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<1>
Accession Number
2038142371
Title
Posterior left pericardiotomy: what is the advantage in cardiac surgery?.
Source
European Journal of Cardio-thoracic Surgery. 67 (pp i18-i26), 2025. Date
of Publication: 01 Mar 2025.
Author
Di Franco A.; Sandner S.; Soletti G.J.; Mack C.A.; Redfors B.; Gaudino M.
Institution
(Di Franco, Soletti, Mack, Gaudino) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Postoperative atrial fibrillation (POAF) is the most common
complication following cardiac surgery and is associated with prolonged
in-hospital stay and increased costs, morbidity (including stroke and
heart failure) and mortality. Posterior pericardiotomy (PP) is a surgical
intervention aimed at draining the pericardium into the left pleural
cavity to reduce POAF occurrence. This review summarizes the current
evidence on the use of PP and highlights future perspectives for clinical
research. METHOD(S): The present work is a narrative review, a
systematic literature search was therefore not performed. After collegial
discussion, the most relevant papers as per the authors' opinion were
selected and formed the basis of the present review. RESULT(S):
Several studies support the hypothesis that PP decreases the incidence of
POAF, pericardial effusion and cardiac tamponade after cardiac surgery.
Although an increased incidence of pleural effusion has been reported
after PP, this finding does not translate into increased pulmonary
complications. Whether the systematic use of PP during cardiac surgery
improves long-term outcomes is unclear. CONCLUSION(S): PP is a simple
and safe technique that holds the potential to positively impact cardiac
surgical patients' postoperative course. The results of upcoming,
multicentre trials will help shed definitive light on this
topic. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<2>
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

<3>
Accession Number
2038142380
Title
Retained blood syndrome after cardiac surgery.
Source
European Journal of Cardio-thoracic Surgery. 67 (pp i3-i8), 2025. Date of
Publication: 01 Mar 2025.
Author
Niemann B.; Grieshaber P.
Institution
(Niemann) Department of Adult and Pediatric Cardiovascular Surgery,
Giessen University Hospital, Giessen, Germany
(Grieshaber) Division of Congenital Cardiac Surgery, Department of Cardiac
Surgery, Heidelberg University Hospital, Heidelberg, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Retained blood syndrome (RBS) is defined as the postoperative
retention of blood within the thoracic cavity. In addition to the
mechanical impacts on cardiac and pulmonary function, RBS triggers
inflammatory processes. It is associated with increased morbidity
following cardiac surgery. The goal of this non-systematic review was to
summarize the current understanding of the pathophysiology, consequences
and both prophylactic and therapeutic measures related to RBS.
 METHOD(S): The subjects to be covered were defined in advance. A
literature search was conducted in PubMed and Google Scholar using
relevant search terms and MeSH terms. CONCLUSION(S): RBS is a
significant complication following cardiac surgical procedures. It is
associated with a poorer prognosis due to mechanical suppression of
haemodynamics and the amplification of inflammatory processes. Therefore,
preventing pericardial and pleural effusions should be a priority in
cardiac surgical care. If RBS occurs, aggressive anti-inflammatory therapy
should be initiated to prevent the development of long-term
complications. Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<4>
Accession Number
2038261902
Title
Association between surgeon age and surgical complications: A systematic
review and meta-analysis.
Source
American Journal of Surgery. 244 (no pagination), 2025. Article Number:
116316. Date of Publication: 01 Jun 2025.
Author
Mussa B.; Defrancisco B.; Petracco P.
Institution
(Mussa, Petracco) Surgical Science Department, University of Turin, Italy
(Defrancisco) Alchemica Hospital, Turin, Italy
Publisher
Elsevier Inc.
Abstract
This meta-analysis synthesizes evidence on the relationship between
surgeon age and surgical complications, incorporating 2.3 million
procedures by 72,000 surgeons. Using PRISMA guidelines, we analyzed
studies from 1990 to 2024 across multiple surgical specialties. Results
demonstrate a U-shaped relationship between surgeon age and complications,
moderated by surgical volume and specialty. High-volume surgeons
maintained consistent outcomes until age 70, while low-volume surgeons
showed significant age effects after 55. Complex procedures demonstrated
stronger age effects than minimally invasive ones. Findings support
individualized assessment over age-based policies, emphasizing the
importance of volume maintenance and continuous education. Copyright
© 2025 The Authors

<5>
Accession Number
2038114832
Title
Postoperative Pain Intensity After Single-port, Double-port, and
Triple-port Video-assisted Lung Lobectomy: A Three-arm Parallel Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Kosinski S.; Putowski Z.; Stachowicz J.; Czajkowski W.; Wilkojc M.;
Zietkiewicz M.; Zielinski M.
Institution
(Kosinski, Stachowicz, Czajkowski, Wilkojc, Zielinski) Klara Jelska's
Pulmonary Hospital, Zakopane, Poland
(Kosinski) Jagiellonian University Medical College,
Orthopaedic-Rehabilitation University Hospital, Zakopane, Poland
(Putowski) Jagiellonian University Medical College, Centre for Intensive
and Perioperative Care, Cracow, Poland
(Zietkiewicz) Jagiellonian University Medical College, John Paul II
Hospital, Cracow, Poland
Publisher
W.B. Saunders
Abstract
Objective: Video-assisted thoracic surgery (VATS) has evolved from a
multiport approach to a one-port approach to reduce the degree of surgical
trauma. However, there is no consensus on the number of incisions leading
to less postoperative pain. Early postoperative pain was compared after
three technical variants of VATS lobectomy under multimodal analgesia,
including thoracic epidural analgesia. Design(s): This study was
designed as a prospective, randomized, controlled clinical trial with
three parallel arms. Setting(s): Single-center study.
 Participant(s): A total of 112 adult patients with ASA statuses I to
III who were scheduled to undergo elective VATS lobectomy for early-stage
non-small cell lung cancer were enrolled. Intervention(s): Patients
were randomly assigned to one of three groups: single-port, double-port,
and triple-port VATS lobectomy. The same postoperative analgesia protocol
was used in each group. Measurements and Main Results: The primary
outcome was postoperative pain intensity at rest and when coughing within
the first 72 hours after surgery. The secondary outcomes were cumulative
opioid consumption and the composite rate of postoperative complications.
A total of 112 patients were enrolled in the study, 91 of whom completed
the study protocol. There were no significant differences between the
study groups in terms of pain intensity either at rest (p = 0.319) or when
coughing (p = 0.202). There was no difference in the incidence of
postoperative complications. Conclusion(s): This study revealed no
differences in pain intensity in the early postoperative period between
three different technical variants of VATS lobectomy when an analgesia
protocol based on thoracic epidural anesthesia was used. Copyright
© 2025 Elsevier Inc.

<6>
Accession Number
2034059623
Title
Incidence of stroke in patients with atrial fibrillation undergoing
surgical treatment: a meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
233. Date of Publication: 01 Dec 2025.
Author
Lin D.; Cheng Y.; Yu S.; Liu X.; Yan C.; Cheng W.
Institution
(Lin, Cheng, Yu, Liu, Yan, Cheng) Department of Cardiac Surgery, Southwest
Hospital, Third Military Medical University (Army Medical University),
Chongqing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Atrial fibrillation (AF) is self-limiting condition, but it
may also increase the risk of stroke and death. The association between AF
and surgery with stroke was assessed both subjectively and statistically
using systematic review and meta-analysis. Method(s): For data
collection, a thorough search was made in PubMed, EMBASE, Science Direct,
Google Scholar, and Cochrane Library using searching keywords
"postoperative ischemic stroke, atrial fibrillation, stroke, cardiac
surgery, brain ischemia, and heart surgery". Direct and indirect
comparisons were made using random-effect network meta-analysis.
 Result(s): 16-studies were identified comprising of 132,208 patient,
64% male, median age > 63 years and follow-up > 1.5 years. Pooling the
results from the random-effects model showed odds ratios associated with
the risk of stroke of surgical processes (CABG) in patients with AF. The
odds ratio OR = 1.1 (0.65-1.54, P < 0.001) and heterogeneity (I2 = 17%, P
= 0.13) exposing higher risk of the stroke. Odds ratio (HR 1.5, 0.9-1.71)
without heterogeneity showed greater risk of stroke after heart valve
surgery in patients with AF. Study 8 didn't show any risk of the stroke
after left atrial appendage (LAA) clipping intervention, but the outcomes
were biased. A pooled analysis showed odd ratio OR, 2 (1.7-2.1, P <
0.0001), without heterogeneity indicating higher stroke risk in general
cardiac surgery. The patients undergone cardiac surgery from three studies
with pooled analysis study-5 OR 2 (1.7-2.1, P > 0.001), study-6 OR 1.8
(1.7-1.9, P > 0.001), and study-14 OR 7.8 (6.2-8.1, P > 0.0001).
 Conclusion(s): The study clearly defines stroke outcomes when they
are quantified, however, further research is required. Copyright
© The Author(s) 2025.

<7>
Accession Number
2038079933
Title
Survival outcomes in isolated severe tricuspid regurgitation according to
therapeutic modalities: a systematic review and meta-analysis.
Source
Open Heart. 12(1) (no pagination), 2025. Article Number: e002986. Date of
Publication: 12 Mar 2025.
Author
Suc G.; Mesnier J.; Cailliau A.; Habib M.; Delhomme C.; Arangalage D.;
Himbert D.; Ducrocq G.; Brochet E.; Vahanian A.; Iung B.; Urena-Alcazar M.
Institution
(Suc, Mesnier, Cailliau, Habib, Delhomme, Arangalage, Himbert, Ducrocq,
Brochet, Vahanian, Iung, Urena-Alcazar) Cardiology, Hopital Bichat, APHP,
Paris, France
(Suc, Mesnier, Cailliau, Habib, Delhomme, Arangalage, Himbert, Ducrocq,
Brochet, Vahanian, Iung, Urena-Alcazar) Universite Paris Cite, Paris,
France
(Suc, Mesnier, Cailliau, Habib, Delhomme, Arangalage, Himbert, Ducrocq,
Brochet, Vahanian, Iung, Urena-Alcazar) INSERM, Paris, France
Publisher
BMJ Publishing Group
Abstract
Importance Managing isolated severe tricuspid regurgitation (TR) poses
significant challenges, with questions recently arising about the efficacy
of surgery and percutaneous therapies compared with conservative
approaches in improving survival. Objective We aimed to assess the
available evidence on mortality associated with different treatment
modalities for isolated severe TR. Evidence review A comprehensive search
of medical databases was conducted. Studies reporting mortality of
isolated TR at 1-year follow-up, with TR severity classified as
moderate-to-severe or worse, were included. Exclusion criteria were TR
associated with left-heart disease and combined procedures (treating other
valves). The primary endpoint was all-cause mortality at 1 year, with
secondary outcomes including in-hospital, 2-year and 5-year mortality.
Mortality was compared by meta-analysis and meta-regression using age, sex
and left ventricular ejection fraction as confounders. Findings 25 studies
met the inclusion criteria. Mean age was 72.0 years among the 5702
patients managed medically, 71.3 years among the 1416 patients treated
percutaneously and 59.3 years among the 1990 patients managed surgically.
In medically managed patients, 1-year, 2-year and 5-year mortality rates
were 14%, 20% and 46%, respectively. Among percutaneously managed
patients, there was an in-hospital mortality of 1% and a 1-year mortality
rate of 18%, which increased to 22% at 2 years. Surgically managed
patients experienced an in-hospital mortality of 8% with 1-year, 2-year
and 5-year mortality rates of 15%, 20% and 30%, respectively. No
statistical differences in mortality were observed at 1, 2 or 5 years.
Those results were confirmed after adjusted meta-regression. Conclusions
These findings underscore the significant long-term mortality associated
with isolated severe TR, regardless of treatment group. Despite potential
selection bias, both percutaneous and surgical interventions did not offer
lower mortality rates compared with medical management after 2 years.
Further research is warranted to improve outcomes in the management of
isolated TR. Copyright © 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.

<8>
Accession Number
2034059351
Title
Whole stomach versus narrow gastric tube reconstruction after
esophagectomy for esophageal cancer (ATHLETE trial): study protocol for a
randomized controlled trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 111. Date of
Publication: 01 Dec 2025.
Author
Kitadani J.; Hayata K.; Goda T.; Tominaga S.; Fukuda N.; Nakai T.; Nagano
S.; Ojima T.; Shimokawa T.; Kawai M.
Institution
(Kitadani, Hayata, Goda, Tominaga, Fukuda, Nakai, Nagano, Ojima, Kawai)
Second Department of Surgery, School of Medicine, Wakayama Medical
University, 811-1, 811-1 Kimiidera, Wakayama, Japan
(Shimokawa) Clinical Study Support Center, Wakayama Medical University,
Wakayama, Japan
Publisher
BioMed Central Ltd
Abstract
Background: There are two types of methods of creating a gastric conduit
after esophagectomy for patients with esophageal cancer: narrow gastric
tube reconstruction or whole stomach reconstruction. Whole stomach
reconstruction with good blood perfusion was reported in a prospective
cohort study to be safe and that it has the possibility to prevent
anastomotic leakage (AL). We therefore planned a randomized controlled
phase III study to investigate the superiority of whole stomach
reconstruction over narrow gastric tube reconstruction after esophagectomy
for esophageal cancer. Method(s): This is a single center, two-arm,
open-label, randomized phase III trial. We calculated that 65 patients in
each arm of this study and total study population of 130 patients are
required according to our historical data on narrow gastric tube
reconstruction and prospective data on whole stomach reconstruction. In
the narrow gastric tube group, a 3.5-cm-wide gastric tube is made along
the greater curvature of the stomach using linear staplers. Otherwise, in
the whole stomach group, after the lymphadenectomy of the lesser curvature
and No.2, the stomach is cut just below the esophagogastric junction using
a linear stapler. The primary endpoint of this study is the incidence of
AL. Secondary endpoints are the occurrence rate of anastomotic stenosis,
the occurrence rate of pneumonia, the occurrence rate of all postoperative
complications, the occurrence rate of reflux esophagitis, quality of life
evaluation by EORTC QLQ-C30 and EORTC OES-18, nutritional evaluation, the
amount of blood loss, postoperative hospital stays, and blood flow
evaluation. Complications are evaluated using the Clavien-Dindo
classification (version 2.0), and those of grade II or higher are
considered to be postoperative complications. Discussion(s): If the
optimal method for creating a gastric conduit after esophagectomy is
clarified, it may be possible to contribute to improving short-term and
long-term surgical outcomes for patients undergoing surgery for esophageal
cancer. Trial registration: The protocol of ATHLETE trial was registered
in the UMIN Clinical Trials Registry as UMIN000050677
(http://www.umin.ac.jp/ctr/index.htm). Date of registration: March 26,
2023. Date of first participant enrollment: March 27, 2023. Copyright
© The Author(s) 2025.

<9>
Accession Number
646745338
Title
Effects of acoustic stimulation on painful procedures in preterm and
full-term infants: A systematic review and network meta-analysis.
Source
International journal of nursing studies. 165 (pp 105031), 2025. Date of
Publication: 01 May 2025.
Author
Ding S.; Wang Q.; Fu X.; Huang X.; Liao L.; Zhang Y.
Institution
(Ding, Wang, Fu, Liao) Birth Room, Chengdu Women's and Children's Central
Hospital, School of Medicine, University of Electronic Science and
technology of, China
(Huang) Surgery Intensive Care Unit, Chengdu Women's and Children's
Central Hospital, School of Medicine, University of Electronic Science and
technology of, China
(Zhang) Birth Room, Chengdu Women's and Children's Central Hospital,
School of Medicine, University of Electronic Science and technology of,
China
Abstract
AIM: This study aims to compare and rank the effects of acoustic
stimulation on painful procedures in both preterm and full-term infants.
 METHOD(S): Six databases including Medline, Web of Science, the
Cochrane Central Register of Controlled Trials, Cumulative Index to
Nursing and Allied Health Literature, Embase, and SinoMed, were searched
from inception to July, 2023. A Bayesian network meta-analysis with random
effects models was performed using R software and Stata 15.0. The quality
of included studies was assessed using the Cochrane Collaboration's tool.
The study protocol was registered at PROSPERO (Registration number:
CRD42023451102). RESULT(S): A total of 28 studies involving 2624
preterm and full-term infants were included and 8 acoustic stimulation
interventions were identified. Regarding pain levels during procedures,
maternal voice, maternal voice plus, music therapy and maternal voice
plus, music therapy plus, other pharmaceutical interventions, vocal music
therapy, white noise, and white noise plus were significantly more
effective than control group [standardized mean differences (SMD) ranged
from -2.6 to -0.87]. White noise plus was the most effective intervention
for reducing pain levels during procedures (90.6 %). Regarding pain levels
after procedures (no specific time mentioned), maternal voice, maternal
voice plus, music therapy and maternal voice plus, music therapy plus,
other pharmaceutical interventions, other non-pharmaceutical
interventions, routine care, vocal music therapy, and white noise plus
were significantly more effective than control group (SMD ranged from -4.7
to -1.6). Music therapy and maternal voice plus was the most effective
intervention for reducing pain levels after procedures, without specific
time mentioned (95.29 %). Regarding pain levels 1 min after procedures,
only music therapy plus and other pharmaceutical interventions were
effective (SMD ranged from -4.5 to -4.9) and music therapy plus was the
most effective intervention (93.41 %). No interventions had significant
effects on pain levels 3, 5, and 10 min after procedures. Regarding heart
rate, only white noise plus could provide a lower increase during
procedures. For oxygen saturation, only vocal music therapy could provide
a lower decrease after painful procedures (no specific time mentioned). No
interventions had significant effects on stabilizing respiratory rate.
 CONCLUSION(S): This review suggests that multiple acoustic
stimulation interventions are effective for pain relief in both preterm
and full-term infants undergoing painful procedures. More high quality
studies with larger sample size are required to generate evidence
regarding the short- and long-term effectiveness and safety of acoustic
stimulation interventions on painful procedures. Copyright © 2025
Elsevier Ltd. All rights reserved.

<10>
Accession Number
646071084
Title
Preoperative inspiratory muscle training improves lung function prior to
elective heart valve surgery and reduces postoperative lung function
impairment and pulmonary complications: a randomised trial.
Source
Journal of physiotherapy. 71(1) (pp 27-34), 2025. Date of Publication: 01
Jan 2025.
Author
Yu P.; Luo Z.; Wang Y.; Lin S.; Qin D.; Jones A.Y.; He J.
Institution
(Yu, Luo) Rehabilitation Medicine Centre, West China Hospital, Sichuan
University, Sichuan, China
(Wang) Cardiovascular Surgery Research Laboratory, West China Hospital,
Sichuan University, China
(Lin) Department of Rehabilitation, Fuwai Central China Cardiovascular
Hospital, Zhengzhou, China
(Qin) Department of Rehabilitation Medicine, Tianjin Chest Hospital,
Tianjin, China
(Jones) School of Health and Rehabilitation Sciences, University of
Queensland, Brisbane, Australia
(He) National Clinical Research Centre for Geriatrics, West China
Hospital, Sichuan University, Chengdu, China; Med-X Centre for
Manufacturing, Sichuan University, Chengdu, China
Abstract
QUESTION: What is the effect of 3 days of preoperative inspiratory muscle
training (IMT) on lung function prior to heart valve surgery and on
postoperative lung function and pulmonary complications compared with sham
and no IMT? DESIGN: A three-arm, multicentre, randomised controlled trial
with concealed allocation, intention-to-treat analysis and blinded
assessment of some outcomes. PARTICIPANTS: This study included 228 adults
scheduled for heart valve surgery. INTERVENTIONS: The IMT group received 3
days of IMT at 30% maximal inspiratory pressure, the sham IMT group
received the same but at 10% maximal inspiratory pressure and the control
group received no IMT. OUTCOME MEASURES: Spirometric measures, maximal
inspiratory pressure and maximum voluntary ventilation were measured at
hospital admission, the day before surgery and at discharge. The incidence
of postoperative pulmonary complications (primary outcome) and adverse
events were recorded. RESULT(S): A total of 215 participants
completed surgery as planned and all participants were followed up until
discharge. Spirometric measures, maximal inspiratory pressure and maximum
voluntary ventilation improved in all groups between admission and the day
before surgery, but more so in the IMT group. At discharge, these measures
had deteriorated in all groups, but less so in the IMT group. Preoperative
IMT reduced the total number of participants experiencing a pulmonary
complication in the IMT group compared with the sham IMT group (ARR -0.18,
95% CI -0.33 to -0.03) and compared with the control group (ARR -0.21, 95%
CI -0.35 to -0.05). Very few adverse events occurred in all three groups.
 CONCLUSION(S): Preoperative IMT improved lung function prior to
surgery and at hospital discharge and reduced postoperative pulmonary
complications in adults undergoing elective heart valve surgery.
REGISTRATION: ChiCTR2100054869. Copyright © 2024. Published by
Elsevier B.V.

<11>
Accession Number
2038233883
Title
Volume status and volume responsiveness assessment: A literature review of
systematic reviews.
Source
Trends in Anaesthesia and Critical Care. 61 (no pagination), 2025. Article
Number: 101546. Date of Publication: 01 Apr 2025.
Author
Fatahi M.; Mohammadi A.; Foroughian M.
Institution
(Fatahi) Department of Emergency Medicine, Emergency Medicine Specialist,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Mohammadi) Cardiologist, Echocardiologist, Nikan Hospital, Tehran, Iran,
Islamic Republic of
(Foroughian) Department of Emergency Medicine, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Churchill Livingstone
Abstract
Intravenous fluid administration is an essential and life-saving procedure
in every hospital setting. Balancing fluid resuscitation could be
challenging due to the risk associated with both hypovolemia and
hypervolemia. We conducted an extensive literature review on systematic
reviews related to this topic to examine the effectiveness of various
invasive and non-invasive methods for assessing volume status and fluid
responsiveness. Traditional invasive methods, including central venous
pressure measurements, have limited predictive values. Noninvasive
sonographic measurements of the inferior vena cava, internal jugular vein,
and carotid artery have the potential to be reliable alternatives for
assessing volume status. Measuring cardiac output with echocardiographic
methods provides valuable information. Volume responsiveness can be
evaluated reliably through stroke volume and pulse pressure variations, as
well as the end-expiratory occlusion test in patients under mechanical
ventilation. Copyright © 2025 Elsevier Ltd

<12>
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. Copyright © 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.

<13>
Accession Number
2038238410
Title
Identifying heterogeneity of treatment effect for antibiotic duration in
bloodstream infection: an exploratory post-hoc analysis of the BALANCE
randomised clinical trial.
Source
eClinicalMedicine. 83 (no pagination), 2025. Article Number: 103195. Date
of Publication: 01 May 2025.
Author
Ong S.W.X.; Pinto R.; Rishu A.; Tong S.Y.C.; Commons R.J.; Conly J.M.;
Evans G.A.; Fralick M.; Kandel C.; Lagace-Wiens P.R.S.; Lee T.C.; Lother
S.A.; MacFadden D.R.; Marshall J.C.; Martel-Laferriere V.; Mayette M.;
McDonald E.G.; Neary J.D.; Prazak J.; Raby E.; Regli A.; Rogers B.A.;
Smith S.; Taggart L.R.; Wang H.T.; Wuerz T.; Yahav D.; Young P.J.; Fowler
R.A.; Daneman N.
Institution
(Ong, Pinto, Fowler, Daneman) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(Ong, Tong) Department of Infectious Diseases, University of Melbourne, At
the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC,
Australia
(Ong, Pinto, Rishu, Fowler, Daneman) Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Ong, Tong) Victorian Infectious Diseases Service, Royal Melbourne
Hospital, Peter Doherty Institute for Infection and Immunity, Melbourne,
VIC, Australia
(Commons) Global Health Division, Menzies School of Health Research and
Charles Darwin University, Darwin, NT, Australia
(Commons) General and Subspecialty Medicine, Grampians Health, Ballarat,
VIC, Australia
(Conly) Department of Medicine, University of Calgary and Alberta Health
Services, Calgary, AB, Canada
(Evans) Division of Infectious Diseases, Department of Medicine, Queen's
University, Kingston, ON, Canada
(Fralick) Division of General Internal Medicine, Sinai Health System,
Toronto, ON, Canada
(Kandel) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Kandel) Division of Infectious Diseases, Michael Garron Hospital,
Toronto, ON, Canada
(Lagace-Wiens) Department of Medical Microbiology and Infectious Diseases,
University of Manitoba, Winnipeg, MB, Canada
(Lee) Division of Infectious Diseases, Department of Medicine, McGill
University, Montreal, Canada
(Lother, Wuerz) Department of Internal Medicine, University of Manitoba,
Winnipeg, MB, Canada
(MacFadden) Division of Infectious Diseases, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Marshall) Interdepartmental Division of Critical Care Medicine and
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Marshall) Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto,
ON, Canada
(Martel-Laferriere) Division of Microbiology and Infectious Diseases,
Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
(Mayette) University of Sherbrooke, Sherbrooke, QC, Canada
(McDonald) Division of General Internal Medicine, McGill University Health
Centre, Montreal, QC, Canada
(Neary) Division of General Internal Medicine, Department of Medicine,
McMaster University, Hamilton, ON, Canada
(Prazak) Department of Intensive Care Medicine, Bern University Hospital,
University of Bern, Bern, Switzerland
(Raby) Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch,
WA, Australia
(Regli) Intensive Care Unit, SJOG Murdoch Hospital, Perth, WA, Australia
(Rogers) Monash University School of Clinical Sciences at Monash Health,
Melbourne, VIC, Australia
(Smith) Division of Infectious Diseases, Department of Medicine,
University of Alberta, Edmonton, AB, Canada
(Taggart) Division of Infectious Diseases, Unity Health Toronto, Toronto,
ON, Canada
(Wang) Department of Medicine, Division of Critical Care Medicine, Centre
Hospitalier de l'Universite de Montreal (CHUM), Universite de Montreal,
Montreal, QC, Canada
(Yahav) Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel
(Young) Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
Publisher
Elsevier Ltd
Abstract
Background: The BALANCE trial demonstrated non-inferiority of 7 (vs 14)
day antibiotic durations in patients with uncomplicated non-S.
aureus/lugdunensis bacterial bloodstream infections (BSI). However, there
may be patient subgroups who benefit from longer durations. We aimed to
evaluate if bedside clinical decision rules could identify these
subgroups. Method(s): In this post-hoc analysis of the multicentre,
randomised BALANCE trial (October 17, 2014-May 5, 2023), we applied three
clinical decision rules to investigate heterogeneity of treatment effect
in 7-day vs 14-day antibiotic durations on 90-day all-cause mortality. We
used the rules to categorize patients in BALANCE into different risk
groups and calculated the unadjusted absolute risk difference (RD) for
90-day mortality in patients receiving 7- vs 14-day antibiotics within
each risk group. Statistical significance was tested using an interaction
test. The BALANCE trial is registered with ClinicalTrials.gov
(NCT03005145). Finding(s): 3581 patients were included. All three
rules predicted mortality risk, but none identified statistically
significant effect modification: (a) static rule (low-risk: RD -0.58, 95%
CI -8.91 to 7.73; moderate-risk: RD -.01, 95% CI -3.86 to 1.83; high-risk:
RD -2.65, 95% CI -7.12 to 1.81; p = 0.74); (b) dynamic rule (met rule on
day 7: RD -2.18, 95% CI -4.81 to 0.45; did not meet rule: RD 1.75, 95% CI
-3.89 to 7.40; p = 0.16); and (c) early clinical failure criteria
(score<2: RD -2.38, 95% CI -5.0 to 0.23; score >=2: RD -0.65, 95% CI -5.06
to 3.77; p = 0.24). Results were consistent across sensitivity analyses
including imputation for missing data and restricting analyses to
gram-negative BSI. Interpretation(s): The decision rules included in
our analyses did not identify a subgroup of patients within BALANCE that
would benefit from 14 (vs 7) days of treatment. 7-day treatment duration
is sufficient for most patients with uncomplicated non-S.
aureus/lugdunensis BSI. Future research could explore data-driven
machine-learning approaches to identify comprehensive combinations of
patient characteristics that may guide individualised duration of
antibiotic therapy. Funding(s): The BALANCE trial was funded by the
Canadian Institutes of Health Research, Health Research Council of New
Zealand, Australian National Medical Research Council, Physicians Services
Incorporated Ontario and Ontario Ministry of Health and Long-term Care
Innovation Fund. SWXO conducted this study as part of his PhD studies,
with funding from: the Emerging & Pandemic Infections Consortium
(University of Toronto, Canada); Connaught International Scholarship
(University of Toronto, Canada); the Queen Elizabeth II Graduate
Scholarship in Science and Technology (QEII-GSST; Government of Ontario,
Canada); and the Melbourne Research Scholarship (University of Melbourne,
Australia). VML is supported by Clinical Research Scholar-Junior 2 program
(FRQ-S). Copyright © 2025 The Author(s)

<14>
[Use Link to view the full text]
Accession Number
2037820402
Title
How Long Should Patients Be Treated With Postcardiotomy Venoarterial
Extracorporeal Membrane Oxygenation? Individual Patient Data Pooled
Analysis.
Source
Critical Care Medicine. 53(4) (pp e908-e915), 2025. Date of Publication:
01 Apr 2025.
Author
Biancari F.; Makikallio T.; L'Acqua C.; Ruggieri V.G.; Cho S.-M.; Dalen
M.; Welp H.; Jonsson K.; Ragnarsson S.; Hernandez Perez F.J.; Gatti G.;
Alkhamees K.; Loforte A.; Lechiancole A.; D'Errigo P.; Rosato S.;
Spadaccio C.; Pettinari M.; Fiore A.; Mariscalco G.; Perrotti A.; Arafat
A.A.; Albabtain M.A.; Albarak M.M.; Laimoud M.; Djordjevic I.;
Samalavicius R.; Alonso-Fernandez-Gatta M.; Wilhelm M.J.; Kaserer A.;
Bonalumi G.; Juvonen T.; Polvani G.
Institution
(Biancari, Bonalumi, Polvani) Department of Cardiac Surgery, Centro
Cardiologico Monzino IRCCS, Milan, Italy
(Makikallio) Department of Medicine, South-Karelia Central Hospital,
University of Helsinki, Lappeenranta, Finland
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Milan, Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan, Italy
(Ruggieri) Division of Cardiothoracic and Vascular Surgery, Robert Debre
University Hospital, Reims, France
(Cho) Divisions of Neurosciences, Critical Care and Cardiac Surgery,
Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Dalen) Department of Molecular Medicine and Surgery, Department of
Cardiac Surgery, Karolinska Institutet, Karolinska University Hospital,
Stockholm, Sweden
(Welp) Department of Cardiothoracic Surgery, Munster University Hospital,
Munster, Germany
(Jonsson) Department of Cardiac Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Ragnarsson) Department of Cardiothoracic Surgery, University of Lund,
Lund, Sweden
(Hernandez Perez) Department of Cardiology, Puerta de Hierro University
Hospital, Madrid, Spain
(Gatti) Division of Cardiac Surgery, Cardio-Thoracic and Vascular
Department, University Hospital of Trieste, Trieste, Italy
(Alkhamees) Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
(Loforte) Department of Surgical Sciences, University of Turin, Turin,
Italy
(Lechiancole) Cardiothoracic Department, University Hospital of Udine,
Udine, Italy
(D'Errigo, Rosato) Center for Global Health, Italian National Institute,
Rome, Italy
(Spadaccio) Department of Cardiac Surgery, University of Cincinnati
Medical Center, Cincinnati, OH, United States
(Pettinari) Cardiac Surgery Unit, Cardiovascular Department, Cliniques
Universitaire Saint Luc, Brussel, Belgium
(Fiore) Department of Cardiac Surgery, Hopitaux Universitaires Henri
Mondor, Creteil, France
(Mariscalco) Department of Intensive Care Medicine and Cardiac Surgery,,
Glenfield Hospital,, University Hospitals of Leicester, Leicester, United
Kingdom
(Perrotti) Department of Thoracic and Cardio-Vascular Surgery, University
Hospital Jean Minjoz, Besancon, France
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt
(Albabtain) Cardiology Clinical Pharmacy, Prince Sultan Cardiac Center,
Riyadh, Saudi Arabia
(Albarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, King Faisal
Specialist Hospital and Research Center, Riyadh, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo,
Egypt
(Djordjevic) Department of Cardiothoracic Surgery, University Hospital
Cologne, Cologne, Germany
(Samalavicius) 2nd Department of Anesthesia,, Vilnius University Hospital
Santaros Klinikos, Vilnius, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Salamanca,
Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid,
Spain
(Wilhelm) Clinic for Cardiac Surgery, University Heart Center, University
and University Hospital Zurich, Zurich, Switzerland
(Kaserer) Institute of Anesthesiology, University and University Hospital
Zurich, Zurich, Switzerland
(Juvonen) Research Unit of Surgery, Anesthesiology and Intensive Care,
University of Oulu, Oulu, Finland
(Juvonen) Department of Cardiac Surgery, Heart and Lung Center, Helsinki
University Hospital, Helsinki, Finland
(Polvani) Department of Biomedical, Surgical and Dental Sciences,
University of Milan, Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To investigate the optimal duration of venoarterial
extracorporeal membrane oxygenation (ECMO) for cardiogenic shock
refractory to medical therapies after cardiac surgery and whether its
prolonged use is justified. DATA SOURCES: Previously published articles on
postcardiotomy venoarterial ECMO. STUDY SELECTION: Articles reporting on
the early outcome after postcardiotomy venoarterial ECMO in adult patients
were identified through a systematic review of the literature. DATA
EXTRACTION: Data on prespecified patients' characteristics, operative
variables, and outcomes were provided by the authors of previous studies
on this topic. DATA SYNTHESIS: Individual data of 1267 patients treated at
25 hospitals from ten studies were included in this meta-analysis.
In-hospital mortality rates were lowest among patients treated 3-6 days
with venoarterial ECMO. Multilevel mixed-effects logistic regression
considering the cluster effect of the participating hospitals adjusted for
individual patient's risk profile and operative variables showed that the
risk in-hospital mortality did not significantly increase in patients
treated more than 6 days up to 20 days. CONCLUSION(S): The present
study demonstrated that prolonged venoarterial ECMO support after adult
cardiac surgery may be justified. However, the analysis was limited by the
knowledge of only those circumstances known at the start of
ECMO. Copyright © 2025 by the Society of Critical Care Medicine
and Wolters Kluwer Health, Inc. All Rights Reserved.

