoperative Face, Legs, Activity, Cry, and Consolability
(FLACC) pain scale score at 6 h. The analysis employed Student's t-test
for variables with a normal distribution and Chi-squared test/Fisher's
exact test for categorical data, with a significance threshold established
at a P value < 0.05. <br/>Result(s): Intraoperative PIFB decreased the
total dose of fentanyl (P < 0.001) while maintaining a favourable
haemodynamic profile. Postoperative PIFB reduced pain scores (P < 0.001),
as evidenced by a delayed initial request for rescue analgesia (P <
0.001), reduced morphine consumption (P < 0.001) and improved predictive
indicators such as extubation time (P < 0.001) and intensive care unit
stay (P = 0.008) without complications. <br/>Conclusion(s): Single-level,
ultrasound-guided PIFB provides good analgesia and hastens recovery in
children's open-heart surgery through a midline sternotomy.<br/>Copyright
&#xa9; 2025 Indian Journal of Anaesthesia.

<93>
Accession Number
2038328920
Title
Del Nido versus St. Thomas' blood cardioplegia in the young (DESTINY)
trial: protocol for a multicentre randomised controlled trial in children
undergoing cardiac surgery.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e102029. Date of
Publication: 14 Apr 2025.
Author
Drury N.E.; Handley K.; Jarrett H.; Griffin T.; Sun Y.; Bilkhoo I.;
Robertson A.; Tooke C.; Scholefield B.R.; Dunn W.B.; Kostolny M.; Stoica
S.; Van Doorn C.; Pappachan J.V.; Jones T.J.; Caputo M.
Institution
(Drury, Jones) Department of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Drury, Bilkhoo, Jones) Department of Paediatric Cardiac Surgery,
Birmingham Children's Hospital, Birmingham, United Kingdom
(Handley, Sun) Birmingham Clinical Trials Unit, University of Birmingham,
Birmingham, United Kingdom
(Handley) Department of Applied Health Sciences, University of Birmingham,
Birmingham, United Kingdom
(Jarrett, Griffin) Nottingham Clinical Trials Unit, University of
Nottingham, Nottingham, United Kingdom
(Robertson, Kostolny) Department of Paediatric Cardiac Surgery, Great
Ormond Street Hospital for Children, London, United Kingdom
(Tooke, Scholefield) Paediatric Intensive Care, Birmingham Children's
Hospital, Birmingham, United Kingdom
(Scholefield) Critical Care Medicine, Hospital for Sick Children, Toronto,
ON, Canada
(Scholefield) Department of Paediatrics, University of Toronto, Toronto,
ON, Canada
(Dunn) Centre for Metabolomics Research, Biochemistry, Cell and Systems
Biology, University of Liverpool, Liverpool, United Kingdom
(Stoica, Caputo) Department of Paediatric Cardiac Surgery, Bristol Royal
Hospital for Children, Bristol, United Kingdom
(Stoica) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Van Doorn) Department of Congenital Cardiac Surgery, Leeds Children's
Hospital, Leeds, United Kingdom
(Pappachan) Paediatric Intensive Care, Southampton General Hospital,
Southampton, United Kingdom
(Pappachan) Faculty of Medicine, University of Southampton, Southampton,
United Kingdom
(Pappachan) NIHR Southampton Biomedical Research Centre, Southampton,
United Kingdom
(Caputo) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Myocardial protection against ischaemia-reperfusion injury is
a key determinant of heart function and outcome following cardiac surgery
in children. However, myocardial injury still occurs routinely following
aortic cross-clamping, as demonstrated by the ubiquitous rise in
circulating troponin. del Nido cardioplegia was designed to protect the
immature myocardium and is widely used in the USA but has not previously
been available in the UK, where St. Thomas' blood cardioplegia is most
common. The del Nido versus St. Thomas' blood cardioplegia in the young
(DESTINY) trial will evaluate whether one solution is better than the
other at improving myocardial protection by reducing myocardial injury,
shortening ischaemic time and improving clinical outcomes. Methods and
analysis The DESTINY trial is a multicentre, patient-blinded and
assessor-blinded, parallel-group, individually randomised controlled trial
recruiting up to 220 children undergoing surgery for congenital heart
disease. Participants will be randomised in a 1:1 ratio to either del Nido
cardioplegia or St. Thomas' blood cardioplegia, with follow-up until 30
days following surgery. The primary outcome is area under the
time-concentration curve for plasma high-sensitivity troponin I in the
first 24 hours after aortic cross-clamp release. Secondary outcome
measures include the incidence of low cardiac output syndrome and
Vasoactive-Inotropic Score in the first 48 hours, total aortic cross-clamp
time, duration of mechanical ventilation and lengths of stay in the
paediatric intensive care unit and the hospital. Ethics and dissemination
The trial was approved by the West Midlands - Coventry and Warwickshire
National Health Service Research Ethics Committee (21/WM/0149) on 30 June
2021. Findings will be disseminated to the academic community through
peer-reviewed publications and presentation at national and international
meetings. Parents will be informed of the results through a newsletter in
conjunction with a national charity. Trial registration number
ISRCTN13638147; Pre-results.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.

<94>
Accession Number
2034223804
Title
Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score
matching analysis.
Source
Annals of Intensive Care. 15(1) (no pagination), 2025. Article Number: 48.
Date of Publication: 01 Dec 2025.
Author
Paulo N.; Kimmoun A.; Hajage D.; Hubert P.; Levy D.; Pineton de Chambrun
M.; Chommeloux J.; Saura O.; Del Marmol G.; Moyon Q.; Hekimian G.; Gautier
M.; Luyt C.E.; Lebreton G.; Levy B.; Combes A.; Schmidt M.
Institution
(Paulo, Levy, Pineton de Chambrun, Chommeloux, Saura, Del Marmol, Moyon,
Hekimian, Gautier, Luyt, Combes, Schmidt) AP-HP, Service de Medecine
Intensive-Reanimation, Institut de Cardiologie, Hopital Pitie-Salpetriere,
47 Boulevard de L'Hopital, Paris, France
(Kimmoun, Hubert, Pineton de Chambrun, Chommeloux, Saura, Hekimian, Luyt,
Levy, Combes, Schmidt) Institut Lorrain du Coeur Et Des Vaisseaux, Service
de Medecine Intensive-Reanimation, FCRIN-INICRCT, Universite de Lorraine,
CHRU de Nancy, Nancy, France
(Hajage, Pineton de Chambrun, Chommeloux, Saura, Hekimian, Luyt, Combes,
Schmidt) Departement Biostatistique Sante Publique Et Information
Medicale, Centre de Pharmacoepidemiologie (Cephepi), Sorbonne Universite,
AP-HP, Hopital Pitie-Salpetriere, Unite de Recherche Clinique PSL-CFX,
Paris, France
(Levy, Pineton de Chambrun, Chommeloux, Saura, Hekimian, Luyt, Lebreton,
Combes, Schmidt) Institute of Cardiometabolism and Nutrition, Sorbonne
Universite, Paris, France
(Lebreton, Combes, Schmidt) AP-HP, Cardiac Surgery Department, Institut de
Cardiologie, Hopital Pitie-Salpetriere, Paris, France
(Combes) Sorbonne Universite, GRC 30 RESPIRE, Paris, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Preliminary evidence from small, single-center studies
suggests levosimendan may improve the likelihood of successful
venoarterial extracorporeal membrane oxygenation (VA-ECMO) weaning in
patients with cardiogenic shock. However, the literature is limited and
presents conflicting results. We aimed to assess the benefits of
levosimendan on VA-ECMO for time to successful ECMO weaning, using a
pragmatic and rigorous definition of successful VA-ECMO weaning in
patients with potential for cardiac function recovery. <br/>Method(s): A
retrospective bicentric study over 6 years was conducted, including
patients who received levosimendan during their ECMO course. Patients with
post-cardiotomy cardiogenic shock or end-stage chronic heart failure were
excluded. Patients receiving levosimendan while on VA-ECMO were matched to
those not receiving levosimendan during the same period, based on
pre-specified variables and time from ECMO initiation. The primary
endpoint was successful VA-ECMO weaning, defined as survival without
death, heart transplantation, or LVAD within 30 days after VA-ECMO
withdrawal. <br/>Result(s): Over the study period, 320 patients treated
with VA-ECMO for refractory cardiogenic shock were included, of whom 68
received levosimendan during their ECMO course. Propensity score matching
yielded 47 unique pairs of patients with comparable characteristics. After
matching, successful ECMO weaning was achieved in 16 out of 47 patients
(34%) in the no-levosimendan group and 21 out of 47 patients (45%) in the
levosimendan group (sHR, 1.45 [95% CI, 0.77-2.70]; P = 0.25). Similarly,
there were no significant differences between the groups in terms of
bridge-to-heart transplant, LVAD, or death. Left ventricular ejection
fraction and aortic velocity time integral improved significantly after
levosimendan in all patients, regardless of their VA-ECMO weaning status.
<br/>Conclusion(s): In patients with non-postoperative cardiogenic shock
supported by peripheral VA-ECMO, levosimendan was not associated with
increased rates of successful VA-ECMO weaning or improved 30-day and
6-month bridge-free survival. Results from double-blinded randomized
controlled trials are urgently needed to clarify the effectiveness and
optimal timing of levosimendan in this specific population.<br/>Copyright
&#xa9; The Author(s) 2025.

<95>
Accession Number
2034220147
Title
Sex-related outcomes during short-term mechanical circulatory support: A
systematic review and meta-analysis of propensity-score matched studies.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Luiz L.; Mesadri Gewehr D.; Picado-Loaiza S.; Ohashi L.; Goebel N.; Rylski
B.; Ayala R.
Institution
(Luiz) Department of Medicine, University of the Region of Joinville,
Joinville, Brazil
(Mesadri Gewehr) Curitiba Heart Institute, Curitiba, Brazil
(Picado-Loaiza) Department of Cardiovascular Surgery, Hospital Mexico, San
Jose, Costa Rica
(Ohashi) Department of Cardiovascular Surgery, Federal University Sao
Paulo, Sao Paulo, Brazil
(Goebel, Rylski, Ayala) Department of Cardiovascular Surgery, Robert Bosch
Hospital, Stuttgart, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: The association between sex and cardiovascular risk and
different responses to heart failure therapies is well established.
However, sex related outcomes of different types of short-term mechanical
circulatory support (MCS) therapy remains controversial. <br/>Method(s):
We performed a systematic review and meta-analysis of studies comparing
outcomes of MCS between sexes. We restricted inclusion to propensity score
matched studies to minimize the risk of confounding. We pooled binary and
continuous outcomes with odds ratio (OR) and mean differences (MD),
respectively, under a random effects model. <br/>Result(s): We pooled 6
propensity score matched studies evaluating sex related outcomes during
short-term MCS, with 18,720 patients, of whom 9442 (50.5%) were male and
9278 (49.5%) were female. Subgroup analysis showed higher 30-day mortality
during ECMO (OR 1.11; 95% CI 1.01-1.22; p =.038; I² = 0%) in
males, but lower 30-day mortality during Impella therapy than females (OR
0.87; 95% CI 0.80-0.94; p =.001; I² = 0%). Males had a higher
need of myocardial revascularization (OR 3.09; 95% CI 1.56-5.99; p =.001;
I² = 0%), but a higher risk of acute kidney injury (OR 1.20;
95% CI 1.09-1.31; p <.001; I² = 18%). <br/>Conclusion(s):
In-hospital and 30-day mortality were similar between females and
males.<br/>Copyright &#xa9; The Author(s) 2025.