<15>
Accession Number
2032850509
Title
Regular human insulins versus rapid-acting insulin analogues in children
and adolescents with type 1 diabetes: a protocol for a systematic review
with meta-analysis and Trial Sequential Analysis.
Source
Systematic Reviews. 14(1) (no pagination), 2025. Article Number: 5. Date
of Publication: 01 Dec 2025.
Author
Petersen J.J.; Juul S.; Kamp C.B.; Faltermeier P.; Sillassen C.D.B.; Dos
Santos T.J.; Jakobsen J.C.
Institution
(Petersen, Juul, Kamp, Faltermeier, Sillassen, Jakobsen) Centre for
Clinical Intervention Research, Copenhagen Trial Unit, Capital Region of
Denmark, Copenhagen, Denmark
(Petersen) Faculty of Health and Medical Sciences, Copenhagen University,
Copenhagen, Denmark
(Juul) Mental Health Centre Stolpegaard, Mental Health Services in the
Capital Region of Denmark, Gentofte, Denmark
(Juul) Department of Psychology, University of Copenhagen, Copenhagen,
Denmark
(Kamp, Faltermeier, Sillassen, Jakobsen) Department of Regional Health
Research, The Faculty of Health Sciences, University of Southern Denmark,
Odense, Denmark
(Sillassen) Department of Cardiology and Endocrinology, Slagelse Hospital,
Region of Zealand, Slagelse, Denmark
(Dos Santos) Unit of Pediatrics, Hospital Vithas Almeria, Instituto
Hispalense de Pediatria, Andalusia, Almeria, Spain
(Dos Santos) Department of Nursing, Physiotherapy, and Medicine, Faculty
of Health Sciences, University of Almeria, Almeria, Spain
Publisher
BioMed Central Ltd
Abstract
Background: Type 1 diabetes is a serious, chronic disorder with an
increasing incidence among children and adolescents. Glycemic control in
individuals with type 1 diabetes is better managed through a basal-bolus
regimen with either regular human or rapid-acting insulin analogues
administered as a bolus at mealtimes. Rapid-acting insulin analogues have
been hypothesized to cause optimal glycemic control and less risk of
hypoglycemic episodes compared to regular human insulins. However, this
has never been systematically assessed in children and adolescents with
type 1 diabetes. Therefore, this systematic review aims to assess the
beneficial and harmful effects of regular human insulins versus
rapid-acting insulin analogues in children and adolescents.
 Method(s): This is a protocol for a systematic review. A search in
major medical databases (e.g., MEDLINE, EMBASE, CENTRAL) and clinical
trial registries will be performed by a search specialist. We will include
published and unpublished randomized clinical trials comparing regular
human insulins versus rapid-acting insulin analogues (lispro, aspart, or
glulisine). Two review authors will independently extract data and conduct
risk of bias assessments. Primary outcomes will be severe hypoglycemia,
ketoacidosis, and serious adverse events. Secondary outcomes will be
quality of life, HbA1c, and non-serious adverse events. Data will be
analyzed using fixed-effect meta-analyses, random-effects meta-analyses,
and Trial Sequential Analysis. Several subgroup analyses are planned. Risk
of bias will be assessed with the Cochrane Risk of Bias tool-version 2, an
eight-step procedure will be used to assess if the thresholds for clinical
significance are crossed, and the certainty of the evidence will be
assessed by Grading of Recommendations, Assessment, Development and
Evaluations (GRADE). Discussion(s): The beneficial and adverse
effects of regular human insulins versus rapid-acting insulin analogues
have not been systematically assessed in children and adolescents. There
is a need for a comprehensive systematic review of the current evidence.
Systematic review registration: PROSPERO: CRD42024508625. Copyright
© The Author(s) 2025.

<16>
Accession Number
2038070070
Title
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. 103 (no pagination), 2025. Article Number:
111811. Date of Publication: 01 Apr 2025.
Author
Snel L.I.P.; Oosterom-Eijmael M.J.P.; Rampanelli E.; Lankadeva Y.R.;
Plummer M.P.; Preckel B.; Hermanides J.; van Raalte D.H.; Hulst A.H.
Institution
(Snel, Oosterom-Eijmael, Preckel, Hermanides, Hulst) Department of
Anesthesiology, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Snel, Oosterom-Eijmael, van Raalte) Department of Endocrinology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Snel, Oosterom-Eijmael, Rampanelli, Hulst) Amsterdam Cardiovascular
Sciences Research Institute, Amsterdam, Netherlands
(Snel, Oosterom-Eijmael, Preckel, Hermanides) Amsterdam Public Health
Research Institute, Quality of Care, Amsterdam, Netherlands
(Rampanelli, van Raalte) Department of Experimental Vascular Medicine,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Rampanelli, Hulst) Amsterdam Gastroenterology Endocrinology Metabolism
Research Institute, Amsterdam, Netherlands
(Lankadeva) Preclinical Critical Care Unit, Florey Institute of
Neuroscience and Mental Health, The University of Melbourne, Melbourne,
VIC, Australia
(Lankadeva, Plummer, Hulst) Department of Critical Care, Melbourne Medical
School, The University of Melbourne, Melbourne, VIC, Australia
(Plummer) Intensive Care Unit Research, Royal Adelaide Hospital, Adelaide,
SA, Australia
Publisher
Elsevier Inc.
Abstract
Background: Sodium-glucose transporter-2 (SGLT2) inhibitors reduced the
incidence of acute kidney injury in large cardiovascular outcome trials in
patients with chronic heart and kidney failure. Acute kidney injury is a
common complication following cardiac surgery. We hypothesized that
perioperative SGLT2 inhibition could reduce kidney injury after cardiac
surgery, measured with the biomarker neutrophil gelatinase-associated
(NGAL). Method(s): In this open-label phase IV, randomized,
parallel-group, pilot study, adult patients undergoing elective cardiac
surgery with cardiopulmonary bypass were randomized to receive either an
SGLT2 inhibitor, empagliflozin (10 mg; oral) once daily, from three days
before surgery until postoperative day two, or standard-of-care. The
primary outcome was the between-group difference of serum NGAL on the
second postoperative day. Moreover, other biomarkers for acute kidney
injury were measured, including serum kidney injury molecule-1 (KIM-1),
hypoxia-inducible factor-1 alpha (HIF-1alpha), and urine NGAL/Creatinine
and KIM-1/Creatinine ratios. Additional outcomes included acute kidney
injury incidence within the first seven days following cardiac surgery
according to Kidney Disease: Improving Global Outcomes criteria and
metabolic parameters, including ketone body concentrations and glycemic
control. Result(s): Between March 2022 and April 2023, 55 patients
were included (sex: 73 % male, age: 66 +/- 10 years, BMI: 28 +/- 4
kg/m2, empagliflozin n = 25, control n = 30) in the
intention-to-treat analysis. There were no significant between-group
differences in serum and urine NGAL or KIM-1. However, empagliflozin
significantly reduced the incidence of acute kidney injury (20 % vs 66.7
%; absolute difference 46.7 %, 95 % CI, -69.7 - -23.6; P < .001). A
significant increase in serum HIF-1alpha after surgery was solely observed
in the control group. We observed no between-group differences in the
incidence of (euglycemic) ketoacidosis or hypoglycemic events.
 Conclusion(s): In this pilot study, perioperative SGLT2 inhibition
was not associated with lower NGAL levels. We observed that SGLT2
inhibition reduced the incidence of acute kidney injury in this small
study population. As the results of this pilot study are
hypotheses-generating, further validation is needed in a large-scale,
double-blind, placebo-controlled, randomized trial, which is currently
ongoing. Copyright © 2024

<17>
Accession Number
2034129767
Title
Effects of high-flow oxygen therapy on oxygenation in dogs undergoing
diagnostic bronchoscopy.
Source
Frontiers in Veterinary Science. 12 (no pagination), 2025. Article Number:
1545427. Date of Publication: 2025.
Author
Ortlieb J.; Bender H.; Schneider M.; Tacke S.; Hassdenteufel E.
Institution
(Ortlieb, Bender, Schneider, Tacke, Hassdenteufel) Department of
Veterinary Clinical Sciences, Small Animal Clinic,
Justus-Liebig-University Giessen, Giessen, Germany
Publisher
Frontiers Media SA
Abstract
Introduction: Hypoxemia is a common complication during bronchoscopy and
bronchoalveolar lavage (BAL). High-Flow Oxygen Therapy (HFOT) has been
used to improve oxygenation and prevent periods of hypoxemia in people
undergoing bronchoscopy. Objective(s): The main objective of this
study was to evaluate the effect of HFOT on oxygenation in dogs undergoing
diagnostic bronchoscopy compared to a traditional oxygen supplementation
method (TOT). A secondary objective was to assess potential HFOT-related
complications. Method(s): Prospective randomized clinical trial. Dogs
presented for diagnostic bronchoscopy were randomly assigned to receive
either HFOT or TOT using nasal cannulas during the bronchoscopic
procedure. Oxygenation was monitored through PaO<inf>2</inf> measurements
taken at seven time points: baseline (t0), after preoxygenation (t1),
post-induction (t2), pre- and post-BAL sampling (t3 and t4), at the end of
the procedure (t5), and 1 h after bronchoscopy (t6). Pre- and
post-procedure thoracic radiographs were assessed for air leak syndrome or
aerophagia. Result(s): 20 privately owned dogs presented for
diagnostic bronchoscopy were included in the study (HFOT group: n = 10,
TOT group: n = 10). Baseline characteristics and physiological parameters
did not differ significantly between groups. Five dogs in each group
showed hypoxemia (PaO<inf>2</inf> < 80 mmHg) at baseline with 1/5 in each
group having PaO<inf>2</inf> < 60 mmHg. HFOT improved oxygenation
throughout the procedure, with a significant increase in PaO<inf>2</inf>
observed after preoxygenation (P = 0.001) and at the end of the procedure
(P = 0.013). Additionally, only 1/10 dogs in the HFOT group experienced
hypoxemia during bronchoscopy compared to 5/10 dogs in the TOT group, and
patients in the HFOT achieved numerically higher PaO<inf>2</inf> values
across all time points during the procedure (t1-t5). No serious adverse
events related to HFOT were observed, although aerophagia occurred in both
groups without necessitating intervention. Conclusion(s): HFOT can
improve oxygenation and prevent episodes of hypoxemia in dogs undergoing
bronchoscopy compared to traditional oxygen supplementation
methods. Copyright © 2025 Ortlieb, Bender, Schneider, Tacke and
Hassdenteufel.

<18>
Accession Number
2034065399
Title
A Current Perspective on Left Atrial Appendage Closure Device Infections:
A Systematic Review.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Sener Y.Z.; Ozer S.F.; Karahan G.
Institution
(Sener) Department of Cardiology, Thoraxcentrum, Erasmus MC, Rotterdam,
Netherlands
(Ozer) Department of Cardiology, Karaman Training and Research Hospital,
Karaman, Turkey
(Karahan) Department of Infectious Diseases and Clinical Microbiology,
University of Health Sciences Gaziosmanpasa Training and Research
Hospital, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Left atrial appendage (LAA) closure has become the standard of
care for patients with atrial fibrillation (AF) at high risk of
thromboembolism who are intolerant or unwilling to take anticoagulants.
LAA occlusion device infection is a challenging complication, and there is
a paucity of data on the management and outcomes of LAA occlusion device
infection. We aimed to summarize the existing literature and highlight the
knowledge gap in this area. Method(s): A detailed search was
conducted through the databases PubMed/MEDLINE, EMBASE, Web of Science,
CINAHL, and Cochrane Central using the relevant keywords. All cases with
presented data regarding diagnosis, treatment, and outcome were included
from the reports. Result(s): The analysis included 12 case reports
encompassing a total of 12 patients. The mean age was 73.6 +/- 11.0 years,
and 50% of the cases were male. The most commonly implanted device was the
Watchman (in eight of the 12 cases). The median time between LAA closure
and infection was 6.6 (0.2-36) months. Transesophageal echocardiography
was diagnostic in all cases, and positron emission tomography/computed
tomography (PET/CT) was useful in diagnosis in three cases. The most
common pathogen was Staphylococcus aureus (n = 7). The LAAC device was
removed in seven cases; one patient refused surgery, and in the other
three cases, removal of the device was not considered appropriate due to
the patient's poor condition. Data on whether the device was removed could
not be retrieved for one patient. Mortality occurred in three cases (25%),
and all deaths occurred during hospitalization. Conclusion(s): LAA
closure device infections are rare but carry a high risk of complications
and mortality. Treatment should include device removal in appropriate
cases, and antibiotherapy alone should be considered only in selected
cases. Further studies are needed to clarify diagnostic and treatment
strategies based on the causative pathogens and patient
status. Copyright © 2025 Wiley Periodicals LLC.

<19>
[Use Link to view the full text]
Accession Number
2033489974
Title
Nanotechnology-based Strategies for Molecular Imaging, Diagnosis, and
Therapy of Organ Transplantation.
Source
Transplantation. 108(8) (pp 1730-1748), 2024. Date of Publication: 01 Aug
2024.
Author
Sun R.; Wang N.; Zheng S.; Wang H.; Xie H.
Institution
(Sun, Wang, Zheng, Wang, Xie) Division of Hepatobiliary and Pancreatic
Surgery, Department of Surgery, First Affiliated Hospital, School of
Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
(Sun, Wang, Zheng, Wang, Xie) NHC Key Laboratory of Combined Multi-organ
Transplantation, Zhejiang Province, Hangzhou, China
(Sun, Wang, Zheng, Wang, Xie) Key Laboratory of the Diagnosis and
Treatment of Organ Transplantation, CAMS, Zhejiang Province, Hangzhou,
China
(Sun, Wang, Zheng, Wang, Xie) Key Laboratory of Organ Transplantation,
Zhejiang Province, Hangzhou, China
(Sun, Wang, Zheng, Wang, Xie) State Key Laboratory for Diagnosis and
Treatment of Infectious Diseases, Zhejiang Province, Hangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Organ transplantation is the preferred paradigm for patients with
end-stage organ failures. Despite unprecedented successes, complications
such as immune rejection, ischemia-reperfusion injury, and graft
dysfunction remain significant barriers to long-term recipient survival
after transplantation. Conventional immunosuppressive drugs have limited
efficacy because of significant drug toxicities, high systemic immune
burden, and emergence of transplant infectious disease, leading to poor
quality of life for patients. Nanoparticle-based drug delivery has emerged
as a promising medical technology and offers several advantages by
enhancing the delivery of drug payloads to their target sites, reducing
systemic toxicity, and facilitating patient compliance over free drug
administration. In addition, nanotechnology-based imaging approaches
provide exciting diagnostic methods for monitoring molecular and cellular
changes in transplanted organs, visualizing immune responses, and
assessing the severity of rejection. These noninvasive technologies are
expected to help enhance the posttransplantation patient survival through
real time and early diagnosis of disease progression. Here, we present a
comprehensive review of nanotechnology-assisted strategies in various
aspects of organ transplantation, including organ protection before
transplantation, mitigation of ischemia-reperfusion injury, counteraction
of immune rejection, early detection of organ dysfunction
posttransplantation, and molecular imaging and diagnosis of immune
rejection. Copyright © 2024 Lippincott Williams and Wilkins. All
rights reserved.

<20>
Accession Number
2025043585
Title
Evaluation of functional and aesthetic outcomes of free dermal fat graft
versus superficial musculoaponeurotic system flap after superficial
parotidectomy: randomized clinical trial.
Source
BJS Open. 7(3) (no pagination), 2023. Article Number: zrac173. Date of
Publication: 01 Jun 2023.
Author
Fawzy A.; Balbaa M.A.; Hagag M.
Institution
(Fawzy, Balbaa, Hagag) Department of General Surgery, Faculty of Medicine,
Menoufia University, Menoufia, Shebin El Kom, Egypt
Publisher
Oxford University Press
Abstract
Background: Parotidectomy is the standard procedure for treatment of many
parotid lesions; however, it has several drawbacks. Facial asymmetry and
Frey's syndrome are the most annoying complications to patients. Insertion
of interpositioning grafts into the parotidectomy bed can decrease these
complications significantly. Free dermal fat graft (FDFG) and superficial
musculoaponeurotic system (SMAS) flap have very promising results. This
RCT aimed to compare these two techniques regarding functional and
aesthetic outcomes. Method(s): Between February 2016 and October
2021, adult patients undergoing superficial conservative parotidectomy in
a single centre for a benign indication were randomized into two equal
groups using a closed envelope method. In one group, FDFG was inserted at
the parotidectomy bed, whereas, in the other group, SMAS flap was
performed. Preoperative, operative, and postoperative data were recorded
and analysed. The primary outcome was the development of Frey's syndrome.
 Result(s): Seventy-eight patients were randomized into two equal
groups of 39 patients. There was no significant difference between the two
groups regarding development of Frey's syndrome. There was no significant
statistical difference between study groups regarding demographic data,
co-morbidities, parotid pathologies, specimen volumes, total operating
time, and postoperative complications. A tendency for over correction was
observed in FDFG and under correction in SMAS flap. There was no
statistically significant difference between the study groups regarding
the patients' aesthetic satisfaction with the majority displaying
excellent satisfaction with no poor results. Conclusion(s): FDFG and
SMAS flap are simple, rapid, and reliable procedures and are effective in
improving both functional and aesthetic outcomes post-parotidectomy. They
have comparable results; however, selection of either procedure can be
determined according to patient and tumour characteristics. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of BJS Society Ltd.

<21>
Accession Number
2034046958
Title
Comparison of ezetimibe and atorvastatin versus atorvastatin alone on
short-term major adverse cardiac events after percutaneous coronary
intervention, a double-blind placebo-controlled randomized clinical trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 108. Date of
Publication: 01 Dec 2025.
Author
Farshidi H.; Bijani B.; Sobhani S.A.; Dastsouz F.; Abbaszadeh S.
Institution
(Farshidi, Bijani, Dastsouz, Abbaszadeh) Cardiovascular Research Center,
Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic
Republic of
(Farshidi) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sobhani) Department of Pathology, School of Medicine, Hormozgan
University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Major cardiovascular events (MACE) after percutaneous coronary
intervention (PCI) are among the most common causes of death in patients.
Lipid-lowering strategies seem to affect these events. Reaching the best
regimen for controlling lipid abnormalities is important. This study aimed
to compare the effect of ezetimibe and atorvastatin versus atorvastatin
alone in short-term major cardiovascular events in patients after PCI in
Bandar Abbas in 2018. Method(s): This double-blinded randomized
controlled trial was done in Bandar Abbas in 2018 on 224 patients.
Patients were randomly divided into two groups either to receive ezetimibe
and atorvastatin (group A) or atorvastatin alone (group B). Patients were
followed for 1 month for major cardiovascular events and drug side
effects. Data was analyzed using SPSS software. Result(s): Patients
in the two groups had similar baseline characteristics. The mean
low-density lipoproteins (LDL) level was 69.83 +/- 28.8 in group A and
82.45 +/- 29.9 in group B (P = 0.014). At the end of the study,
high-sensitivity C-reactive protein (hs-CRP) values were notably lower in
group A (P value = 0.005). Three (2.7%) patients in group A and 1 patient
(0.9%) in group B had a myocardial infarction (P value = 0.313). Also, 11
patients (9.8%) in group A and 13 patients (11.6%) in group B had unstable
angina (P value = 0.666). No patients had death, cerebrovascular event, or
stent thrombosis in the two groups. Conclusion(s): Although adding
ezetimibe to atorvastatin can decrease LDL and hs-CRP levels in short-term
follow-up; it is not effective in lowering short-term major cardiovascular
events in patients after PCI. Studies with longer-term follow-up are
recommended. Trial registration: IRCT, IRCT20171028037047N1. Registered on
22 June 2018, https://irct.behdasht.gov.ir/trial/28808. Copyright
© The Author(s) 2025.

<22>
Accession Number
2037916262
Title
Invasive vs Conservative Management of Patients With Chronic Total
Occlusion: Results From the ISCHEMIA Trial.
Source
Journal of the American College of Cardiology. 85(12) (pp 1335-1349),
2025. Date of Publication: 01 Apr 2025.
Author
Bangalore S.; Mancini G.B.J.; Leipsic J.; Budoff M.J.; Xu Y.; Anthopolos
R.; Brilakis E.S.; Dwivedi A.; Spertus J.A.; Jones P.G.; Cho Y.J.; Mark
D.B.; Hague C.J.; Min J.K.; Reynolds H.R.; Elghamaz A.; Nair R.G.;
Mavromatis K.; Gosselin G.; Banerjee S.; Pejkov H.; Lindsay S.; Grantham
J.A.; Williams D.O.; Stone G.W.; O'Brien S.M.; Hochman J.S.; Maron D.J.
Institution
(Bangalore, Xu, Anthopolos, Reynolds, Hochman) New York University
Grossman School of Medicine, New York, NY, United States
(Mancini, Leipsic, Hague) University of British Columbia, Vancouver, BC,
Canada
(Budoff) Lundquist Institute, Los Angeles, CA, United States
(Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Dwivedi) Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell, Northwell Health, Hempstead, NY, United States
(Dwivedi) Division of Cardiology, Lenox Hill Hospital, Northwell Health,
New York, NY, United States
(Spertus, Jones, Cho, Grantham) University of Missouri-Kansas City's
Healthcare Institute for Innovations in Quality and Saint Luke's Mid
America Heart Institute, Kansas City, MO, United States
(Mark, O'Brien) Duke Clinical Research Institute and Duke University,
Durham, NC, United States
(Min) Cleerly, New York, NY, United States
(Elghamaz) Northwick Park Hospital-Royal Brompton Hospital, London, United
Kingdom
(Nair) Government Medical College, Kerala, India
(Mavromatis) Emory University School of Medicine and Atlanta VA Healthcare
System, Atlanta, GA, United States
(Gosselin) Montreal Heart Institute, Montreal, QC, Canada
(Banerjee) University of Texas Southwestern Medical Center, Dallas, TX,
United States
(Pejkov) University Clinic of Cardiology, Skopje, North Macedonia
(Lindsay) Bradford Teaching Hospitals NHS Foundation Trust, Bradford,
United Kingdom
(Williams) Brigham and Women's Hospital, Boston, MA, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Maron) Department of Medicine, Stanford University, Stanford, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Randomized trials of chronic total occlusion (CTO)
revascularization vs medical therapy have yielded inconsistent results.
 Objective(s): The aim of this study was to evaluate outcomes with an
initial invasive strategy (INV) vs an initial conservative strategy (CON)
in patients with coronary computed tomographic angiography
(CCTA)-determined CTO in the ISCHEMIA (International Study of Comparative
Health Effectiveness With Medical and Invasive Approaches) trial.
 Method(s): Participants in ISCHEMIA who underwent CCTA evaluated for
CTO by the core laboratory (3,113 of 5,179 randomized patients [60%]) were
categorized into subgroups with (100% stenosis) and without (<100%
stenosis) CTO. Primary analysis compared outcomes in those randomized to
INV vs CON using an intention-to-treat approach. Secondary analyses
compared outcomes using inverse probability weighting to model successful
CTO revascularization (REV) in all INV participants vs CON participants.
 Result(s): Of the 3,113 CCTA-evaluable participants, 1,470 had at
least 1 CTO (752 INV and 718 CON). INV did not reduce cardiovascular (CV)
death or myocardial infarction (MI) (5-year difference -3.5%; 95% CI:
-7.8% to 0.8%) and resulted in more procedural MIs (2.5%; 95% CI:
1.0%-4.0%) but fewer spontaneous MIs (-6.3%; 95% CI: -9.7% to -3.2%) than
CON. CTO REV modeled across INV had a high probability (>90%) of any lower
CV death or MI, MI, spontaneous MI, unstable angina, and heart failure
counterbalanced by a higher rate of procedural MI. CTO REV significantly
improved angina-related quality of life (mean difference 4.6 points), Rose
Dyspnea Scale score (rescaled) (mean difference 5.3 points), and EQ-5D
visual analog scale score (4.6 points). Conclusion(s): In the
ISCHEMIA trial, the risks and benefits of INV compared with CON were
similar among patients with and without CCTA-determined CTO (more frequent
procedural MI, less frequent spontaneous MI, and significantly improved
angina and dyspnea-related quality of life). In an observational
comparison, successful CTO REV was associated with a high probability of
lower CV death or MI (driven by lower MI) compared with CON.
(International Study of Comparative Health Effectiveness With Medical and
Invasive Approaches [ISCHEMIA]; NCT01471522) Copyright © 2025
American College of Cardiology Foundation

<23>
Accession Number
2006074502
Title
STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage:
Protocol for a randomised controlled trial.
Source
European Stroke Journal. 5(4) (pp 414-422), 2020. Date of Publication: 01
Dec 2020.
Author
Larsen K.T.; Forfang E.; Pennlert J.; Glader E.-L.; Kruuse C.; Wester P.;
Ihle-Hansen H.; Carlsson M.; Berge E.; Al-Shahi Salman R.; Bruun Wyller
T.; Ronning O.M.
Institution
(Larsen, Berge, Bruun Wyller) Department of Geriatric Medicine, Oslo
University Hospital, Oslo, Norway
(Larsen, Forfang, Ihle-Hansen, Bruun Wyller, Ronning) University of Oslo,
Institute of Clinical Medicine, Oslo, Norway
(Pennlert, Glader, Wester) Department of Public Health and Clinical
Medicine, Umea University Hospital, Umea, Sweden
(Kruuse) Herlev Gentofte Hospital and University of Copenhagen, Herlev,
Denmark
(Wester) Department of Clinical Sciences, Karolinska Institute, Danderyds
Hospital, Stockholm, Sweden
(Ihle-Hansen) Department of Neurology, Oslo University Hospital, Oslo,
Norway
(Carlsson) Department of Neurology, Nordland Hospital Trust, Bodo, Norway
(Carlsson) Department of Clinical Medicine, UiT The Arctic University of
Norway, Tromso, Norway
(Al-Shahi Salman) Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, United Kingdom
(Ronning) Department of Neurology, Akershus University Hospital,
Lorenskog, Norway
Publisher
SAGE Publications Ltd
Abstract
Background and aims: Many patients with prior intracerebral haemorrhage
have indications for antithrombotic treatment with antiplatelet or
anticoagulant drugs for prevention of ischaemic events, but it is
uncertain whether such treatment is beneficial after intracerebral
haemorrhage. STudy of Antithrombotic Treatment after IntraCerebral
Haemorrhage will assess (i) the effects of long-term antithrombotic
treatment on the risk of recurrent intracerebral haemorrhage and occlusive
vascular events after intracerebral haemorrhage and (ii) whether imaging
findings, like cerebral microbleeds, modify these effects. Method(s):
STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is a
multicentre, randomised controlled, open trial of starting versus avoiding
antithrombotic treatment after non-traumatic intracerebral haemorrhage, in
patients with an indication for antithrombotic treatment. Participants
with vascular disease as an indication for antiplatelet treatment are
randomly allocated to antiplatelet treatment or no antithrombotic
treatment. Participants with atrial fibrillation as an indication for
anticoagulant treatment are randomly allocated to anticoagulant treatment
or no anticoagulant treatment. Cerebral CT or MRI is performed before
randomisation. Duration of follow-up is at least two years. The primary
outcome is recurrent intracerebral haemorrhage. Secondary outcomes include
occlusive vascular events and death. Assessment of clinical outcomes is
performed blinded to treatment allocation. Target recruitment is 500
participants. Trial status: Recruitment to STudy of Antithrombotic
Treatment after IntraCerebral Haemorrhage is on-going. On 30 April 2020,
44 participants had been enrolled in 31 participating hospitals. An
individual patient-data meta-analysis is planned with similar randomised
trials. Copyright © European Stroke Organisation 2020.

<24>
Accession Number
626155330
Title
Silent brain infarcts on diffusion-weighted imaging after carotid
revascularisation: A surrogate outcome measure for procedural stroke? A
systematic review and meta-analysis.
Source
European Stroke Journal. 4(2) (pp 127-143), 2019. Date of Publication: 01
Jun 2019.
Author
Traenka C.; Engelter S.T.; Brown M.M.; Dobson J.; Frost C.; Bonati L.H.
Institution
(Traenka, Engelter, Bonati) Stroke Center and Department of Neurology,
University Hospital Basel and University of Basel, Basel, Switzerland
(Traenka, Engelter) Neurorehabilitation Unit, University of Basel,
University Center for Medicine of Aging and Rehabilitation, Felix Platter
Hospital, Basel, Switzerland
(Brown, Bonati) Stroke Research Group, Department of Brain Repair &
Rehabilitation, UCL Institute of Neurology, London, United Kingdom
(Dobson, Frost) Department of Medical Statistics, Faculty of Epidemiology
and Population Health, London School of Hygiene and Tropical Medicine,
London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Aim: To investigate whether lesions on diffusion-weighted imaging (DWI+)
after carotid artery stenting (CAS) or endarterectomy (CEA) might provide
a surrogate outcome measure for procedural stroke. Material(s) and
Method(s): Systematic MedLine database search with selection of all
studies published up to the end of 2016 in which DWI scans were obtained
before and within seven days after CAS or CEA. The correlation between the
underlying log odds of stroke and of DWI+ across all treatment groups
(i.e. CAS or CEA groups) from included studies was estimated using a
bivariate random effects logistic regression model. Relative risks of DWI+
and stroke in studies comparing CAS vs. CEA were estimated using
fixed-effect Mantel-Haenszel models. Result(s): We included data of
4871 CAS and 2099 CEA procedures (85 studies). Across all treatment groups
(CAS and CEA), the log odds for DWI+ was significantly associated with the
log odds for clinically manifest stroke (correlation coefficient 0.61 (95%
CI 0.27 to 0.87), p = 0.0012). Across all carotid artery stenting groups,
the correlation coefficient was 0.19 (p = 0.074). There were too few CEA
groups to reliably estimate a correlation coefficient in this subset
alone. In 19 studies comparing CAS vs. CEA, the relative risks (95%
confidence intervals) of DWI+ and stroke were 3.83 (3.17-4.63, p <
0.00001) and 2.38 (1.44-3.94, p = 0.0007), respectively.
 Discussion(s): This systematic meta-analysis demonstrates a
correlation between the occurrence of silent brain infarcts on
diffusion-weighted imaging and the risk of clinically manifest stroke in
carotid revascularisation procedures. Conclusion(s): Our findings
strengthen the evidence base for the use of DWI as a surrogate outcome
measure for procedural stroke in carotid revascularisation procedures.
Further randomised studies comparing treatment effects on DWI lesions and
clinical stroke are needed to fully establish surrogacy. Copyright
© European Stroke Organisation 2019.

<25>
Accession Number
2037568104
Title
Treatment Selection for the High-Risk Patient with Stage I Non-Small Cell
Lung Cancer: Sublobar Resection, Stereotactic Ablative Radiotherapy or
Image-Guided Thermal Ablation?.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(1) (pp 114-121), 2025.
Date of Publication: 01 Mar 2025.
Author
Pennathur A.; Lanuti M.; Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.;
Suh R.D.; Mak R.H.; Brunelli A.; Criner G.J.; Mazzone P.J.; Walsh G.;
Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Pettiford B.;
Rocco G.; Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.;
Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, MA, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, PA, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, NC, United
States
(Wafford) The American Association for Thoracic Surgery, Beverly, MA,
United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, IL, United States
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, CA, United States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, MA, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, OH, United
States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, LA, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United
States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
NC, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, UT, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, NY, United States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, TX, United States
(Keshavarz) Department of Family Medicine, McMaster University, ON, Canada
Publisher
W.B. Saunders
Abstract
A significant proportion of patients with stage I non-small cell lung
cancer (NSCLC) are considered at high risk for complications or mortality
after lobectomy. The American Association for Thoracic Surgery (AATS)
previously published an expert consensus document detailing important
considerations in determining who is at high risk. The current objective
was to evaluate treatment options and important factors to consider during
treatment selection for these high-risk patients. After systematic review
of the literature, treatment options for high-risk patients with stage I
NSCLC were reviewed by an AATS expert panel. Expert consensus statements
and vignettes pertaining to treatment selection were then developed using
discussion and a modified Delphi method. The expert panel identified
sublobar resection, stereotactic ablative radiotherapy (SABR), and
image-guided thermal ablation (IGTA) as modalities applicable in the
treatment of high-risk patients with stage I NSCLC. The panel also
identified lung-nodule-related factors that are important to consider in
treatment selection. Using this information, the panel formulated 14
consensus statements and 5 vignettes illustrating clinical scenarios. This
article summarizes important factors to consider in treatment selection
using these modalities, which are applicable in high-risk patients with
stage I NSCLC. The choice of which modality (sublobar resection, SABR, or
IGTA) is optimal in high-risk patients with stage I NSCLC is complex, but
a surgical approach is generally favored when deemed safe. SABR and IGTA
are reasonable options in select patients. SABR is more commonly used than
IGTA and is likely the next-best choice. A multi-disciplinary review of
patient and tumor characteristics is essential for achieving an optimal
decision. The clinical treatment decision should also take patient
perspectives, preferences, and quality of life into
consideration. Copyright © 2024 Elsevier Inc.

<26>
Accession Number
2037514654
Title
Systematic Review of the Comparative Studies of Image-Guided Thermal
Ablation, Stereotactic Radiosurgery, and Sublobar Resection for Treatment
of High-Risk Patients with Stage I Non-Small Cell Lung Cancer.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(1) (pp 106-113), 2025.
Date of Publication: 01 Mar 2025.
Author
Pennathur A.; Lanuti M.; Merritt R.E.; Wolf A.; Keshavarz H.; Loo B.W.;
Suh R.D.; Mak R.H.; Brunelli A.; Criner G.J.; Mazzone P.J.; Walsh G.;
Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Pettiford B.;
Rocco G.; Luketich J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.;
Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, NY, United States
(Keshavarz) Department of Family Medicine, McMaster University, Ontario,
Canada
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, CA, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United
States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, MA, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, PA, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, OH, United
States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, TX, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, IL, United States
(Wafford) The American Association for Thoracic Surgery, Beverly, MA,
United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
NC, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, LA, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, UT, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, NC, United
States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
The Clinical Practice Standards Committee of the American Association for
Thoracic Surgery assembled an expert panel and conducted a systematic
review of the literature detailing studies directly comparing treatment
options for high-risk patients with stage I non-small cell lung cancer
(NSCLC). A systematic search was performed to identify publications
comparing outcomes following image-guided thermal ablation (IGTA),
stereotactic ablative radiotherapy (SABR; also called stereotactic body
radiation therapy [SBRT] and stereotactic radiosurgery [SRS]), and
sublobar resection-the main treatment options applicable to high-risk
patients with stage I NSCLC. There were no publications detailing
completed randomized controlled trials comparing these treatment options.
Several retrospective studies with comparisons were identified, some of
which used large, population-based registries. The findings of several of
these studies are summarized in this Expert Review article. Registry
studies comparing IGTA with SABR in propensity-score matched patients with
stage I NSCLC found no difference in overall survival. The use of thermal
ablation was less frequent and had wider variation depending on geographic
region as compared with SABR, however. Studies yielding high-quality data
comparing SABR with sublobar resection have been limited. When comparing
sublobar resection with IGTA, sublobar resection was associated with
superior primary tumor control and overall survival in the retrospective
cohort studies. Retrospective comparative studies are difficult to assess
due to the inherent biases or treatment selection and the definitions of
loco-regional control. Prospective randomized trials are needed to fully
evaluate the outcomes of treatment options applicable to high-risk
patients with early-stage lung cancer. Copyright © 2024

<27>
Accession Number
2037514971
Title
Systematic Review of Stereotactic Ablative Radiotherapy
(SABR)/Stereotactic Body Radiation Therapy (SBRT) for Treatment of
High-Risk Patients with Stage I Non-Small Cell Lung Cancer.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(1) (pp 89-98), 2025.
Date of Publication: 01 Mar 2025.
Author
Wolf A.; Loo B.W.; Mak R.H.; Liptay M.; Pettiford B.; Rocco G.; Lanuti M.;
Merritt R.E.; Keshavarz H.; Suh R.D.; Brunelli A.; Criner G.J.; Mazzone
P.J.; Walsh G.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong B.; Luketich
J.; Schuchert M.J.; Varghese T.K.; D'Amico T.A.; Pennathur A.; Swanson
S.J.
Institution
(Luketich, Schuchert, Pennathur) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, PA, United
States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, MA, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, PA, United States
(D'Amico) Department of Surgery, Duke Cancer Institute, Durham, NC, United
States
(Wafford) The American Association for Thoracic Surgery, Beverly, MA,
United States
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, IL, United States
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, CA, United States
(Mak) Department of Radiation Oncology, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, MA, United States
(Marshall) Sarasota Memorial Hospital, Jellison Cancer Institute,
Sarasota, FL, United States
(Mazzone) Respiratory Institute, Cleveland Clinic, Cleveland, OH, United
States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, OH, United States
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, LA, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Suh) Department of Radiological Sciences, Ronald Reagan UCLA Medical
Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United
States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
NC, United States
(Varghese) Division of Cardiothoracic Surgery, University of Utah,
Huntsman Cancer Center, Salt Lake City, UT, United States
(Wolf) Department of Thoracic Surgery, The Icahn School of Medicine at
Mount Sinai and Mount Sinai Hospital, New York, NY, United States
(Walsh) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, TX, United States
(Keshavarz) Department of Family Medicine, McMaster University, ON, Canada
Publisher
W.B. Saunders
Abstract
Stereotactic ablative radiotherapy (SABR) has emerged as an alternative,
non-surgical treatment for high-risk patients with stage I non-small cell
lung cancer (NSCLC) with increased use over time. The American Association
for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC)
assembled an expert panel and conducted a systematic review of the
literature evaluating the results of SABR, which is also referred to as
stereotactic body radiation therapy (SBRT) or stereotactic radiosurgery
(SRS), prior to developing treatment recommendations for high-risk
patients with stage I NSCLC based on expert consensus. Publications
detailing the findings of 16 prospective studies of SABR and 14
retrospective studies of SABR for the management of early-stage lung
cancer in 54,697 patients were identified by systematic review of the
literature with further review by members of our expert panel. Medical
inoperability (93-95%) was the primary reason for utilizing SABR. The
median rate of histologically confirmed cancer in treated patients was 67%
(range 57-86%). In retrospective studies and prospective studies, the most
common dosing regimens were 48-54 Gy in 3-5 fractions and 44-66 Gy in 3-5
fractions respectively. The median follow-up after SABR was 30 months
(range 15-50). The complications, oncological results and quality of life
after SABR in high-risk patients with early-stage NSCLC are summarized in
this Expert Review article. Further prospective randomized trials are
needed and are currently underway to compare outcomes after SABR with
outcomes after sublobar resection to fully evaluate treatment options
applicable this high-risk group of patients. Copyright © 2024

<28>
[Use Link to view the full text]
Accession Number
2038032221
Title
Mechanical heart valves between myths and new evidence: A systematic
review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 26(1) (pp 18-28), 2025. Date of
Publication: 01 Jan 2025.
Author
Santarpino G.; Serraino G.F.; Cardetta F.; Di Mauro M.; De Feo M.;
Menicanti L.; Paparella D.; Mastroroberto P.; Sorrentino S.; Speziale G.;
Pollari F.; Mauro M.; Torella M.; Coscioni E.; Chello M.; Barili F.;
Parolari A.
Institution
(Santarpino, Serraino, Mastroroberto, Mauro) Department of Experimental
and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro,
Italy
(Santarpino) Department of Cardiac Surgery, Citta di Lecce Hospital, GVM
Care and Research, Lecce, Italy
(Santarpino, Pollari) Department of Cardiac Surgery, Klinikum Nurnberg,
Paracelsus Medical University Nuremberg, Nuremberg, Germany
(Cardetta, Chello) Department of Cardiac Surgery, University Campus
Biomedico, Rome, Italy
(Di Mauro) Faculty of Health, Medicine and Life Sciences Maastricht
University, Maastricht, Netherlands
(De Feo, Torella) Department of Translational Medical Sciences, University
of Campania Luigi Vanvitelli, Naples, Italy
(Menicanti, Parolari) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
(Paparella) Department of Medical and Surgical Sciences, Division of
Cardiac Surgery, University of Foggia, Foggia, Italy
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
(Sorrentino) Department of Medical and Surgical Sciences, Magna Graecia
University of Catanzaro, Catanzaro, Italy
(Speziale) Division of Cardiac Surgery, Anthea Hospital, GVM Care &
Research, Bari, Italy
(Coscioni) Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi
d'Aragona, Salerno, Italy
(Barili) Department of Biomedical and Clinical Sciences, Universita Degli
Studi di Milano, Italy
(Barili) IRCCS Ospedale Galeazzi-sant'Ambrogio, Milan, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
AimsThe use of mechanical valve prostheses in cardiac surgery remains a
necessary and indicated intervention in a large number of patients.
However, predicted results associated with their use, on which current
guideline recommendations have been developed, are based on dated studies
at risk of bias (e.g. use of old generation models, very high
international normalized ratio regimes).MethodsA comprehensive search in
multiple electronic databases was conducted from January 1995 to January
2024 using predefined criteria. The primary outcomes included all-cause
death, bleeding events and thromboembolic events (i.e. stroke) at
follow-up.ResultsOverall, 38 studies were included in the meta-analysis.
Cumulative meta-analysis results for mortality, thromboembolic events and
bleeding events were initially extremely variable and tended to become
more consistent over time. A meta-regression for the impact of age and sex
on mortality showed no difference, whereas a meta-regression for the
impact of age and sex on thromboembolic events and on bleeding events
showed a higher risk in the elderly and in female patients,
respectively.ConclusionThe lack of fundamental information on the type of
anticoagulant treatment (e.g. dosage, monitoring method) in the studies
published to date does not allow us to draw any definitive conclusions on
the outcomes of mechanical valve prostheses. The most recent studies have
provided more consistent results, which in the past were highly variable,
probably due to overcoming the bias in the use of prosthetic models of
different generations. Copyright © 2025 Lippincott Williams and
Wilkins. All rights reserved.

<29>
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. Copyright © 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.

<30>
Accession Number
2035949465
Title
Ovarian cancer and isolated cardiophrenic lymph nodes metastases: a
systematic review.
Source
Journal of the Turkish German Gynecology Association. 26(1) (pp 49-54),
2025. Date of Publication: 01 Mar 2025.
Author
Psomiadou V.; Fotiou A.; Iavazzo C.
Institution
(Psomiadou, Iavazzo) Metaxa Memorial Cancer Hospital, Piraeus, Greece
(Fotiou) Department of Obstetrics and Gynecology, National and
Kapodistrian University of Athens Medical School, Attikon Hospital,
Athens, Greece
Publisher
Galenos Publishing House
Abstract
Currently, there is limited information available on the best course of
action for advanced epithelial ovarian cancer (OC) with isolated
extra-peritoneal disease in the cardiophrenic lymph nodes. Recently, there
have been numerous reports of successful surgical removal of metastatic
cardiophrenic lymph nodes in patients with OC, mostly during primary or
interval cytoreduction procedures. However, the optimal management of
isolated, extra-peritoneal cardiophrenic lymph node metastasis (ICLNM)
remains unclear, since this clinical scenario is rather uncommon in OC and
chemotherapy is so far the indicated treatment for patients with from
advanced stage disease. We searched the English-language literature for
cases of OC with ICLNM or recurrence, evaluating the feasibility and
safety of surgical excision. From 2009 to 2022 only 11 cases were
reported. In seven the tumor was of serous histology. ICLN was detected in
five cases with primary disease and in the remaining six it was recurrence
of OC. The primary disease was treated in 10/11 patients with primary
cytoreduction while the other received systemic chemotherapy. The ICLNM
was removed in all the patients, in 10 via video-assisted thoracic surgery
and in one via transdiaphragmatic incision. Median follow-up was 10
months. Copyright © 2025 The Author.

<31>
Accession Number
2037970347
Title
Outcomes of periprocedural continuation vs interruption of oral
anticoagulation in transcatheter aortic valve replacement.
Source
World Journal of Cardiology. 17(3) (no pagination), 2025. Article Number:
104000. Date of Publication: 26 Mar 2025.
Author
Goyal A.; Shoaib A.; Fareed A.; Jawed S.; Khan M.T.; Salim N.; Zameer U.;
Siddiqui A.; Thakur T.; Sulaiman S.A.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College, KEM
Hospital, Maharashtra, Mumbai, India
(Shoaib, Fareed, Jawed, Khan, Salim, Zameer, Siddiqui) Department of
Internal Medicine, Karachi Medical and Dental College, Sindh, Karachi,
Pakistan
(Thakur) Department of Internal Medicine, Government Medical College,
Punjab, Patiala, India
(Sulaiman) Department of Internal Medicine, The University of Jordan,
Amman, Jordan
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Up to one-third of patients undergoing transcatheter aortic
valve replacement (TAVR) have an indication for oral anticoagulation
(OAC), primarily due to underlying atrial fibrillation. The optimal
approach concerning periprocedural continuation vs interruption of OAC in
patients undergoing TAVR remains uncertain, which our meta-analysis aims
to address. AIM To explore safety and efficacy outcomes for patients
undergoing TAVR, comparing periprocedural continuation vs interruption of
OAC therapy. METHODS A literature search was conducted across major
databases to retrieve eligible studies that assessed the safety and
effectiveness of TAVR with periprocedural continuous vs interrupted OAC.
Data were pooled using a random-effects model with risk ratio (RR) and
their 95% confidence interval (CI) as effect measures. All statistical
analyses were conducted using Review Manager with statistical significance
set at P < 0.05.RESULTS Four studies were included, encompassing a total
of 1813 patients with a mean age of 80.6 years and 49.8% males. A total of
733 patients underwent OAC interruption and 1080 continued. Stroke
incidence was significantly lower in the OAC continuation group (RR =
0.62, 95%CI: 0.40-0.94; P = 0.03). No significant differences in major
vascular complications were found between the two groups (RR = 0.95,
95%CI: 0.77-1.16; P = 0.60) and major bleeding (RR = 0.90, 95%CI:
0.72-1.12; P = 0.33). All-cause mortality was non-significant between the
two groups (RR = 0.83, 95%CI: 0.57-1.20; P = 0.32). CONCLUSION
Continuation of OAC significantly reduced stroke risk, whereas it showed
trends toward lower bleeding and mortality that were not statistically
significant. Further large-scale studies are crucial to determine clinical
significance. Copyright ©The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<32>
Accession Number
2038105916
Title
Comparison of two different intrathecal morphine doses for postoperative
analgesia after video-assisted thoracoscopic surgery.
Source
Journal of Anaesthesiology Clinical Pharmacology. 41(2) (pp 219-225),
2025. Date of Publication: 01 Apr 2025.
Author
Okbaz V.; Turktan M.; Gulec E.; Hatipoglu Z.; Bahceci C.; Karacaoglu I.C.
Institution
(Okbaz, Turktan, Gulec, Hatipoglu) Department of Anesthesiology and
Reanimation, Cukurova University, Faculty of Medicine, Adana, Turkey
(Bahceci) Department of Econometrics and Statistics, Adnan Menderes
University, Faculty of Economics, Aydin, Turkey
(Karacaoglu) Department of Thoracic Surgery, Cukurova University, Faculty
of Medicine, Adana, Turkey
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative pain is one of the most common problems
after thoracic surgery. In this study, we aimed to investigate the
analgesic effects of two different doses of intrathecal morphine (ITM)
based on ideal body weight in patients who underwent video-assisted
thoracoscopic surgery (VATS). Material(s) and Method(s): Forty-six
patients scheduled for elective lung resection were included in this
study. Patients were allocated to receive 10 mug/kg (Group I) and 7 mug/kg
(Group II) ITM according to the ideal body weight for postoperative
analgesia. Intraoperative and postoperative hemodynamic variables,
postoperative morphine consumption, pain scores (at rest and effort), side
effects, and additional analgesic requirements were recorded.
 Result(s): Postoperative pain scores did not differ in the first 12 h
between the groups, but were significantly lower in Group I compared with
Group II at 18 and 24 hours (P = 0.024 and P = 0.017 at rest, and P =
0.025 and P = 0.002 at effort, respectively). Postoperative morphine
consumption was statistically significantly lower in Group I at all time
periods (P < 0.05). The incidence of side effects was similar for both
groups (P > 0.05). Conclusion(s): The use of 10 mug/kg ITM according
to the ideal body weight provides more effective analgesia without
increasing the side effects compared to 7 mug/kg ITM after
VATS. Copyright © 2025 Journal of Anaesthesiology Clinical
Pharmacology.

<33>
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. 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. 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). 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. Copyright © 2025 The Authors

<34>
Accession Number
2038133250
Title
Cardiac Surgery 2024 Reviewed.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2025. Date of
Publication: 2025.
Author
Kirov H.; Caldonazo T.; Mukharyamov M.; Toshmatov S.; Fleckenstein P.;
Kyashif T.; Siemeni T.; Doenst T.
Institution
(Kirov, Caldonazo, Mukharyamov, Toshmatov, Fleckenstein, Kyashif, Siemeni,
Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University of Jena, University Hospital Jena, Jena,
Germany
Publisher
Georg Thieme Verlag
Abstract
For the 11th consecutive time, we systematically reviewed the
cardio-surgical literature for the past year (2024), using the PRISMA
approach for a results-oriented summary. In 2024, the discussion on the
value of randomized and registry evidence increased, triggered by
consistent findings in the field of coronary artery disease (CAD) and
discrepant results in structural heart disease. The literature in 2024
again confirmed the excellent long-term outcomes of CABG compared with PCI
in different scenarios, generating further validation for the CABG
advantage reported in randomized studies. This has been reflected in the
new guidelines for chronic CAD in 2024. Two studies indicate novel
perspectives for CABG, showing that cardiac shockwave therapy in CABG
improves myocardial function in ischemic hearts and that CABG guided by
computed tomography is safe and feasible. For aortic stenosis, an early
advantage for transcatheter (TAVI) compared with surgical (SAVR) treatment
has found more support; however, long-term TAVI results keep being
challenged, this year by new FDA and registry data in favor of SAVR. For
failed aortic valves, redo-SAVR showed superior results compared with
valve-in-valve TAVI. In the mitral field, studies showed short-term
noninferiority for transcatheter treatment compared with surgery for
secondary mitral regurgitation (MR), and significant long-term survival
benefit in registries with surgery for primary MR. Finally, surgery was
associated with better survival compared with medical therapy for acute
type A aortic intramural hematoma. This article summarizes publications
perceived as important by us. It cannot be complete nor free of individual
interpretation but provides up-to-date information for patient-specific
decision-making. Copyright © 2025. Thieme.All rights reserved.

<35>
Accession Number
2033528954
Title
Impact of SGLT2 Inhibitors on Renal Function in Type 2 Diabetic Patients
with Coronary Artery Disease Undergoing Percutaneous Intervention: A
Systematic Review and Meta-Analysis.
Source
Current Diabetes Reviews. 21(9) (no pagination), 2025. Article Number:
e030724231535. Date of Publication: 2025.
Author
Basutkar R.S.; Cutinha R.M.; Sathish V.; Shahil A.; C.K N.S.
Institution
(Basutkar, Cutinha, Sathish, Shahil, C.K) Department of Pharmacy Practice,
Nitte (Deemed to be University), NGSM Institute of Pharmaceutical
Sciences, NGSMIPS, Karnataka, Mangalore, India
Publisher
Bentham Science Publishers
Abstract
Background: Contrast agents directly cause kidney toxicity in patients who
are candidates for percutaneous intervention having cardiovascular disease
with type 2 diabetes. Aim(s): This meta-analysis aims to assess the
effects of SGLT2i on renal function in individuals undergoing percutaneous
intervention. Method(s): The databases used for the search included
Google Scholar, PubMed, Cochrane Central Registry of Controlled Trials,
and Scopus. We considered randomized controlled and observational studies
published from January, 2013, to August, 2023. Eligibility to include the
studies was assessed independently. The Cochrane modified data extraction
form and Joanna Briggs Institute were used to extract the data. The
quality of the studies was evaluated using the Cochrane risk of bias tool
and the Newcastle-Ottawa scale. The GradePro software was used to measure
the certainty of the evidence. Result(s): The pooled estimate showed
a substantial reduction in serum creatinine levels at 48 and 72 hours
post-PCI who received SGLT2i (MD -9.57; 95% CI -18.36, -0.78; p-value 0.03
and MD -14.40; 95% CI -28.57, -0.22; p-value 0.05). There was a decrease
in the occurrence of the CI-AKI among SGT2i users (RR: 0.46; 95% CI: 0.32,
0.67; p value< 0.0001). No substantial difference was observed in the
number of patients requiring hemodialysis; however, a lower proportion of
patients among SGLT2i users required hemodialysis (RR: 0.88; 95% CI: 0.19,
4.07; p-value = 0.87). Conclusion(s): The use of SGLT2i confers
substantial beneficial effects on kidney function and reduces the
occurrence of contrast-induced acute kidney injury among diabetes patients
undergoing PCI procedures with cardiovascular disease. Copyright
© 2025 Bentham Science Publishers.

<36>
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. Objective(s): To systematically synthesize
the quantitative and qualitative evidence on the barriers and facilitators
to medication adherence in patients after PCI surgery. 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). 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. 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. Copyright © 2025
Elsevier Inc.

<37>
Accession Number
646852111
Title
Mitral repair with annuloplasty for moderate ischemic mitral regurgitation
in people undergoing coronary artery bypass surgery.
Source
Cochrane Database of Systematic Reviews. 2025(3) (no pagination), 2025.
Article Number: CD015777. Date of Publication: 21 Mar 2025.
Author
Paez R.P.; Rocco I.S.; Guizilini S.; Flumignan R.L.G.; Carmo A.C.F.D.;
Gomes W.J.
Institution
(Paez, Rocco, Guizilini, Gomes) Postgraduation Program in Cardiology,
Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Rocco, Guizilini, Gomes) Division of Cardiovascular Surgery, Universidade
Federal de Sao Paulo, Sao Paulo, Brazil
(Flumignan) Department of Surgery, Division of Vascular and Endovascular
Surgery, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Carmo) Regional Medicine Library (BIREME), Universidade Federal de Sao
Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the effects of mitral repair with
annuloplasty for moderate ischemic mitral regurgitation in people
undergoing coronary artery bypass grafting. Copyright © 2025 The
Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<38>
Accession Number
2034076538
Title
Hemoadsorption use in adult cardiac surgery for infective endocarditis: A
comprehensive meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2025. Date of
Publication: 2025.
Author
Dutta P.; Ganduboina R.; Muderrisoglu C.; Obulareddy A.C.R.; Palagati K.;
Areddy V.R.; Reddy G.A.; Sainathan S.
Institution
(Dutta, Muderrisoglu) Department of Surgery, University of Illinois,
Chicago, IL, United States
(Ganduboina) Department of Surgery, NRI Institute of Medical Sciences,
Visakhapatnam, India
(Obulareddy) Division of Surgery, SVS Medical College, Mahbubnagar, India
(Palagati) Division of Surgery, Government Medical College, Anantapur,
India
(Areddy) Division of Surgery, Sri Venkateswara Medical College, Tirupati,
India
(Reddy) Division of Internal Medicine, New York Medical College at St
Mary's General Hospital and St Claire's Health, New York, NY, United
States
(Sainathan) Division of Cardiothoracic Surgery, University of Miami,
Miami, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Infective endocarditis (IE) is a severe infection of the
endocardium, primarily affecting the heart valves, exhibiting high
morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary
bypass (CPB) can further exacerbate the inflammatory response and cytokine
production from IE. The current meta-analysis evaluates the use of
CytoSorb hemoadsorption in IE patients undergoing cardiac
surgery to determine its efficacy in reducing inflammatory mediators and
improving clinical outcomes. Method(s): PubMed, Cochrane, Google
Scholar, Clinical Trials, and Google Scholar were searched for articles
until July 2024. After performing a risk of bias and quality assessment,
data on operative times, mortality, and morbidity were extracted for
meta-analysis. Statistical Software R (version 4.4.0) was used to
calculate odds ratio (OR) and standardized mean differences using a
random-effect model with a 95% confidence interval (CI) and p-value less
than 0.05. Result(s): Eight studies, encompassing 1076 patients, were
included in the analysis. These comprised three randomized controlled
trials and five nonrandomized studies. The majority of these studies
exhibited some concerns regarding bias. Hemoadsorption group showed lower
discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, p = 0.05) compared to
controls, but no significant disparity is observed in other outcomes.
In-hospital outcomes also showed higher heterogeneity, with an I2 value
greater than 50%. Conclusion(s): CytoSorb use in patients undergoing
cardiac surgery with CPB used for IE has no impact on operative mortality
and morbidity but has a beneficial effect on discharge
mortality. Copyright © The Author(s) 2025.

<39>
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

<40>
Accession Number
2037799177
Title
Use of Hydroxycobolamin in the Prevention of Vasoplegic Syndrome in Adult
Patients Undergoing Cardiopulmonary Bypass: A Controlled Prospective
Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(5) (pp 1180-1187),
2025. Date of Publication: 01 May 2025.
Author
Salah D.; Ahmed S.; Ibrahim D.A.
Institution
(Salah, Ahmed, Ibrahim) Anesthesia, Intensive Care Unit, and Pain, Ain
Shams University, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objective: We hypothesized that the prophylactic use of hydroxocobalamin
in patients at high-risk patients to develop vasoplegia after
cardiopulmonary bypass (CPB) may decrease its incidence. Design(s):
This randomized placebo-controlled prospective single-center study was
conducted on high-risk patients for vasoplegia who underwent coronary
artery bypass grafting (CABG). Setting(s): This study was conducted
in Ain Shams University Hospitals from August 2019 to October 2023 in
cardiothoracic operative rooms and its intensive care unit.
 Participant(s): Patients included in the study were 18 to 60 years
old and undergoing CABG and/or valve surgery on CPB and had 2 or more
preoperative risk factors for vasoplegia. They were receiving using
preoperative beta-blocker or angiotensin-converting enzyme inhibitor with
a preoperative ejection fraction of less than 35% and a history of thyroid
disease and preoperative diuretics. Intervention(s): At the end of
CPB, the patients were assigned randomly into two groups: group I
consisted of 30 patients who received hydroxocobalamin 5 g intravenously
via the central venous catheter as a bolus over 15 minutes reconstituted
in 200 mL of normal saline, and group II (control) consisted of 30
patients who received 200 mL of normal saline intravenously over 15
minutes. Measurements and Main Results: The primary outcome was the
change in mean arterial pressure between baseline and all time points (30
and 60 minutes after CPB initiation and 30 and 60 minutes after CPB
separation) between the two groups and within the same group. The
comparison regarding the change in systemic venous resistance between
baseline and all time points (30 and 60 minutes before CPB initiation and
30 and 60 minutes after CPB separation) between the two groups and within
the same group is calculated. Cardiac index was calculated 30 min before
CPB initiation and 30 min after CPB separation. Doses of norepinephrine
and its equivalent, incidence of vasoplegic shock syndrome, serum lactate,
number of ventilator days, intensive care unit length of stay, hospital
length of stay, incidence of norepinephrine-resistant refractory
vasoplegia, acute kidney injury, shock liver and mortality in 1 week were
calculated. Results showed that mean arterial pressure and systemic venous
resistance at minutes 30 and 60 after CPB separation was significantly
higher in group I compared to group II. Cardiac index was significantly
lower in group I compared to group II. Norepinephrine requirements
(microg/kg/min) at minutes 30 and 60 after CPB separation as well as
average total dose norepinephrine equivalent were significantly lower in
group I. Serum lactate was also found to be significantly lower in group
I. Incidence of vasoplegic shock syndrome, norepinephrine-resistant
refractory vasoplegia, number of ventilator days, intensive care unit
length of stay, hospital length of stay, acute kidney injury, shock liver,
and mortality was less frequent in group I, but the differences were
statistically significant only for vasoplegia and refractory vasoplegia.
 Conclusion(s): This study showed that prophylactic hydroxocobalamin
can be used effectively to decrease the incidence of vasoplegic syndrome,
and total vasopressor dose, as well as improve tissue perfusion in
high-risk patients in cardiac surgeries. Copyright © 2025
Elsevier Inc.

<41>
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. Copyright © 2025

<42>
Accession Number
2033022347
Title
Preoperative intravenous versus oral iron supplementation for elective
surgery: evidence based on 12 randomized trials.
Source
Postgraduate Medicine. 137(2) (pp 155-163), 2025. Date of Publication:
2025.
Author
Yue L.; Zhang J.; Wang Z.; Qi L.; Zhao Y.; Wang S.; Shang M.; Li C.; Sun
H.
Institution
(Yue, Zhang, Li, Wang, Qi, Zhao, Wang, Li, Sun) Orthopaedic Department,
Peking University First Hospital, Beijing, China
(Shang) Department of Medical Statistics, Peking University First
Hospital, Beijing, China
Publisher
Taylor and Francis Ltd.
Abstract
Aim: This study aims to clarify hematological parameters, transfusion
requirements, and adverse events of preoperative intravenous (IVIS) versus
oral iron supplementation (OIS) in elective surgery patients.
 Method(s): We conducted a comprehensive literature search across
multiple databases up to 10 December 2023. Twelve RCTs involving 930
participants met our eligibility criteria. Our analysis focused on
post-treatment hemoglobin levels, changes in hemoglobin from baseline,
ferritin levels, hemoglobin attainment rates, transfusion requirements,
and adverse events. We employed the random-effects model for data
synthesis, calculating pooled standard mean differences (SMD) or mean
differences (MD) or risk ratios (RR) with 95% confidence intervals (CI).
Methodological quality was assessed using the Cochrane ROB 2 tool. The
GRADE approach evaluated the confidence in effect estimates.
 Finding(s): IVIS significantly improved post-treatment hemoglobin
levels (MD = 0.77 g/dL, 95% CI [0.30 to 1.23]), hemoglobin increments (MD
= 0.69 g/dL, 95% CI [0.01 to 1.37]), and ferritin levels (MD = 260.03
ng/mL, 95% CI [119.65 to 400.42]) compared to OIS. IVIS also led to a
higher hemoglobin attainment rate (RR = 1.88, 95% CI [1.24 to 2.86]). No
significant differences were noted in transfusion rates or volumes. IVIS
was associated with fewer digestive (RR = 0.10, 95% CI [0.05 to 0.22]; I2
= 0%) but more pain-related adverse events (RR = 7.79, 95% CI [1.78 to
34.07]; I2 = 0%). Hospital stay durations and mortality rates were similar
between the two groups. Interpretation(s): IVIS offers a superior
improvement in hematological parameters for elective surgery patients but
not reducing transfusion needs compared to OIS. While IVIS has fewer
digestive adverse events, it increases pain-related complications. These
findings highlight the importance of personalized approaches in selecting
iron supplementation methods, carefully balancing time, efficacy, and
adverse event profiles. Registration: PROSPERO
CRD42023483284. Copyright © 2025 Informa UK Limited, trading as
Taylor & Francis Group.

<43>
Accession Number
2036060800
Title
Impact of Reducing Intervals Between Two Cardioplegia Injections on
Clinical Outcomes Among Pediatrics Undergoing Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
Iranian Heart Journal. 26(2) (pp 6-14), 2025. Date of Publication: 01 Apr
2025.
Author
Jalali A.; Dehaki M.G.; Asheghi Y.; Kachoueian N.; Yaghoubi A.; Sadeghpour
S.; Shahandashti F.J.; Serajpour Z.; Gorjipour F.
Institution
(Jalali, Dehaki, Asheghi, Yaghoubi, Shahandashti, Gorjipour) Rajaie
Cardiovascular Institute, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Kachoueian) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Sadeghpour, Serajpour) Nilou Medical Laboratory, Tehran, Iran, Islamic
Republic of
(Gorjipour) Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Iranian Heart Association
Abstract
Background: The use of a cardiopulmonary bypass machine during heart
surgery can increase the risk of myocardial damage, as indicated by
elevated levels of troponin I and creatine phosphokinase markers.
Therefore, there is a need to reduce ischemia-reperfusion injury following
pediatric cardiopulmonary bypass surgery. It appears that myocardial
damage may be mitigated by shortening the intervals between cardioplegia
injections. Method(s): This randomized controlled trial was conducted
on pediatric patients undergoing surgery for Tetralogy of Fallot.
Participants were randomly assigned to either an intervention group or a
control group using the block randomization method. In the intervention
group, the interval between 2 doses of Del Nido cardioplegia was reduced
to 40 minutes, while patients in the control group received Del Nido
cardioplegia every 60 minutes. Data for the trial were collected using
checklists prepared by the researcher. Result(s): The study findings
indicated that, although the mean levels of troponin and phosphokinase
were significantly lower in the trial group compared with the control
group, the changes in both markers across different measurement times were
similar in both groups. Most other clinical outcome parameters of heart
surgeries, such as left ventricular ejection fraction, the time required
for the heart rhythm to return to normal after aortic declamping, and the
type of arrhythmia, did not show significant differences between the trial
groups. Conclusion(s): The findings of our trial demonstrated that,
although there were no statistically significant changes in hemodynamic
status, left ventricular ejection fraction, blood urea nitrogen,
creatinine levels, inotropic score, time for heart rhythm resumption, and
frequency of arrhythmia, reducing the interval between 2 Del Nido
injections had positive effects on myocardial protection in pediatric
heart surgeries. (Iranian Heart Journal 2025; 26(2): 6-14). Copyright
© 2025, Iranian Heart Association. All rights reserved.