<96>
Accession Number
2038348036
Title
A Systematic Review and Expert Recommendation on the Diagnosis of
Pulmonary Hypertension Associated With Lung Disease: A Position Paper of
the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).
Source
Archivos de Bronconeumologia. (no pagination), 2025. Date of Publication:
2025.
Author
Rodriguez-Chiaradia D.A.; Torres-Castro R.; Piccari L.; Garcia-Ortega A.;
Perez-Penate G.M.; de Miguel-Diez J.; Perez-Rojo R.; Cano-Pumarega I.;
Mora-Cuesta V.; Blanco I.; Figueira-Goncalves J.M.; del Pozo R.;
Lopez-Meseguer M.; Martinez-Menaca A.; Tenes A.; Molina-Molina M.; Barbera
J.A.
Institution
(Rodriguez-Chiaradia, Piccari) Pulmonology Department, Hospital del Mar,
Hospital del Mar Research Institute, Universitat Pompeu Fabra, CIBERES,
(ISCIII), Barcelona, Spain
(Torres-Castro) Pulmonology Department, Hospital Clinic de
Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Departamento de
Kinesiologia, Universidad de Chile, Santiago, Chile
(Garcia-Ortega) Pulmonology Department, Hospital Doctor Peset, Fundacion
para el Fomento de la Investigacion Sanitaria de la Comunidad Valenciana
(FISABIO), Valencia, Spain
(Perez-Penate) Pulmonary Vascular Unit, Pulmonology Department, Hospital
Universitario de Gran Canaria "Dr Negrin", Spain
(de Miguel-Diez) Pulmonology Department, Hospital General Universitario
Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon
(IiSGM), Universidad Complutense de Madrid, CIBER de Enfermedades
Respiratorias (CIBERES), Madrid, Spain
(Perez-Rojo) Pulmonology Department, Hospital Universitario 12 de Octubre,
Fundacion Investigacion Biomedica Hospital Universitario 12 de Octubre,
Madrid, Spain
(Cano-Pumarega, Tenes) Pulmonology Department, Hospital Universitario
Ramon y Cajal, Madrid, Spain
(Cano-Pumarega, Tenes) IRYCIS, Instituto Ramon y Cajal de investigacion
sanitaria, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de
Salud Carlos III, Madrid, Spain
(Mora-Cuesta, Martinez-Menaca) Pulmonology Department, Hospital
Universitario Marques de Valdecilla - IDIVAL, Cantabria, Santander, Spain
(Mora-Cuesta, Lopez-Meseguer, Martinez-Menaca) ERN-LUNG (European
Reference Network on Rare Respiratory Diseases), Spain
(Blanco, Barbera) Pulmonology Department, Hospital Clinic de
Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Spain
(Blanco, Barbera) CIBERES, ERN-LUNG (European Reference Network on Rare
Respiratory Diseases), Spain
(Figueira-Goncalves) Pulmonology Department, Hospital Universitario
Nuestra Senora de Candelaria, Santa Cruz de Tenerife, Spain
(del Pozo) Pulmonology Department, Hospital Juan Ramon Jimenez, Huelva,
Spain
(Lopez-Meseguer) Pulmonology Department, Hospital Vall d'Hebron,
Barcelona, CIBERES, Spain
(Molina-Molina) Interstitial Lung Diseases Unit (UFIP), Pulmonology
Department, Hospital Universitario de Bellvitge, Instituto de
Investigacion Biomedica de Bellvitge (IDIBELL), CIBER de Enfermedades
Respiratorias (CIBERES), Barcelona, Spain
Publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
Abstract
Pulmonary hypertension (PH) is a common complication of chronic
respiratory diseases (CRD) associated with increased morbidity and
mortality. Early and individualized identification of PH in these patients
is crucial to better understand the evolution of the disease and to assess
the application of therapeutic measures aimed at its control. However,
there is no consensus on how to approach the diagnostic process. The
scarce scientific evidence in this field justifies the creation of this
SEPAR position paper, which aims to become a tool to aid in the diagnosis
of PH associated with CRD that facilitates decision making for the benefit
of patients and the optimization of resources. A panel of 16 SEPAR experts
has identified three critical questions. The answers to these questions
were developed by the panel members, who were divided into three groups
according to their expertise in the underlying disease in question:
chronic obstructive pulmonary disease, interstitial lung disease and
obesity hypoventilation syndrome. Prior to the discussion and drafting of
the document by each group, a systematic review of the literature was
performed according to the guidelines recommended by the Preferred
Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). We
generated a schematic proposal adjusted to the characteristics of each
disease for the diagnostic approach to PH associated with respiratory
disease.<br/>Copyright &#xa9; 2025 SEPAR

<97>
Accession Number
2038328919
Title
Design of a randomised, placebo-controlled, double-blind multicentre study
assessing the effect of colchicine on the incidence of knee or hip
replacements in symptomatic knee or hip osteoarthritis: the ECHO trial.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e098096. Date of
Publication: 14 Apr 2025.
Author
Heijman M.W.J.; Van Den Ende C.H.M.; Cornel J.H.; Smolders J.M.H.; Schers
H.J.; Kievit W.; Koeter S.; Van Den Bemt B.J.F.; Popa C.D.
Institution
(Heijman, Van Den Ende) Department of Research, Sint Maartenskliniek,
Nijmegen, Netherlands
(Heijman, Van Den Ende, Popa) Department of Rheumatology, Radboud
University Medical Center, Nijmegen, Netherlands
(Cornel) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Dutch Network for Cardiovascular Research (WCN), Utrecht,
Netherlands
(Smolders) Department of Orthopedics, Sint Maartenskliniek, Nijmegen,
Netherlands
(Schers) Department of Primary and Community Care, Radboud University
Medical Center, Nijmegen, Netherlands
(Kievit) Department of Health Evidence, Radboud University Medical Center,
Nijmegen, Netherlands
(Koeter) Department of Orthopedics, Canisius Wilhelmina Hospital,
Nijmegen, Netherlands
(Van Den Bemt) Department of Pharmacy, Sint Maartenskliniek, Nijmegen,
Netherlands
(Van Den Bemt) Department of Pharmacy, Radboud University Medical Center,
Nijmegen, Netherlands
(Popa) Department of Rheumatology, Sint Maartenskliniek, Nijmegen,
Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Osteoarthritis (OA) is a multifactorial disease in which
low-grade inflammation is considered to play a pivotal role. Although
colchicine is a widely used anti-inflammatory drug in the treatment of
gout, its effect in OA is still disputed due to inconsistent results of
short-term clinical trials. Therefore, we aim to evaluate the effect of
long-term colchicine 0.5 mg once daily on the incidence of knee or hip
replacements in patients with knee or hip OA. Methods and analysis The
ECHO trial is a prospective, multicentre, randomised, double-blind,
placebo-controlled, phase III trial in which 1200 participants with knee
or hip OA tolerant to colchicine during a 30-day run-in period will be 1:1
randomised to colchicine 0.5 mg once daily or matching placebo using
concealed allocation. The primary endpoint is the time from randomisation
to the first knee or hip replacement assessed up to 4.5 years. Secondary
endpoints include course of pain, physical function, joint space
narrowing, low-grade inflammation, quality of life, clinical or
radiological onset of OA in a new joint group other than present at
baseline, number of participants using pain medication during the study,
onset of new cardiovascular events (ie, myocardial infarction,
ischaemia-driven coronary revascularisation, ischaemic stroke, peripheral
artery disease or cardiovascular death) and direct and indirect costs
related to treatment and disease burden due to OA. Harm-related endpoints
include the number of (serious) adverse events, the number of withdrawals
due to (serious) adverse events and changes in laboratory data (ie, serum
creatinine, estimated glomerular filtration rate and alanine transferase)
throughout the study. The primary analysis will be performed according to
the intention-to-treat principle. Ethics and dissemination This trial has
been approved by the Medical Ethics Review Committee East-Netherlands.
Findings will be presented at scientific meetings and published in a
peer-reviewed scientific journal. Trial registration number
NCT06578182.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY. Published by BMJ Group.

<98>
Accession Number
647064174
Title
Transcatheter vs. surgical aortic valve replacement in women: the RHEIA
trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 02
Apr 2025.
Author
Tchetche D.; Pibarot P.; Bax J.J.; Bonaros N.; Windecker S.; Dumonteil N.;
Nietlispach F.; Messika-Zeitoun D.; Pocock S.J.; Berthoumieu P.; Swaans
M.J.; Timmers L.; Rudolph T.K.; Bleiziffer S.; Leroux L.; Modine T.; van
der Kley F.; Auffret V.; Tomasi J.; Stastny L.; Hengstenberg C.; Andreas
M.; Leclercq F.; Gandet T.; Mascherbauer J.; Trescher K.; Prendergast B.;
Vasa-Nicotera M.; Chieffo A.; Mares J.; Wesselink W.; Rakova R.; Kurucova
J.; Bramlage P.; Eltchaninoff H.
Institution
(Tchetche, Dumonteil) Groupe Cardiovasculaire Interventionnel, Clinique
Pasteur ,45 avenue de Lombez, France
(Pibarot) Department of Cardiology, Quebec Heart & Lung Institute, Laval
University, Quebec City, QC, Canada
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Bonaros, Stastny) Department of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
(Nietlispach) Hirslanden Klinik Im Park, HeartCenter Im Park, Zurich,
Switzerland
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Pocock) Department of Medical Statistics, London School of Hygiene &
Tropical Medicine, London, United Kingdom
(Berthoumieu) Department of Cardiac and Thoracic Surgery, Toulouse, France
(Swaans) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Timmers) Department of Cardiology, St Antonius Ziekenhuis Nieuwegein,
Nieuwegein, Netherlands
(Rudolph) Clinic for General and Interventional Cardiology/Angiology,
Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
(Bleiziffer) Department of Thoracic and Cardiovascular Surgery, Heart and
Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
(Leroux) Department of Interventional Cardiology, Cardiology Hospital of
the Haut-Leveque, University of Bordeaux, Pessac, France
(Modine) Service Medico-chirurgical de cardiologie, CHU de Bordeaux,
Pessac, France
(van der Kley) Hart Long Centrum, Leids Universitair Medisch Centrum,
Leiden, Netherlands
(Auffret) Service de Cardiologie, CHU de Rennes, Universite de Rennes 1,
Rennes, France
(Tomasi) Chirurgie thoracique, cardiaque et vasculaire, CHU Rennes-Hopital
de Pontchaillou, Rennes, France
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Medical University of Vienna, Vienna, Austria
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Leclercq) Department of Cardiology, Montpellier University Hospital,
Montpellier, France
(Gandet) CHU Montpellier-Hopital Arnaud de Villeneuve, Montpellier, France
(Mascherbauer) Department of Internal Medicine 3/Cardiology, University
Hospital Sankt Polten, Karl Landsteiner University of Medical Science,
Austria
(Trescher) Department of Heart Surgery, University Hospital Sankt Polten,
Karl Landsteiner University of Medical Science, Austria
(Prendergast) St. Thomas' Hospital, London, United Kingdom
(Vasa-Nicotera) Cardiology Department, Hospital Sindelfingen-Boblingen,
Sindelfingen, Germany
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Mares) Department of Data Science, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Wesselink, Rakova, Kurucova) Medical Affairs, Edwards Lifesciences,
Prague, Czechia
(Bramlage) Institute for Pharmacology and Preventive Medicine,
Cloppenburg, Germany
(Eltchaninoff) Inserm U1096, CHU Rouen, Department of Cardiology, Univ
Rouen Normandie, Rouen, France
Abstract
BACKGROUND AND AIMS: Although women with severe symptomatic aortic
stenosis have more complications than men when undergoing surgical valve
replacement, they are under-represented in clinical trials. The Randomized
researcH in womEn all comers wIth Aortic stenosis (RHEIA) trial
investigates the balance of benefits and risks of transcatheter aortic
valve implantation (TAVI) vs. surgery in women. <br/>METHOD(S): Women were
randomized 1:1 to transfemoral TAVI with a balloon-expandable valve or
surgery. The primary composite endpoint was death, stroke, or (valve,
procedure or heart failure related) rehospitalization at 1 year.
Non-inferiority testing with a pre-specified 6% margin and superiority
testing were performed in the as-treated population. <br/>RESULT(S): At 48
European centres, 443 women underwent randomization, and 420 were treated
as randomized. Mean age was 73 years, and the mean estimated surgical risk
of death was 2.1% (Society of Thoracic Surgeons risk score). Kaplan-Meier
estimates of the primary endpoint event rates at 1 year were 8.9% in the
TAVI and 15.6% in the surgery group. This difference of -6.8% with an
upper 95% confidence limit of -1.5% demonstrated the non-inferiority of
TAVI (P < .001). The two-sided 95% confidence interval of -13.0% to -.5%
further resulted in superiority (P = .034). The 1-year incidence of the
primary endpoint components was: .9% with TAVI vs. 2.0% with surgery for
death from any cause, 3.3% vs. 3.0% for stroke, and 5.8% vs. 11.4% for
rehospitalization. <br/>CONCLUSION(S): Among women with severe aortic
stenosis, the incidence of the composite of death, stroke, or
rehospitalization at 1 year was lower with TAVI than with surgery.
CLINICALTRIALS.GOV NUMBER: NCT04160130.<br/>Copyright &#xa9; The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved. For commercial re-use, please
contact reprints@oup.com for reprints and translation rights for reprints.
All other permissions can be obtained through our RightsLink service via
the Permissions link on the article page on our site-for further
information please contact