<44>
Accession Number
2038185568
Title
Pharmaco-Invasive Strategy with Half-Dose Recombinant Human Prourokinase
Versus Primary Percutaneous Coronary Intervention.
Source
Anatolian Journal of Cardiology. 29(4) (pp 164-172), 2025. Date of
Publication: 01 Apr 2025.
Author
Jiang C.; Dou J.; Yang H.; Guo R.; Gao J.; Liu B.; Shu H.; Hou Y.; Zhao
L.; Guo J.; Luo D.
Institution
(Jiang, Dou, Yang, Guo, Gao) School of Medicine, Chengde Medical
University, Hebei, Chengde, China
(Liu, Shu, Hou, Zhao, Guo, Luo) Department of Cardiology, Chengde Central
Hospital, Second Clinical College of Chengde Medical University, Hebei,
Chengde, China
Publisher
Turkish Society of Cardiology
Abstract
Background: Primary percutaneous coronary intervention (PPCI) is preferred
as the reperfusion option for patients with ST-segment elevation
myocardial infarction (STEMI). Method(s): This study conducted the
pharmaco-invasive strategy with half-dose recombinant human prourokinase
(PHDP) trial to evaluate whether the PHPD encompassing early fibrinolysis
coupled with timely catheterization, provides efficacy and safety similar
to that of PPCI in STEMI patients. We randomly assigned patients with
STEMI aged 18-80 years who presented within 24 h of their symptoms to
receive either PHDP or PPCI. Result(s): There was no significant
difference in the 2 arms for the primary endpoints, which were defined as
thrombolysis in myocardial infarction (TIMI) flow grade 3, TIMI myocardial
perfusion grade 3, and ST-segment resolution >=70% 1 hour after
percutaneous coronary intervention. The secondary endpoints, including
slow flow/no-reflow (P < .001), malignant arrhythmia (P < .001), and
hypotension (P < .001), occurred more frequently in the PPCI arm than in
the PHDP arm. The combined 30-day follow-up outcomes occurred more often
in the PPCI group than in the PHDP group (P= .032). There were no reported
cases of in-hospital intracranial hemorrhage or major bleeding events; the
rates of minor bleeding events were similar (P= .157). Conclusion(s):
Among patients with STEMI presenting <=24 hours after symptom onset who
received the PHDP, the efficacy of complete epicardial and myocardial
reperfusion was similar to that among patients who received the PPCI. In
addition, PHDP was associated with a decreased risk of procedure-related
complications. Conducting clinical efficacy and safety trials with the
pharmaco-invasive strategy and the half-dose of fibrinolytic drug is
warranted. Copyright@Author(s)

<45>
Accession Number
2033501313
Title
Oral vs. Outpatient Parenteral Antimicrobial Treatment for Infective
Endocarditis: Study Protocol for the Spanish OraPAT-IE GAMES Trial.
Source
Infectious Diseases and Therapy. 14(3) (pp 643-655), 2025. Article Number:
100213. Date of Publication: 01 Mar 2025.
Author
Alonso-Socas M.M.; Lopez-Lirola A.; Goikoetxea-Agirre A.J.; Ribas M.A.;
Navarro D.; Sala C.; Ambrosioni J.; Olivares P.; Lopez-Cortes L.E.;
Morales I.; Mendez I.; de Cueto M.; Calvo-Jambrina R.; Barquero J.M.;
Araji O.; Almendro-Delia M.; Brase A.; Calvo-Fernandez A.; Tauron M.;
Recasens L.; Sorli L.; Suarez M.; Silverio A.; Sanchez F.; Ribas N.;
Serrat R.; Molina L.; Mestres A.; Mas A.; Ginel A.J.; Horcajada-Gallego
J.P.; Ble M.; Lopez-Montesinos I.; Salavert-Lleti M.; Garcia-Bustos V.;
Fernandez-Navarro J.A.; Calabuig-Munoz E.; Montero-Alonso M.;
Tasias-Pitarch M.; Domingo-Valero D.; Arnau-Vives M.A.; Blanes-Hernandez
R.; Vives-Borras M.; Vidal-Bonet L.; Ruiz de Gopegui-Bordes E.;
Ribas-Blanco M.A.; Zarauza J.; Teira R.; Ruiz-Alonso N.; Parra J.A.;
Pajaron M.; Gutierrez-Diez J.; Gutierrez-Cuadra M.; Gutierrez-Fernandez
L.; Gonzalez-Rico C.; Garrido R.; Garcia I.; Fernandez-Sampedro M.;
Farinas-Alvarez C.; Farinas M.C.; Cobo-Belaustegui M.; Arnaiz de las
Revillas F.; Arminanzas-Castillo C.; Amado-Fernandez C.; Aguero-Balbin J.;
Martin-Blanco N.; Oteo J.A.; Garcia-Alvarez L.; Corral-Armas E.; Blanco
J.R.; Azcona-Gutierrez J.M.; Azcarate P.; Alonso L.J.; Saura D.;
Roura-Piloto A.; Perez-Andreu J.; Ortin A.; Oliva M.J.; Moral-Escudero E.;
Martinez-Toldos M.C.; de Gea J.H.; de la Morena Valenzuela G.; Blazquez
A.; Hernandez-Torres A.; Vazquez E.G.; Canovas S.; Albert L.;
Rivera-Martinez M.A.; Lopez-Contreras J.; Leta-Petracca R.; Grillo S.;
Ginel-Iglesias A.; Barros-Membrilla A.; Camprecios M.; Gasch O.; Monsalvez
V.; Gomila A.; Calzado S.; Diaz E.; Lozano L.; Capilla S.; Guillamon L.;
Guillaumet E.; Castaldo F.; Araujo G.; Dietl B.; Ibars S.; Xercavins M.;
Boix-Palop L.; Badia C.; Rosillo S.; Romero M.; Rial-Baston V.; Ramirez
U.; Moreno M.; Loeches B.; Antorrena I.; Ruiz S.; Rodriguez-Roda-Stuart
J.; del Rio A.; Oliva E.; Navas E.; Martin-Davila P.; Moya J.L.; Hermida
J.M.; Centella T.; Sanchez-Rodriguez I.; Gracia-Sanchez L.; Blasco A.;
Sbraga F.; Ruiz-Majoral A.; Alegre O.; Sanchez-Salado J.C.; Berbel D.;
Ardanuy C.; Grau I.; Carratala J.; Escrihuela-Vidal F.;
Gonzalez-de-la-Aleja P.; Pinargote-Celorio H.; Reus S.; Plazas J.; Merino
E.; Llamas P.; Climent V.; Carrasco R.; Goyeneche M.; Bidegain M.; Sanchez
S.; Zabalo-Arrieta M.; Villanueva-Benito I.; Vicente-Anza D.;
Unamuno-Ugartemendia I.; Solla-Ruiz I.; Sebastian-Alda R.; Sanchez-Haza
E.; Saez-Berbejillo A.; Reviejo K.; Rengel-Jimenez A.;
Perez-Moreiras-Lopez J.I.; Kortajarena-Urkola X.; Iribarren J.A.;
Granda-Bauza A.; Goyeneche del Rio M.; Goenaga M.A.; Fuentes A.;
Eizaguirre-Yarza A.; Echeverria T.; del Bosque-Martin C.;
Bustinduy-Odriozola M.J.; Berritu-Boronat E.; Azkune-Galparsoro H.; Camino
X.; Alvarez-Rodriguez I.; Voces R.; Vitoria Y.; Rodriguez R.; Rodrigo D.;
Nieto J.; Montejo M.; Lopez-Soria L.; Irurzun-Zuazabal J.; Iruretagoyena
J.R.; Ibarrola-Hierro M.; Goikoetxea A.J.; Euba-Ugarte G.; Del Alamo
Martinez de Lagos M.; Guio-Carrion L.; Crespo A.; Campana-Lazaro M.; Boado
M.V.; Blanco R.; Blanco-Vidal M.J.; Bereciartua E.; de la Villa S.;
Verde-Moreno E.; Vazquez P.; Valerio M.; Segado A.; Sanchez-Perez E.;
Rodriguez-Abella H.; Rincon C.; Pinto A.; Pinilla B.; Pedraz A.; Olmedo
M.; Monzon D.; Munoz P.; Melero R.; Martinez-Selles M.; Marin M.; Machado
M.; Hualde A.M.; Kestler-Hernandez M.; Gonzalez-Ramallo V.;
Gonzalez-Moraga F.J.; Mansilla A.G.; Garcia-Leoni M.E.; Gargallo E.;
Fortuny-Ribas R.; Estevez A.; Delgado-Montero A.; Cuerpo-Caballero G.;
Calatayud J.; Bouza E.; Bermejo J.; Alvarez-Uria A.; Alonso J.C.; Adan I.;
Rodriguez-Moreno F.; Prada-Arrondo P.; Perez-Ramirez A.; Lorenzo de la
Pena L.; Lacalzada J.; Gonzalez Gonzalez J.; Garcia-Rosado D.;
Fernandez-Sarabia J.; Delgado-Melian T.; Castro B.; Alonso M.D.M.;
Poyato-Borrego M.; Sanchez-Dominguez E.; Ortiz-Carrellan A.; Marin G.;
Luque-Marquez R.; Lopez-Haldon J.; Lepe J.A.; Gutierrez-Carretero E.;
Navarro-Amuedo D.; de Alarcon A.; Vila J.; Tuset M.; Vidal B.; Urra X.;
Tolosana J.M.; Tellez A.; Soy D.; Sitges M.; Sanchis L.; Sandoval E.;
Rovira I.; Roque M.; Roca C.; Regueiro A.; Ramirez J.; Quintana E.; Pomar
J.L.; Perissinotti A.; Pericas J.M.; Pereda D.; Pare C.; Ortiz J.; Ninot
S.; Nicolas D.; Moreno A.; Miro J.M.; Marco F.; Lopez T.; Llopis-Perez J.;
Hernandez-Meneses M.; Garcia-Pares D.; Garcia de la Maria C.; Fuster D.;
Fita G.; Fernandez-Pittol M.; Espasa M.; Falces C.; de Diego O.; Cuervo
G.; Canas M.A.; Castella M.; Cartana R.; Brunet M.; Azqueta M.; Ascaso M.;
Alcocer J.; Almela M.; Andrea R.
Institution
(Cuervo, Hernandez-Meneses, Moreno, Sala, Ambrosioni, Miro) Infectious
Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona,
Villarroel 170, Barcelona, Spain
(Nicolas) Internal Medicine-Home Hospitalization Unit, Hospital
Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
(Vidal) Cardiology Department, Hospital Clinic-IDIBAPS, University of
Barcelona, Barcelona, Spain
(Fernandez-Pittol) Microbiology Department, Hospital Clinic-IDIBAPS,
University of Barcelona, Barcelona, Spain
(Cuervo, de Alarcon, Martin-Davila, Lopez-Montesinos, Lopez-Cortes,
Ambrosioni, Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
(de Alarcon, Luque-Marquez, Navarro) Clinical Unit of Infectious Diseases,
Microbiology and Parasitology (UCEIMP), Institute of Biomedicine of
Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of
Seville, Seville, Spain
(Alonso-Socas, Lopez-Lirola) Hospital Universitario de Canarias, Tenerife,
Spain
(Gonzalez-Ramallo) Hospital General Universitario Gregorio Maranon,
Madrid, Spain
(Goikoetxea-Agirre) Hospital Universitario de Cruces, Bilbao, Spain
(Goenaga) Hospital Universitario Donosti, Instituto Investigacion
Biogipuzkoa, San Sebastian, Spain
(Merino) Unit of Infectious Diseases, Alicante General University Hospital
- Alicante Institute of Health and Biomedical Research (ISABIAL),
Alicante, Spain
(Merino) Clinical Medicine Department, Miguel Hernandez University, Elche,
Spain
(Escrihuela-Vidal) Hospital Universitario de Bellvitge, Barcelona, Spain
(Martin-Davila) Hospital Universitario Ramon y Cajal, Instituto Ramon y
Cajal de Investigacion Sanitaria (IRYCIS), Madrid, Spain
(Loeches) Hospital Universitario La Paz, Madrid, Spain
(Boix-Palop) Hospital Mutua de Terrassa, Terrassa, Spain
(Gasch) Servei de Malalties Infeccioses, Hospital Universitari Parc Tauli,
Institut d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Universitat
Autonoma de Barcelona, Sabadell, Spain
(Camprecios) Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
(Hernandez-Torres) Hospital Virgen de la Arrixaca, Murcia, Spain
(Garcia-Alvarez) Hospital San Pedro-CIBIR, Logrono, Spain
(Pajaron) Hospital Marques de Valdecilla, Santander, Spain
(Ribas) Hospital Son Espases, Palma, Spain
(Blanes-Hernandez) Hospital de La Fe, Valencia, Spain
(Lopez-Montesinos) Hospital del Mar, Barcelona, Spain
(Lopez-Cortes) Unidad Clinica de Enfermedades Infecciosas y Microbiologia,
Hospital Universitario Virgen Macarena, Seville, Spain
(Lopez-Cortes) Departamentos de Medicina y Microbiologia, Facultad de
Medicina, Universidad de Sevilla, Seville, Spain
(Lopez-Cortes) Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Seville,
Spain
Publisher
Adis
Abstract
Introduction: The POET trial demonstrated that moving from intravenous to
oral antibiotics in stable patients with left-sided infective endocarditis
(IE) was noninferior to fully parenteral treatment. However, it did not
compare outpatient strategies. Method(s): The OraPAT-IE GAMES trial
is a noninferiority, multicenter, randomized, open-label study aimed to
compare partial oral versus outpatient parenteral antibiotic therapy
(OPAT) for consolidation of antibiotic treatment in left-sided IE. A total
of 342 stable patients with IE caused by selected micro-organisms will
eventually be included. After a minimum of 10 days of parenteral
treatment, stable patients are randomized to oral therapy or OPAT. The
primary end-point is a composite of all-cause mortality, unplanned cardiac
surgery, relapse of positive blood cultures and/or unplanned hospital
admission. Patients are followed-up for 6 months after completing
antibiotic therapy. Planned Outcome: This trial seeks to demonstrate the
equivalent efficacy of the two outpatient strategies currently available
for stable patients with IE in the consolidation phase of antibiotic
treatment. Conclusion(s): In a global context of limited healthcare
resources and a sustained increase in elderly and frail patients, it is of
great importance to demonstrate the effectiveness and safety of outpatient
management strategies that could reduce the duration of conventional
hospitalizations with their potential complications and inherent costs.
Trial Registration: EudraCT: 2020-001024-34. ClinicalTrials.gov
identifier: NCT05398679. Copyright © The Author(s) 2025.

<46>
Accession Number
2033975200
Title
Surgical pulmonary valve redo versus transcatheter pulmonary valve
replacement for Tetralogy of Fallot patients.
Source
Expert Review of Cardiovascular Therapy. 23(3) (pp 87-95), 2025. Date of
Publication: 2025.
Author
Penteris M.; Lampropoulos K.
Institution
(Penteris) Department of Medicine, Democritus University of Thrace,
Alexandroupolis, Greece
(Lampropoulos) School of Medicine, European University of Cyprus, Nicosia,
Cyprus
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: To perform a systematic review to compare the efficacy and
safety of transcatheter pulmonary valve replacement (TPVR) and surgical
pulmonary valve replacement (SPVR) in managing pulmonary valve dysfunction
in Tetralogy of Fallot (TOF) patients. Method(s): This review
investigates through three different databases for randomized control
trials or observational studies evaluating TOF patients who underwent TPVR
or SPVR until November 2024. The outcomes of interest were hemodynamic
improvement, reduction in pulmonary regurgitation or stenosis,
complications, quality of life, and long-term outcomes. Result(s):
Four retrospective studies (1919 procedures) were analyzed. TPVR was
non-inferior to SPVR, with a comparable safety profile. The durability of
bioprosthetic valves was similar between TPVR and SPVR (HR: 0.97, 95% CI:
0.55-1.73; p = 0.93) and was influenced by patients' age at PVR (HR: 0.78
per 10 years from <1 year; 95% CI: 0.63-0.96; p = 0.02) and true inner
valve diameter. Conclusion(s): TPVR is a safe and less-invasive
alternative to SPVR with comparable efficacy in reducing pulmonary
regurgitation. Complication rates are similar and valve durability is
primarily age- and valve size-dependent. Although further research on long
term outcomes is needed, TPVR may be integrated into routine practices,
offering a viable alternative for high-risk TOF patients. Registration:
This systematic review was registered on the international prospective
register of systematic reviews (PROSPERO; #CRD42024615871). Copyright
© 2025 Informa UK Limited, trading as Taylor & Francis Group.

<47>
Accession Number
2038167176
Title
Can amino acid interventions prevent acute kidney injury in cardiac
surgery? A meta-analysis and systematic review.
Source
Nephrology Dialysis Transplantation. 40(4) (pp 823-826), 2025. Date of
Publication: 01 Apr 2025.
Author
Tinica G.; Brinza C.; Popa C.; Covic A.; Voroneanu L.; Kanbay M.; Burlacu
A.
Institution
(Covic, Tinica, Brinza, Popa, Covic, Voroneanu, Burlacu) Department of
Medicine, Faculty of Medicine, University of Medicine and Pharmacy
"Grigore T. Popa", Iasi, Romania
(Covic, Covic, Voroneanu) Department of Nephrology, Nephrology Clinic,
Dialysis, and Renal Transplant Center - "C.I. Parhon" University Hospital,
Iasi, Romania
(Tinica, Burlacu) Department of Cardiology, Institute of Cardiovascular
Diseases "Prof. Dr George I.M. Georgescu", Iasi, Romania
(Kanbay) Department of Internal Medicine, Division of Nephrology, Koc
University School of Medicine, Istanbul, Turkey
(Kanbay) Department of Medicine, Koc University School of Medicine,
Istanbul, Turkey
Publisher
Oxford University Press

<48>
Accession Number
2033994171
Title
Cardiovascular Involvement in SYNE Variants: A Case Series and Narrative
Review.
Source
Cardiogenetics. 15(1) (no pagination), 2025. Article Number: 2. Date of
Publication: 01 Mar 2025.
Author
Ravera F.; Dusi V.; Bocchino P.P.; Gobello G.; Giannino G.; Melis D.;
Brach Del Prever G.M.; Angelini F.; Saglietto A.; Giustetto C.; Gallone
G.; Pidello S.; Cannillo M.; Cingolani M.M.; Deaglio S.; Marra W.G.; De
Ferrari G.M.; Raineri C.
Institution
(Ravera, Dusi, Bocchino, Gobello, Giannino, Melis, Angelini, Saglietto,
Giustetto, Gallone, Pidello, De Ferrari, Raineri) Division of Cardiology,
Cardiovascular and Thoracic Department, Citta della Salute e della
Scienza, Turin, Italy
(Ravera, Dusi, Gobello, Giannino, Melis, Brach Del Prever, Giustetto,
Gallone, Deaglio, De Ferrari) Department of Medical Sciences, University
of Turin, Turin, Italy
(Brach Del Prever, Deaglio) Immunogenetics and Transplant Biology Unit,
Citta della Salute e della Scienza, Turin, Italy
(Cannillo, Cingolani, Marra) Division of Cardiology, Ivrea Hospital,
Ivrea, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac laminopathies encompass a wide range of diseases caused by defects
in nuclear envelope proteins, including cardiomyopathy, atrial and
ventricular arrhythmias and conduction system abnormalities. Two genes,
namely LMNA and EMD, are typically associated with these disorders and are
part of the routine genetic panel performed in affected patients. Yet,
there are other markedly fewer known proteins, the nesprins, encoded by
SYNE genes, that play a pivotal role in connecting the nuclear envelope to
cytoskeletal elements. So far, SYNE gene variants have been described in
association with neurodegenerative diseases; their potential association
with cardiac disorders, albeit anecdotally reported, is still largely
unexplored. This review focuses on the role of nesprins in cardiomyocytes
and explores the potential clinical implications of SYNE variants by
presenting five unrelated patients with distinct cardiac manifestations
and reviewing the literature. Emerging research suggests that SYNE-related
cardiomyopathies involve disrupted nuclear-cytoskeletal coupling, leading
to impaired cardiac function. Understanding these mechanisms is critical
for furthering insights into the broader implications of nuclear envelope
proteins in cardiac health and for potentially developing targeted
therapeutic strategies. Additionally, our data support the inclusion of
SYNE genes in the cardiac genetic panel for cardiomyopathies and cardiac
conduction disorders. Copyright © 2025 by the authors.

<49>
Accession Number
2038152877
Title
Prophylactic use of intravascular balloon occlusion in elective general
non-cardiac surgery. Systematic review and meta-analysis of the
literature.
Source
Cardiovascular and Metabolic Science. 36(1) (pp 35-50), 2025. Date of
Publication: 01 Jan 2025.
Author
Caicedo-Moncada B.L.; Beltran-Torres F.A.; Mendez-Ordonez E.M.
Institution
(Caicedo-Moncada, Beltran-Torres) Division of Postgraduate and advanced
training, Faculty of Medicine, El Bosque University, Bogota, Colombia
Publisher
Asociacion Nacional de Cardiologos de Mexico
Abstract
Introduction: the use of endovascular occlusion balloon in elective
non-cardiac surgery has emerged as an effective strategy to prevent
intraoperative bleeding, a significant complication that can impact both
surgical outcomes and patient recovery. This device, which selectively
occludes large blood vessels, allows for precise control of blood flow,
thereby minimizing the risk of hemorrhage and improving visibility in
critical surgical areas. Material(s) and Method(s): a search was
performed across three major databases (PubMed, Ovid, and Embase), in
addition to Google Scholar as a source of gray literature and the National
Institute of Health (NIH) as a national database, covering the period from
2014 to 2024. Result(s): this systematic review included 17 articles;
two showed a moderate risk of bias, while the others demonstrated good
quality and low risk of bias. A total of 3,379 patients were analyzed,
95.3% women. The primary indication for the use of endovascular occlusion
balloons was surgical procedures related to abnormal placentation in 67.5%
of cases, with an average blood loss of 1,256 mL (SD: 699.9). The
application of the balloon resulted in a significant reduction in blood
loss of 856 mL (OR -3.43; 95% CI -6.22 to -0.63), with no significant
differences observed in age, gender, or surgical duration.
 Conclusion(s): the use of intravascular balloon occlusion in elective
non-cardiac general surgical procedures with a high risk of hemorrhage
demonstrates effectiveness in reducing intraoperative blood loss. The most
frequently observed complications include transient arterial thrombosis
and localized issues at the puncture site. While various clinical
scenarios for its application have been described, the strongest evidence
supports its use in obstetric procedures, particularly those related to
abnormal placentation. Copyright © 2025 Asociacion Nacional de
Cardiologos de Mexico. All rights reserved.

<50>
Accession Number
2037967591
Title
Psychological interventions for depression and anxiety in patients with
coronary heart disease, heart failure or atrial fibrillation: Cochrane
systematic review and meta-analysis.
Source
European Journal of Cardiovascular Nursing. 24(2) (pp 194-204), 2025. Date
of Publication: 01 Mar 2025.
Author
Ski C.F.; Taylor R.S.; McGuigan K.; Long L.; Lambert J.D.; Richards S.H.;
Thompson D.R.
Institution
(Ski, Thompson) School of Nursing and Midwifery, Queen's University
Belfast, 97 Lisburn Road, Belfast, United Kingdom
(Ski) Australian Centre for Heart Health, 75-79 Chetwynd Street,
Melbourne, VIC, Australia
(Taylor) MRC/CSO Social and Public Health Sciences Unit, Robertson Centre
for Biostatistics, School of Health and Well Being, University of Glasgow,
90 Byres Road, Glasgow, United Kingdom
(McGuigan) Queen's Communities and Place, Queen's University Belfast, 2-8
Fitzwilliam Street, Belfast, United Kingdom
(Long) MRC/CSO Social and Public Health Sciences Unit, School of Health
and Wellbeing, University of Glasgow, 90 Byres Road, Glasgow, United
Kingdom
(Lambert) Department for Health, University of Bath, Claverton Down, Bath,
United Kingdom
(Richards) Leeds Institute of Health Sciences, University of Leeds, 6
Claredon Way, Leeds, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Depression and anxiety occur frequently in individuals with
cardiovascular disease and are associated with poor prognosis. This
Cochrane systematic review and meta-analysis assessed the effectiveness of
psychological interventions on psychological and clinical outcomes in
adults with coronary heart disease (CHD), heart failure (HF) or atrial
fibrillation (AF). Methods and Results: CENTRAL, MEDLINE, Embase,
PsycINFO, and CINAHL databases were searched from January 2009 to July
2022 for randomized controlled trials of psychological interventions vs.
controls in adults with CHD, HF, or AF. Twenty-one studies (n = 2591) were
assessed using random-effects models. We found psychological interventions
reduced depression [standardized mean difference (SMD) -0.36; 95%
confidence interval (CI) -0.65 to -0.06; P = 0.02], anxiety (SMD -0.57;
95% CI -0.96 to -0.18; P = 0.004), and improved mental health-related
quality of life (HRQoL) (SMD 0.63, 95% CI 0.01 to 1.26; P = 0.05)
(follow-up 6-12 months), but not physical health-related quality of life,
all-cause mortality or major adverse cardiovascular events compared with
controls. High heterogeneity was present across meta-analyses.
Meta-regression analysis showed that psychological interventions designed
to target anxiety, were more effective than non-targeted interventions.
 Conclusion(s): This review found that psychological interventions
improved depression, anxiety and mental HRQoL, with those targeting
anxiety to show most benefit. Given the statistical heterogeneity, the
precise magnitude of effects remains uncertain. Increasing use of
multifactorial psychological interventions shows promise for incorporating
patient needs and preferences. Investigation of those at high risk of poor
outcomes, comparison of intervention components and those with AF is
warranted. Copyright © 2024 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology.

<51>
Accession Number
2032965896
Title
Pre-operative subjective functional capacity and postoperative outcomes in
adult non-cardiac surgery: a systematic review and meta-analysis.
Source
Anaesthesia. 80(5) (pp 561-571), 2025. Date of Publication: 01 May 2025.
Author
Takahashi K.; Chiba K.; Honda A.; Iizuka Y.; Yoshinaga K.; Deo A.S.;
Uchida T.
Institution
(Takahashi, Uchida) Department of Anaesthesiology, Institute of Science
Tokyo Hospital, Tokyo, Bunkyo, Japan
(Chiba, Honda, Iizuka) Department of Anaesthesiology and Critical Care
Medicine, Jichi Medical University Saitama Medical Centre, Saitama, Omiya,
Japan
(Yoshinaga) Department of Anaesthesiology and Critical Care Medicine,
Jichi Medical University, Tochigi, Shimotsuke, Japan
(Deo) Department of Anaesthesiology, NU Hospitals, Karnataka, Bengaluru,
India
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Assessment of functional capacity is an essential part of
peri-operative risk stratification. Subjective functional capacity is
easier to examine than objective tests of patient fitness. However, the
association between subjective functional capacity and postoperative
outcomes has not been established. Method(s): Four databases were
searched for studies describing the associations between subjective
functional capacity and postoperative outcomes in adults undergoing
non-cardiac surgery. Meta-analysis was conducted among studies where
functional capacity was expressed in metabolic equivalents. The primary
outcome was postoperative major adverse cardiovascular events. Secondary
outcomes were mortality and postoperative overall complications. We
estimated the ORs of the outcomes in patients with poor functional
capacity (< 4 metabolic equivalents) as compared with those with good
functional capacity (>= 4 metabolic equivalents). Random-effects models
were used for the meta-analysis. Result(s): We identified 7835
abstracts. After screening and a full-text review, 23 studies were
selected. Evaluation methods of functional capacity included:
questionnaires (n = 7); specific questions (n = 6); and subjective
assessment by anaesthetists (n = 5). The probability of major
postoperative adverse cardiovascular events was significantly higher in
patients with poor functional capacity (OR 1.84, 95%CI 1.62-2.08) than in
those with good functional capacity. Patients with poor functional
capacity also had higher odds of mortality (OR 2.48, 95%CI 1.45-4.25) and
postoperative complications (OR 1.85, 95%CI 1.34-2.55).
 Discussion(s): Subjective functional capacity of < 4 metabolic
equivalents was associated with postoperative complications including
cardiovascular events and other serious outcomes. The results need to be
interpreted with caution due to the diverse measures used to assess
functional capacity. Copyright © 2025 Association of
Anaesthetists.

<52>
Accession Number
2027792011
Title
Systematic review and meta-analysis comparing Manta device and Perclose
device for closure of large bore arterial access.
Source
Journal of Vascular Access. 26(1) (pp 15-21), 2025. Date of Publication:
01 Jan 2025.
Author
Cheema T.; Venero C.; Champaneria S.; Younas S.; Hadeed Khan M.A.; Anjum
I.; Ijaz U.; Haider S.; Akbar M.S.; Abdul-Waheed M.; Saleem S.
Institution
(Cheema) West Suburban Medical Center, Oak Park, IL, United States
(Venero, Champaneria, Haider, Akbar, Abdul-Waheed, Saleem) University of
Kentucky College of Medicine, Lexington, KY, United States
(Younas, Ijaz) Khyber Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Hadeed Khan) Peshawar Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Anjum) Vassar Brothers Medical Center, Poughkeepsie, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Data comparing MANTA device with Perclose device for large bore arterial
access closure is limited. We performed meta-analysis to compare safety
and efficacy of the two devices in large (14 Fr sheath) arteriotomy
closure post-TAVR. Relevant studies were identified via PubMed, Cochrane,
and EMBASE databases until June, 2022. Data was analyzed using random
effect model to calculate relative odds of VARC-2 defined access-site
complications and short-term (in-hospital or 30-day) mortality. A total of
12 studies (2 RCT and 10 observational studies) comprising 2339 patients
were included. The odds of major vascular complications (OR 0.99, 95% CI
0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI
0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI
0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p =
0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma
formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis,
occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and
short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both
devices were similar. MANTA device has a similar efficacy and safety
profile compared to Perclose device. Copyright © The Author(s)
2024.

<53>
Accession Number
2029025221
Title
Effect of oxygen delivery during cardiopulmonary bypass on postoperative
neurological outcomes in patients undergoing cardiac surgery: A scoping
review of the literature.
Source
Perfusion (United Kingdom). 40(2) (pp 283-294), 2025. Date of Publication:
01 Mar 2025.
Author
Elsebaie A.; Shakeel A.; Zhang S.; Alarie M.; El Tahan M.; El-Diasty M.
Institution
(Elsebaie) Faculty of Health Sciences, Queen's University, ON, Kingston,
Bangladesh
(Shakeel) School of Medicine, Queen's University, ON, Kingston, Bangladesh
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, ON, Kingston, Bangladesh
(Alarie) Kingston Health Sciences Centre, Kingston, ON, Canada
(El Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
(El-Diasty) University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
SAGE Publications Ltd
Abstract
Background: Reduced oxygen delivery (DO<inf>2</inf>) during
cardiopulmonary bypass (CPB) was proposed as a risk factor for the
development of postoperative neurological complications (PONCs), including
cerebrovascular accidents (CVA), delirium, and postoperative cognitive
dysfunction (POCD). We aimed to review the current evidence on the
association between intraoperative DO<inf>2</inf> and the incidence of
PONCs. Method(s): MEDLINE, Embase, the Cochrane Library, and Web of
Science were electronically searched to identify comparative studies from
inception until July 2023 that reported the association between
intraoperative DO<inf>2</inf> levels and the incidence of PONCs (as
defined by the scales and diagnostic tools utilized by the studies'
authors) in adults patients undergoing cardiac surgery using CPB.
 Result(s): Of the 2513 papers identified, 10 studies, including
21,875 participants, were included. Of these, three studies reported on
delirium, two on POCD, and five on CVA. Eight studies reported reduced
intraoperative DO<inf>2</inf> in patients who developed delirium and CVA.
There was a lack of consensus on the cut-off of DO<inf>2</inf> levels or
the correlation between the period below these threshold values and the
development of PONC. Conclusion(s): Limited data suggest that
maintaining intraoperative DO<inf>2</inf> above the critical threshold
levels and ensuring adequate intraoperative cerebral perfusion may play a
role in minimizing the incidence of neurological events in adult patients
undergoing cardiac surgery on cardiopulmonary bypass. Copyright ©
The Author(s) 2024.

<54>
Accession Number
2033988929
Title
Three-Dimensional-Printed Models Reduce Adverse Events of Left Atrial
Appendage Occlusion: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Santos J.D.; Beloy F.J.; Sulague R.M.; Okudzeto H.; Medina J.R.; Cartojano
T.D.; Cruz N.; Mortalla E.D.; Kpodonu J.
Institution
(Santos, Cruz) Our Lady of Fatima University College of Medicine,
Valenzuela City, Philippines
(Beloy) Ateneo School of Medicine and Public Health, Pasig City,
Philippines
(Sulague) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Okudzeto) Dodowa Health Research Center, Greater Accra Region, Dodowa,
Ghana
(Medina) Manila Central University College of Medicine, Caloocan City,
Philippines
(Cartojano, Mortalla) Cebu Institute of Medicine, Cebu City, Philippines
(Kpodonu) Beth Israel Deaconess Medical Center, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Left atrial appendage occlusion (LAAO) has an
excellent safety profile but there is growing evidence of adverse
long-term sequelae of peri-device leak and device-related thrombus. This
study seeks to determine if guidance from 3D-printed models of left atrial
appendages reduces the incidence of side effects. Method(s): A
systematic literature search was conducted in the following databases:
Pubmed, Google Scholar, and Europe PMC. Cohort studies that directly
compared outcomes using 3D-printed model simulations before undergoing
LAAO versus using conventional imaging only among patients with
nonvalvular atrial fibrillation, CHA<inf>2</inf>DS<inf>2</inf>-VASc scores
>= 1, and relative or absolute contraindications to long-term
anticoagulation were included. Clinical outcomes included incidence of
peri-device leak, mismatch, and device-related thrombus. Meta-analysis was
done using the random-effects model. Result(s): Only three cohort
studies were eligible for meta-analysis with a mean follow-up period of 25
months. This included a total of 204 patients (mean age, 75 years). Using
3D printed models of left atrial appendage based on transesophageal
echocardiogram and cardiac computed tomography had statistically
significantly less incidence of peri-device leak (log OR -2.47; 95% CI:
-3.70 to 1.24; p = 0.00), incidence of mismatch (log OR -1.61; 95% CI:
-2.50 to 0.73; p = 0.00) and shorter procedural time (mean difference
-24.86; 95% CI: -31.75 and -27.11; p = 0.00). Although the incidence of
device-related thromboembolism was 49% less in the 3D printing-guided
group, the difference was not statistically significant (p = 0.58).
 Conclusion(s): Less incidence of peri-device leak and mismatch were
observed with 3D printing-guided left atrial appendage occlusion. A highly
powered randomized controlled trial may have to be done to confirm the
findings. Copyright © 2025 Wiley Periodicals LLC.

<55>
Accession Number
2029083961
Title
Plasma hyperosmolality during cardiopulmonary bypass is a risk factor for
postoperative acute kidney injury: Results from double blind randomised
controlled trial.
Source
Perfusion (United Kingdom). 40(2) (pp 466-474), 2025. Date of Publication:
01 Mar 2025.
Author
Svenmarker S.; Claesson Lingehall H.; Malmqvist G.; Appelblad M.
Institution
(Svenmarker, Malmqvist) Department of Public Health and Clinical Medicine,
Umea University, Umea, Sweden
(Claesson Lingehall) Department of Nursing, Umea University, Umea, Sweden
(Appelblad) Department of Public Health and Clinical Medicine, Heart
Centre, Umea University, Umea, Sweden
Publisher
SAGE Publications Ltd
Abstract
Introduction: The study objective was to investigate whether a Ringer's
acetate based priming solution with addition of Mannitol and sodium
concentrate increases the risk of cardiac surgery associated kidney injury
(CSA-AKI). Method(s): This is a double blind, prospective randomized
controlled trial from a single tertiary teaching hospital in Sweden
including patients aged >=65 years (n = 195) admitted for routine cardiac
surgery with cardiopulmonary bypass. Patients in the study group received
Ringer's acetate 1000 mL + 400 mL Mannitol (60 g) + sodium chloride 40 mL
(160 mmol) and heparin 2 mL (10 000 IU) 966 mOsmol (n = 98), while
patients in the control group received Ringer's acetate 1400 mL + heparin
2 mL (10 000 IU), 388 mOsmol (n = 97) as pump prime. Acute kidney injury
was analysed based on the Kidney Disease Improving Outcomes (KDIGO 1-3)
definition. Result(s): The overall incidence of CSA-AKI (KDIGO stage
1) was 2.6% on day 1 in the ICU and 5.6% on day 3, postoperatively. The
serum creatinine level did not show any postoperative intergroup
differences, when compared to baseline preoperative values. Six patients
in the Ringer and five patients in the Mannitol group developed CSA-AKI
(KDIGO 1-3), all with glomerular filtration rates <60 mL/min/1.73
m2. These patients showed significantly higher plasma
osmolality levels compared to preoperative values. Hyperosmolality
together with patient age and the duration of the surgery were independent
risk factors for postoperative acute kidney injury (KDIGO 1-3).
 Conclusion(s): The use of a hyperosmolar prime solution did not
increase the incidence of postoperative CSA-AKI in this study, while high
plasma osmolality alone increased the associated risk by 30%. The data
suggests further examination of plasma hyperosmolality as a relative risk
factor of CSA-AKI. Copyright © The Author(s) 2024.

<56>
Accession Number
2038118068
Title
Comparing erector spinae plane (ESP) and thoracic paravertebral (TPV)
block analgesic effect after elective video-assisted thoracic surgery: a
randomized, multiple-blinded, non-inferiority trial.
Source
Journal of Thoracic Disease. 17(3) (pp 1531-1540), 2025. Date of
Publication: 31 Mar 2025.
Author
Dossi R.; Patella M.; Barozzi B.; Dellaferrera G.; Tessitore A.;
Gimigliano I.; Cafarotti S.; Saporito A.
Institution
(Dossi, Barozzi, Gimigliano, Saporito) Department of Anaesthesia, San
Giovanni Hospital, Bellinzona, Switzerland
(Patella, Dellaferrera, Tessitore, Cafarotti) Department of Thoracic
Surgery, San Giovanni Hospital, Bellinzona, Switzerland
(Cafarotti, Saporito) Faculty of Biomedical Sciences, University of Lugano
(USI), Lugano, Switzerland
Publisher
AME Publishing Company
Abstract
Background: Video-assisted thoracic surgery (VATS) is the gold standard
for minimally invasive lung resections. Postoperative pain from VATS can
hinder breathing and increase complications. Thoracic epidural analgesia
(TEA) is effective but invasive. Less invasive options like thoracic
paravertebral (TPV) block and erector spinae plane (ESP) block are being
explored. This study compares ESP and TPV in a randomized, non-inferiority
trial, focusing on opioid consumption post-VATS. Method(s): This
single-center, randomized, multiple-blinded, controlled, non-inferiority
trial included 50 patients undergoing VATS at the Regional Hospital of
Bellinzona and Valli (ORBV). Patients were randomized to receive either an
ESP block with local anesthetic and a TPV block with saline (Anest ESP) or
an ESP block with saline and a TPV block with local anesthetic (Sham ESP).
The primary outcome was the cumulative dose of rescue opioids at 24 and 48
hours postoperatively. Result(s): Data from 47 patients were
analyzed. There was no statistically significant difference in opioid
consumption between the Anest ESP and Sham ESP groups at 24 hours (P=0.09)
and 48 hours (P=0.12). In a sub-analysis by type of surgery, the NRS
values were higher, as postulated, in major surgery. Cardiopulmonary
complications and procedural times were low and comparable between groups.
 Conclusion(s): The study did not demonstrate the non-inferiority of
the ESP block compared to the TPV block for postoperative analgesia
following VATS. However, both blocks provided effective pain relief with
no significant differences in outcomes. The findings suggest that both ESP
and TPV blocks are viable alternatives to TEA. Copyright © AME
Publishing Company.

<57>
Accession Number
2032956166
Title
Early and Late Outcomes of Transcatheter Aortic Valve Replacement in
Patients With Prior Chest Radiation: A Systematic Review and
Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(5) (pp 1012-1023),
2025. Date of Publication: 01 Apr 2025.
Author
Tzoumas A.; Kyriakoulis I.; Ntoumaziou A.; Sagris M.; Kampaktsis P.N.
Institution
(Tzoumas) Division of Cardiovascular Health and Disease, University of
Cincinnati Medical Center, Cincinnati, OH, United States
(Kyriakoulis) Faculty of Medicine, School of Health Sciences, University
of Thessaly, Larissa, Greece
(Ntoumaziou) Cincinnati Children's Hospital, Cincinnati, OH, United States
(Sagris) School of Medicine, "Hippokration" General Hospital, National and
Kapodistrian University of Athens, Athens, Greece
(Kampaktsis) Hackensack University Medical Center, Hackensack, NJ, United
States
(Kampaktsis) Aristotle University of Thessaloniki, Thessaloniki, Greece
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients with prior history of chest or mediastinal radiation
are deemed high risk for surgical AVR. Transcatheter aortic valve
replacement (TAVR) has emerged as a promising alternative for these
patients, however, this patient population was underrepresented in prior
TAVR trials. Aim(s): To compare the outcomes of TAVR in patients with
versus without a history of prior chest or mediastinal radiation.
 Method(s): This study was performed according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Systematic search of electronic databases was conducted up to September
2023. We compared early and late mortality as well as complications. A
meta-analysis was conducted with the use of a random effects model. The
I-square statistic was used to assess heterogeneity. Result(s): Seven
studies comprising 6358 patients were included in this meta-analysis.
Patients undergoing TAVR in the radiation group had a higher risk for
heart failure exacerbation (OR: 2.06; 95% CI: 1.18-3.59) and aortic valve
reintervention (OR: 5.68; 95% CI: 1.83-17.67) in the early postoperative
period compared to the nonradiation group. Analysis revealed similar
short-term (in-hospital or 30-day) all-cause-mortality (OR: 1.63; 95% CI:
0.89-2.98) between the two groups. Other perioperative complications
including myocardial infarction (MI), stroke, pacemaker insertion
requirement, major bleeding as well as access-related complications were
not significantly different between the two groups. TAVR in the radiation
group was not associated with increased all-cause mortality compared to
the nonradiation group (OR: 1.40; 95% CI: 0.93-2.11) after a mean
follow-up of 17.6 months. Other endpoints including MI, stroke, need for
pacemaker insertion, heart failure readmission rate, and need for aortic
valve reintervention were similar in the mid-term follow-up between the
two groups. Conclusion(s): TAVR in patients with a history of prior
chest or mediastinal radiation was associated with similar short-term and
mid-term mortality compared to patients without radiation. The history of
chest or mediastinal radiation was associated with more frequent heart
failure hospitalizations and aortic valve reintervention in the
postoperative period. No difference was found in mid-term complications.
Future studies are warranted to validate our findings. Copyright
© 2025 Wiley Periodicals LLC.

<58>
Accession Number
2032938622
Title
Midterm Outcomes of Endovascular Pulmonary Artery Debanding in Children.
Source
Catheterization and Cardiovascular Interventions. 105(5) (pp 998-1004),
2025. Date of Publication: 01 Apr 2025.
Author
Haddad R.N.; Sleiman N.; El Rassi I.; Saliba Z.
Institution
(Haddad, Saliba) Department of Pediatric Cardiology, Hotel Dieu de France
University Medical Center, Saint Joseph University, Beirut, Lebanon
(Haddad) M3C-Necker, Necker-Enfants Malades University Hospital,
Assistance Publique - Hopitaux de Paris (AP-HP), Paris, France
(Sleiman) Department of Pediatrics, Hotel Dieu de France University
Medical Center, Saint Joseph University, Beirut, Lebanon
(El Rassi) Department of Pediatric Cardiac Surgery, Heart Centre of
Excellence, Al Jalila Children's Speciality Hospital, Dubai, United Arab
Emirates
Publisher
John Wiley and Sons Inc
Abstract
Background: Pulmonary artery banding (PAB) palliates pulmonary
over-circulation, while endovascular debanding (ED) offers a less invasive
alternative to repeat surgery. Objective(s): To evaluate our
experience with ED. Aim(s): Retrospective review of single-center
data (2015-2023) on children with single, multiple, or "Swiss-cheese"
muscular ventricular septal defects (MVSDs) undergoing ED. Result(s):
Ten patients (50% male) underwent ED at a median age of 5 years (IQR,
1.8-6.8) and weight of 15 kg (IQR, 10.6-19.7). Four patients had single
MVSD, six had multiple MVSDs. Debanding occurred at a median of 52.8
months (IQR, 18.4-76.6) post-PAB, utilizing six non-compliant Numed Z-MED
and four semi-compliant Balt Cristal high-pressure balloons. Median
pulmonary valve annulus (PVA) diameters were 15.5 mm (IQR, 12.5-16.8)
angiographically. Median balloon-to-PVA diameter ratio was 1 (IQR, 1-1),
and median balloon-to-band diameter ratio was 2 (IQR, 1.8-2). Median
trans-PAB gradient decreased from 100 mmHg (IQR, 86-108) to 40 mmHg (IQR,
26-46) (p < 0.01) and oxygen saturation improved from a median of 92%
(IQR, 86%-97%) to 98% (IQR, 96%-98%) (p < 0.05). There were no procedural
complications. Four patients underwent MVSD device closure a median of 7
months (IQR, 3-15) before ED, while seven had concomitant closures,
including two with prior closures. Over a median follow-up of 91.7 months
(IQR, 71.8-130.7), two patients required redo ED at 23 and 36 months, one
with a contained vessel tear. Last recorded maximal Doppler gradient was
27 mmHg (IQR, 9-39). Conclusion(s): Total ED is safe with
satisfactory midterm outcomes, though repeat dilations may be necessary
during follow-up. Copyright © 2025 Wiley Periodicals LLC.

<59>
Accession Number
2031074431
Title
Impact of Dexmedetomidine Dosing and Timing on Acute Kidney Injury and
Renal Outcomes After Cardiac Surgery: A Meta-Analytic Approach.
Source
Annals of Pharmacotherapy. 59(4) (pp 319-329), 2025. Date of Publication:
01 Apr 2025.
Author
Li H.; Wang L.; Shi C.; Zhou B.; Yao L.
Institution
(Li, Wang, Shi, Zhou, Yao) Department of Anesthesiology, Peking University
International Hospital, Beijing, China
Publisher
SAGE Publications Inc.
Abstract
Background: Acute kidney injury (AKI) is a common and serious complication
following cardiac surgery. Dexmedetomidine, a highly selective
alpha2-adrenergic agonist, has shown potential renoprotective effects, but
previous studies have yielded conflicting results. Objective(s): This
meta-analysis aimed to evaluate the efficacy and safety of dexmedetomidine
in preventing AKI and reducing postoperative serum creatinine levels in
adult patients undergoing cardiac surgery. Method(s): We
comprehensively searched 5 databases for randomized controlled trials
comparing dexmedetomidine with control groups in adult cardiac surgery
patients. The main outcomes were the incidence of AKI and change in
postoperative serum creatinine levels. Meta-analyses were conducted using
RevMan 5.4 models, and subgroup analyses were performed based on
dexmedetomidine dosing and timing of administration. Continuous outcomes
were combined and analyzed using either mean difference (M.D.), while
dichotomous outcomes were analyzed using risk ratio (RR) with 95%
confidence intervals (CI). Result(s): Our study included a total of
14 trials involving 2744 patients. Dexmedetomidine administration
significantly reduced the incidence of AKI compared to control groups (RR
= 0.54, 95% CI: 0.41-0.70, P < 0.00001). Postoperative serum creatinine
levels were also lower with dexmedetomidine (MD = -0.14 mg/dL, 95% CI:
-0.28 to -0.001, P =0.04). Subgroup analyses revealed that higher initial
doses (>0.5 mug/kg) and administration during intraoperative and
postoperative periods were associated with more pronounced renoprotective
effects. Dexmedetomidine did not significantly affect mortality but
reduced the duration of the length of hospital stay and mechanical
ventilation. Conclusions and Relevance: This meta-analysis
demonstrates that dexmedetomidine administration, particularly at higher
doses and during both intraoperative and postoperative periods, reduces
the risk of AKI in adults undergoing cardiac surgery. These findings
support the use of dexmedetomidine as a preventive strategy to enhance
renal outcomes in this population. Copyright © The Author(s)
2024.

<60>
[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. Copyright © 2025 European Society of
Anaesthesiology and Intensive Care.

<61>
Accession Number
2029310008
Title
Globalization of perfusion education: Our profession's contribution to
addressing cardiac surgery inequity worldwide.
Source
Perfusion (United Kingdom). 40(2) (pp 513-515), 2025. Date of Publication:
01 Mar 2025.
Author
Searles B.; Groom R.
Institution
(Searles) Department of Cardiovascular Perfusion, SUNY Upstate Medical
University, Syracuse, NY, United States
(Groom) Department of Cardiothoracic Surgery, Tenwek Hospital College of
Health Sciences, Tenwek Hospital, Bomet, Kenya
Publisher
SAGE Publications Ltd

<62>
Accession Number
2038087756
Title
Triclosan-Containing Sutures for the Prevention of Surgical Site
Infection: A Systematic Review and Meta-Analysis.
Source
JAMA Network Open. 8(3) (no pagination), 2025. Article Number: e250306.
Date of Publication: 07 Mar 2025.
Author
Jalalzadeh H.; Timmer A.S.; Buis D.R.; Dreissen Y.E.M.; Goosen J.H.M.;
Graveland H.; Griekspoor M.; Ijpma F.F.A.; Van Der Laan M.J.; Schaad R.R.;
Segers P.; Van Der Zwet W.C.; De Jonge S.W.; Wolfhagen N.; Boermeester
M.A.
Institution
(Jalalzadeh, Timmer, De Jonge, Wolfhagen, Boermeester) Department of
Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam,
Netherlands
(Jalalzadeh, Timmer, De Jonge, Wolfhagen, Boermeester) Amsterdam
Gastroenterology Endocrinology and Metabolism, Amsterdam, Netherlands
(Jalalzadeh, Buis, Dreissen, Goosen, Graveland, Griekspoor, Ijpma, Van Der
Laan, Schaad, Segers, Van Der Zwet, Wolfhagen, Boermeester) Dutch National
Guideline Group for Prevention of Postoperative Surgical Site Infections,
Dutch Association of Medical Specialists, Utrecht, Netherlands
(Buis, Dreissen) Department of Neurosurgery, Amsterdam UMC Location
University of Amsterdam, Amsterdam, Netherlands
(Goosen) Department of Orthopedic Surgery, Sint Maartenskliniek, Ubbergen,
Netherlands
(Graveland, Griekspoor) Dutch Association of Medical Specialists, Utrecht,
Netherlands
(Ijpma, Van Der Laan) Division of Trauma Surgery, Department of Surgery,
University Medical Center Groningen, Groningen, Netherlands
(Schaad) Department of Anesthesiology, Leiden University Medical Centre,
Leiden, Netherlands
(Schaad) Dutch Association of Anesthesiology, Utrecht, Netherlands
(Segers) Department of Cardiothoracic Surgery, Maastricht University
Medical Center+, Maastricht, Netherlands
(Van Der Zwet) Department of Medical Microbiology, Infectious Diseases and
Infection Prevention, Maastricht University Medical Center, Maastricht,
Netherlands
Publisher
American Medical Association
Abstract
Importance: International guidelines recommend the use of
triclosan-containing sutures for the prevention of surgical site
infections. However, controversy still remains about triclosan-containing
suture use in clinical practice since several new randomized clinical
trials (RCTs) have shown contradicting results. Objective(s): To
update a previous systematic review and meta-analysis of the association
of triclosan-containing sutures with surgical site infections and explore
the potential added value of new RCTs. Data Sources: PubMed, Embase,
and Cochrane CENTRAL databases were searched from January 1, 2015, to
March 14, 2023. The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guideline was followed. Study Selection: Published
RCTs comparing triclosan-containing sutures with similar sutures without
triclosan for the prevention of surgical site infections in any type of
surgery were included. Data Extraction and Synthesis: Two authors (H.J.
and A.S.T.) independently extracted and pooled data in a random-effects
(Mantel-Haenszel) model. The certainty of evidence was assessed using the
Grading of Recommendations, Assessment, Development and Evaluation
approach, and trial sequential analysis was used to estimate whether
further studies would reveal different outcomes. Main Outcomes and
Measures: The primary outcome was the incidence of surgical site
infections, expressed as relative risk (RRs) and corresponding 95% CIs.
Secondary outcomes were the incidence of surgical site infections
according to depth (superficial incisional, deep incisional, and
organ/space) and adverse events related to triclosan-containing sutures.
 Result(s): The systematic review yielded 15 additional RCTs compared
with a previous published review in 2017. A meta-analysis of 31 studies
including 17968 participants (62% male) undergoing various types of
surgery was performed. Use of triclosan-containing sutures was associated
with fewer surgical site infections compared with sutures without
triclosan (RR, 0.75; 95% CI, 0.65-0.86). The certainty of evidence was
moderate after downgrading for heterogeneity (tau2 = 0.04;
I2 = 43%). In the trial sequential analysis of all trials and a
sensitivity analysis excluding studies with a high risk of bias, the
cumulative z curve crossed the trial sequential monitoring boundary for
benefit, confirming the robustness of the summary effect estimate.
 Conclusions and Relevance: This updated meta-analysis found
moderate-certainty evidence that wound closure with triclosan-containing
sutures was associated with a lower risk of surgical site infections. The
trial sequential analysis suggests that future trials that would change
these findings are improbable. Copyright © 2025 Jalalzadeh H et
al.

<63>
Accession Number
2029544283
Title
A systematic review of cardiac surgery clinical prediction models that
include intra-operative variables.
Source
Perfusion (United Kingdom). 40(2) (pp 328-342), 2025. Date of Publication:
01 Mar 2025.
Author
Jones C.; Taylor M.; Sperrin M.; Grant S.W.
Institution
(Jones, Sperrin) Division of Informatics, Imaging and Data Science,
Faculty of Biology, Medicine and Health, Manchester Academic Health
Science Centre, University of Manchester, Manchester, United Kingdom
(Jones) Department of Clinical Perfusion, University Hospital Southampton
NHS Foundation Trust, Southampton General Hospital, Southampton, United
Kingdom
(Taylor) Department of Cardiothoracic Surgery, Manchester University
Hospital Foundation Trust, Wythenshawe Hospital, Manchester, United
Kingdom
(Grant) Division of Cardiovascular Sciences, ERC, Manchester University
Hospitals Foundation Trust, University of Manchester, Manchester, United
Kingdom
(Grant) South Tees Academic Cardiovascular Unit, South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: Most cardiac surgery clinical prediction models (CPMs) are
developed using pre-operative variables to predict post-operative
outcomes. Some CPMs are developed with intra-operative variables, but none
are widely used. The objective of this systematic review was to identify
CPMs with intra-operative variables that predict short-term outcomes
following adult cardiac surgery. Method(s): Ovid MEDLINE and EMBASE
databases were searched from inception to December 2022, for studies
developing a CPM with at least one intra-operative variable. Data were
extracted using a critical appraisal framework and bias assessment tool.
Model performance was analysed using discrimination and calibration
measures. Result(s): A total of 24 models were identified. Frequent
predicted outcomes were acute kidney injury (9/24 studies) and
peri-operative mortality (6/24 studies). Frequent pre-operative variables
were age (18/24 studies) and creatinine/eGFR (18/24 studies). Common
intra-operative variables were cardiopulmonary bypass time (16/24 studies)
and transfusion (13/24 studies). Model discrimination was acceptable for
all internally validated models (AUC 0.69-0.91). Calibration was poor
(15/24 studies) or unreported (8/24 studies). Most CPMs were at a high or
indeterminate risk of bias (23/24 models). The added value of
intra-operative variables was assessed in six studies with statistically
significantly improved discrimination demonstrated in two.
 Conclusion(s): Weak reporting and methodological limitations may
restrict wider applicability and adoption of existing CPMs that include
intra-operative variables. There is some evidence that CPM discrimination
is improved with the addition of intra-operative variables. Further work
is required to understand the role of intra-operative CPMs in the
management of cardiac surgery patients. Copyright © The Author(s)
2024.

<64>
Accession Number
2038005393
Title
Donor-derived cell-free dna as a diagnostic biomarker for acute rejection
in heart transplantation: A systematic review and meta-analysis.
Source
Transplantation Reviews. 39(2) (no pagination), 2025. Article Number:
100916. Date of Publication: 01 Apr 2025.
Author
Wang L.; Liu S.; Zhao Y.
Institution
(Liu, Wang, Liu, Zhao) Department of Nuclear Medicine, The Second Hospital
of Jilin University, Changchun, China
Publisher
Elsevier Inc.
Abstract
Background: Endomyocardial biopsy is widely acknowledged as the gold
standard for detecting rejection following heart transplantation. However,
the operation itself carries a risk of myocardial tissue damage and
associated complications during and after surgery. Given the limitations
of existing diagnostic approaches, non-invasive biomarkers are crucial.
 Objective(s): This study assessed the diagnostic utility of
donor-derived cell-free DNA (dd-cfDNA) in detecting AR in heart transplant
recipients. Method(s): A systematic literature search was conducted
across PubMed, Embase, Cochrane Library, and Web of Science from inception
to August 1, 2024, to identify studies evaluating the diagnostic
performance of dd-cfDNA for AR in heart transplant recipients. Retrieved
studies were screened using EndNote X9. Meta-analysis was performed using
Meta-Disc software version 1.4 and STATA/SE 14.0. Result(s): Ten
studies were included in the meta-analysis. The pooled sensitivity,
specificity, and area under the receiver operating characteristic curve
with 95 % confidence intervals (CIs) were 65 % (95 % CI, 61-68 %), 79 %
(95 % CI, 78-80 %), and 0.83, respectively. Conclusion(s): This
meta-analysis indicates that plasma dd-cfDNA may serve as a promising
non-invasive biomarker for the diagnosis of acute rejection in heart
transplant recipients. However, further research is warranted to
investigate factors influencing diagnostic performance and optimize
clinical utility. Copyright © 2025 Elsevier Inc.

<65>
Accession Number
2033981818
Title
Intra-operative ventilation strategies and their impact on clinical
outcomes: a systematic review and network meta-analysis of randomised
trials.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Jivraj N.K.; Lakbar I.; Sadeghirad B.; Muller M.M.; Sohn S.Y.; Peel J.K.;
Jaffer A.; Phoophiboon V.; Trivedi V.; Chaudhuri D.; Lu C.; Liu Y.;
Giammarioli B.; Einav S.; Burns K.E.A.
Institution
(Jivraj) Department of Anesthesiology and Pain Medicine and Department of
Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
(Jivraj, Burns) Interdepartmental Division of Critical Care Medicine,
Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
(Lakbar) Anesthesiology and Intensive Care; Anesthesia and Critical Care
Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of
Montpellier, Montpellier, France
(Sadeghirad) Department of Anesthesia and Department of Health Research
Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Sadeghirad) Michael DeGroote Institute for Pain Research and Care,
Hamilton, ON, Canada
(Muller) Institute of Intensive Care Medicine, University Hospital Zurich,
Zurich, Switzerland
(Sohn) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Peel) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Jaffer) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Phoophiboon, Giammarioli) Division of Critical Care Medicine, Unity
Health Toronto - St. Michael's Hospital, Li Ka Shing Knowledge Institute,
Toronto, ON, Canada
(Phoophiboon, Burns) Division of Critical Care Medicine, Department of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Trivedi) Institute for Better Health, Trillium Health Partners,
Mississauga, ON, Canada
(Chaudhuri) Division of Critical Care, Intensive Care Unit, Department of
Medicine, McMaster University, St Joseph's Healthcare Hamilton, Hamilton,
ON, Canada
(Lu) Keenan Research Centre for Biomedical Science, St. Michael's
Hospital, Toronto, ON, Canada
(Liu) Department of Laboratory Medicine and Pathobiology, University of
Toronto, ON, Canada
(Einav) Maccabi Healthcare Services Sharon Region, Hebrew University
Faculty of Medicine and Medint Medical Intelligence, Jerusalem, Israel
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pulmonary complications are common and
associated with significant morbidity and mortality; however, the optimal
intra-operative ventilation strategy to prevent postoperative pulmonary
complications remains unclear. The aim of this study was to evaluate the
effect of intra-operative ventilation strategy, including tidal volumes,
positive end-expiratory pressure (PEEP) and use of recruitment manoeuvres
on the incidence of postoperative pulmonary complications in adults having
non-cardiothoracic surgery. Method(s): Relevant databases were
searched to identify randomised controlled trials that directly compared
intra-operative ventilation strategies among surgical patients who were
followed up for > 24 hours postoperatively and reported at least one
outcome of interest. Result(s): A total of 51 randomised controlled
trials were included. Compared with a high tidal volume/zero PEEP
strategy, low tidal volume strategies likely reduced the risk of
postoperative pulmonary complications when combined with: high PEEP (risk
ratio (RR) 0.44, 95%CI 0.22-0.87); high PEEP with recruitment manoeuvres
(RR 0.60, 95%CI 0.49-0.75); personalised PEEP with recruitment manoeuvres
(RR 0.53, 95%CI 0.42-0.69); low PEEP (RR 0.63, 95%CI 0.50-0.78); and low
PEEP with recruitment manoeuvres (RR 0.65, 95%CI 0.46-0.93) (all moderate
certainty evidence). Compared with a low tidal volume/low PEEP strategy, a
low tidal volume strategy with personalised PEEP likely reduces the risk
of postoperative pulmonary complications (RR 0.85, 95%CI 0.73-0.99,
moderate certainty). Discussion(s): Among patients undergoing
non-cardiothoracic surgery, the use of intra-operative low tidal volume
ventilation with a range of acceptable PEEP levels likely reduced the risk
of postoperative pulmonary complications compared with high tidal volumes
and zero PEEP. This study highlights the need for implementation research
at both the provider and system levels to improve intra-operative
adherence to lung protective ventilation strategies. Copyright ©
2025 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on
behalf of Association of Anaesthetists.

<66>
Accession Number
646049677
Title
Do Extended Reality Interventions Benefit Patients Undergoing Elective
Cardiac Surgical and Interventional Procedures? A Systematic Review and
Meta-analysis.
Source
Journal of clinical nursing. 34(4) (pp 1465-1492), 2025. Date of
Publication: 01 Apr 2025.
Author
Harris E.; Fenton S.; Stephenson J.; Ewart F.; Goharinezhad S.; Lee H.;
Astin F.
Institution
(Harris, Ewart, Goharinezhad, Astin) School of Health, Wellbeing and
Social Care, Faculty of Wellbeing, Education and Language Studies, Open
University, Milton Keynes, United Kingdom
(Fenton, Lee) School of Computing and Engineering, University of
Huddersfield, Huddersfield, United Kingdom
(Stephenson) School of Human and Health Sciences, University of
Huddersfield, Huddersfield, United Kingdom
Abstract
BACKGROUND: Extended reality (XR) interventions have the potential to
benefit patients undergoing elective cardiac surgical and interventional
procedures. However, there are no systematic reviews with meta-analyses to
guide clinical care. AIM: To critically evaluate the evidence on the
effectiveness of XR interventions on patient anxiety and pain and other
associated outcomes. DESIGN: Systematic review and meta-analysis following
the PRISMA 2020 statement. DATA SOURCES: A systematic search of five
databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to
July 2023. METHOD(S): Screening and data extraction was conducted
independently by multiple reviewers. Stata (Version 17) was used to
conduct meta-analyses for patient anxiety and pain. Secondary patient
outcomes were summarised in a synthesis. The Cochrane Risk of Bias
(Version 2) tool was applied to trials and the NHLBI Study Quality
Assessment tools to all other study designs. RESULT(S): Of the 3372
records identified, 22 were included, 10 of which were eligible for
inclusion in the meta-analyses. Fifty-seven percent of randomised trials
were rated as high risk of bias. Virtual reality (VR) was the only XR
technology evaluated. VR significantly reduced pre-procedural anxiety
(standardised mean difference: -1.29; 95% confidence interval - 1.96,
-0.62, p < 0.001), and peri-procedural anxiety (standardised mean
difference: -0.50; 95% confidence interval - 0.83, -0.18, p < 0.003) but
did not reduce pain levels, compared with usual care. VR increased
pre-procedural knowledge and postsurgical physical and pulmonary function.
VR interventions may also improve emotional wellbeing, care delivery and
physiological outcomes, but evidence was inconsistent. CONCLUSION(S):
XR potentially benefits cardiac patients undergoing elective invasive
procedures and surgery by reducing pre- and peri-procedural anxiety and
increasing procedural knowledge and physical function. RELEVANCE TO
CLINICAL PRACTICE: Cardiac nurses' role can be supported by VR
interventions to improve the patient experience and several aspects of
patient care. PATIENT OR PUBLIC CONTRIBUTION: Not applicable as this is a
systematic review. Copyright © 2024 The Author(s). Journal of
Clinical Nursing published by John Wiley & Sons Ltd.

<67>
Accession Number
2038026244
Title
Effect of Dexmedetomidine on Cerebrovascular Carbon Dioxide Reactivity
During Pediatric Cardiac Surgery With Cardiopulmonary Bypass.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Sun L.; Zhang K.; Wang H.; Ji W.; Huang Y.; Bai J.; Zheng J.
Institution
(Sun, Zhang, Ji, Huang, Bai, Zheng) Department of Anesthesiology, Shanghai
Children's Medical Center, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
(Sun, Zhang, Ji, Huang, Bai, Zheng) Department of Anesthesiology, National
Children's Medical Center, Shanghai, China
(Wang) GE Healthcare, Shanghai, China
Publisher
W.B. Saunders
Abstract
Objective: To assess the effects of dexmedetomidine (DEX) on
cerebrovascular autoregulation in children with congenital heart disease
(CHD) using transcranial color-coded duplex sonography (TCCD).
 Design(s): Randomized controlled trial. Setting(s): This
single-center study was conducted at a tertiary care center in Shanghai,
China. Patient(s): Fifty-nine children aged 0 to 6 years with CHD who
underwent cardiac surgery with cardiopulmonary bypass were enrolled.
 Intervention(s): Children were randomly assigned to receive either
DEX (DEX group) or normal saline (control group) for 10 minutes following
anesthetic induction. Cerebrovascular carbon dioxide reactivity
(CVR-CO<inf>2</inf>) was assessed by adjustment of lung ventilation.
 Measurements and Main Results: Patients underwent TCCD before and
after surgery. CVR-CO<inf>2</inf>, resistance index (RI), pulsatility
index (PI), mean blood flow velocity (V<inf>mean</inf>) of the right
middle cerebral artery, and regional cerebral oxygen saturation
(ScrO<inf>2</inf>) of the right frontal lobe were measured and analyzed at
three distinct time points, resulting in six measurements. Hemodynamic
parameters, including heart rate (HR) and mean arterial pressure (MAP),
were recorded at each time point. The parameters CVR-CO<inf>2</inf> (p =
0.402), PI (p = 0.203), RI (p = 0.290), V<inf>mean</inf> (p = 0.290),
ScrO<inf>2</inf> (p = 0.426), HR (p = 0.522), and MAP (p = 0.236) were
comparable between the two groups. In the control group, PI, RI, and HR
significantly differed before and after surgery. In the DEX group, RI,
V<inf>mean</inf>, ScrO<inf>2,</inf> and HR significantly differed before
and after surgery. Conclusion(s): A low loading dose of DEX did not
compromise CVR-CO<inf>2</inf> in children with CHD undergoing cardiac
surgery with cardiopulmonary bypass. Copyright © 2025 Elsevier
Inc.

<68>
Accession Number
2033963078
Title
Clinical Outcomes and Prognostic Implications of TAVR in Patients With
Active Cancer: A Meta-Analysis.
Source
Clinical Cardiology. 48(3) (no pagination), 2025. Article Number: e70121.
Date of Publication: 01 Mar 2025.
Author
Saberian P.; Contreras R.; Gurram A.; Nasrollahizadeh A.; Keetha N.R.;
Nguyen A.L.; Nayak S.S.; Keivanlou M.-H.; Hashemi M.; Amini-Salehi E.;
Ameen D.
Institution
(Saberian, Hashemi) Cardiovascular Research Center, Hormozgan University
of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Contreras, Nayak, Ameen) Department of Internal Medicine, Yale New Heaven
Health Bridgeport Hospital 267 Grant St, Bridgeport, CT, United States
(Gurram) Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Nasrollahizadeh) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Keetha) Ohio Kidney and Hypertension Center 7255, Middleburg Hts, OH,
United States
(Nguyen) Division of Hematology/Oncology, Department of Internal Medicine,
UC San Diego Health Moores Cancer Center, San Diego, CA, United States
(Keivanlou, Amini-Salehi) School of Medicine, Guilan University of Medical
Sciences, Rasht, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an
alternative to surgical aortic valve replacement (SAVR) for high-risk
patients with severe aortic stenosis (AS). However, the clinical outcomes
and prognostic implications of TAVR in patients with active cancer remain
uncertain. This meta-analysis evaluates procedural success, complications,
and survival outcomes of TAVR in patients with and without active cancer.
 Method(s): A comprehensive literature search was conducted across
PubMed, Scopus, and Web of Science databases. Statistical analysis was
performed using a random-effects model. Statistical analyses were
conducted using STATA version 18.0. Result(s): The results of the
meta-analysis showed no significant difference in in-hospital mortality
between cancer and non-cancer patients (OR = 1.17; 95% CI: 0.83, 1.65; p =
0.27). Similarly, 30-day mortality did not differ between the two groups
(OR = 0.93; 95% CI: 0.72, 1.19; p = 0.49). However, 1-year mortality was
significantly higher in cancer patients (OR = 1.93; 95% CI: 1.45, 2.56; p
< 0.01). Two-year mortality was also higher in cancer patients (OR = 2.65;
95% CI: 1.79, 3.93; p < 0.01). No significant differences were observed in
major bleeding, acute kidney injury, stroke, or permanent pacemaker
implantation between the groups. Conclusion(s): While TAVR offers
comparable in-hospital and short-term survival outcomes for cancer and
non-cancer patients, long-term mortality is significantly higher in those
with active cancer. These findings suggest that TAVR is a viable option
for cancer patients with severe AS but requires careful long-term
prognostic considerations. Further studies are needed to optimize
management strategies for this complex population. Copyright ©
2025 The Author(s). Clinical Cardiology published by Wiley Periodicals
LLC.