<99>
Accession Number
2038332239
Title
Family Socioeconomic Status and Neurodevelopment Among Patients With
Dextro-Transposition of the Great Arteries.
Source
JAMA Network Open. 7(11) (no pagination), 2024. Article Number: e2445863.
Date of Publication: 19 Nov 2024.
Author
Cassidy A.R.; Rofeberg V.; Bucholz E.M.; Bellinger D.C.; Wypij D.;
Newburger J.W.
Institution
(Cassidy) Mayo Clinic, 200 First St SW, Rochester, MN, United States
(Cassidy) Department of Psychiatry and Psychology, Mayo Clinic, Rochester,
MN, United States
(Cassidy) Department of Pediatric and Adolescent Medicine, Mayo Clinic,
Rochester, MN, United States
(Rofeberg, Wypij, Newburger) Department of Cardiology, Boston Children's
Hospital, Boston, MA, United States
(Bucholz) Section of Cardiology, Department of Pediatrics, University of
Colorado School of Medicine, Aurora, United States
(Bellinger) Department of Neurology, Boston Children's Hospital, Harvard
Medical School, Boston, MA, United States
(Bellinger) Department of Psychiatry and Behavioral Sciences, Boston
Children's Hospital, Harvard Medical School, Boston, MA, United States
(Newburger) Department of Pediatrics, Harvard Medical School, Boston, MA,
United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
American Medical Association
Abstract
Key Points Question How is socioeconomic status (SES) associated with the
neurodevelopment over time of individuals with dextro-transposition of the
great arteries (d-TGA)? Findings In this cohort study of 164 patients with
d-TGA evaluated at 1, 4, 8, and 16 years, lower SES was associated with
worse neurodevelopmental outcomes from early childhood through
adolescence. Declining neurodevelopmental status over time was associated
with lower SES tertile and younger maternal age at childbirth. Meaning
Findings of this study suggest that neurodevelopmental monitoring and
intervention services should be intensified for children with critical
congenital heart disease, such as d-TGA, and low SES. IMPORTANCE Data are
limited on the longitudinal implications of socioeconomic status (SES) for
neurodevelopmental outcomes among persons with complex congenital heart
disease (CHD). OBJECTIVES To examine the association of family SES,
maternal educational level, and maternal IQ with the neurodevelopment of
individuals with dextro-transposition of the great arteries (d-TGA) from
age 1 to 16 years and to identify how SES-related disparities change with
age. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed data of
participants enrolled in the Boston Circulatory Arrest Study, a randomized
clinical trial conducted in Boston, Massachusetts, from 1988 to 1992.
Participants were infants with d-TGA who underwent arterial switch
operation and, after operation, underwent in-person neurodevelopmental
status evaluations at ages 1, 4, 8, and 16 years. Analyses were conducted
from April 2021 to August 2024. EXPOSURES Mean Hollingshead scores at
birth, age 1 year, and age 4 years were used to assign participants to SES
tertiles (lowest, middle, or highest). MAIN OUTCOMES AND MEASURES
Age-appropriate neurodevelopmental outcomes assessed at 4 study time
points (ages 1, 4, 8, and 16 years) via in-person administration of a
range of well-validated measures. Standardized neurodevelopmental
composite scores from each evaluation were derived from principal
component analysis and compared across SES tertiles, adjusting for birth
and medical characteristics. These scores were used to categorize the
sample into latent classes; patient and medical factors for a 3-class
model were used to estimate latent class using multinomial regression.
RESULTS The sample included 164 patients with d-TGA (123 males [75%]; mean
[SD] gestational age at birth, 39.8 [1.2] weeks; 3 with Asian [2%], 6 with
Black [4%], 5 with Hispanic [3%], and 146 with White [89%] race and
ethnicity) and their mothers (mean [SD] age at birth, 28.5 [5.2] years).
Lower SES tertile was associated with worse scores on most individual
neurodevelopmental tests and worse neurodevelopmental composite scores at
ages 4, 8, and 16 years. For example, mean (SD) neurodevelopmental
composite scores at age 4 years were -0.49 [0.83] for lowest, 0.00 [0.81]
for middle, and 0.47 [1.10] for highest SES tertile (F<inf>2</inf> = 15.5;
P < .001). When measured at consecutive time points, differences between
SES tertiles were of similar magnitude. A latent class analysis produced
2- and 3-class models representing patients with stable (103 [64%] and 85
[53%]), improving (20 [13%]), and declining (57 [36%] and 55 [34%])
neurodevelopmental status. Those experiencing declines in
neurodevelopmental status were more likely to have younger maternal age at
childbirth (26.6 [5.1] vs 29.6 [4.9] and 29.1 [5.1] years; P = .002),
lower maternal IQ (91.0 [14.1] vs 100.1 [11.1] and 96.2 [11.0]; P < .001),
and lower SES (35.2 [10.8] vs 40.9 [9.9] and 35.8 [10.1]; P = .003)
compared with those with stable or improving status. CONCLUSIONS AND
RELEVANCE This cohort study of individuals with d-TGA found an association
between lower family SES and worse neurodevelopmental outcomes in
childhood and continuing throughout adolescence as well as greater decline
in neurodevelopmental status over time. Effective strategies are needed to
improve access to neurodevelopmental monitoring and intervention services
for children with CHD from lower socioeconomic backgrounds.<br/>Copyright
&#xa9; 2024 Cassidy AR et al. JAMA Network Open.

<100>
Accession Number
2038334163
Title
Compare the Intra-Operative Hemodynamics and the Perioperative Analgesic
Efficacy of Superficial Sapb, to Deep SAPB, and to Thoracic Epidural
Analgesia in Thoracotomies.
Source
Pakistan Journal of Medical and Health Sciences. 17(12) (pp 184-187),
2023. Date of Publication: 01 Dec 2023.
Author
Tahir I.; Zia M.; Yaseen H.M.W.; Khawaja A.Z.; Maqbool S.; Zaidi S.I.A.
Institution
(Tahir) Department of Thoracic Surgery, Hayatabad Medical Complex
Peshawar, Pakistan
(Zia) ICU Madina Teaching Hospital, Punjab Medical College Faisalabad,
Pakistan
(Yaseen) Anesthesia and Critical Care Niazi Medical College Sargodha,
Pakistan
(Khawaja) Anesthesia Punjab Rangers Teaching Hospital, RMDC Lahore,
Pakistan
(Maqbool) Department of Anesthesia Allied Hospital, Faisalabad Medical
University Faisalabad, Pakistan
(Zaidi) Department of Anesthesiology & Intensive Care, Avicenna Medical
College & Hospital, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Pain management following thoracotomy is still difficult
because of its severity and complications. SAPB is getting popular as a
procedure to replace TEA in the management of postoperative pain.
<br/>Objective(s): The aim of this study was to compare the intraoperative
effectiveness and safety of perioperative analgesic effect of superficial
SAPB, deep SAPB, and TEA in patients undergoing thoracic surgeries.
<br/>Material(s) and Method(s): This randomized controlled trial was
performed on 60 patients undergoing thoracotomy at the Department of
Surgery, Civil Hospital Bahawalpur, from January to June 2022. Patients
were randomized into three groups: SAPB were defined as superficial SAPB,
deep SAPB, and TEA. Intraoperative systolic and diastolic BP,
postoperative pain scores at 1, 6 and 12 hours,heart rate, time to first
rescue analgesia, total postoperative analgesia, duration of surgery, and
hospital stay were key outcomes. The data were analysed using one-way
ANOVA and Tukey's post hoc test, p <= 0.05 was deemed to be significant.
<br/>Result(s): Mean age was 41 (+/-13.72) years and mean BMI was 24.44
(+/-3.18). There differences among groups was insignificant (p > 0.05) in
intraoperativeheart rate or BP. Diastolic blood pressure was significantly
different (p = 0.030). There were no significant differences in each group
with respect to postoperative pain scores, time to first rescue analgesic
and total analgesic consumption (p > 0.05). Duration of surgery and
hospital stay to recovery outcomes were also comparable (p > 0.05).
<br/>Conclusion(s): Both superficial and deep SAPB provide comparable
analgesic efficacy and hemodynamic stability to TEA in thoracic surgeries.
SAPB offers a safe and effective alternative, particularly for patients
with contraindications to TEA.<br/>Copyright &#xa9; 2023 Lahore Medical
And Dental College. All rights reserved.