<69>
[Use Link to view the full text]
Accession Number
2038049227
Title
Identifying research activity on brain ultrasonography in craniocerebral
diseases by bibliometric and visualized analysis of a 20-year journey of
global publications.
Source
Medicine (United States). 104(12) (pp e41927), 2025. Date of Publication:
21 Mar 2025.
Author
Yu Z.; Xiao J.; Ma F.; Li S.
Institution
(Yu, Ma, Li) Department of Neurosurgery, The First Affiliated Hospital of
Shandong First Medical University, Shandong Provincial Qianfoshan
Hospital, Jinan, China
(Xiao) Department of Medical Ultrasound, The First Affiliated Hospital of
Shandong First Medical University, Shandong Provincial Qianfoshan
Hospital, Jinan, China
(Li) Department of Neurosurgery, Jiangxi Provincial People's Hospital, The
First Affiliated Hospital of Nanchang Medical College, Nanchang, China
(Li) Nanchang University, Nanchang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Brain ultrasonography has emerged as a key tool in neurocritical care.
This study aimed to investigate the global research trends and future
research directions in the application of brain ultrasonography for
craniocerebral diseases using quantification and visualization approaches.
Publications on brain ultrasonography published between 2004 and 2024
retrieved from the Web of Science Core Collection database were screened
against predetermined inclusion and exclusion criteria and analyzed. The
data were processed using VOSviewer and CiteSpace to identify core
countries/regions, institutions, authors, journals, collaborations, and
research trends. Over the past 2 decades, 1251 articles focusing on brain
ultrasonography as the primary subject were published across 455 journals
by 5655 authors from 1619 institutions in 84 countries/regions.
Publications exhibited a fluctuating and gradually progressive trend, with
the number of publications per year peaking between 2019 and 2021. The
USA, the United Kingdom, and Germany emerged as leading countries in this
field, demonstrating robust cooperation with other countries/regions.
Additionally, the University of Leicester and Panerai RB was the most
prolific institution and author, respectively. The clinical applications
of brain ultrasonography have progressively broadened from neurocritical
care to encompass the general intensive care unit and emergency
department. Finally, recent scholarly attention has primarily been
directed toward the "deep learning framework"and "hypoxic-ischemic brain
injury."Globally, publications focusing on brain ultrasonography displayed
a fluctuating and gradually progressive trend over the past 2 decades.
Moreover, primary clinical applications and techniques have been
constantly expanding. Overall, the findings of our study expanded our
understanding of the current status of brain ultrasonography, potentially
guiding future development directions in this field. Copyright ©
2025 the Author(s).

<70>
Accession Number
2037393591
Title
Integrating Quality Metrics with Enhanced Recovery Pathways in Coronary
Artery Bypass Grafting.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(1) (pp 48-57), 2025.
Date of Publication: 01 Mar 2025.
Author
Phillips K.G.; Galloway A.; Grossi E.A.; Swistel D.; Smith D.E.; Mosca R.;
Zias E.
Institution
(Phillips, Galloway, Grossi, Swistel, Smith, Mosca, Zias) Department of
Cardiothoracic Surgery, Division of Cardiac Surgery, NYU Langone Health,
New York, NY, United States
Publisher
W.B. Saunders
Abstract
Quality improvement and enhanced recovery initiatives for coronarybypass
surgery have reduced complications, shortened hospital stay and recovery
times, and improved patient outcomes. Beyond the Society of Thoracic
Surgery's (STS) quality metrics, many other operative measures, such as
completeness of revascularization, and patient care measures add quality
and value for patients undergoing coronary artery bypass surgery; and
Enhanced Recovery after Surgery (ERAS) protocols have improved patient
experience and recovery, leading to better outcomes and significant
healthcare savings. Copyright © 2025 Elsevier Inc.

<71>
Accession Number
2038026250
Title
Analgesic Efficacy of Bilateral Ultrasound-Guided Transversus Thoracic
Muscle Plane Block Versus Erector Spinae Plane Block in Pediatric Patients
Undergoing Corrective Cardiac Surgeries: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Madkour M.A.F.A.; Abueldahab E.I.B.; Elela A.H.A.; Youssef M.F.; Gado A.A.
Institution
(Madkour, Abueldahab, Elela, Youssef, Gado) Department of Anesthesiology
and Intensive Care Medicine, Cairo University, Cairo, Egypt, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: Transversus thoracic plane block (TTPB) and erector spinae
plane block (ESPB) are gaining popularity in cardiac surgeries to avoid
excessive narcotic use and achieve fast-track extubation This study was
performed to compare the analgesic efficacy of TTPB to that of ESPB in
pediatric patients undergoing cardiac surgeries. The study was conducted
in a university pediatric hospital (ClinicalTrials.gov NCT05559684).
 Design(s): Single-center prospective randomized controlled study.
 Setting(s): Tertiary referring pediatric university hospital.
 Participant(s): Sixty pediatric patients undergoing corrective
cardiac surgeries during the period from November 2022 to August 2023.
 Intervention(s): Randomization was done using a sealed envelope
technique that contained 20 labels of (control), 20 labels of (ESPB), and
another 20 labels of (TTPB). Patients in the control group (n = 20) were
given fentanyl infusion at a dosage of 0.5 microg/kg/h throughout the
whole operation, in addition to 1 microg/kg during skin incision,
sternotomy, and aortic cannulation. Patients in the ESPB group (n = 20)
were given fentanyl infusion at a dose of 0.5 microg/kg/h all through the
whole operation plus ultrasound-guided ESPB done bilaterally by injecting
0.4 mL/kg (1:1 solution of Bupivacaine25 % and lidocaine 1%) on each side.
Patients in the TTPB group were given fentanyl infusion at a dose of 0.5
microg/kg/h throughout the operation plus ultrasound-guided TTPB done
bilaterally by injecting 0.4 mL/kg on each side (1:1 solution of
bupivacaine 0.25 % and lidocaine 1%). Measurements and Main Results:
Primary outcome was the total intraoperative fentanyl consumption;
secondary outcomes included hemodynamics and time to first analgesic
request (which is the elapsed time between giving the block and the
patient's FLACC score >=4), postoperative fentanyl consumption, extubation
time, and adverse events. Intraoperative fentanyl consumption was
significantly decreased in the TTPB group (3.4 +/- 2.9) compared with the
control group (6.7 +/- 4.2), mean difference = 3.35, 95% CI (0.84, 5.86),
p = 0.006. It was comparable between the ESPB group and the control group.
Also, the TTPB and ESPB groups were comparable regarding the primary
outcome, mean difference 1.2, 95% CI (-1.31, 3.71), p = 0.486. Total
fentanyl consumption in the intensive care unit was significantly
decreased in the TTPB group (1.1 +/- 1.54) than in the control group (4.6
+/- 4.25), mean difference 3.55, 95% CI (1.5, 5.6) with p = 0.001. Other
pairwise comparisons were comparable between the groups. The time to first
rescue analgesia was significantly longer in TTPB group (5.15 +/- 4.21)
compared to the control group (1.95 +/- 3.5), mean difference -3.2, 95% CI
(-5.68, -0.72), p = 0.04. Patients in ESPB needed first rescue analgesia
slightly earlier (4.9 +/- 4.4) than patients in TTPB group, mean
difference -0.25, 95% CI (-3.01, 2.51), p = 0.979 and non-significantly
longer than control group, mean difference -2.95, 95% CI (-5.5, -0.4), p =
0.064. Fast-track extubation was significantly increased in patients who
received TTPB (85%) than in those who received ESPB (50%), relative risk =
0.58, 95% CI (0.36, 0.94), p = 0.018 and those in the control group (30%),
relative risk = 0.35, 95% CI (0.17, 0.706), p < 0.001). Also,
ultrafast-track extubation was significantly increased in patients who
received TTPB (60%) than those in the control group 15%), relative risk =
0.25, 95% CI (0.08, 0.75), p = 0.007. Conclusion(s): Both TTPB and
ESPB reduced nociception and appeared comparable in providing
perioperative analgesia as they reduced pain scores and intraoperative and
postoperative narcotic dosage, which facilitated early extubation. TTPB
was superior to ESPB regarding fast-track extubation and provided a double
incidence for the ultrafast-track extubation, but this was related to the
hyper incidence of adverse events not thought related to
analgesia. Copyright © 2025 Elsevier Inc.

<72>
[Use Link to view the full text]
Accession Number
2038177837
Title
Effects of Nicorandil, Isosorbide Mononitrate, or Diltiazem on Radial
Artery Grafts after CABG: The Randomized ASRAB-Pilot Trial.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2025. Article
Number: e014542. Date of Publication: 2025.
Author
Zhu Y.; Zhang W.; Qin K.; Liu Y.; Yao H.; Wang Z.; Ye X.; Zhou M.; Li H.;
Qiu J.; Xu H.; Sun Y.; Gaudino M.; Zhao Q.
Institution
(Zhu, Qin, Liu, Yao, Wang, Ye, Zhou, Li, Qiu, Xu, Sun, Gaudino) Department
of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University,
School of Medicine, China
(Zhang, Zhao) School of Public Health, Fudan University, Shanghai, China
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The optimal antispastic treatment after coronary artery bypass
grafting using radial artery (RA) grafts is controversial. This clinical
trial aimed to generate pilot comparative data on the effects of
nicorandil, isosorbide mononitrate, or diltiazem on RA grafts.
 METHOD(S): This was a single-center, randomized, open-label,
parallel-group pilot trial. Eligible patients who underwent coronary
artery bypass grafting using RA grafts were randomized in a 1:1:1 ratio to
receive oral nicorandil (15 mg daily), isosorbide mononitrate (50 mg
daily), or diltiazem (180 mg daily) for 24 weeks post-coronary artery
bypass grafting. The primary outcome was RA graft failure (modified
Fitzgibbon grade B, S, or O) at 1 and 24 weeks, assessed by coronary
computed tomography angiography. RESULT(S): Among 150 randomized
participants, 149 (mean age, 56.8 years; 13.4% women) with 177 RA grafts
were assessed at least once by coronary computed tomography angiography,
including 50 participants with 64 RA grafts in the nicorandil group, 50
participants with 57 RA grafts in the isosorbide mononitrate group, and 49
participants with 56 RA grafts in the diltiazem group, respectively. At 1
week post-coronary artery bypass grafting, the RA graft failure rates were
lower with nicorandil versus diltiazem (19.4% versus 25.0%; difference,
-5.6% [95% CI, -20.6% to 9.3%]) and isosorbide mononitrate versus
diltiazem (18.2% versus 25.0%; difference, -6.8% [95% CI, -21.8% to
8.6%]). The RA graft failure rates were slightly higher with nicorandil
versus isosorbide mononitrate (19.4% versus 18.2%; difference, 1.2% [95%
CI, -13.3% to 15.2%]). At 24 weeks, RA graft failure rates were lower with
nicorandil versus diltiazem (16.1% versus 27.8%; difference, -11.7% [95%
CI, -26.6% to 3.4%]), and isosorbide mononitrate versus diltiazem (12.5%
versus 27.8%; difference, -15.3% [95% CI, -29.8% to -0.2%]), and slightly
higher with nicorandil versus isosorbide mononitrate (16.1% versus 12.5%;
difference, 3.6% [95% CI, -9.6% to 16.4%]). CONCLUSION(S): In this
pilot trial, treatment with nicorandil or isosorbide mononitrate was
associated with a lower RA graft failure rate compared with diltiazem.
Larger hypothesis-testing trials are warranted. Copyright © 2025
American Heart Association, Inc.

<73>
Accession Number
2033959488
Title
Prognostic value of baseline RV dysfunction using TAPSE and TAPSE to PASP
ratio in patients undergoing mitra-clip: a systematic review and
meta-analysis.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 2025.
Author
Rmilah A.A.; Ghaly R.; Pfeiffer C.; Saeed M.H.; Khojah A.; Jaber S.;
Alzu'Bi H.; Tabash A.; Chib A.; Darwish R.; Prokop L.; Elajami T.K.;
Arsanjani R.
Institution
(Rmilah) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Rmilah, Pfeiffer, Tabash, Chib) Department of Internal Medicine, Magnolia
Regional Health Center, Corinth, MS, United States
(Ghaly) Department of Internal Medicine, University of Missouri-Kansas
City, Kansas City, MO, United States
(Saeed, Khojah, Jaber) Department of Internal Medicine, Al-Habib Hospital,
Riyadh, Saudi Arabia
(Alzu'Bi, Elajami) Department of Cardiovascular Medicine, Mount Sinai
Medical Center, Miami, FL, United States
(Darwish) Department of Internal Medicine, Al Salam Specialized Hospital,
Cairo, Egypt
(Prokop) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
(Arsanjani) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix,
AZ, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Mitra-clip is an established therapy for high-risk surgical candidates who
are refractory to optimal medical treatment. Reports have shown that right
ventricular dysfunction (RVD) has been associated with increased morbidity
and mortality in heart failure (HF) patients. Our goal of this systematic
review/meta-analysis is to assess the prognosis of baseline RV function
markers including TAPSE (tricuspid annular plane systolic excursion) and
TAPSE:PASP (pulmonary artery systolic pressure) ratio after Mitra-clip.
MEDLINE and EMBASE were searched from inception to December 20th, 2023,
for studies discussing the prognostic outcome of pre-existing RVD in
Mitra-clip patients. Definition of RV dysfunction was reported as an
abnormal TAPSE (< 15-16 mm) or RV-PA (right ventricle-pulmonary artery)
uncoupling expressed as abnormal TAPSE:PASP ratio (< 0.30-0.37 mm/mmHg).
We included all original research studies (excluding reviews,
meta-analysis, commentaries/editorials, and animal studies) that assessed
the prognostic utility of TAPSE and TAPSE:PASP ratio in patients with MR
undergoing Mitra-clip. Reviewers independently screened the studies and
extracted the pertinent data. Odds ratios (OR) were calculated using a
random-effects model. Twelve reports enrolling 3526 patients were
included. Mean age ranged from 70 to 81 years and 61.1% patients were
male. Primary, secondary, and mixed MR were reported in 36.9%, 61.4%, and
1.8% respectively. Mean LVEF ranged from 27% to 57.1% and 93.7% of
patients had MR grade >= 3 + (at least moderate to severe MR). Patients
with RVD had a reduction in the overall survival (OS) after Mitra-clip at
6 months (81.8% vs 90.5%, OR = 0.45 [0.35-0.58]; P < 0.001), 1-year (71.1%
vs 85.7%, OR = 0.40 [0.33-0.48]; P < 0.001), and 2-year (60.3% vs 76.8%,
OR = 0.37 [0.31-0.45]; P < 0.001) compared to normal RV group. Likewise,
HF re-admission free survival was minimized among RVD patients at 6 months
(76.8% vs 88.1%, OR = 0.47 [0.34-0.65]; P < 0.001), 1-year (64.5% vs
81.3%, OR = 0.44 [0.35-0.55]; P < 0.001), and 2-year (58.2% vs 78.9%, OR =
0.41 [0.30-0.56]; P < 0.001) compared to normal RV group. Decreased TAPSE:
PASP was associated with lower OS at 6-month (OR = 0.46 [0.31-0.68]; P <
0.001), 1-year (OR = 0.37 [0.29-0.47]; P < 0.001), and 2-year (OR = 0.35
[0.25-0.47]; P < 0.001) and reduced HF re-admission free survival at
6-month ((OR = 0.44 [0.31-0.62]; P < 0.001), 1-year (OR = 0.41[0.31-0.54];
P < 0.001), and 2-year (OR = 0.41 [0.31-0.58]; P < 0.001) after
Mitra-clip. Furthermore, decreased TAPSE negatively impacted the OS and HF
re-admission at 6-month (OR = 0.40 [0.21-0.77]; P = 0.006), and 1-year (OR
= 0.50 [0.31-0.80]; P = 0.004) and increased HF re-admission rate at
6-month (OR = 0.27 [0.13-0.56]; P = 0.0005), and 1-year (OR = 0.30
[0.15-0.58]; P = 0.0004). Pre-existing RVD as expressed by TAPSE < 15-16
mm or TAPSE:PASP ratio < 0.30-0.37 mmHg reduced the OS and HF readmission
free survival after Mitra-clip. Copyright © The Author(s), under
exclusive licence to Springer Nature B.V. 2025.

<74>
Accession Number
2034099530
Title
Inflammation and platelet hyperresponsiveness in coronary artery disease
and the influence of Talin-1/alphaIIbbeta3-mediated bidirectional
signaling pathway.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1535182. Date of Publication: 2025.
Author
Shi S.; Gao J.; Zhang Y.; Zhan M.; Tan Z.; Wang P.; Fu J.; Liu J.
Institution
(Shi, Gao, Zhang, Fu, Liu) Beijing Key Laboratory of Pharmacology of
Chinese Materia Medica, Institute of Basic Medical Sciences of Xiyuan
Hospital, China Academy of Chinese Medical Sciences, Beijing, China
(Zhan) Department of Encephalopathy, Xiyuan Hospital, China Academy of
Chinese Medical Sciences, Beijing, China
(Tan) Wangjing Hospital, China Academy of Chinese Medical Sciences,
Beijing, China
(Wang) National Clinical Research Center for Chinese Medicine Cardiology,
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: While platelet hyperreactivity constitutes an independent risk
factor for major adverse cardiovascular events (MACEs) in coronary artery
disease, its molecular underpinnings remain poorly characterized. Recent
advances in transcriptomic profiling have revealed potential associations
with specific RNA signatures. Through systematic bioinformatics analysis
of differential gene expression patterns and pathway activation in CHD
patients, this study aims to elucidate key molecular regulators of
platelet hyperactivity, establishing a theoretical framework for
developing precision therapeutic strategies to mitigate post-CHD
complications. Method(s): This randomized controlled study included
16 CHD patients and 16 healthy controls. Inflammation markers, platelet
aggregation function, and CD62p levels were assessed using flow cytometry.
Mitochondrial morphology and organelles were observed using scanning
electron microscopy and transmission electron microscopy. Genes related to
symptom alteration between CHD patients and healthy controls were
identified using the criteria of p < 0.05. The molecular correlations of
these genes were analyzed using a comprehensive perspective that included
Gene Ontology (GO) biological process and Kyoto Encyclopedia of Genes and
Genomes (KEGG) pathway analyses. Western blot and correlation analyses
were also conducted to validate the expression and diagnostic value of the
DEGs. Result(s): CHD patients exhibited alterations in platelet
organelles ultrastructure, heightened platelet activation and aggregation,
and disturbance of the inflammatory equilibrium. RNA sequencing
demonstrated distinct changes in the gene expression profiles of
circulating platelets from CHD patients. The increase in platelet
activation and aggregation could be partially associated with the
upregulation of the Talin-1 and alphaIIbbeta3 proteins expression.
 Conclusion(s): Abnormal transcription and platelet activation occur
after CHD onset, and upregulation of the Talin-1/alphaIIbbeta3-mediated
bidirectional signaling pathway are the primary pathological features.
Clinical Trial Registration: https://www.chictr.org.cn/, identifier
ChiCTR2100041998. Copyright © 2025 Shi, Gao, Zhang, Zhan, Tan,
Wang, Fu and Liu.

<75>
Accession Number
2038122671
Title
External validity of randomized clinical trials in vascular surgery:
Systematic review of demographic factors of patients recruited to
randomized clinical trials with comparison to the National Vascular
Registry.
Source
BJS Open. 9(2) (no pagination), 2025. Article Number: zrae156. Date of
Publication: 01 Apr 2025.
Author
Cutteridge J.; Barsby J.; Hume S.; Lemmey H.A.L.; Lee R.; Bera K.D.
Institution
(Cutteridge) Specialised Foundation School, York and Scarborough Teaching
Hospitals NHS Foundation Trust, York, United Kingdom
(Cutteridge) Department of Health Sciences, Faculty of Sciences,
University of York, York, United Kingdom
(Barsby) Foundation School, Newcastle Upon Tyne Hospitals NHS Foundation
Trust, Newcastle, United Kingdom
(Barsby, Hume, Lemmey) Oxford Medical School, Oxford University, Oxford,
United Kingdom
(Lee, Bera) Nuffield Department of Surgical Sciences, University of
Oxford, Oxford, United Kingdom
(Lee, Bera) Vascular Surgery Department, John Radcliffe Hospital, Oxford
University NHS Foundation Trust, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Evidence-based medicine relies on randomized clinical trials,
which should represent the patients encountered in clinical practice.
Characteristics of patients recruited to randomized clinical trials
involving vascular index operations (carotid endarterectomy, abdominal
aortic aneurysm repair, infrainguinal bypass and major lower limb
amputations) were compared with those recorded in the National Vascular
Registry across England and Wales. Method(s): MEDLINE, Embase, Web of
Science, CENTRAL, clinicaltrials.gov and World Health Organization
International Trials Registry Platform (CRD42021247905) were searched for
randomized clinical trials involving the index operations. Demographic
(age, sex, ethnicity) and clinical (co-morbidities, medications, body mass
index, smoking, alcohol, cognition) data were extracted, by operation.
Characteristics of operated on patients were extracted from publicly
available National Vascular Registry reports (2014-2020). All findings are
reported according to PRISMA guidelines. Rayyan.AI, Excel and GraphPad
Prism were used for screening and analysis. Result(s): A total of 307
randomized clinical trials (66 449 patients) were included and compared
with National Vascular Registry data for 119 019 patients. Randomized
clinical trial patients were younger across all operations; for carotid
endarterectomy, bypass and major lower limb amputation randomized clinical
trials, there were differences in female patient representation. Further
comparisons were limited by the insufficient baseline data reporting
across randomized clinical trials, though reporting improved over decades.
National Vascular Registry reports lacked information on patient factors
such as patient ethnicity or body mass index. Conclusion(s): There
are significant differences in demographic and clinical factors between
patients recruited to vascular surgery randomized clinical trials and the
real-world National Vascular Registry vascular surgery patient population.
Minimum reporting standards for baseline data should be defined to allow
future randomized clinical trials to represent real-world patient
populations and ensure the external validity of their
results. Copyright © 2025 The Author(s). Published by Oxford
University Press on behalf of BJS Foundation Ltd.

<76>
Accession Number
2033978307
Title
Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve
Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping
Study.
Source
Clinical Cardiology. 48(3) (no pagination), 2025. Article Number: e70117.
Date of Publication: 01 Mar 2025.
Author
Zhang R.; Zhu C.; Chen S.; Tian F.; Chen Y.
Institution
(Zhang, Chen) Xiamen Cardiovascular Hospital, Xiamen University, Xiamen,
China
(Zhang, Zhu, Chen, Tian, Chen) School of Nursing, Fujian University of
Traditional Chinese Medicine, Fuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: This systematic review and evidence mapping study aims to
assess the effects of exercise-based cardiac rehabilitation on clinical
outcomes in patients after heart valve surgery. By consolidating and
visualizing existing evidence, the study seeks to identify gaps in
knowledge, evaluate the quality and breadth of current research, and
provide guidance for clinical practice and future research. The evidence
mapping will highlight under-researched areas and inform healthcare
providers on effective strategies to enhance postoperative recovery.
 Method(s): A comprehensive search was performed across multiple
databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science,
CNKI, and Wanfang, up to May 2024. Two reviewers independently screened
the articles, extracted relevant data, and assessed study quality. Study
characteristics and outcomes were visualized using bubble plots.
 Result(s): Ten systematic reviews/meta-analyses met the inclusion
criteria. Based on AMSTAR-2, two were rated "high quality," two "low
quality," and six "very low quality." Using the GRADE system, of the 48
pieces of evidence across 10 outcomes, 1 was "high quality," 8 "moderate,"
19 "low," and 20 "very low.". Conclusion(s): Current evidence
indicates that exercise-based cardiac rehabilitation can enhance physical
capacity, left ventricular ejection fraction, peak oxygen uptake, and
daily living activities in heart valve surgery patients. However, more
large-scale, high-quality studies are needed to verify its effects on
all-cause mortality, quality of life, adverse events, return to work, and
emotional health. Copyright © 2025 The Author(s). Clinical
Cardiology published by Wiley Periodicals, LLC.

<77>
Accession Number
2033968918
Title
Efficacy and Safety of Thoracic Epidural vs. Paravertebral Block for
Analgesia in Thoracotomy: A Systematic Review of Randomized Controlled
Trials.
Source
Current Pain and Headache Reports. 29(1) (no pagination), 2025. Article
Number: 69. Date of Publication: 01 Dec 2025.
Author
Eaves G.K.; Ware E.E.; Touchet D.R.; Hamilton W.K.; Netterville S.S.;
Stevens J.R.; Ahmadzadeh S.; Shekoohi S.; Kaye A.D.
Institution
(Eaves, Ware, Touchet, Hamilton, Netterville, Stevens) School of Medicine,
Louisiana State University Health Sciences Center at Shreveport,
Shreveport, LA, United States
(Ahmadzadeh, Shekoohi, Kaye) Department of Anesthesiology, Louisiana State
University Health Sciences Center Shreveport, Shreveport, LA, United
States
(Kaye) Departments of Pharmacology, Toxicology, and Neurosciences,
Louisiana State University Health Sciences Center Shreveport, Shreveport,
LA, United States
Publisher
Springer
Abstract
Purpose of Review: This systematic review aimed to compare the efficacy
and safety of thoracic epidural block (TEB) and thoracic paravertebral
block (TPB) for managing postoperative pain following thoracotomy for
pulmonary procedures. Recent Findings: A comprehensive search of PubMed,
Embase, Web of Science, and Google Scholar identified randomized
controlled trials (RCTs) published prior to April 10, 2024. Studies were
eligible if they compared TEB and TPB in adult patients undergoing
thoracotomy for pulmonary procedures and reported outcomes on
postoperative pain, opioid consumption, hemodynamic parameters, or
complications. Two reviewers independently screened studies, extracted
data, and assessed quality using the Cochrane Risk of Bias tool. The
review adhered to PRISMA guidelines. From 1,114 records screened, 7 RCTs
comprising 429 patients met the inclusion criteria. TEB demonstrated
superior pain relief in the immediate postoperative period, particularly
when continuous infusions with opioids were utilized. TPB, however,
provided greater hemodynamic stability, with significantly lower rates of
hypotension and more stable mean arterial pressure and heart rate during
the first 24 h. Beyond 24 h, both techniques offered comparable pain
relief and opioid consumption. While the incidence of nausea, vomiting,
and urinary retention was similar between groups, TPB was associated with
fewer respiratory complications. Summary: Both TEB and TPB are
effective for postoperative pain management following thoracotomy, each
with distinct advantages. TEB provides optimal early pain control, making
it suitable for patients with significant early postoperative pain. TPB,
with its superior hemodynamic profile, is better suited for patients at
risk of hypotension or cardiovascular instability. Tailoring analgesic
strategies to patient-specific needs can optimize outcomes. Future
large-scale RCTs are necessary to confirm these findings across broader
thoracic surgical populations. Registration and Protocol: This review was
registered with PROSPERO prior to initiation (Registration Number:
CRD42024578768). Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<78>
Accession Number
2037992848
Title
Survival after heart transplants from circulatory-dead versus brain-dead
donors: Meta-analysis of reconstructed time-to-event data.
Source
Transplantation Reviews. 39(2) (no pagination), 2025. Article Number:
100917. Date of Publication: 01 Apr 2025.
Author
Al-Tawil M.; Wang W.; Chandiramani A.; Zaqout F.; Diab A.H.; Sicouri S.;
Ramlawi B.; Haneya A.
Institution
(Al-Tawil, Diab, Haneya) Department of Cardiac and Thoracic Surgery, Heart
Center Trier, Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Al-Tawil, Sicouri, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Wang) Department of Surgery, Broomfield Hospital, Essex, Chelmsford,
United Kingdom
(Chandiramani) Department of Cardiology, Royal Papworth Hospital,
Cambridge, United Kingdom
(Zaqout) Department of Surgery, University College London, London, United
Kingdom
(Ramlawi) Lankenau Heart Institute, Wynnewood, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Heart transplantation (HTx) using donors after circulatory
death (DCD) has the potential to significantly boost overall transplant
rates. This study aims to reconstruct data from individual studies
comparing survival between HTx from DCD recipients and donation after
brain (DBD) recipients. Method(s): MEDLINE, Embase, Scopus, were
searched up to August 2024. We included studies that reported a
Kaplan-Meier summary of survival comparing DCD and DBD HTx. Digitization
of the Kaplan-Meier curves and reconstruction of individual patient data
followed by survival analysis that was conducted using R software.
 Result(s): Six studies including a total of 3240 patients (2242 DBD
and 998 DCD) were included in the final analysis. There was no significant
difference in the overall survival rates between DCD and DBD patients
(Hazard Ratio (HR): 1.01, 95 % CI [0.81-1.25], P = 0.91). However, the
proportional hazard assumption was violated, deeming such results
inconclusive. Time-varying flexible parametric model revealed a
significantly declining survival in DCD recipients 3 years after surgery.
Landmark analyses further suggest this declining trend in the DCD group at
the two-year landmark (HR: 1.67, p = 0.021) and the four-year mark (HR:
2.78, p = 0.002). However, data beyond 6 years is limited. Evidence
comparing direct procurement and normothermic regional perfusion is
scarce, with no significant survival differences observed.
 Conclusion(s): This meta-analysis shows that, despite similar early
survival outcomes, DCD heart transplants showed a trend towards a lower
long-term survival, with the difference becoming evident around three
years post-transplantation. These findings highlight the need for enhanced
monitoring and optimized post-transplant care in DCD recipients. Further
studies with strict and long-term follow-up are warranted to confirm these
results. Copyright © 2025 Elsevier Inc.

<79>
Accession Number
2034059495
Title
Combination of urinary biomarkers can predict cardiac surgery-associated
acute kidney injury: a systematic review and meta-analysis.
Source
Annals of Intensive Care. 15(1) (no pagination), 2025. Article Number: 45.
Date of Publication: 01 Dec 2025.
Author
Kiss N.; Papp M.; Turan C.; Koi T.; Madach K.; Hegyi P.; Zubek L.; Molnar
Z.
Institution
(Kiss, Papp, Turan, Koi, Madach, Hegyi, Zubek, Molnar) Centre for
Translational Medicine, Semmelweis University, 78 Ulloi Str., Budapest,
Hungary
(Kiss) Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
(Kiss, Papp, Turan, Madach, Zubek, Molnar) Department of Anaesthesiology
and Intensive Therapy, Semmelweis University, Budapest, Hungary
(Papp) Department of Anaesthesiology and Intensive Therapy, Saint John's
Hospital, Budapest, Hungary
(Koi) Department of Stochastics, Budapest University of Technology and
Economics, Budapest, Hungary
(Hegyi) Institute for Translational Medicine, Medical School, University
of Pecs, Pecs, Hungary
(Hegyi) Institute of Pancreatic Diseases, Semmelweis University, Budapest,
Hungary
(Molnar) Poznan University of Medical Sciences, Poznan, Poland
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Acute kidney injury (AKI) develops in 20-50% of patients
undergoing cardiac surgery (CS). We aimed to assess the predictive value
of urinary biomarkers (UBs) for predicting CS-associated AKI. We also
aimed to investigate the accuracy of the combination of UB measurements
and their incorporation in predictive models to guide physicians in
identifying patients developing CS-associated AKI. Method(s): All
clinical studies reporting on the diagnostic accuracy of individual or
combined UBs were eligible for inclusion. We searched three databases
(MEDLINE, EMBASE, and CENTRAL) without any filters or restrictions on the
11th of November, 2022 and reperformed our search on the 3rd of November
2024. Random and mixed effects models were used for meta-analysis. The
main effect measure was the area under the Receiver Operating
Characteristics curve (AUC). Our primary outcome was the predictive values
of each individual UB at different time point measurements to identify
patients developing acute kidney injury (KDIGO). As a secondary outcome,
we calculated the performance of combinations of UBs and clinical models
enhanced by UBs. Result(s): We screened 13,908 records and included
95 articles (both randomised and non-randomised studies) in the analysis.
The predictive value of UBs measured in the intraoperative and early
postoperative period was at maximum acceptable, with the highest AUCs of
0.74 [95% CI 0.68, 0.81], 0.73 [0.65, 0.82] and 0.74 [0.72, 0.77] for
predicting severe CS-AKI, respectively. To predict all stages of CS-AKI,
UBs measured in the intraoperative and early postoperative period yielded
AUCs of 0.75 [0.67, 0.82] and 0.73 [0.54, 0.92]. To identify all and
severe cases of acute kidney injury, combinations of UB measurements had
AUCs of 0.82 [0.75, 0.88] and 0.85 [0.79, 0.91], respectively.
 Conclusion(s): The combination of urinary biomarkers measurements
leads to good accuracy. Copyright © The Author(s) 2025.

<80>
Accession Number
2038026254
Title
Acute Pain Management with Ultrasound-Guided Erector Spinae Plane Block
and Serratus Anterior Plane Block in Patients Undergoing Coronary Artery
Bypass via Mini-thoracotomy: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Xin L.; Wang L.; Feng Y.
Institution
(Xin, Feng) Department of Anesthesiology, Peking University People's
Hospital, Beijing, China
(Wang) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Science and Peking Union Medical College, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to examine the analgesic efficacy of
erector spinae plane (ESP) block or combined ESP and superficial serratus
anterior plane (SAP) block in patients undergoing elective coronary artery
bypass via mini-thoracotomy. Design(s): Randomized controlled study.
 Setting(s): Operating room, intensive care unit, and ward.
 Patient(s): Fifty-four patients undergoing elective coronary artery
bypass via mini-thoracotomy. Intervention(s): Eligible patients were
randomly allocated to single-ESP block (ESP group) or combined ESP and
superficial SAP block (ESP+SAP group). Measurements and Main Results:
The primary outcome was dynamic numerical rating scale (NRS) scores (on
coughing) for the surgical incision site 6 hours after skin closure.
Secondary outcomes included dynamic NRS scores for surgical incision at
12, 18, 24, and 48 hours postoperatively plus NRS scores for the chest
tube, hydromorphone consumption, quality of recovery, and adverse events
within 48 hours postoperatively. The ESP+SAP group had lower dynamic NRS
scores for surgical incision at postoperative 6 hours (mean difference:
-2.1, 95% CI -2.8 to -1.4, adjusted p < 0.001) and 12 hours (-1.3, 95% CI
-2.0 to -0.7, adjusted p < 0.001) compared to the ESP group. The ESP+SAP
group also showed lower dynamic NRS scores for the chest tube at 6 hours
(-1.4, 95% CI -2.0 to -0.9, adjusted p < 0.001) and 12 hours (-1.2, 95% CI
-1.7 to -0.6, adjusted p < 0.001) postoperatively. Linear mixed-model
analysis showed that NRS scores for the surgical incision and chest tube
were lower in the ESP+SAP group compared to the ESP group (both p < 0.05).
 Conclusion(s): Compared with ESP block alone, ESP combined with
superficial SAP block reduced pain scores in patients undergoing coronary
artery bypass via mini-thoracotomy. Copyright © 2025

<81>
Accession Number
2038049344
Title
Care guided by tissue oxygenation and haemodynamic monitoring in off-pump
coronary artery bypass grafting (Bottomline-CS): Assessor blind, single
centre, randomised controlled trial.
Source
BMJ. (no pagination), 2025. Article Number: e082104. Date of Publication:
2025.
Author
Han J.; Zhai W.; Wu Z.; Zhang Z.; Wang T.; Ren M.; Liu Z.; Sessler D.I.;
Guo Z.; Meng L.
Institution
(Han, Zhai, Zhang, Wang) Department of Anesthesiology, Tianjin Chest
Hospital, Tianjin University, Tianjin, China
(Wu) Department of Critical Care, Tianjin Chest Hospital, Tianjin
University, Tianjin, China
(Ren) Tianjin Research Institute of Cardiovascular Disease, Tianjin, China
(Liu) Department of Biostatistics and Health Data Science, Indiana
University School of Medicine, Indiana University, Indianapolis, IN,
United States
(Sessler) Department of Anesthesiology and Center for Outcomes Research,
UTHealth, Houston, TX, United States
(Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin University, Tianjin, China
(Meng) Department of Anesthesia, Indiana University School of Medicine,
Indianapolis, IN, United States
Publisher
BMJ Publishing Group
Abstract
Objective: To assess whether perioperative management guided by
near-infrared spectroscopy to determine tissue oxygen saturation and
haemodynamic monitoring reduces postoperative complications after off-pump
coronary artery bypass grafting. Design(s): Assessor blinded, single
centre, randomised controlled trial (Bottomline-CS trial).
 Setting(s): A tertiary teaching hospital in China.
 Participant(s): 1960 patients aged 60 years or older who were
scheduled for elective off-pump coronary artery bypass grafting.
 Intervention(s): All patients had multisite monitoring of tissue
oxygen saturation (bilateral forehead and unilateral forearm
brachioradialis) and haemodynamic monitoring. Both groups received usual
care, including arterial blood pressure, central venous pressure,
electrocardiography, and transoesophageal echocardiography when indicated.
Guided care aimed to maintain tissue oxygenation within 10% above or below
preoperative baseline values, established 24-48 hours before surgery, from
the start of anaesthesia until extubation or for up to 24 hours
postoperatively. In the usual care group, tissue oximetry and haemodynamic
data were concealed, and care was routine. Main Outcome Measure(s):
The primary outcome was the incidence of a composite of 30 day
postoperative complications, which were cerebral, cardiac, respiratory,
renal, infectious, and mortality complications. Secondary outcomes
included the individual components of the composite outcome, new-onset
atrial fibrillation, and hospital length of stay. Result(s): Of 1960
patients randomly assigned, data from 967 guided care and 974 usual care
patients were analysed. During anaesthesia, the area under the curve for
tissue oxygen saturation measurements outside the plus and minus 10%
baseline range was significantly smaller with guided care than only usual
care: left forehead 32.4 versus 57.6 (%xmin, P<0.001), right forehead 37.9
versus 62.6 (P<0.001), and forearm 14.8 versus 44.7 (P<0.001). The primary
composite outcome occurred in 457/967 (47.3%) patients in the guided care
group and 466/974 (47.8%) patients in the usual care group (unadjusted
risk ratio 0.99 (95% confidence interval 0.90 to 1.08), P=0.83). No
secondary outcomes differed significantly between groups. The largest
observed difference was in incidence of pneumonia, which was less frequent
in the guided care group (88/967, 9.1%) than in the usual care group
(121/974, 12.4%) and not statistically significant after adjusting for
multiple comparisons. Conclusion(s): Guided care by use of multisite
near-infrared spectroscopy and haemodynamic monitoring effectively
maintained tissue oxygenation near baseline levels compared with usual
care. However, no clear evidence was noted that this approach reduced the
incidence of major postoperative complications. These findings do not
support the routine use of near-infrared spectroscopy and haemodynamic
monitoring to maintain tissue oxygenation during off-pump coronary artery
bypass grafting. Trial registration: ClinicalTrials.gov
NCT04896736. Copyright © Author(s) (or their employer(s)) 2019.

<82>
[Use Link to view the full text]
Accession Number
2038244062
Title
Effect of Disclosing a Polygenic Risk Score for Coronary Heart Disease on
Adverse Cardiovascular Events.
Source
Circulation: Genomic and Precision Medicine. (no pagination), 2025.
Article Number: e004968. Date of Publication: 2025.
Author
Naderian M.; Hamed M.E.; Vaseem A.A.; Norland K.; Dikilitas O.;
Teymourzadeh A.; Bailey K.R.; Kullo I.J.
Institution
(Naderian, Hamed, Vaseem, Norland, Teymourzadeh, Kullo) Department of
Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
(Dikilitas) Department of Internal Medicine, Mayo Clinic, Rochester, MN,
United States
(Bailey) Department of Quantitative Health Sciences, Mayo Clinic,
Rochester, MN, United States
(Kullo) Gonda Vascular Center, Mayo Clinic, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the MI-GENES clinical trial (URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01936675),
participants at intermediate risk of coronary heart disease (CHD) were
randomized to receive a Framingham risk score (Framingham risk score
group, n=103) or an integrated risk score (integrated risk score group
[IRS<inf>g</inf>], n=104) that additionally included a polygenic risk
score. After 6 months, IRS<inf>g</inf> participants had higher statin
initiation and lower low-density lipoprotein cholesterol. We conducted a
post hoc 10-year follow-up analysis to investigate whether disclosure of a
polygenic risk score for CHD was associated with a reduction in major
adverse cardiovascular events (MACE). METHOD(S): Participants were
followed from randomization in October 2013 to September 2023 to ascertain
MACE, testing for CHD, and changes in risk factors. The primary outcome
was time to first MACE, defined as cardiovascular death, nonfatal
myocardial infarction, coronary revascularization, and nonfatal stroke.
Statistical analyses included Cox proportional hazards regression and
linear mixed-effects models. RESULT(S): We followed all participants
who completed the trial, 100 in Framingham risk score group and 103 in
IRS<inf>g</inf> (mean age at the end of follow-up, 68.2+/-5.2; 48% male).
During a median follow-up of 9.5 years, 9 MACEs occurred in Framingham
risk score group and 2 in IRS<inf>g</inf> (hazard ratio, 0.20 [95% CI,
0.04-0.94]; P=0.042). In Framingham risk score group, 47 (47%) underwent
at least 1 diagnostic test for CHD, compared with 30 (29%) in
IRS<inf>g</inf> (hazard ratio, 0.51 [95% CI, 0.32-0.81]; P=0.004). A
higher proportion of IRS<inf>g</inf> participants were on statin therapy
during the first 4 years postrandomization and had a greater reduction in
low-density lipoprotein cholesterol for up to 3 years postrandomization.
No significant differences were observed between 2 groups in other
traditional cardiovascular risk factors during follow-up.
 CONCLUSION(S): Disclosure of an integrated risk score that included a
polygenic risk score to individuals at intermediate risk for CHD was
associated with lower MACE incidence after 10 years, likely due to higher
statin initiation, leading to lower low-density lipoprotein cholesterol
levels. Copyright © 2025 American Heart Association, Inc.

<83>
Accession Number
2034205200
Title
Etomidate vs Ketamine-Propofol for Induction of Anesthesia in Coronary
Artery Bypass Grafting: An Updated Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Kumar N.; Bardia A.; Fitzsimons M.G.; Essandoh M.; Mitchell J.; Falkson
S.R.; Dalia A.; Tang J.; Sawyer T.R.; Iyer M.H.
Institution
(Kumar, Bardia, Fitzsimons, Falkson, Dalia) Department of Anesthesia,
Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Essandoh, Tang, Iyer) Department of Anesthesiology, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Mitchell) Department of Anesthesiology and Perioperative Medicine,
University of California Los Angeles, Los Angeles, CA, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Etomidate has minimal cardiovascular depressant effects at the
cost of endogenous cortisol production suppression, whereas propofol has
vasodilatory and myocardial depressant properties, which may be poorly
tolerated in the cardiac surgical population. To offset the undesirable
effects of propofol, ketamine can be co-administered to harness its
cardiac stimulatory properties. Though etomidate is a more cardio-stable
induction agent than propofol, its superiority over the combination of
propofol and ketamine-colloquially known as "ketofol"-remains
controversial. Method(s): United States National Library of Medicine
Database (MEDLINE) and Excerpta Medica Database (EMBASE) were searched for
randomized controlled trials published since 2010 comparing etomidate and
ketofol relative to propofol alone for induction of general anesthesia for
coronary artery bypass grafting (CABG). Key data collected included
post-induction nadir mean arterial pressure (MAP), heart rate, cardiac
index, systemic vascular resistance (SVR), and serum cortisol levels at 24
hours postoperatively. Variables were compared by calculating a weighted
mean difference (WMD) [95% confidence interval (CI)]. Result(s): This
analysis included 15 studies (1125 patients). Anesthetic induction with
etomidate was associated with a higher nadir MAP and SVR compared to
ketofol during the peri-induction period by WMD 4.77 mmHg [95% CI 0.31,
9.23, P = 0.04] and 42.22 dynes/cm5 [95% CI 0.49-83.94, P =
0.05]. However, there was no difference in the frequency of needed boluses
of vasopressors or fluids for peri-induction hypotension.
 Conclusion(s): Though etomidate appears to provide a superior
hemodynamic profile compared to ketofol, both agents require similar
degrees of clinical response to hypotension during the induction of CABG
surgery patients. Copyright © The Author(s) 2025.

<84>
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. Copyright © 2025 College of Physicians and Surgeons
Pakistan. All rights reserved.

<85>
Accession Number
2038260189
Title
FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass
Grafting in Patients With Diabetes.
Source
JAMA Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Engstrom T.; Horsted
Thyregod H.G.; Beleslin B.; Putnik S.; Tapp L.; Barker T.; Redwood S.;
Young C.; Bech G.J.-W.; Hoohenkerk G.J.F.; De Bruyne B.; Pijls N.H.J.;
Fearon W.F.; Bhindi R.; Brady P.; Yong A.; Yan T.; Ng M.; Plunkett B.;
Layland J.; Newcomb A.; Sapontis J.; Smith J.; Asrress K.; El Nakadi B.;
Noiseux N.; Peniston C.; Chong A.-Y.; Glineur D.; Minhas K.; Raab M.;
Nemec P.; Engstroem T.; Thyregod G.; Modrau I.; Rioufol G.; Farhat F.;
Park S.-J.; Choo S.J.; Kalinauskas G.; Bruinsma B.; Larsen A.I.;
Haaverstad R.; Menon M.; El Gamel A.; Jagic N.; Sreckovic M.; Rosic M.;
Witt N.; Corbascio M.; Ostlund-Papadogeorgos N.; Angeras O.; Jeppsson A.;
Oldroyd K.; Berry C.; Watkins S.; Al-Attar N.; MacCarthy P.; Wendler O.;
Curzen N.; Miskolczi S.; Sunil O.; Sarma J.; Barnard J.; Baker T.;
Kharbanda R.; Sayeed R.
Institution
(Takahashi, Otsuki, Ding, Fearon) Stanford University School of Medicine,
Stanford University, Stanford, CA, United States
(Takahashi, Otsuki, Ding, Fearon) Stanford Cardiovascular Institute,
Stanford University, Stanford, CA, United States
(Zimmermann) St Antonius Hospital, Nieuwegein, Netherlands
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Engstrom, Horsted Thyregod) Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Beleslin, Putnik) Medical Faculty, University Clinical Center of Serbia,
University of Belgrade, Belgrade, Serbia
(Tapp, Barker) University Hospitals Coventry and Warwickshire, Coventry,
United Kingdom
(Redwood, Young) St Thomas' Hospital, London, United Kingdom
(Bech, Hoohenkerk) Hagaziekenhuis, The Hague, Netherlands
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Outcomes in patients with diabetes after fractional flow
reserve (FFR)-guided percutaneous coronary intervention (PCI) using
current-generation drug-eluting stents (DES) compared with coronary artery
bypass grafting (CABG) are unknown. OBJECTIVES To investigate the relative
treatment effect of PCI vs CABG according to diabetes status with respect
to major adverse cardiac and cerebrovascular events (MACCE) at 3 years and
to evaluate the impact of the SYNTAX score. DESIGN, SETTING, AND
PARTICIPANTS This is a prespecified subgroup analysis of the FAME
(Fractional Flow Reserve vs Angiography for Multivessel Evaluation) 3
trial, an investigator-initiated, randomized clinical trial conducted at
48 centers worldwide. The FAME 3 trial enrolled patients with 3-vessel
coronary artery disease not involving the left main undergoing coronary
revascularization between August 2014 and December 2019. Data analysis was
conducted in August 2023. Clinical follow-up was performed at hospital
discharge and at 1 month, 6 months, 1 year, 2 years, and 3 years after
randomization. INTERVENTION Either FFR-guided PCI with current-generation
DES or CABG. MAIN OUTCOMES AND MEASURES The primary end point was MACCE,
defined as the composite of all-cause death, myocardial infarction,
stroke, or repeat revascularization at 3 years. RESULTS Of 1500 total
patients enrolled, mean (SD) patient age was 65.1 (8.4) years, and 265
patients (17.7%) were female. The FAME 3 trial included 428 patients with
diabetes (28.5%). Patients with diabetes, especially those receiving
insulin, had a higher risk of MACCE at 3 years compared with those without
diabetes. Regarding relative treatment effect, the risk of MACCE was
higher after FFR-guided PCI compared with CABG in both patients with
diabetes (hazard ratio [HR], 1.44; 95% CI, 0.91-2.28; P = .12) and those
without diabetes (HR, 1.50; 95% CI, 1.08-2.07; P = .02), with no
significant interaction (P for interaction = .94). In patients with a low
SYNTAX score (<23), there was no significant difference in MACCE between
PCI and CABG, while in patients with an intermediate to high SYNTAX score
(>=23), PCI had a higher risk of MACCE than CABG, regardless of diabetes
status. CONCLUSIONS AND RELEVANCE In this subgroup analysis of the FAME 3
randomized clinical trial, the relative benefit of CABG compared with
FFR-guided PCI was similar among patients with and without
diabetes. Copyright © 2025 American Medical Association. All
rights reserved, including those for text and data mining, AI training,
and similar technologies.

<86>
Accession Number
2034205093
Title
Treatment of and outcomes from hypotension in the post-anaesthesia care
unit: A single-centre retrospective cohort study.
Source
Anaesthesia and Intensive Care. (no pagination), 2025. Date of
Publication: 2025.
Author
Douglas N.; Gilbert S.; Ong J.; Kave B.; Leslie K.; Darvall J.N.
Institution
(Douglas, Gilbert, Ong, Kave, Leslie, Darvall) Department of Anaesthesia
and Pain Management, The Royal Melbourne Hospital, Parkville, Australia
(Douglas, Leslie, Darvall) Department of Critical Care, Melbourne Medical
School, University of Melbourne, Parkville, Australia
Publisher
SAGE Publications Inc.
Abstract
Hypotension after non-cardiac surgery is common and associated with harm.
Anaesthetists treat hypotension in the post-anaesthesia care unit (PACU)
with intravenous (IV) fluids and vasopressor medications. Our aim was to
determine the incidence of hypotension after these treatments. We
conducted a single centre retrospective cohort study of all adult patients
who were hypotensive (systolic blood pressure less than 90 mmHg) in the
PACU after non-cardiac, non-obstetric surgery over a one-year period. The
primary outcome was a composite of hypotension or vasopressor infusion in
the 24 h after PACU discharge. During the study 459 patients were
hypotensive in the PACU. No treatment was administered in 232 (51%)
episodes, IV fluid alone was administered in 138 (30%) episodes,
vasopressors alone were administered in 22 (5%) episodes, and both fluid
and vasopressors were administered in 67 (14%) patients. A total of 167
patients (36%) met the primary outcome, of which 118 (25%) were
hypotensive and 49 (11%) required vasopressor infusions. The treatment
group was significantly associated with the primary outcome (P < 0.001),
with 36 (15%) patients who received no treatment becoming hypotensive,
compared with 67 (46%, P < 0.001) patients who received IV fluid alone, 12
(55%, P < 0.001) who received vasopressors alone and 52 (75%, P < 0.001)
who received both IV fluid and vasopressors. Patients who were hypotensive
in the PACU frequently developed later hypotension or required
vasopressors in the 24 h after PACU discharge. Treatments delivered in the
PACU had limited long-term effectiveness. Novel treatments to protect
patients from subsequent hypotension are urgently needed. Copyright
© The Author(s) 2025.

<87>
Accession Number
2034205104
Title
Year in Review 2024: Noteworthy Literature in Cardiothoracic Critical
Care.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Gilliland S.; Kim K.K.; Li X.; Tanabe K.; Hennigan A.; Alber S.
Institution
(Gilliland, Kim, Li, Tanabe, Hennigan, Alber) Department of
Anesthesiology, University of Colorado, Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
This article reviews noteworthy additions to the literature for the
management of critically ill cardiothoracic surgical patients published in
2024. We reviewed 8100 articles to identify 10 publications that provided
new or updated information across a diverse range of topics including
extracorporeal membrane oxygenation (ECMO), sepsis and shock, and acute
hypoxemic respiratory failure (AHRF). Additional topics within these
publications included prophylaxis guidelines and evidence for prevention
of common complications in the intensive care unit, such as bleeding,
thrombosis, and acute kidney injury (AKI). Copyright © The
Author(s) 2025.

<88>
[Use Link to view the full text]
Accession Number
2038244096
Title
Validation of Medicare Advantage Claims for Long-Term Outcome Assessment
in Low-Risk Aortic Valve Replacement.
Source
Circulation: Cardiovascular Quality and Outcomes. (no pagination), 2025.
Article Number: e011991. Date of Publication: 2025.
Author
Lalani C.; Medina F.; Oseran A.S.; Liang L.; Song Y.; Butala N.M.; Kazi
D.S.; Cohen D.J.; Strom J.B.; Wadhera R.K.; Yeh R.W.
Institution
(Lalani, Oseran, Kazi, Strom, Wadhera, Yeh) Division of Cardiology, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Medina, Liang, Song) Richard A. and Susan F. Smith Center for Outcomes
Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA, United States
(Butala) Division of Cardiology, Rocky Mountain Regional Va Medical
Center, University of Colorado, School of Medicine, Aurora, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) Division of Cardiology, St. Francis Hospital, Roslyn, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Although Medicare Advantage (MA) plans provide coverage to
>50% of Medicare beneficiaries, it is unclear whether MA claims can be
used similarly to Medicare Fee-For-Service (FFS) claims for clinical
outcomes assessment. In this study, we evaluate the accuracy of claims
algorithms previously validated in FFS to assess comorbidities and
outcomes in MA patients after aortic valve replacement. METHOD(S): We
compared the concordance of 11 claims-based covariates (diabetes,
hypertension, atrial flutter/fibrillation, myocardial infarction) and
outcomes (stroke, disabling stroke, transient ischemic attack, major
vascular complication, bleeding, permanent pacemaker implantation, death)
among FFS and MA patients with the covariates and adjudicated outcomes in
the multinational Evolut Low-Risk Trial (2016-2018). We used claims
algorithms for 1-year outcomes and calculated sensitivity, specificity,
positive predictive value, negative predictive value, and kappa, using
adjudicated outcomes as the reference. We compared the kappa for MA versus
FFS using the 2-sample z-test with a significance level of P<0.05.
 RESULT(S): Among 1139 US patients aged 65+ years old in the Evolut
Low-Risk Trial, 782 patients (175 MA and 607 FFS) were linked to claims
data and had complete comorbidity data. Among all covariates, claims
algorithms for covariates had sensitivities >=85% for identifying
diabetes, atrial flutter/fibrillation, and hypertension in MA and FFS. For
the outcomes, sensitivities were >=85% for bleeding (comprehensive),
permanent pacemaker implantation, and death. The kappa was higher in MA
versus FFS for diabetes (P=0.03) and hypertension (P=0.025) but was lower
in myocardial infarction (P<0.0001). There was no statistically
significant difference in the kappa agreement between MA versus FFS for
any of the selected outcomes. CONCLUSION(S): Medicare claims have a
similar level of kappa agreement in MA versus FFS for most covariates and
outcomes. As patients shift to MA, ascertainment of outcomes using
Medicare claims in postapproval studies remains valid for select
outcomes. Copyright © 2025 American Heart Association, Inc.

<89>
Accession Number
2034207378
Title
Opioid-Sparing Effects of Erector Spinae Plane Block in Off-Pump Coronary
Artery Bypass Grafting with Median Sternotomy: A Randomized Controlled
Trial.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Zhang Y.; Liu J.; Lv K.; Wang F.; Shi Y.; You P.; Wang W.
Institution
(Zhang, Lv, Wang, You, Wang) Department of Anesthesiology, Jining No. 1
People's Hospital, Shandong, Jining, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Shi) Department of Cardiac and Vascular Surgery, Jining No. 1 People's
Hospital, Shandong, Jining, China
Publisher
Springer
Abstract
Purpose: This study assessed the efficacy of preoperative erector spinae
plane block (ESPB) in reducing intraoperative opioid use and enhancing
recovery in off-pump coronary artery bypass grafting (OPCABG) patients,
who typically require high-dose opioids with associated postoperative
risks. Method(s): A prospective, double-blind randomized controlled
trial was conducted on 37 patients. Patients were randomized to receive
either bilateral ESPB with 0.375% ropivacaine or a sham block with normal
saline. Primary outcomes included intraoperative sufentanil consumption,
while secondary outcomes encompassed hemodynamic stability, postoperative
pain scores, mechanical ventilation (MV) duration, and hospital stay.
 Result(s): The ESPB group demonstrated a significant reduction in
intraoperative sufentanil consumption compared to the sham group (150.3
+/- 36.1 microg vs. 194.4 +/- 38.3 microg, p = 0.001). Postoperatively,
ESPB patients exhibited lower pain scores at rest and during coughing
within the first 6 h post-extubation (p < 0.001) and required less rescue
analgesia (5.3% vs. 50.0%, p = 0.003). Additionally, ESPB shortened MV
duration (5.43 +/- 1.65 h vs. 6.88 +/- 1.68 h, p = 0.013). No significant
differences were observed in cardiac care unit or hospital stay lengths.
 Conclusion(s): Preoperative ESPB effectively reduces intraoperative
opioid requirements and provides sustained analgesia in the early
postoperative period, facilitating earlier extubation. These findings
support ESPB as a valuable component of multimodal analgesia in OPCABG,
though further large-scale studies are needed to validate these results
and optimize its application. Clinical Trial Registration: The trial was
registered with the China Clinical Trials Center
(http://www.chictr.org.cn, ChiCTR2200066902) on December 21,
2022. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<90>
Accession Number
647028794
Title
APPLICATIONS OF VISCOELASTIC TESTING IN MICROSURGERY: A SYSTEMIC REVIEW
AND META-ANALYSIS.
Source
Georgian medical news. (337) (pp 6-12), 2023. Date of Publication: 01 Apr
2023.
Author
Hamidian Jahromi A.; Arnold S.; Konofaos P.
Institution
(Hamidian Jahromi) 1Division of Plastic & Reconstructive Surgery, Temple
University Medical Center, Philadelphia, PA, United States
(Arnold) 2Division of Plastic & Reconstructive Surgery, Rush University
Medical Center, Chicago, IL, United States
(Konofaos) Department of Plastic Surgery, University of Tennessee Health
Science Center (UTHSC), Memphis, TN, United States
Abstract
Viscoelastic testing including thromboelastography (TEG) and rotational
thromboelastometry (ROTEM) has gained increasing popularity across many
medical fields in recent years. As TEG/ROTEM testing uses whole blood
sample and evaluates interactions between cellular components i.e.,
platelets, red blood cells and the clotting factors, these evaluations are
uniquely capable of assessing coagulation in an in-vitro environment,
resembling native conditions unlike those of conventual clotting tests
(CCTs). While viscoelastic based protocols and applications are more
commonplace in hepatic and cardiac surgery and trauma scenarios, results
have attracted the attention of additional disciplines including
microsurgery. TEG/ROTEM tests, with their ability to assess real-time risk
of excessive bleeding or thrombosis, may be useful in the monitoring of
microsurgery patients who may be at an increased risk for flap failure.
The following review of TEG/ROTEM testing focuses on the most common
applications of these coagulation tests and the evidence that does or does
not support such uses. A systematic review and meta-analysis of the
current application of TEG/ROTEM in microsurgery is reported along with an
emphasis on the future that it might hold for the field.

<91>
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. 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). 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. 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. Copyright © 2025 Elsevier B.V.

<92>
Accession Number
647015257
Title
Efficacy, Safety, and Cost-effectiveness of 'Internet + Pharmacy Care' via
the Alfalfa App in Warfarin Therapy Management After Cardiac Valve
Replacement:A Randomized Controlled Trial.
Source
JMIR mHealth and uHealth. (no pagination), 2025. Date of Publication: 25
Mar 2025.
Author
Qian Y.; Chen W.; Zhou B.; Li J.; Guo Y.; Weng Z.; Zhang J.
Institution
(Qian) Clinical Research and Trial Center, Second Affiliated Hospital of
Kunming Medical University, CN, 1st floor ,Building 1 ,Inpatient
Building#374 Dianmian Road, Kunming, China
(Chen, Zhou) Second Clinical College of Kunming Medical University, CN,
Kunming, China
(Li, Weng) School of Pharmacy, Kunming Medical University, CN, Kunming,
Yunnan, China
(Guo) Department of Vascular Surgery, Fuwai Yunnan Hospital, Chinese
Academy of Medical Sciences, CN, Kunming, Yunnan, China
(Zhang) Department of Pharmacy, Fujian Maternity and Child Health Hospital
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
CN, Fuzhou, China
Abstract
BACKGROUND: Anticoagulation management (AM) is important in preventing
complications in patients undergoing cardiac valve replacement (CVR). The
development of mobile applications offers new opportunities for the
management of long-term anticoagulants. However, there is a lack of
randomized controlled trials evaluating the effectiveness, safety,
cost-effectiveness, and user demand for online AM. OBJECTIVE(S): We
aimed to evaluate the efficacy, safety, and cost-effectiveness of a
3-month warfarin dose adjustment mobile app-Alfalfa-compared to offline
management in patients post-CVR. We also explored the app's feasibility on
user satisfaction and demand. METHOD(S): This study was a randomized
controlled trial with assessments conducted at baseline and at a 3-month
follow-up. Participants were eligible if they (1) had been on warfarin
therapy for at least 3 months, (2) received warfarin management either
through the Alfalfa app or via pharmacist-led anticoagulation outpatient
clinic visits, (3) consented to regular follow-ups, (4) had not
experienced serious bleeding or thrombotic events in the 3 months prior to
warfarin treatment. A P value <=.05 was considered statistically
significant. RESULT(S): A total of 405 participants were included in
the analysis. The Time in Therapeutic Range (TTR) was significantly higher
in the Alfalfa app group compared to the offline group (66.46% vs. 46.65%,
P<.001). Participants in the Alfalfa app group had a higher monitoring
frequency (8.14 vs. 4.47, P<. 001) and a greater percentage of
international normalized ratio (INR) values within the target range
(896/1660, 53.98% vs. 346/899, 38.49%; P<.001) than those in the offline
group. Additionally, the Alfalfa app group exhibited lower rates of
subtherapeutic (235/1660, 14.16% vs. 152/899, 16.91%; P<.05), and extreme
subtherapeutic INR values (273/1660, 16.45% vs. 186/899, 20.69%; P<.05)
compared to the offline group. However, the incidence of minor bleeding
was higher in the Alfalfa app group (12/204, 5.9% vs. 3/201, 1.5%; P
=.02). In terms of cost-effectiveness, the Alfalfa app group had a
significantly lower average cost per test (42.37 vs. 78.3, P< .001),
average time per test (47.42 vs. 90.74, P< .001), and cost-effectiveness
ratio (C/E ratio: 385.90 vs. 662.90) compared to the offline group. A
total of 86 participants completed the satisfaction questionnaire, and the
vast majority of participants expressed high levels of satisfaction with
the Alfalfa App, while also providing further suggestions for improvement.
 CONCLUSION(S): The integration of 'Internet + Pharmacy Care' using
the Alfalfa App can improve the effectiveness of warfarin anticoagulation
management in patients following heart valve surgery. The Alfalfa app
provides a more efficient, secure, and cost-effective solution to warfarin
management compared to traditional offline methods. CLINICALTRIAL: Chinese
Clinical Trial Registry, ChiCTR; ChiCTR1900021920;
https://www.chictr.org.cn/showproj.html?proj=36832.

<93>
Accession Number
647018681
Title
Antithrombotic therapy after left atrial appendage occlusion.
Source
Expert review of cardiovascular therapy. (no pagination), 2025. Date of
Publication: 28 Mar 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
Abstract
INTRODUCTION: Left atrial appendage occlusion (LAAO) represents a strategy
to minimize the risk of thromboembolic events 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 and represents the
rationale behind antithrombotic therapy following LAAO. AREAS COVERED: A
comprehensive literature search has been performed on PubMed, Web of
Science and Cochrane, up to November 2024, with no significant
restrictions. Antithrombotic drugs after LAAO include vitamin K
antagonists (VKA), direct oral anticoagulants (DOAC), antiplatelet drugs,
and their combinations. Initial experience with LAAO supported
high-intensity regimens, while the current paradigm favors simplified
approaches allowing for a proper device healing without any increase in
bleeding. The aims of our review were to define the rationale and
implications of antithrombotic therapy following LAAO, and to provide an
overview of current evidence on various antithrombotic regimens. EXPERT
OPINION: The optimal antithrombotic regimen after percutaneous LAAO
remains controversial, highlighting the need for randomized trials on this
topic. Based on aggregate data, DOAC seems to be the strategy with 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.

<94>
[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. (no pagination), 2025.
Article Number: e010858. Date of Publication: 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.
 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). 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. 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. Copyright © 2025 American Heart Association, Inc.

<95>
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. Copyright © 2025 International Anesthesia
Research Society.

<96>
Accession Number
2034183396
Title
Year in Review 2024: Noteworthy Literature in Cardiac Anesthesiology.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Seres T.; Wilkey B.; Weitzel N.; Clendenen N.
Institution
(Seres, Wilkey, Clendenen) Department of Anesthesiology, University of
Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, United
States
(Weitzel) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
SAGE Publications Inc.
Abstract
The research findings relevant for Cardiac Anesthesiology studies
published in 2024 involved key innovations in devices and gene therapy in
addition to the expansion of transcatheter techniques for valve repair or
replacement. We reviewed 447 relevant articles and selected 21 as the most
noteworthy studies published in 2024. Themes that emerged from our review
include the etiology and prevention of delirium or outcomes after
mechanical circulatory support. Robust clinical outcome data now supports
the use of microaxial flow devices for mechanical circulatory support for
cardiogenic shock due to acute myocardial infarction. Pharmacology
development presents colchicine as anti-inflammatory medication to prevent
atrial fibrillation or intravenous amino acids for kidney protection after
cardiopulmonary bypass. Technological advances include implantable
wireless pacing-defibrillator devices, pulmonary artery pressure
monitoring in heart failure patients, extracorporeal blood purification
for preventing acute kidney injury and hypothermic oxygenated perfusion of
the donor heart in heart transplantation. Transcatheter interventions on
mitral or aortic valve were gaining advances over surgical procedures.
Novel paradigms included treatments with gene therapy for cardiac
amyloidosis or refractory angina and the emerging risk of microplastic
exposure in cardiovascular events. Copyright © The Author(s)
2025.

<97>
[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. Copyright ©
2025 Wolters Kluwer Health, Inc. All rights reserved.

<98>
Accession Number
2034180568
Title
Impact of high-fidelity simulation on the performance of oxygenator
change-outs among perfusion students.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Collins J.; Voitik A.; Leonor A.R.; Juricek L.T.; Ellis M.; Kaur R.;
Weinberg A.
Institution
(Collins, Juricek, Ellis, Kaur, Weinberg) Department of Cardiovascular
Perfusion, College of Health Sciences, Rush University, Chicago, IL,
United States
(Voitik) Perfusion Services, University of Washington Medical Center,
Seattle, WA, United States
(Leonor) Perfusion Services, UC Health University of Colorado Hospital,
Auroura, CO, United States
(Kaur) Department of Respiratory Care, College of Health Sciences, Rush
University, Chicago, IL, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Simulation is increasingly utilized in the clinical training
of healthcare professionals. Many perfusion programs in the United States
use simulation to teach students both technical skills and effective
communication. However, there is a lack of clarity regarding the optimal
timing for introducing simulation into the curriculum and how to assess
students' competencies. This study aims to evaluate whether combining
simulation with didactic education is more effective than didactic
education alone for learning perfusion-specific tasks, such as oxygenator
changeouts. Method(s): This was a pilot, randomized controlled study
conducted during November 2020. Subjects who were in their first year and
enrolled in a cardiovascular perfusion program at the university were
included. Subjects were randomly assigned to receive didactic education
alone (control) or didactic in combination with the simulation training
(experimental). Both groups received the didactic portion of the
oxygenator change out procedure and the experimental group received
supplemental simulation training. The primary outcome was oxygenator
change-out completion time (recorded in minutes and seconds) to identify
and change-out an oxygenator in a cardiopulmonary bypass circuit. The
secondary outcome was total communication score and subject's overall
performance assessment using the scoring system referenced by Burkhart et
al. Result(s): The experimental group (n = 8) performed the
oxygenator change-out significantly faster (363.63 +/- 87.1 seconds vs
558.11 +/- 185.75 seconds, p =.016) as compared to the control group (n =
9). However, there was no significant difference between the control and
experimental groups in overall communication skills (p =.152) or the
scoring system (p =.053) used to score subjects technical skills.
 Conclusion(s): The study findings revealed that the group receiving
both didactic instruction and simulation performed an oxygenator
change-out significantly faster than the group that received only didactic
instruction. These results suggest that incorporating simulation of
emergency scenarios into perfusion training can enhance students' speed in
performing complex tasks, better preparing them for real clinical
situations. Copyright © The Author(s) 2025.