<101>
Accession Number
2034219237
Title
Beyond the Incision: Understanding Catheter Induced Coronary Artery
Dissection.
Source
Current Treatment Options in Cardiovascular Medicine. 27(1) (no
pagination), 2025. Article Number: 31. Date of Publication: 01 Dec 2025.
Author
Geeslin D.; Addington M.; Trotman D.; Alexander J.; Ammon J.; Adeboye A.
Institution
(Geeslin, Ammon) Department of Internal Medicine, University of Tennessee
Health Science Center, Memphis, TN, United States
(Addington, Trotman, Alexander, Adeboye) Department of Cardiology,
University of Tennessee Health Science Center, Memphis, TN, United States
(Adeboye) Department of Cardiology, Lt. Col. Luke Weathers, Jr. VA Medical
Center, Memphis, TN, United States
Publisher
Springer
Abstract
Purpose of Review: Catheter Induced Coronary Artery Dissection (CICAD) is
a rare but potentially life-threatening complication of cardiac
catheterization and percutaneous coronary intervention (PCI). This review
explores CICAD, covering its incidence, pathophysiology, risk factors,
clinical presentation, management strategies, and clinical outcomes. This
review aims to enhance cardiovascular clinicians in their understanding of
CICAD, aiding in improving prevention, management strategies, and clinical
outcomes for all patients. Recent Findings: Incidence estimates were
variable, with potential underreporting and underestimation. Patient
independent risk factors included catheter types, catheter sizes, and
procedural complexities. Patient dependent risk factors include
hypertension, diabetes mellitus, hyperlipidemia, and female sex. Clinical
presentations of CICAD encompassed a spectrum from asymptomatic cases to
life-threatening emergencies. Preventative methods include catheter
selection, catheter placement, limiting torque, and careful use of
contrast injection. Trans-radial approach (TRA) compared to the
transfemoral access (TFA) showed no increased risk in years when the TRA
was the predominant selection. Management strategies have varied over time
with the development of new technologies and operator experience, but
range from conservative approaches to stenting and surgical interventions.
As interventional techniques and devices continue to develop there seems
to be limited scenarios where stenting is not the preferred option to
treat CICAD. <br/>Summary: This review emphasizes the importance of
understanding CICAD for enhancing patient safety during invasive
cardiovascular procedures. A compelling need arises for large-scale,
diverse studies to provide more precise estimates of CICAD incidence,
refine our understanding of risk profiles, and facilitate the development
of evidence-based strategies for its prevention and
management.<br/>Copyright &#xa9; The Author(s) 2025.

<102>
Accession Number
2034220669
Title
Combined Catheter Ablation and Left Atrial Appendage Occlusion in Atrial
Fibrillation: From Data to Clinical Reality.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Dimitriadis K.; Adamopoulou E.; Pyrpyris N.; Iliakis P.; Beneki E.;
Konstantinidis D.; Fragkoulis C.; Antonopoulos A.; Papanikolaou A.;
Aznaouridis K.; Aggeli K.; Tsioufis K.
Institution
(Dimitriadis, Adamopoulou, Pyrpyris, Iliakis, Beneki, Konstantinidis,
Fragkoulis, Antonopoulos, Papanikolaou, Aznaouridis, Aggeli, Tsioufis)
First Department of Cardiology, School of Medicine, National and
Kapodistrian University of Athens, Hippokration General Hospital, Vas
Sofias 114, Athens, Greece
Publisher
Springer
Abstract
Purpose: Atrial fibrillation (AF) requires treatment that focuses on two
main goals: symptom control and prevention of thromboembolic events.
Catheter ablation and left atrial appendage occlusion (LAAO) constitute
two well-established treatment methods in selected patients that
accomplish these two goals correspondingly. Recently, there is increasing
interest in performing the two procedures concomitantly in a so-called
"combined" or "one-stop" procedure. This review aims to summarize the
current data on the combined procedure, from the rationale and the
techniques to its clinical efficacy, indications and future directions.
<br/>Method(s): An extensive search has been conducted using the
MEDLINE/PubMed database to identify the relevant studies. <br/>Result(s):
The reported success rates of the combined procedure are very high and
frequently reach 100% when performed by experienced operators. The
periprocedural and follow-up complications are low, the procedure is
cost-effective, while there is significant stroke, bleeding and arrhythmia
incidence reduction that does not seem to be undermined by interference
between the two interventions. There are also a few indications that the
one-stop procedure has a positive effect on left atrial mechanical
function as it has been correlated with left atrial reverse remodeling. On
the other hand, some studies suggest possible increase in peri-device
leaks (PDLs), compared with LAAO alone, which could in turn negatively
affect the clinical outcomes. Most available studies are small and
observational, with a lack of randomized controlled trials.
<br/>Conclusion(s): Catheter ablation and left atrial appendage occlusion
can be safely and effectively combined in a cost-effective single
procedure in carefully selected patients.<br/>Copyright &#xa9; The
Author(s) 2025.

<103>
Accession Number
2038348421
Title
Left Atrial Appendage Occlusion in Solid Organ Transplant Patients.
Source
JACC: Case Reports. (no pagination), 2025. Article Number: 103295. Date
of Publication: 2025.
Author
Dunham A.J.; Noom M.; Hawk F.; Casals L.; Koelmeyer H.; Sequeira A.R.;
Mehta V.; Chandran K.; Mehta J.J.; Mohanty B.D.
Institution
(Dunham, Noom) University of South Florida Morsani College of Medicine,
Tampa, FL, United States
(Hawk, Sequeira, Mehta, Chandran, Mohanty) Division of Cardiovascular
Sciences, University of South Florida Morsani College of Medicine, Tampa,
FL, United States
(Casals, Koelmeyer) Division of Internal Medicine, University of South
Florida Morsani College of Medicine, Tampa, FL, United States
(Mehta) Division of Cardiology, Department of Medicine, University of
Florida Malcolm Randall Department of Veterans Affairs Medical Center,
Gainesville, FL, United States
Publisher
Elsevier Inc.
Abstract
Percutaneous left atrial appendage occlusion (LAAO) is increasingly used
to provide nonpharmacologic stroke prevention in patients with atrial
fibrillation, particularly patients at high risk for complications of
anticoagulation. Randomized controlled trials establishing LAAO safety and
efficacy excluded solid organ transplantation recipients; thus, the role
of LAAO in these patients is poorly understood. We present a series of
patients with a history of solid organ transplantation who underwent LAAO
and include patient-level data on indication, safety, and long-term
outcomes. Our cohort demonstrated excellent efficacy and procedural safety
with successful implantation in all cases, no major periprocedural
complications, and successful discontinuation of systemic
anticoagulation.<br/>Copyright &#xa9; 2025 The Authors

<104>
Accession Number
2038348900
Title
Stroke in Heart Failure With Reduced Ejection Fraction: Systematic Review
and Meta-Analysis of Randomized Trials.
Source
JACC: Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Gallone G.; Savoca F.; Miccoli D.; Bohm M.; De Ferrari G.M.; Gottlieb
S.S.; Lancellotti P.; Lindenfeld J.; Saldarriaga C.; Samad Z.; Teerlink
J.R.; Savarese G.; Ammirati E.
Institution
(Gallone, Savoca, Miccoli, De Ferrari) Division of Cardiology,
Cardiovascular and Thoracic Department, Citta della Salute e della
Scienza, Turin, Italy
(Gallone, Savoca, Miccoli, De Ferrari) Department of Medical Sciences,
University of Turin, Italy
(Bohm) Clinic III for Internal Medicine (Cardiology, Angiology, and
Intensive Care Medicine) Saarland University, Homburg/Saar, Germany
(Gottlieb) Division of Cardiovascular Medicine, University of Maryland
School of Medicine and Baltimore, Veterans Administration Medical Center,
Baltimore, MD, United States
(Lancellotti) University of Liege Hospital, GIGA Institute, Department of
Cardiology, CHU SartTilman, Liege, Belgium
(Lindenfeld) Division of Cardiovascular Medicine, Vanderbilt University
Medical Center, Nashville, TN, United States
(Saldarriaga) CardioVID Clinic, University of Antioquia, Medellin,
Colombia
(Samad) The Aga Khan University, Karachi, Pakistan
(Teerlink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center, School of Medicine, University of California San Francisco, San
Francisco, CA, United States
(Savarese) Department of Clinical Science, Sodersjukhuset; Karolinska
Institutet, Stockholm, Sweden
(Ammirati) De Gasperis Cardio Center, Transplant Center, Niguarda
Hospital, Milano, Italy
(Ammirati) Department of Health Sciences, University of Milano-Bicocca,
Monza, Italy
Publisher
Elsevier Inc.
Abstract
Background: Patients with heart failure with reduced ejection fraction
(HFrEF) have a heightened stroke risk. However, stroke as an endpoint in
heart failure trials remains under-reported. <br/>Objective(s): The
authors sought to define the incidence, characteristics, predictors,
modifier treatments, and prognostic impact of stroke in patients with
HFrEF who were enrolled in randomized controlled trials (RCTs).
<br/>Method(s): The authors systematically reviewed MEDLINE for RCTs of
pharmacologic and nonpharmacologic treatments in HFrEF. The annualized
stroke incidence was the primary outcome. Subgroup analyses and
meta-regressions were performed to determine the baseline modulating
characteristics and to assess the association of stroke with other
clinical outcomes. <br/>Result(s): Of 7,104 records, 188 RCTs fulfilled
inclusion criteria for the systematic review. Of these, 158 studies
(84.0%) did not report stroke outcomes and were excluded from the
meta-analysis, leading to a final cohort of 30 studies, with 61 arms and
75,327 patients. Stroke incidence was 1.1% (95% CI: 0.9%-1.3%;
I²: 74%) with high heterogeneity across trials. Higher NYHA
functional class (P < 0.001), lower systolic blood pressure (P < 0.001),
diuretic use (P = 0.001), and diabetes (P < 0.001) were associated with
stroke. No association of renin-angiotensin-aldosterone inhibitors,
beta-blockers, mineralocorticoid receptor antagonists, and transcatheter
mitral valve replacement with stroke was observed. Stroke was associated
with higher risk of all-cause and cardiovascular mortality, heart failure
hospitalization and acute coronary syndromes (P < 0.001 for all).
<br/>Conclusion(s): Stroke was reported in a vast minority of HFrEF RCTs
with heterogeneous definitions and no reference to underlying mechanisms.
Despite under-reporting, stroke incidence is non-negligible. Stroke is
associated with HFrEF-specific characteristics and outcomes, whereas it is
not impacted by current HFrEF treatments. There is a need for dedicated
research into preventive strategies and effective treatments to address
this debilitating and deadly comorbidity. (Stroke Events in Heart Failure
With Reduced Ejection Fraction-A Systematic Review and Meta-Analysis of
Pharmacologic Randomized Trial; CRD42023418422)<br/>Copyright &#xa9; 2025
American College of Cardiology Foundation

<105>
[Use Link to view the full text]
Accession Number
647046720
Title
Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve
Implantation.
Source
The New England journal of medicine. (no pagination), 2025. Date of
Publication: 29 Mar 2025.
Author
Raposeiras-Roubin S.; Amat-Santos I.J.; Rossello X.; Gonzalez Ferreiro R.;
Gonzalez Bermudez I.; Lopez Otero D.; Nombela-Franco L.; Gheorghe L.; Diez
J.L.; Baladron Zorita C.; Baz J.A.; Munoz Garcia A.J.; Vilalta V.;
Ojeda-Pineda S.; de la Torre Hernandez J.M.; Cordoba Soriano J.G.;
Regueiro A.; Bordes Siscar P.; Salgado Fernandez J.; Garcia Del Blanco B.;
Martin-Reyes R.; Romaguera R.; Moris C.; Garcia Blas S.; Franco-Pelaez
J.A.; Cruz-Gonzalez I.; Arzamendi D.; Romero Rodriguez N.; Diez-Del Hoyo
F.; Camacho Freire S.; Bosa Ojeda F.; Astorga Burgo J.C.; Molina Navarro
E.; Caballero Borrego J.; Ruiz Quevedo V.; Sanchez-Recalde A.; Peral
Disdier V.; Alegria-Barrero E.; Torres-Llergo J.; Feltes G.; Fernandez
Diaz J.A.; Cuellas C.; Jimenez Britez G.; Sanchez-Rubio Lezcano J.;
Barreiro-Pardal C.; Nunez-Gil I.; Abu-Assi E.; Iniguez-Romo A.; Fuster V.;
Ibanez B.
Institution
(Raposeiras-Roubin, Rossello, Fuster, Ibanez) Centro Nacional de
Investigaciones Cardiovasculares Carlos III, Madrid, Spain
(Raposeiras-Roubin, Gonzalez Ferreiro, Gonzalez Bermudez, Baz,
Iniguez-Romo) Cardiology Department, University Hospital Alvaro Cunqueiro
and Instituto de Investigacion Sanitaria Galicia Sur, Vigo, Spain
(Raposeiras-Roubin) University of Santiago de Compostela, Santiago de
Compostela, Spain
(Amat-Santos, Rossello, Lopez Otero, Baladron Zorita, Baz, Ojeda-Pineda,
Garcia Del Blanco, Garcia Blas, Cruz-Gonzalez, Iniguez-Romo, Ibanez)
Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares,
Madrid, Spain
(Amat-Santos, Baladron Zorita) Cardiology Department, University Clinical
Hospital of Valladolid, Valladolid, Spain
(Rossello, Peral Disdier) Cardiology Department, University Hospital Son
Espases and Instituto de Investigacion Sanitaria Islas Baleares, Palma de
Mallorca, Spain
(Rossello) Universitat de les Illes Balears, Palma, Spain
(Lopez Otero) Cardiology Department, University Hospital Montecelo,
Pontevedra, Spain
(Nombela-Franco, Nunez-Gil) Cardiology Department, University Clinical
Hospital San Carlos, Madrid, Spain
(Gheorghe) Cardiology Department, University Hospital Puerta del Mar,
Cadiz, Spain
(Diez) Cardiology Department, University Hospital La Fe, Valencia, Spain
(Munoz Garcia) Cardiology Department, University Hospital Virgen de la
Victoria, Malaga, Spain
(Vilalta) Cardiology Department, University Hospital German Trias i Pujol,
Badalona, Spain
(Ojeda-Pineda) Cardiology Department, University Hospital Reina Sofia,
Cordoba, Spain
(de la Torre Hernandez) Cardiology Department, University Hospital Marques
de Valdecilla and Instituto de Investigacion Sanitaria Valdecilla,
Santander, Spain
(Cordoba Soriano) Cardiology Department, University Hospital of Albacete,
Albacete, Spain
(Regueiro) Cardiology Department, University Clinical Hospital, Barcelona,
Philippines
(Bordes Siscar) Cardiology Department, University General Hospital of
Alicante, Alicante, Spain
(Salgado Fernandez) Cardiology Department, University Hospital Juan
Canalejo, A Coruna, Spain
(Garcia Del Blanco) Cardiology Department, University Hospital Vall
d'Hebron, Barcelona, Philippines
(Martin-Reyes) Cardiology Department, University Hospital La Luz, Madrid,
Spain
(Romaguera) Cardiology Department, University Hospital Bellvitge,
Barcelona, Philippines
(Moris) Cardiology Department, University Hospital Central de Asturias,
Oviedo, Spain
(Garcia Blas) Cardiology Department, University Clinical Hospital of
Valencia, Valencia, Spain
(Franco-Pelaez, Ibanez) Cardiology Department, University Hospital
Fundacion Jimenez Diaz and Instituto de Investigacion Sanitaria-Fundacion
Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
(Cruz-Gonzalez) Cardiology Department, University Clinical Hospital of
Salamanca, Salamanca, Spain
(Arzamendi) Cardiology Department, University Hospital Santa Creu i Sant
Pau, Biomedical Research Institute IIB-Sant Pau, Barcelona, Philippines
(Romero Rodriguez) Cardiology Department, University Hospital Virgen del
Rocio, Seville, Spain
(Diez-Del Hoyo) Cardiology Department, University Hospital 12 de Octubre,
Madrid, Spain
(Camacho Freire) Cardiology Department, University Hospital Juan Ramon
Jimenez, Huelva, Spain
(Bosa Ojeda) Cardiology Department, University Hospital of Canarias,
Tenerife, Spain
(Astorga Burgo) Cardiology Department, University Hospital of Cruces,
Spain
(Molina Navarro) Cardiology Department, University Hospital Virgen de las
Nieves, Granada, Spain
(Caballero Borrego) Cardiology Department, University Hospital San
Cecilio, Granada, Spain
(Ruiz Quevedo) Cardiology Department, University Hospital of Navarra,
Pamplona, Spain
(Sanchez-Recalde) Cardiology Department, University Hospital Ramon y
Cajal, Madrid, Spain
(Alegria-Barrero) Cardiology Department, University Hospital Torrejon and
University Francisco de Vitoria, Madrid, Spain
(Torres-Llergo) Cardiology Department, University Hospital of Jaen, Jaen,
Spain
(Feltes) Cardiology Department, University Hospital Vithas Arturo Soria,
Madrid, Spain
(Feltes, Nunez-Gil) University Europea of Madrid, Madrid, Spain
(Fernandez Diaz) Cardiology Department, University Hospital Puerta del
Hierro, Madrid, Spain
(Cuellas) Cardiology Department, University Hospital of Leon, Leon, Spain
(Jimenez Britez) Cardiology Department, Clinica Teknon, Barcelona,
Philippines
(Sanchez-Rubio Lezcano) Cardiology Department, University Hospital Miguel
Servet, Zaragoza, Spain
(Barreiro-Pardal) Anesthesiology Department, University Hospital
Montecelo, Pontevedra, Spain
(Nunez-Gil) Cardiology Department, University Hospital of Torrejon, Ribera
Salud Group, Madrid, Spain
(Abu-Assi) Cardiology Department, University Hospital of Povisa, Ribera
Salud Group, Vigo, Spain
(Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount
Sinai, NY, United States
Abstract
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the
risk of heart-failure admission among high-risk patients. However, most
patients with valvular heart disease, including those undergoing
transcatheter aortic-valve implantation (TAVI), have been excluded from
randomized trials. <br/>METHOD(S): We conducted this randomized,
controlled trial in Spain to evaluate the efficacy of dapagliflozin (at a
dose of 10 mg once daily) as compared with standard care alone in patients
with aortic stenosis who were undergoing TAVI. All the patients had a
history of heart failure plus at least one of the following: renal
insufficiency, diabetes, or left ventricular systolic dysfunction. The
primary outcome was a composite of death from any cause or worsening of
heart failure, defined as hospitalization or an urgent visit, at 1 year of
follow-up. <br/>RESULT(S): A total of 620 patients were randomly assigned
to receive dapagliflozin and 637 to receive standard care alone after
TAVI; after exclusions, a total of 1222 patients were included in the
primary analysis. A primary-outcome event occurred in 91 patients (15.0%)
in the dapagliflozin group and in 124 patients (20.1%) in the
standard-care group (hazard ratio, 0.72; 95% confidence interval [CI],
0.55 to 0.95; P = 0.02). Death from any cause occurred in 47 patients
(7.8%) in the dapagliflozin group and in 55 (8.9%) in the standard-care
group (hazard ratio, 0.87; 95% CI, 0.59 to 1.28). Worsening of heart
failure occurred in 9.4% and 14.4% of the patients, respectively
(subhazard ratio, 0.63; 95% CI, 0.45 to 0.88). Genital infection and
hypotension were significantly more common in the dapagliflozin group.
<br/>CONCLUSION(S): Among older adults with aortic stenosis undergoing
TAVI who were at high risk for heart-failure events, dapagliflozin
resulted in a significantly lower incidence of death from any cause or
worsening of heart failure than standard care alone. (Funded by Instituto
de Salud Carlos III and others; ClinicalTrials.gov number,
NCT04696185.).<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<106>
Accession Number
2034207377
Title
Geranylgeranylacetone as Prevention for Postoperative Atrial Fibrillation
(GENIALITY).
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
S. Ramos K.; Nassiri S.; Wijdeveld L.F.J.; van der Palen R.L.; Kuipers
M.F.; Hills M.T.; Slijkerman P.; van Raalte D.H.; Handoko M.L.; de Groot
N.M.S.; Grewal N.; Klautz R.J.M.; Eringa E.C.; Brundel B.J.J.M.
Institution
(S. Ramos, Wijdeveld, van der Palen, Eringa, Brundel) Amsterdam
Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam
University Medical Center, Location Vrije Universiteit Amsterdam, De
Boelelaan 1117, Amsterdam, Netherlands
(Nassiri, Handoko) Department of Cardiology, Amsterdam University Medical
Center, Amsterdam, Netherlands
(Kuipers) AFIP Foundation, Amsterdam, Netherlands
(Hills) Stopafib.Org, American Foundation for Women'S Health, Decatur, TX,
United States
(Slijkerman) Innovation Exchange Amsterdam, Amsterdam University Medical
Center, Amsterdam, Netherlands
(van Raalte) Diabetes Center, Department of Internal Medicine, Amsterdam
University Medical Center, Amsterdam, Netherlands
(de Groot) Department of Cardiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Leiden University
Medical Center, Leiden, Netherlands
(Eringa) Department of Physiology, Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
Publisher
Springer
Abstract
Purpose: Abstract: Interestingly, 30-50% of patients undergoing elective
cardiothoracic surgery develop postoperative AF (PoAF). Unfortunately,
preventive PoAF therapy is still suboptimal. In our previous studies, we
showed that oral Geranylgeranylacetone (GGA) administration increased
cardioprotective heat shock protein (HSP) protecting against AF onset and
progression in clinically relevant animal model studies. <br/>Method(s):
The GENIALITY study is a phase II single-center, double-blind,
placebo-controlled randomized trial comparing the efficacy of GGA in
preventing PoAF. Participants (N = 146) are adult patients, without any
registered history of AF, undergoing elective open-heart surgery for
valvular disease, coronary artery bypass grafting, or concomitant, and are
allocated with ratio 1:1 in treatment or placebo groups. Daily
administration of 300 mg of GGA or placebo starts 5 days before until 3
days after surgery. Cardiac rhythm will be monitored using a Holter
monitoring post-surgery until hospital discharge. Additionally, blood
samples, right atrial appendage tissue, and epicardial adipose tissue will
be collected to assess proteostasis levels. <br/>Result(s): The primary
endpoint is the assessment of PoAF incidence in the GGA group compared to
the placebo group. Secondary endpoints include the evaluation of HSP
levels through biochemical analysis in both blood and atrial tissue.
<br/>Conclusion(s): The GENIALITY study aims to reduce PoAF incidence in
the GGA group compared to the placebo group. Herewith, we expect to obtain
proof of concept for a beneficial effect of GGA in preventing PoAF in
patients undergoing cardiothoracic surgery. Trial Registration: Clinical
Trial Information System (CTIS) registry: 2024-514743-28-00. Authorized on
September 30th 2024.<br/>Copyright &#xa9; The Author(s) 2025.

<107>
Accession Number
2038271022
Title
Study protocol: diagnosis of atrial fibrillation in postoperative thoracic
surgery using a smartwatch, an open-label randomised controlled study
(THOFAWATCH trial).
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e097765. Date of
Publication: 09 Apr 2025.
Author
Huette P.; Beyls C.; Diouf M.; Ibrahima A.; Haye G.; Guilbart M.; Lefebvre
T.; Bayart G.; Lhotellier F.; Radji M.; Walczak K.-A.; Caboche M.; De
Dominicis F.; Georges O.; Berna P.; Merlusca G.; Hermida A.; Traulle S.;
Dupont H.; Mahjoub Y.; Abou-Arab O.; Bernasinski M.; Coupez A.; Besserve
P.; Henry A.; Daumin C.; BenAmmar A.; Leviel F.; Macq P.-Y.; Labont B.A.;
David G.; Epailly J.; Esmard P.-E.; Vernier A.; Bartoli P.; Delmas J.;
Romby S.; Marx S.; Fikri M.; Benoit-Fallet H.; Nam E.; Zakine J.; Zaatar
A.; Flet T.
Institution
(Huette, Lhotellier, Radji, Walczak, Caboche) Anesthesiology and critical
care, Pauchet sante, Victor Pauchet Clinic, Amiens, France
(Huette, Beyls, Ibrahima, Haye, Guilbart, Lefebvre, Bayart, Dupont,
Mahjoub, Abou-Arab) Amiens University Hospital, Hauts-deFrance, Amiens,
France
(Diouf) Department of Statistics, Amiens Hospital University, Amiens,
France
(De Dominicis, Georges, Merlusca) Department of Thoracic surgery, Amiens
Hospital University, Amiens, France
(Berna, Merlusca) Department of Thoracic Surgery, Pauchet sante, Victor
Pauchet Clinic, Amiens, France
(Hermida) Department of Cardiology, Amiens University hospital, Amiens,
France
(Traulle) Department of Cardiology, Victor Pauchet Clinic, Amiens, France
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative atrial fibrillation (POAF) affects
approximately 20% of patients undergoing thoracic surgery and is
associated with severe complications such as stroke, myocardial
infarction, heart failure, and increased mortality. Early diagnosis is
critical to mitigate these risks, but conventional monitoring is limited
in detecting asymptomatic episodes. Smartwatches equipped with single-lead
ECG and atrial fibrillation (AF) detection algorithms offer a novel
approach for early POAF detection. This study aims to evaluate the
effectiveness of smartwatch-based monitoring compared with standard care
in identifying POAF following thoracic surgery. Methods and analysis The
THOFAWATCH trial is a randomised, bicentric open-label study enrolling 302
adult patients undergoing major thoracic surgery (pneumonectomy or
lobectomy) with one-lung ventilation. Eligible patients will be randomised
into two groups: (1) the 'Smartwatch Monitoring' group, where participants
will undergo rhythm monitoring using a smartwatch and (2) the
'Conventional Monitoring' group, receiving standard care without
smartwatch monitoring. In the intervention group, any smartwatch-detected
POAF episodes will be confirmed by 12-lead ECG. The primary outcome is the
incidence of POAF within 7-day postsurgery. Secondary outcomes include the
rate of asymptomatic POAF, cardiovascular prognosis evaluated at 2 and 6
months (composite major adverse cardiovascular events outcome),
feasibility of smartwatch usage (device usage time and success rate of
single-lead ECGs) and recurrence or management of AF at follow-up.
Inclusion criteria include adults (>18 years) undergoing scheduled
thoracic surgery and able to use the smartwatch device. Exclusion criteria
encompass patients with prior AF, those requiring telemetry, or undergoing
reoperations. Statistical analysis will assess the primary outcome using
chi² or Fisher's exact test (alpha=5%), while secondary
outcomes will include descriptive and inferential statistics, with
analysis conducted using SAS V.9.4. Ethics and dissemination Ethical
approval for this bicentric study has been granted by the institutional
review board (IRB) of the University Hospital of Amiens (Comite de
Protection des Personnes sud-ouest et outre-mer 1, 21050 Toulouse, France,
registration number ID RDB: 2022-A02028-27 in November 2024). The trial is
registered under ClinicalTrials. gov (ID: (NCT06724718)). Results will be
disseminated through peer-reviewed publications and scientific conferences
to inform clinical practice regarding POAF detection and management
following thoracic surgery.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025.

<108>
Accession Number
647050178
Title
Cardiac Biomarkers in Patients with Asymptomatic Severe Aortic Stenosis:
Analysis from the EARLY TAVR Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 31 Mar 2025.
Author
Lindman B.R.; Pibarot P.; Schwartz A.; Oldemeyer J.B.; Su Y.R.; Goel K.;
Cohen D.J.; Fearon W.F.; Babaliaros V.; Daniels D.; Chhatriwalla A.;
Suradi H.S.; Shah P.; Szerlip M.; Mack M.J.; Dahle T.; O'Neill W.W.;
Davidson C.J.; Makkar R.; Sheth T.; Depta J.; DeVries J.T.; Southard J.;
Pop A.; Sorajja P.; Hahn R.T.; Zhao Y.; Leon M.B.; Genereux P.
Institution
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN; Division of Cardiovascular Medicine, Vanderbilt
University Medical Center, Nashville, TN
(Pibarot) Department of Cardiology, Quebec Heart and Lung Institute, Laval
University, QC, Canada
(Schwartz, Hahn) Columbia University Medical Center/NewYork-Presbyterian
Hospital, New York, NY
(Oldemeyer) University of Colorado Health, Loveland, CO, United States
(Su) Division of Cardiovascular Medicine, Vanderbilt University Medical
Center, Nashville, TN; Cardiology Core Laboratory for Translational and
Clinical Research, Vanderbilt University Medical Center, Nashville, TN
(Goel) Division of Cardiovascular Medicine, Vanderbilt University Medical
Center, Nashville, TN, United States
(Cohen) Columbia University Medical Center/NewYork-Presbyterian Hospital,
New York, NY; Cardiovascular Research Foundation, New York, NY; St.
Francis Hospital and Heart Center, Roslyn, NY
(Fearon) Interventional Cardiology Section, Division of Cardiovascular
Medicine, Department of Medicine, Stanford University School of Medicine,
Stanford, CA, and VA Palo Alto Health Care System, Palo Alto, CA
(Babaliaros) Emory School of Medicine, Atlanta, GA, United States
(Daniels) Division of Cardiology, California Pacific Medical Center, San
Francisco, CA, United States
(Chhatriwalla) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Suradi) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Shah) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Szerlip, Mack) Baylor Scott & White Heart Hospital, Plano, Richardson, TX
(Dahle) CentraCare Heart & Vascular Center, St. Cloud, MN, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Davidson) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Sheth) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, Ontario, Canada
(Depta) Sands-Constellation Heart Institute, Rochester Regional Health
(DeVries) Heart and Vascular Center, Section of Cardiovascular Medicine,
Dartmouth-Hitchcock Medical Center, NH, Lebanon
(Southard) Division of Cardiovascular Medicine, UC Davis Health System,
University of California-Davis, Sacramento, CA, United States
(Pop) Department of Cardiology, AMITA Alexian Brothers Medical Center, Elk
Grove Village, IL, United States
(Sorajja) Minneapolis Heart Institute Foundation, Abbott Northwestern
Hospital, Minneapolis, MN, United States
(Zhao) Edwards Lifesciences, Irvine, CA, United States
(Leon) Columbia University Medical Center/NewYork-Presbyterian Hospital,
New York, NY; Cardiovascular Research Foundation, New York, NY
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
Abstract
BACKGROUND: The EARLY TAVR trial demonstrated that early transcatheter
aortic valve replacement (TAVR) intervention was superior to clinical
surveillance (CS) with delayed TAVR in patients with asymptomatic, severe
aortic stenosis (AS). Cardiac biomarkers are associated with maladaptive
remodeling, symptom onset, and worse outcomes after TAVR. Whether elevated
biomarkers identify asymptomatic patients more likely to benefit from
early intervention is unknown. <br/>METHOD(S): A core laboratory measured
N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high sensitivity
cardiac troponin T (hs-cTnT). Associations between biomarker levels and
risk of the trial primary endpoint (death, stroke, or unplanned
cardiovascular hospitalization) and other secondary endpoints were
examined with Kaplan-Meier curves and Cox proportional hazard models.
Interaction tests were performed to assess whether the treatment effect of
early TAVR, compared with CS, differed according to biomarker levels.
<br/>RESULT(S): Among 901 patients randomized in EARLY TAVR, 798 (89%) had
biospecimens measured (median NT-proBNP 287 [145, 601]; median hs-cTnT
14.6 [10.5, 21.0]). Higher levels of NT-proBNP and hs-cTnT were broadly
associated with higher event rates for multiple endpoints. In general,
there was no significant interaction between baseline biomarkers and
treatment group with respect to any composite or individual endpoint
examined, although trends broadly demonstrated a greater relative benefit
of early TAVR at lower biomarker levels. There was a significant
interaction between hs-cTnT and treatment group with respect to death or
heart failure hospitalization (HFH) (interaction p=0.04) and HFH alone
(interaction p=0.03) such that the relative benefit of early TAVR was
greater for patients with normal, rather than elevated, levels of hs-cTnT
at baseline. For some endpoints, higher baseline NT-proBNP was associated
with numerically greater absolute risk reduction with early TAVR than
lower NT-proBNP levels. <br/>CONCLUSION(S): In patients with asymptomatic
severe high gradient AS, higher NT-proBNP and hs-cTnT levels were broadly
associated with higher event rates as expected. However, the relative
benefit of an early TAVR strategy was consistent regardless of baseline
biomarker levels and, contrary to our hypothesis, tended to be more
pronounced in those with the lowest biomarker levels. These findings
suggest limited value for single measurements of these biomarkers to guide
the timing of TAVR in asymptomatic patients.

<109>
Accession Number
2034172001
Title
Comparative Analysis of Perioperative Analgesia Methods in Thoracic
Surgery: A Literature Systemic Review.
Source
Journal of Clinical Medicine. 14(7) (no pagination), 2025. Article Number:
2484. Date of Publication: 01 Apr 2025.
Author
Kanani F.; Nugzar R.; Shimonov M.; Akar F.A.
Institution
(Kanani, Shimonov) Department of Surgery, The Edith Wolfson Medical
Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv, Israel
(Nugzar) Department of Anaesthesia, The Edith Wolfson Medical Center,
Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel
Aviv, Israel
(Akar) Department of Thoracic Surgery, The Edith Wolfson Medical Center,
Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel
Aviv, Israel
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Effective pain management following thoracic
surgery remains challenging yet crucial for optimal patient outcomes. This
literature review compares the efficacy, safety, and clinical outcomes of
different perioperative analgesia methods in thoracic surgery patients,
focusing on paravertebral block (PVB), intercostal nerve block (ICNB),
epidural analgesia (EPI), erector spinae plane block (ESPB), and
patient-controlled analgesia (PCA). <br/>Method(s): A systematic search
was conducted across medical databases, yielding ten relevant randomized
controlled trials and meta-analyses. <br/>Result(s): The evidence
indicates that paravertebral block provides superior pain control with
lower opioid requirements, fewer adverse events, and higher patient
satisfaction compared to other methods. While epidural analgesia offers
pain control comparable to PVB, it is associated with higher technical
failure rates and side effects, including urinary retention,
nausea/vomiting, and hypotension. ICNB and ESPB demonstrate efficacy
superior to systemic analgesia but generally inferior to PVB in terms of
pain scores and opioid consumption. <br/>Conclusion(s): This review
highlights the need for individualized approaches to perioperative pain
management in thoracic surgery, with paravertebral block emerging as a
preferred option due to its favorable efficacy and safety
profile.<br/>Copyright &#xa9; 2025 by the authors.

<110>
Accession Number
647040320
Title
Efficacy and safety of tranexamic acid in non-cardiac arterial procedures:
a systematic review and meta-analysis.
Source
Annals of vascular surgery. (no pagination), 2025. Date of Publication:
27 Mar 2025.
Author
Steunenberg T.A.H.; Bakker N.C.; Wiersema A.M.; Tournoij E.; Yeung K.K.;
Jongkind V.
Institution
(Steunenberg) Department of Vascular Surgery, Amsterdam University Medical
Center, location Vrije Universiteit, Boelelaan 117, Amsterdam, The
Netherlands; Department of Vascular Surgery, Amsterdam University Medical
Center, location University of Amsterdam, Meibergdreef 9, Amsterdam, The
Netherlands; Department of Vascular Surgery, Dijklander Hospital,
Maelsonstraat 3, Hoorn, the Netherlands; Amsterdam Cardiovascular
Sciences, Atherosclerosis & Aortic diseases, Amsterdam, the Netherlands
(Bakker) Department of Vascular Surgery, Amsterdam University Medical
Center, location Vrije Universiteit, Amsterdam, Netherlands
(Wiersema, Jongkind) Department of Vascular Surgery, Amsterdam University
Medical Center, location Vrije Universiteit, Boelelaan 117, Amsterdam, The
Netherlands; Department of Vascular Surgery, Dijklander Hospital,
Maelsonstraat 3, Hoorn, the Netherlands; Amsterdam Cardiovascular
Sciences, Atherosclerosis & Aortic diseases, Amsterdam, the Netherlands
(Tournoij) Department of Vascular Surgery, Dijklander Hospital,
Maelsonstraat 3, Hoorn, Netherlands
(Yeung) Department of Vascular Surgery, Amsterdam University Medical
Center, location Vrije Universiteit, Boelelaan 117, Amsterdam, The
Netherlands; Department of Vascular Surgery, Amsterdam University Medical
Center, location University of Amsterdam, Meibergdreef 9, Amsterdam, The
Netherlands; Amsterdam Cardiovascular Sciences, Atherosclerosis & Aortic
diseases, Amsterdam, the Netherlands
Abstract
OBJECTIVES: Non-cardiac arterial procedures (NCAP) are associated with a
high risk of bleeding. Tranexamic acid (TXA) is used among surgical
disciplines to reduce blood loss, however its effectiveness and safety in
NCAP remain unclear. This review evaluates the efficacy and safety of TXA
during NCAP. <br/>METHOD(S): Systematic review and meta-analysis was
performed in accordance with PRISMA guidelines. Literature searches in
PubMed, EMBASE, and Cochrane databases (October 2023 and October 2024)
identified studies investigating TXA in open and endovascular NCAP.
Meta-analyses were conducted using Cochrane's Review Manager.
<br/>RESULT(S): Five studies (n=4304) were identified. One randomized
controlled trial of TXA in non-cardiac surgery (n=9535), including a
vascular cohort (14.8%; n=699 TXA, n=700 placebo), showed lower composite
bleeding outcomes in the overall cohort receiving TXA (9.5% vs 11.7%;
p<0.001), but not in the vascular cohort (HR 0.85; 95%CI 0.64-1.13).
Another trial found no difference in blood loss or transfusion rates in
100 patients undergoing open abdominal aortic aneurysm surgery. Both
trials reported no increased cardiovascular or thrombo-embolic
complications (TEC) or 30-day mortality. A prospective study showed
similar thrombosis-related technical failure rates in traumatic vascular
injury patients (TXA 6.3% vs 3.8%, p=0.14) and no significant differences
in bleeding or hematoma (TXA 11.4% vs 4.3%, p=0.13). In 297 carotid
endarterectomy (CEA) patients, TXA significantly reduced postoperative
hematoma (7.9% vs 1.3%; p=0.01) without increasing TEC or stroke. TXA
during an intraoperative hemostasis protocol during CEA (TXA n=8) reported
similar results. Meta-analysis showed no significant differences in TEC
(RR 1.10; 95%CI 0.71-1.70) or reoperation rates (RR 0.55; 95%CI
0.19-1.63). <br/>CONCLUSION(S): TXA does not increase the risk of TEC in
NCAP. However, there is currently insufficient evidence that TXA reduces
bleeding complications.<br/>Copyright &#xa9; 2025 The Author(s). Published
by Elsevier Inc. All rights reserved.

<111>
[Use Link to view the full text]
Accession Number
647046893
Title
Routine Cerebral Embolic Protection during Transcatheter Aortic-Valve
Implantation.
Source
The New England journal of medicine. (no pagination), 2025. Date of
Publication: 30 Mar 2025.
Author
Kharbanda R.K.; Kennedy J.; Jamal Z.; Dodd M.; Evans R.; Bal K.K.; Perkins
A.D.; Blackman D.J.; Hildick-Smith D.; Banning A.P.; Baumbach A.; Ludman
P.; Palmer S.; Stables R.H.; Henderson R.; Appleby C.; Cotton J.; Curzen
N.; Ozkor M.; Byrne J.; Aggarwal R.; Das R.; Doshi S.; Watkins S.; Muir
D.F.; Anderson R.; Chowdhary S.; Varcoe R.; Dorman S.; Firoozi S.;
Chelliah R.; Owens C.; Redwood S.; Prendergast B.; Iqbal J.; Ratib K.;
Dospinescu C.; Suresh V.; Cruden N.; Rajathurai T.; Malik I.S.; Wiper A.;
Costopoulos C.; Khurana A.; Banning A.; Clayton T.
Institution
(Kharbanda) Department of Cardiovascular Medicine, John Radcliffe
Hospital, Oxford, United Kingdom
(Kharbanda, Kennedy) Acute Multidisciplinary Imaging and Interventional
Centre, Radcliffe Department of Medicine, University of Oxford, Oxford,
United Kingdom
(Kharbanda) Oxford Biomedical Research Centre, Oxford, United Kingdom
(Jamal, Dodd, Evans, Bal, Perkins, Clayton) Clinical Trials Unit, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Blackman) Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds,
United Kingdom
(Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex,
Brighton, United Kingdom
(Banning) Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Baumbach, Ozkor) Barts Heart Centre, Barts Health NHS Trust, London,
United Kingdom
(Baumbach, Prendergast) LondonUnited Kingdom
(Ludman, Doshi) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Palmer) Centre for Health Economics, University of York, York, United
Kingdom
(Stables, Appleby) Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Stables) University of Liverpool, Liverpool, United Kingdom
(Henderson, Varcoe) Nottingham University Hospitals NHS Trust, Nottingham,
United Kingdom
(Cotton) Heart and Lung Centre, New Cross Hospital, Wolverhampton, United
Kingdom
(Cotton) University of Wolverhampton, Wolverhampton, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton and University
Hospital Southampton, Southampton, United Kingdom
(Byrne) King's College Hospital Foundation Trust, London, United Kingdom
(Aggarwal) Essex Cardiothoracic Centre, Basildon, United Kingdom
(Das) Cardiothoracic Unit, Freeman Hospital, Newcastle upon Tyne, United
Kingdom
(Doshi) University College Birmingham, Birmingham, United Kingdom
(Watkins) Golden Jubilee University National Hospital, United Kingdom
(Watkins) University of Glasgow, Glasgow, United Kingdom
(Muir) James Cook University Hospital, Middlesbrough, United Kingdom
(Anderson) University Hospital of Wales, Cardiff, United Kingdom
(Chowdhary) Manchester Academic Health Sciences Unit, Wythenshawe
Hospital, Manchester, United Kingdom
(Dorman) Bristol Heart Institute, Bristol, United Kingdom
(Firoozi) St. George's Hospital University Foundation Trust, London,
United Kingdom
(Chelliah) Castle Hill Hospital, Cottingham, United Kingdom
(Owens) Royal Victoria Hospital, Belfast, United Kingdom
(Redwood) St. Thomas' Hospital, London, United Kingdom
(Iqbal) Sheffield Teaching Hospitals NHS Foundation Trust and University
of Sheffield, Sheffield, United Kingdom
(Ratib) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
(Dospinescu) Aberdeen Royal Infirmary, Aberdeen, United Kingdom
(Suresh) University Hospitals Plymouth, Plymouth, United Kingdom
(Cruden) Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
(Rajathurai) University Hospital Coventry and Warwickshire NHS Trust,
Coventry, United Kingdom
(Rajathurai) University of Warwick, Warwick, United Kingdom
(Malik) Hammersmith Hospital, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Wiper) Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool,
United Kingdom
(Costopoulos) Royal Papworth Hospital, Cambridge, United Kingdom
(Khurana) Swansea Bay University Health Board, Swansea, United Kingdom
(Banning) Leicester Cardiovascular Biomedical Research Centre, University
Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, United
Kingdom
Abstract
BACKGROUND: Transcatheter aortic-valve implantation (TAVI) is associated
with procedure-related stroke. Cerebral embolic protection (CEP) devices
may reduce embolization to the cerebral circulation and hence the
incidence of stroke. <br/>METHOD(S): We conducted a randomized, controlled
trial across 33 centers in the United Kingdom. We randomly assigned 7635
participants with aortic stenosis in a 1:1 ratio to undergo TAVI with a
CEP device (CEP group) or TAVI without a CEP device (control group). The
primary outcome was stroke within 72 hours after TAVI or before discharge
from the hospital (if discharge occurred sooner). <br/>RESULT(S): A total
of 3815 participants were assigned to the CEP group and 3820 to the
control group. A primary-outcome event occurred in 81 of 3795 participants
(2.1%) in the CEP group and in 82 of 3799 participants (2.2%) in the
control group (difference, -0.02 percentage points; 95% confidence
interval, -0.68 to 0.63; P = 0.94). Disabling stroke occurred in 47
participants (1.2%) in the CEP group and in 53 (1.4%) in the control
group. Death occurred in 29 participants (0.8%) in the CEP group and in 26
(0.7%) in the control group. Overall access-site complications appeared to
be similar in the two groups (8.1% in the CEP group and 7.7% in the
control group). A total of 24 serious adverse events occurred in 22 of
3798 participants (0.6%) in the CEP group, and 13 serious adverse events
occurred in 13 of 3803 participants (0.3%) in the control group.
<br/>CONCLUSION(S): Among participants undergoing TAVI, routine use of CEP
did not decrease the incidence of stroke within 72 hours. (Funded by the
British Heart Foundation and Boston Scientific; BHF PROTECT-TAVI ISRCTN
Registry number, ISRCTN16665769.).<br/>Copyright &#xa9; 2025 Massachusetts
Medical Society.

<112>
Accession Number
647050468
Title
Thoracic-Abdominal Rebalancing Method is Superior in Terms of Decreasing
Respiratory Distress, Postoperative Pulmonary Complications and
Hemodynamic Variables When Compared to Conventional Physiotherapy in
Postoperative Patients of Coronary Artery Bypass Grafting Surgery:
Randomized Clinical Trial.
Source
Physiotherapy research international : the journal for researchers and
clinicians in physical therapy. 30(2) (pp e70050), 2025. Date of
Publication: 01 Apr 2025.
Author
Branco K.R.; Silveira F.D.S.; Ferronato L.; Jabuonski S.C.; Peringer V.S.;
de Lima M.P.; Heinzmann-Filho J.P.; Eibel B.
Institution
(Branco) Master's Student in the Graduate Program in Health Sciences:
Cardiology, Institute of Cardiology of Rio Grande Do Sul (IC/FUC), Porto
Alegre, Brazil
(Silveira) Neonatologist and Pediatric Physiotherapist, Preceptor in
Neurofunctional Rehabilitation and Aquatic Physiotherapy at the Lutheran
University of Brazil in Canoas, Canoas, Brazil
(Ferronato) Physiotherapist Master in Rehabilitation Sciences: Federal
University of Santa Catarina (PPGCR/UFSC), Florianopolis, Brazil
(Jabuonski) Physiotherapist Specialist in Intensive Care: Brazilian
Association of Cardiorespiratory Physiotherapy and Intensive Care
(ASSOBRAFIR), Porto Alegre, Brazil
(Peringer, Eibel) Physical Therapist Coordinator of the Multiprofessional
and Integrated Residency Program in Health: Cardiology at the Institute of
Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
(de Lima) Physiotherapist Creator of the Thoraco-abdominal Rebalancing
Method and Founder of the Brazilian School of RTA and Respiratory
Biomechanics, Florianopolis, Brazil
(Heinzmann-Filho) Teaching Physiotherapist at Centro Universitario
Cenecista de Osorio (UNICNEC), Osorio, Brazil
Abstract
BACKGROUND AND PURPOSE: TAR method recommends reorganizing ventilatory
muscle synergism, reducing respiratory effort, removing secretions from
the lungs and upper airways, in addition to promoting diaphragmatic
juxtaposition and increasing respiratory muscle strength and adjusting
muscle tone. However, there are few scientific publications on this method
in cardiac patients CABG. To evaluate the effects of the TAR method on
hemodynamic variables, respiratory distress and pulmonary complications in
patients after CABG surgery. <br/>METHOD(S): This is a single-blind,
randomized, clinical trial. Adults (> 35 years old), hemodynamically
stable, who had undergone CABG (< 24 h) and with a prescription for
physiotherapy were included. Patients were randomized into two groups: IG
- TAR; CG-standard physiotherapeutic approach. Interventions were carried
out in two days (twice/day), totaling 04 sessions. The following
parameters were evaluated pre- and post-intervention: HR, RR, SpO2, MAP,
respiratory distress scale. The pulmonary complications scale was applied
at the end of the interventions. The sample consisted of 58 patients, 30
in the CG and 28 in the IG. <br/>RESULT(S): There was no significant
difference (p < 0.05) in sample characteristics, clinical and
perioperative data between groups. There was a significant increase (p <
0.05) in RR and MAP after the intervention in CG and IG. Only in GI there
was a significant reduction in the respiratory distress score (p = 0.001).
Furthermore, there was a lower score (p < 0.0001) on the scale of
pulmonary complications at the end of the interventions in the IG group,
compared to the CG. <br/>DISCUSSION(S): The TAR method reduced respiratory
distress and pulmonary complications in patients after CABG surgery. Given
our findings, it becomes feasible to aim for the applicability of the
method in other populations, expanding it to other elective or
non-elective surgical conditions, in oncology, traumatology, and
neurology, making the recovery process more effective. KEYWORDS:
Physiotherapy; Cardiology; Thoracic-abdominal rebalancing. TRIAL
REGISTRATION: NTC 04631198.<br/>Copyright &#xa9; 2025 John Wiley & Sons
Ltd.

<113>
Accession Number
647042592
Title
Electronic Provider Notification to Facilitate the Recognition and
Management of Severe Aortic Stenosis: a Randomized Clinical Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 30 Mar 2025.
Author
Tanguturi V.K.; Abou-Karam R.; Cheng F.; Duan R.; Inglessis I.; Langer N.;
Yucel E.; Passeri J.; Hung J.; Elmariah S.
Institution
(Tanguturi, Abou-Karam, Cheng, Inglessis, Langer, Yucel, Passeri, Hung)
Division of Cardiology, Massachusetts General Hospital, Boston, MA, United
States
(Duan, Elmariah) Division of Cardiology, University of California- San
Francisco, San Francisco, CA, United States
Abstract
BACKGROUND: Symptomatic severe aortic stenosis (AS) remains undertreated
with high resultant mortality despite increased growth and availability of
aortic valve replacement (AVR) since the advent of transcatheter
therapies. We evaluate the impact of electronic provider notifications
(EPN) on rates of AVR at 1-year. <br/>METHOD(S): In a pragmatic cluster
randomized clinical trial conducted within multicenter academic health
system from March 2022 through November 2023, 285 providers who had
ordered a transthoracic echocardiogram (TTE) with findings potentially
indicative of severe AS with aortic valve area <= 1.0 cm2 were enrolled.
Providers were randomly assigned to receive EPN for each of their patients
with severe AS on TTE or to usual care. Notifications highlighted the
detection of severe AS and included patient-specific clinical guideline
recommendations for its management. The primary endpoint was the
proportion of patients with severe AS receiving AVR within 1-year of the
index TTE. <br/>RESULT(S): A total of 144 providers were randomized to
intervention and 141 to control, resulting in 496 and 443 patients
assigned to each group, respectively. The patient cohort had mean age of
77+/-11 years, was 47% female, and had mean aortic valve area 0.8+/-0.1
cm2. Rates of AVR within 1-year were 48.2% with EPN versus 37.2% with
usual care (OR 1.62; 95% CI 1.13-2.32; p=0.009) and 60.7% and 46.5%,
respectively, amongst symptomatic patients (OR 1.77; 95% CI 1.17-2.65;
p=0.006). Notification treatment effect was highest with EPN in patients
>80 years of age (OR 2.00; 95% CI 1.17-3.41; p=0.01), in women (OR 2.78;
95% CI 1.69-4.57; p<0.001), and when index TTE was performed within the
inpatient setting (OR 2.49, 95% CI 1.44-4.31; p<0.001). Within 1-year,
restricted mean survival time was longer with EPN in all (12 days; p=0.04)
and symptomatic patients (23 days; p=0.01). <br/>CONCLUSION(S): In this
first study of EPN in valvular heart disease, EPN increased rates of AVR
for severe AS, lessened gender and age disparities in AVR utilization, and
improved survival time. EPN may provide a simple, scalable intervention to
raise awareness of critical TTE findings and improve the quality of care
for severe AS.

<114>
Accession Number
2034132390
Title
Antithrombotic therapy after left atrial appendage occlusion.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Raffo C.; Greco A.; Capodanno D.
Institution
(Raffo, Greco, Capodanno) Cardiovascular Department, A.O.U. Policlinico
"G. Rodolico-San Marco", University of Catania, Catania, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Left atrial appendage occlusion (LAAO) represents a strategy
to minimize thromboembolic risk in atrial fibrillation (AF) patients.
However, LAAO carries some risks of periprocedural bleeding, device
embolization, peri-device leaks or device-related thrombosis; the latter
is due to direct blood contact with the device, justifying and represents
the rationale behind antithrombotic therapy following LAAO. Areas covered:
A comprehensive literature search (PubMed, Web of Science, Cochrane) has
been performed up to November 2024. Antithrombotic drugs after LAAO
include vitamin K antagonists (VKA), direct oral anticoagulants (DOAC),
antiplatelet drugs, and their combinations. Initially, high-intensity
regimens were implemented, while current strategies prioritize simplified
approaches to promote device healing without increasing the bleeding risk.
The aims of our review were to define the rationale and implications for
post-LAAO antithrombotic therapy and provide an overview of current
evidence on various antithrombotic regimens. Expert opinion: The optimal
post-LAAO antithrombotic regimen remains controversial, highlighting the
need for randomized trials on this topic. Current data suggest that DOACs
have the lowest probability of thromboembolic events and major bleeding,
while DAPT may be preferred in patients who do not tolerate OAC; finally,
single antiplatelet therapy or no antithrombotic therapy are alternative
options for patients at high bleeding risk.<br/>Copyright &#xa9; 2025
Informa UK Limited, trading as Taylor & Francis Group.

<115>
Accession Number
2030125091
Title
Opioid-sparing effects of ultrasound-guided erector spinae plane block for
video-assisted thoracoscopic surgery: a randomized controlled study.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 53.
Date of Publication: 01 Dec 2024.
Author
Xu H.; Wu W.; Chen X.; He W.; Shi H.
Institution
(Xu, Wu, Chen, Shi) Department of Anesthesiology, Shanghai Pulmonary
Hospital, School of Medicine, Tongji University, Shanghai, China
(He) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School
of Medicine, Tongji University, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: The erector spinae plane block (ESPB) is a new analgesic
method used in thoracic surgery. However, few studies have characterized
their effects on perioperative opioid consumption. We aimed to evaluate
the effects of ESPB on perioperative opioid consumption in patients who
underwent video-assisted thoracoscopic surgery (VATS). <br/>Method(s):
This was a randomized, observer-blinded clinical trial at a single-centre
academic hospital. Eighty patients were scheduled for thoracoscopic
segmentectomy or lobectomy by VATS for lung cancer. Forty participants
were randomly assigned to ESPB or control group. All patients received
intravenous patient-controlled postoperative analgesia. Perioperative
opioid consumption, visual analogue scale (VAS) scores, and adverse events
were recorded. <br/>Result(s): Intraoperative and postoperative opioid
consumption and static/dynamic VAS scores were significantly lower in the
early hours after VATS in the ESPB group (p < 0.05) than the control
group. No significant differences were observed in adverse effects between
the two groups. <br/>Conclusion(s): ESPB reduced intraoperative opioid
consumption and early postoperative pain in patients undergoing VATS. Our
findings support the view that ESPB is a safe and highly effective option
for regional analgesia for VATS. Trial registration:
http://www.chictr.org.cn, ChiCTR1800019335.<br/>Copyright &#xa9; The
Author(s) 2024.