<99>
Accession Number
2034192587
Title
Percutaneous Left Atrial Appendage Closure: Supporting Evidence,
Limitations and Future Directions.
Source
Journal of Clinical Medicine. 14(7) (no pagination), 2025. Article Number:
2300. Date of Publication: 01 Apr 2025.
Author
Imperatore G.; Lochy S.; Ben Yedder M.; Galea R.; Aminian A.
Institution
(Imperatore) Health Science Interdisciplinary Centre, Sant'Anna School of
Advanced Studies, Pisa, Italy
(Lochy) Department of Cardiology, Universitair Ziekenhuis Brussel (UZ
Brussel), Brussels, Belgium
(Ben Yedder, Aminian) Department of Cardiology, Centre Hospitalier
Universitaire de Charleroi, Charleroi, Belgium
(Galea) Department of Cardiology, Bern University Hospital, Inselspital,
University of Bern, Bern, Switzerland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a
promising intervention for stroke prevention in patients with atrial
fibrillation who are contraindicated for long-term anticoagulation
therapy. Despite its growing adoption, a comprehensive review of the LAAO
procedure is essential to consolidate the supporting evidence, identify
limitations, and outline future directions. This review aims to evaluate
the efficacy and safety of LAAO, drawing on clinical trials and real-world
studies to provide a balanced perspective. Additionally, we address the
limitations of current research, including variability in patient
selection, procedural techniques, and follow-up protocols. By highlighting
gaps in the knowledge and areas for improvement, this review aims to guide
future research efforts to optimize and expand the therapeutic potential
of LAAO. Copyright © 2025 by the authors.

<100>
[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. (no pagination), 2025.
Article Number: e011188. Date of Publication: 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, 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. 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. 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]).
 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. Copyright
© 2025 American Heart Association, Inc.

<101>
[Use Link to view the full text]
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. Copyright © 2025 Lippincott Williams and
Wilkins. All rights reserved.

<102>
Accession Number
647011736
Title
Prognostic value of patient-reported outcome measures in adult
heart-transplant patients: a systematic review.
Source
Journal of patient-reported outcomes. 6(1) (pp 23), 2022. Date of
Publication: 16 Mar 2022.
Author
Villa B.P.; Alotaibi S.; Brozzi N.; Spindler K.P.; Navia J.;
Hernandez-Montfort J.
Institution
(Villa) Heart and Vascular Institute, Cleveland Clinic Florida, Weston,
FL, United States
(Alotaibi, Spindler) Heart Center, Segeberger Kliniken GmbH, Bad Segeberg,
Germany
(Brozzi, Navia) Heart and Vascular Institute, Cleveland Clinic Florida,
Weston, FL, United States
(Hernandez-Montfort) Baylor Scott and White Health, Central Texas, United
States
Abstract
BACKGROUND: The aim of this systematic review was to describe the
prognostic value of patient-reported outcome measures (PROMs) in adult
heart-transplant (HT) patients. METHOD(S): A systematic search was
performed on Ovid Medline, CINAHL Plus, Web of Science, and PubMed. The
study protocol was registered on the PROSPERO database (CRD42021225398),
and the last search was performed on January 7, 2021. We included studies
of adult HT patients where generic and disease-specific PROMs were used as
prognostic indicators for survival, readmissions, HT complications, and
the onset of new comorbidities. We excluded studies that used
clinician-reported and patient-experience outcomes. The Quality in
Prognosis Studies tool (QUIPS) was used to measure the risk of bias of the
included studies. RESULT(S): We included five observational studies
between 1987 and 2015, whose populations' mean age ranged from 43 to 56
years and presented a higher proportion of males than females. The Kansas
City Cardiomyopathy Questionnaire demonstrated a negative correlation with
readmissions (coefficient = - 1.177, p = 0.031), and the EQ-5D showed a
negative correlation with the onset of neuromuscular disease after HT
(coefficient = - 0.158, p < 0.001). The Millon Behavioral Health Inventory
and the Nottingham Health Profile demonstrated a statistically significant
association as survival predictors (p = 0.002 and p < 0.05, respectively).
A moderate overall risk of bias was reported in three studies, one study
resulted in a low risk of bias, and a proportion of more than 75% of males
in each of the studies. High heterogeneity between the studies impeded
establishing a link between PROMs and prognostic value.
 CONCLUSION(S): There is low evidence supporting PROMs usage as
prognostic tools in adult HT patients. Comparing outcomes of PROMS to
routine prognostic in wider and systematic settings is warranted.
Systematic use of PROMs in clinical settings is warranted. Copyright
© 2022. The Author(s).

<103>
Accession Number
2038271425
Title
Low versus High Fraction of Inspired Oxygen During Lung Separation in
Thoracic Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Spraider P.; Abram J.; Wally D.; Bernardi D.; Augustin F.; Hell T.;
Tscholl P.; Dejaco H.
Institution
(Spraider, Abram, Wally, Bernardi, Dejaco) Department of Anesthesia and
Intensive Care Medicine, Medical University of Innsbruck, Innsbruck,
Austria
(Augustin) Department of Visceral, Transplant and Thoracic Surgery,
Medical University of Innsbruck, Innsbruck, Austria
(Hell, Tscholl) Data Lab Hell, non-University Research Institution, Zirl,
Austria
Publisher
W.B. Saunders
Abstract
Objectives: To investigate whether a lower fraction of inspired oxygen
(FiO<inf>2</inf>) during the early phase of lung separation is able to
improve overall oxygenation of the blood assessed by the arterial partial
pressure of oxygen (PaO<inf>2</inf>)/FiO<inf>2</inf> ratio, and to
investigate its effect on lung collapse and postoperative pulmonary
complications (PPC). Design(s): Prospective, nonblinded, randomized
controlled trial. Setting(s): Single-center trial at a university
hospital. Participant(s): Patients scheduled for thoracic surgery
requiring one-lung ventilation (OLV). Intervention(s): Study
participants received either a low and then increasing oxygen
concentration after lung separation or pure oxygen and then a decreasing
oxygen concentration. Measurements and Main Results: The primary
endpoint was the PaO<inf>2</inf>/FiO<inf>2</inf> ratio 30 minutes after
the start of OLV. Secondary endpoint included lung collapse defined as
none, partial, or complete during the early phase of OLV and incidence of
PPC. A total of 55 patients were enrolled, 53 of whom were included in the
analysis. The primary endpoint, PaO<inf>2</inf>/FiO<inf>2</inf> ratio, was
comparable in the 2 groups, and the secondary endpoint, lung collapse, was
similar. However, the incidence of PPC was significantly reduced with a
low oxygen content strategy (19% vs 48%; p = 0.042). Conclusion(s): A
strategy of low FiO<inf>2</inf> before and after lung separation did not
improve the oxygenation capacity of the lungs, and lung collapse was
comparable in the 2 study groups. However, the occurrence of PPC was
significantly reduced in the group treated with low
FiO<inf>2</inf>. Copyright © 2025 The Author(s)

<104>
[Use Link to view the full text]
Accession Number
2038232729
Title
Methylxanthine Derivatives in the Treatment of Sinus Node Dysfunction A
Systematic Review.
Source
Cardiology in Review. 33(3) (pp 246-255), 2025. Date of Publication: 01
May 2025.
Author
Roth H.R.; Reinert J.P.
Institution
(Roth, Reinert) Department of Pharmacy Practice, The University of Toledo
College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
While the chronotropic effects of theophylline and aminophylline are
well-known, their clinical application in the treatment of sinus node
dysfunction has not been established in a review. The purpose of this
systematic review is to evaluate the efficacy and safety of
methylxanthines in the treatment of bradyarrhythmias associated with sinus
node dysfunction. A systematic review was conducted in accordance with
PRISMA guidelines on Embase, PubMed, MEDLINE, Cochrane Central, Web of
Science, SciELO, Korean Citation Index, Global Index Medicus, and CINAHL
through June 2023. A total of 607 studies were identified through the
literature search. After applying the inclusion and exclusion criteria, 14
studies were included in this review. The causes of bradyarrhythmias
involving the sinoatrial node included acute cervical spinal cord injury,
coronavirus disease of 2019, carotid sinus syncope, chronotropic
incompetence, heart transplant, and chronic sinus node dysfunction.
Theophylline and aminophylline were shown to be effective for increasing
heart rate and reducing the reoccurrence of bradyarrhythmias. The data on
symptom resolution was conflicting. While many case studies reported a
resolution of symptoms, a randomized controlled trial reported no
significant difference in symptom scores between the control,
theophylline, and pacemaker groups in the treatment of sick sinus
syndrome. The incidence of adverse effects was low across all study
designs. The data suggests methylxanthines may be useful as an alternative
or bridge to nonpharmacologic pacing; however, dosing has yet to be
established for various indications. Overall, methylxanthines proved safe
and effective as a pharmacologic therapy for bradyarrhythmic
manifestations of sinus node dysfunction. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<105>
Accession Number
2038265777
Title
TCTAP A-072 Is Left Atrial Appendage Closure an Effective and Feasible
Alternative in Patients With End-Stage Renal Disease?.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S50-S51), 2025.
Date of Publication: 22 Apr 2025.
Author
Rodriguez-Riascos J.F.; Vemulapalli H.; Prajapati P.; Muthu P.; Srivathsan
K.
Institution
(Rodriguez-Riascos, Vemulapalli, Prajapati, Muthu, Srivathsan) Mayo
Clinic, United States
Publisher
Elsevier Inc.
Abstract
Background: The benefits of oral anticoagulants in patients with end-stage
renal disease (ESRD) remain uncertain due to altered drug metabolism and
increased bleeding risk. Left atrial appendage closure (LAAC) has emerged
as a potential alternative to oral anticoagulation, aiming to reduce
stroke risk without the bleeding complications linked to anticoagulants.
This study aimed to compare LAAC outcomes between patients with and
without ESRD. Method(s): A systematic literature review was conducted
according to PRISMA guidelines, searching PubMed, Cochrane, Embase, and
Scopus databases up to September 2024. The search included the following
terms: "(left atrial appendage) AND (closure OR occlusion) AND
(hemodialysis OR dialysis OR end-stage renal disease OR end-stage kidney
disease OR kidney disease OR renal disease)". After duplicates were
eliminated, title and abstract screening was performed by two independent
blinded reviewers (J.R. and H.V.). Potentially eligible studies were fully
reviewed, and the final selection was made by consensus. Figure 1
summarizes the flowchart for the selection of included studies. The
primary outcome was thromboembolic events or stroke following the
procedure. Secondary outcomes included post-procedural major bleeding,
mortality, device-related thrombosis, acute success, and procedural
complications. Heterogeneity across the included studies was assessed by
the I2 test, considering an I2 > 50% significant.
For analyses demonstrating significant heterogeneity, a random-effects
model was employed. Conversely, for those with non-significant
heterogeneity, a fixed-effects model was utilized. Incidence rate ratios
(IRRs) were used as measures of association for time-dependent outcomes,
while risk ratios (RRs) were reported for non-time-dependent outcomes.
[Formula presented] Results: A total of 497 titles and abstracts were
screened, 33 studies were fully reviewed, and 13 studies reporting data
from 898 ESRD patients and 21,995 non-ESRD patients were included. LAAC
was successful in all the patients with ESRD, no differences in the
success rates between ESRD and no-ESRD patients were documented (RR, 1.0;
95% CI, 0.97-1.04; I2 = 0%; p = 0.79). Patients with ESRD
presented a higher rate of complications (RR, 2.23; 95% CI, 1.14-4.38;
I2 = 67%; p = 0.02) Figure 2. Among four studies comparing 105
patients with ESRD and 513 patients without ESRD, device-related
thrombosis rates were comparable in both groups (RR, 0.59; 95% CI,
0.11-3.04; I2 = 26%; p = 0.53). During follow-up, there was no
significant difference in stroke incidence between ESRD and non-ESRD
patients after LAAC (IRR, 1.44; 95% CI, 0.87-2.37; I2 = 22%; p
= 0.16) (Figure 3). ESRD patients, however, had higher rates of
post-procedure major bleeding (IRR, 1.84; 95% CI, 1.32-2.57; I2
= 17%; p < 0.01) (Figure 4) and mortality (RR, 1.88; 95% CI, 1.28-2.75;
I2 = 0%; p <0.01). [Formula presented] [Formula presented]
[Formula presented] Conclusion(s): To the best of our knowledge, this
is the largest meta-analysis in this field and the first to compare stroke
and bleeding as time-dependent outcomes. Our results support the
feasibility of LAAC in ESRD patients, demonstrating comparable success
rates and an acceptable complication rate. However, the complication rate
was higher than in non-ESRD patients. Finally, while LAAC provides
comparable protection against thromboembolic events in both ESRD and
non-ESRD patients, those with ESRD have a significantly higher risk of
major bleeding and overall mortality. Copyright © 2025

<106>
Accession Number
2038265731
Title
TCTAP A-065 The Influence of Ascending Aorta Dilatation on Transcatheter
Aortic Valve Implantation (TAVI) Outcomes: Unraveling the Risks and
Outcomes.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S47), 2025. Date
of Publication: 22 Apr 2025.
Author
Tri Saputra P.B.; Widiarti W.; Mustofa A.; Savitri C.G.; Eko Putranto
J.N.; Ashari F.Y.; El Chaq Zamzam Multazam C.; Alkaff F.F.; D'Oria M.
Institution
(Tri Saputra, Widiarti, Mustofa, Savitri, Eko Putranto) Universitas
Airlangga, Indonesia
(Ashari) University of Manchester, United Kingdom, United Kingdom
(El Chaq Zamzam Multazam) Imperial College London, United Kingdom, United
Kingdom
(Alkaff) University Medical Center Groningen, Netherlands
(D'Oria) Division of Vascular and Endovascular Surgery, Department of
Clinical Surgical and Health Sciences, University of Trieste, Italy
Publisher
Elsevier Inc.
Abstract
Background: The influence and clinical implications of ascending aorta
dilatation (AAD) on transcatheter aortic valve implantation (TAVI)
outcomes remain ambiguous, largely due to the scarcity and inconsistency
of available data. AAD is frequently observed in patients with aortic
stenosis and may pose additional procedural challenges, potentially
heightening the associated risks. This meta-analysis aims to provide a
comprehensive evaluation of TAVI outcomes in patients with AAD versus
those without, with a particular emphasis on peri-procedural
complications, long-term mortality, and overall procedural efficacy.
 Method(s): A thorough literature search was performed across multiple
scientific databases, including PubMed, ScienceDirect, Web of Science,
Springer, Cochrane, and ClinicalTrials.gov, up to March 2024, in order to
identify studies comparing TAVI outcomes between patients with AAD and
those without. The evaluated outcomes encompassed mortality rates and
procedural complications. Statistical analyses were conducted using
relative risk (RR) and mean difference (MD) calculations, with
heterogeneity quantified through I2 statistics. Result(s):
Ten studies involving 204,078 patients were included and analyzed. The
pooled analysis indicated that patients with AAD had a significantly
higher likelihood of experiencing paravalvular leakage (RR 1.56, 95% CI
1.32-1.84, p<0.00001) and aortic dissection (RR 3.55, 95% CI 1.79-7.06,
p=0.0003) compared to those without AAD. However, no statistically
significant differences were observed in peri-procedural death rates (RR
1.09, 95% CI 0.83-1.42, p=0.53) or one-year survival loss (RR 0.79, 95% CI
0.51-1.23, p=0.30). Furthermore, survival rates at three and five years
remained comparable between the groups. The occurrence of other
complications, including myocardial infarction, permanent pacemaker
implantation, conversion to open surgery, and secondary valve
implantation, showed no significant variation, indicating that AAD does
not substantially influence long-term survival or procedural safety.
[Formula presented] Conclusion(s): Although patients with AAD
experience a higher incidence of aortic dissection and paravalvular
leakage, these complications do not translate into an increased risk of
short-term or long-term mortality. This finding underscores the robustness
of TAVI as a safe and effective treatment strategy for individuals with
AAD. Furthermore, advancements in procedural techniques, valve technology,
and perioperative management have contributed to improved outcomes,
minimizing the impact of anatomical complexities associated with AAD.
Given the comparable survival rates between patients with and without AAD,
TAVI remains as a viable option, offering a minimally invasive alternative
with significant benefits in terms of recovery and quality of
life. Copyright © 2025

<107>
Accession Number
647004339
Title
Impact of pecto-intercostal fascial block on postoperative fatigue in
elderly patients undergoing off-pump coronary artery bypass grafting: a
randomized clinical trial.
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 28 Mar 2025.
Author
Wang X.; Zhou M.; Liu Q.; Shen F.; Zhang Z.; Qi Y.; Sun J.; Wang L.
Institution
(Wang, Wang) Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu
Province Key Laboratory of Anesthesia and Analgesia Application
Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic
and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Department of Anesthesiology,
Xuzhou Central Hospital, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Xuzhou Clinical College of Xuzhou
Medical University, Xuzhou, China
(Shen) Department of Anesthesiology & Key Laboratory of Clinical Science
and Research, Zhongda Hospital, Southeast University, Nanjing, China
Abstract
BACKGROUND: Postoperative fatigue syndrome (POFS) is a common yet often
under-recognized consequence of surgical interventions, particularly in
cardiac surgery. POFS is associated with prolonged recovery times,
extended hospital stays, and increased healthcare costs. Current
strategies for preventing POFS have demonstrated limited success. This
study aims to evaluate the impact of pecto-intercostal fascial block
(PIFB) on the incidence of POFS in elderly patients undergoing
off-pumpcoronary artery bypass graft (CABG) surgery. METHOD(S): In
this randomized controlled trial, 110 elderly patients scheduled for
off-pump CABG surgery were randomly assigned to either the PIFB group (n =
55; 0.4% ropivacaine) or the control group (n = 55; normal saline). The
primary outcome was the incidence of POFS, which was assessed using the
ICFS-10 scale. Secondary outcomes included postoperative pain scores,
opioid consumption, extubation time, duration of ICU and hospital stay,
and Quality of Recovery (QoR-15) scores. RESULT(S): The incidence of
POFS was significantly lower in the PIFB group compared to the control
group on postoperative days 1 (69.0% vs. 92.7%, P = 0.004), 3 (63.6% vs.
83.6%, P = 0.030), and 5 (52.7% vs. 72.7%, P = 0.048), with no significant
differences observed by day 7 and 8 weeks. Pain scores were also markedly
lower in the PIFB group at three time points: immediately after
extubation, 12 hours post-surgery, and 24 hours post-surgery (P < 0.001, P
< 0.001, and P = 0.002, respectively). Furthermore, opioid consumption was
reduced by an average of 11.1 mg (P < 0.001). Patients in the PIFB group
experienced significantly shorter extubation times (5.5 +/- 1.8 hours vs.
8.6 +/- 2.1 hours, P < 0.001), ICU stays (31.8 +/- 7.3 hours vs. 39.4 +/-
7.5 hours, P < 0.001), and hospital stays (8.2 +/- 1.1 days vs. 8.8 +/-
1.2 days, P = 0.007). QoR-15 scores were significantly higher in the PIFB
group on postoperative days 1, 3, and 5 (P < 0.001, P = 0.003, and P =
0.037, respectively). Notably, no PIFB-related adverse events were
reported in either group. CONCLUSION(S): PIFB significantly
alleviated early POFS, enhanced pain management, reduced opioid
consumption, and accelerated recovery, thereby improving the overall
quality of recovery in elderly patients undergoing off-pump
CABG. Copyright © 2025 The Author(s). Published by Wolters Kluwer
Health, Inc.

<108>
Accession Number
2038249370
Title
A Phase 3 Study of Ravulizumab to Protect Patients With Chronic Kidney
Disease From Cardiac Surgery Associated Acute Kidney Injury and Major
Adverse Kidney Events: The Artemis Study.
Source
Heart Lung and Circulation. Conference: The ANZSCTS Annual Scientific
Meeting. Noosa Australia. 34(Supplement 1) (pp S17-S18), 2025. Date of
Publication: 01 Apr 2025.
Author
Smith J.; Ostermann M.; Winterberg P.; Solinsky C.; Li G.; Smith W.;
Engelman D.
Institution
(Smith, Ostermann, Winterberg, Solinsky, Li, Smith, Engelman) Monash
Health, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: In patients undergoing cardiac surgery with CPB, pre-existing
CKD confers substantial risk for the development of cardiac
surgery-associated acute kidney injury (CSA-AKI). CSA-AKI occurs in >=50%
of patients with CKD undergoing cardiac surgery with CPB vs ~20-25% of
patients without CKD. Causes of CSA-AKI are multifactorial and complex.
There are no approved therapies that reduce the risk of AKI after cardiac
surgery with CPB3. Studies suggest that damage and inflammation caused by
IRI and CPB are amplified by complement activation3; early treatment with
C5 inhibitors before onset of ischaemia, may lower this risk.
 Method(s): ARTEMIS (NCT05746559) is a Phase 3, randomised,
double-blind, placebo-controlled, study of ravulizumab in adults with CKD
and stable cardiac disease undergoing non-emergent cardiac surgery with
CPB, to reduce the risk of postoperative AKI and subsequent major adverse
kidney events (MAKE) 90-days post-surgery. It consists of a screening
period, randomisation and dosing 1-7 days prior to surgery with CPB (Day
1), a 90-day primary evaluation period, and survival follow-up day 365
post-CPB. Approximately 736 participants will be randomised 1:1 to receive
a single weight-based dose of ravulizumab or placebo; randomisation will
be based on baseline CKD stage and surgery type. The primary objective is
to assess the efficacy of ravulizumab in reducing the risk of MAKE90,
defined as meeting >=1 of the following by day-90 post-CPB: >=25%
sustained decrease from baseline in estimated glomerular filtration rate;
initiation of kidney replacement therapy; death from any cause. Safety
will also be evaluated. Result(s): Final analysis will be conducted
when all participants have completed the primary evaluation period.
 Conclusion(s): This study aims to assess whether terminal complement
inhibition with ravulizumab is safe and effective in reducing MAKE and
improving outcomes in patients with CKD undergoing cardiac surgery with
CPB. Copyright © 2025

<109>
Accession Number
2038204709
Title
Letter: the effect of virtual reality on postoperative anxiety and pain in
patients following cardiac surgery: a randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 67(4) (no pagination), 2025.
Article Number: ezaf090. Date of Publication: 01 Apr 2025.
Author
Xie H.; Gao F.; Zheng X.
Institution
(Xie, Gao, Zheng) Department of Anesthesiology, Fuzhou University
Affiliated Provincial Hospital, Fuzhou, China
(Xie, Gao, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College of Fujian Medical University, Fuzhou, China
Publisher
European Association for Cardio-Thoracic Surgery

<110>
Accession Number
2034158947
Title
Comparison of multiple arterial grafts vs. single arterial graft in
coronary artery bypass surgery: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1555242. Date of Publication: 2025.
Author
Ding Q.; Zhu Q.; Lu L.; Cheng X.; Ge M.
Institution
(Ding, Zhu, Lu, Cheng, Ge) Department of Cardio-thoracic Surgery, Nanjing
Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical
School, Nanjing, China
(Cheng) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, Clinical College of Nanjing University of Chinese Medicine,
Nanjing, China
Publisher
Frontiers Media SA
Abstract
Observational studies and randomised controlled trials (RCTs) have yielded
conflicting results regarding the outcomes of multiple arterial grafts
(MAG) vs. single arterial grafts (SAG) in coronary artery bypass graft
(CABG) surgery. We conducted a comprehensive search across multiple
databases for RCTs that directly compared MAG and SAG. The clinical
outcomes assessed included all-cause mortality, cardiac-specific
mortality, myocardial infarction (MI), repeat revascularization, stroke,
sternal wound complications, and major bleeding. Outcomes were measured
using hazard ratios (HR), relative risks (RR), and the corresponding 95%
confidence intervals (CI). Eighteen RCTs involving 10,143 patients were
included in the analysis. The follow-up period ranged from 6 months to
12.6 years, and the average age of the patients across the studies ranged
between 56.3 and 77.3 years. MAG and SAG did not differ significantly in
terms of the incidence of sternal wound complications, major bleeding, or
stroke following CABG. However, the MAG group demonstrated a lower risk of
all-cause mortality, cardiac mortality, MI, and repeat revascularization
compared with the SAG group. MAG was associated with higher survival,
lower risk of MI, and fewer repeat revascularization. Nonetheless, there
were no significant differences in the incidence of sternal wound
infections, major bleeding, and stroke between MAG and SAG. Copyright
2025 Ding, Zhu, Lu, Cheng and Ge.

<111>
Accession Number
2038249388
Title
Low Pressure Low Flow of Oxygenated Hypothermic Perfusion of Donor Hearts
in a Porcine Model for up to 6 Hours.
Source
Heart Lung and Circulation. Conference: The ANZSCTS Annual Scientific
Meeting. Noosa Australia. 34(Supplement 1) (pp S19), 2025. Date of
Publication: 01 Apr 2025.
Author
Besanko J.; Coates T.; Edwards J.; Beltrame J.; Worthington M.; Ou R.
Institution
(Besanko, Coates, Edwards, Beltrame, Worthington, Ou) Centre for Clinical
and Experimental Transplantation (CCET), Royal Adelaide Hospital,
Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Evidence from randomised human and experimental trials indicate
that the results of heart transplantation improve with the use of
perfusion of donor hearts. In these reanimation studies, we evaluated the
efficacy of a novel mechanical perfusion device (Organ Angel) in
preserving porcine hearts for 6 hours ex vivo. The device utilises
hypothermic perfusion with celsior solution at a low flow rate of 40
mL/min. Method(s): Twelve (12) porcine hearts were explanted using
standard techniques and randomised to either be preserved via cold storage
(n=6) or mechanical perfusion (n=6). Following preservation, the hearts
were reanimated on a bench bypass circuit and assessed for 2 hours.
Cardiac performance was assessed every 30 minutes in the working model
after a stabilisation period in non-working status (Langendorff model).
 Result(s): The mechanical perfusion device demonstrated superior
preservation compared to cold storage in terms of cardiac performance
(cardiac output) p=0.01 on the bench bypass circuit, electron microscopy,
and biochemical normality. Conclusion(s): These findings suggest that
the mechanical perfusion device provides an alternative to cold storage
preservations and has the potential to improve the preservation of hearts
for transplantation. Copyright © 2025

<112>
Accession Number
2038265870
Title
TCTAP A-071 A Meta-Analysis Comparing the Diagnostic Performance of
Computed Tomography-Derived Fractional Flow Reserve and Coronary Computed
Tomography Angiography for Obstructive CAD in TAVR Planning.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S50), 2025. Date
of Publication: 22 Apr 2025.
Author
Sun M.; Ma Z.; Nie Y.; Zhang B.; Liu L.; Tu C.; Zhang D.; Song X.; Zhang
H.
Institution
(Sun, Ma, Nie, Zhang, Liu, Tu, Zhang, Song, Zhang) Beijing Anzhen
Hospital, China
Publisher
Elsevier Inc.
Abstract
Background: Computed Tomography Fractional Flow Reserve (CT-FFR) and
Coronary Computed Tomography Angiography (CCTA) are potential tools for
evaluating obstructive coronary artery disease (CAD) in the planning of
Transcatheter Aortic Valve Replacement (TAVR). However, their diagnostic
accuracy for clinical application requires further validation. This
meta-analysis aims to evaluate and compare the diagnostic efficacy of
CT-FFR and CCTA in detecting obstructive CAD in patients scheduled for
TAVR. Method(s): We conducted a comprehensive search of PubMed,
Embase, and the Cochrane Library for relevant studies on CCTA, CT-FFR, and
TAVR. The search strategy included dual approaches to identify studies
evaluating the diagnostic performance of CCTA and CT-FFR for pre-TAVR
obstructive CAD. We identified 14 studies on CCTA, 8 studies on CT-FFR,
and 7 studies on both CCTA and CT-FFR. Invasive FFR or invasive coronary
angiography (ICA) served as the reference standards. Result(s):
Initial results showed CT-FFR had a higher area under the curve (AUC) than
CCTA at the per-patient level (0.91 [95% CI 0.88-0.93] vs. 0.82 [95% CI
0.78-0.85], p<0.001). Conversely, CCTA showed a higher AUC than CT-FFR at
the per-vessel level, though this difference was not statistically
significant (0.83 [95% CI 0.80-0.86] vs. 0.87 [95% CI 0.84-0.90],
p=0.064). We refined our selection to studies utilizing both CCTA and
CT-FFR. Results indicated that CT-FFR had a superior AUC compared to CCTA,
both per-patient (0.92 [95% CI 0.90-0.94] vs. 0.69 [95% CI 0.65-0.73],
p<0.001) and per-vessel (0.84 [95% CI 0.84-0.87] vs. 0.77 [95% CI
0.74-0.81], p<0.001). Conclusion(s): CT-FFR demonstrates superior
diagnostic performance compared to CCTA in detecting obstructive CAD
during TAVR planning. The implementation of CT-FFR prior to TAVR can
enhance the diagnostic accuracy for obstructive CAD, potentially reducing
the need for additional invasive coronary angiographies. This can lead to
lower healthcare costs and mitigate risks and complexities associated with
excessive diagnosis and treatment. Copyright © 2025

<113>
Accession Number
2038248474
Title
Systematic Shunting Under General Anesthesia for Carotid Endarterectomy: A
Prospective Study.
Source
Journal of Vascular Surgery. Conference: VEITHsymposium. New York United
States. 81(5 Supplement) (pp S29-S30), 2025. Date of Publication: 01 May
2025.
Author
Sfeir J.
Institution
(Sfeir) Gilbert and Rose-Marie Chagoury School of Medicine, Blat, Lebanon
Publisher
Elsevier Inc.
Abstract
Objectives: Routine shunting is controversial in carotid endarterectomy
(CEA). Some surgeons use it systematically, while others use it when there
are signs of poor perfusion preoperatively. In our study, we show that
systematic shunting is safe and can give similar or even better outcomes
compared to CEA done under cerebral monitoring and selective shunting and
that perioperative management is crucial for better outcomes.
 Method(s): In 10 years, 178 CEA were included, the primary and
secondary endpoints were to evaluate the risks of stroke and mortality and
to evaluate the incidence of complications related to shunt insertion. All
procedures were done by the same team. Forty-six (25%) were symptomatic,
while 132 (75%) were asymptomatic. The confirmation of the stenosis was >
70% on dual imaging (ultrasound and computed tomography
angiography/magnetic resonance angiography). All patients with normal
kidney function underwent coronary angiography, 12 (6.7%) had coronary
stenting, and 2 had coronary artery bypass grafting. Nuclear cardiac
imaging was carried out in patients with moderate renal disease except in
7 operated for repetitive transient ischemic attack within 48 hours. All
had cerebral evaluation by magnetic resonance imaging (MRI). Symptomatic
patients with recent coronary stenting were operated on dual
antiplatelets. All patients were operated under general anesthesia with
the insertion of an ARGYLE shunt. The intravenous heparin bolus varied
between 2500 and 5000 UI, and Dacron patch angioplasty was used. All
patients were admitted in the postoperative period to the CCU for 24
hours. Result(s): No stroke was observed in the postoperative period
(30 days). No shunt-related complication was documented. Transient
dysarthria and weakness were present in 2 (1.12%) and were related to
intraoperative hypotension and documented in brain diffusion MRI. Nine
(5.5%) had elevated troponin, all of whom were in the symptomatic group,
with 3 who had coronary angioplasty and stenting postoperatively. Four had
moderate hematomas with spontaneous resolution. Mortality was around
0.05%; 1 died after MI (symptomatic group). On follow-up at 3 months, no
dissection was seen related to systematic shunting. When comparing these
results with all meta-analyses, we found that our results were very
similar in terms of mortality, procedure-related complications, and stroke
prevention. Conclusion(s): When optimal perioperative assessment of
patients is done, carotid endarterectomy under general anesthesia with
systematic shunting is safe and can produce good outcomes with low rates
of perioperative stroke and death. Copyright © 2025

<114>
Accession Number
2038263878
Title
Comparative Outcomes of Mitral Valve Repair Versus Replacement in
Infective Endocarditis: A 16-Year Meta-Analysis of Time-to-Event Data From
Over 4000 Patients.
Source
American Journal of Cardiology. 246 (pp 33-42), 2025. Date of Publication:
01 Jul 2025.
Author
Comentale G.; Ahmadi-Hadad A.; Moldon H.J.; Carbone A.; Manzo R.; Calanni
Macchio C.; Damiano A.; Bossone E.; Esposito G.; Pilato E.
Institution
(Comentale, Ahmadi-Hadad, Moldon, Calanni Macchio, Damiano, Pilato)
Division of Cardiac Surgery, Department of Advanced Biomedical Sciences,
University of Naples "Federico II", Naples, Italy
(Manzo, Bossone, Esposito) Division of Cardiology, Department of Advanced
Biomedical Sciences, University of Naples "Federico II", Naples, Italy
(Carbone) Division of Cardiology, University of Campania "Luigi
Vanvitelli", Naples, Italy
Publisher
Elsevier Inc.
Abstract
Mitral valve (MV) repair for infective endocarditis (IE) has proven to be
a good and safe option, but current trends favor replacement; the
available data, in addition, don't allow to reach a general consensus on
the preferred first-line approach. The present metanalysis, aimed to
compare short- and long-term outcomes between MV repair (MVRep) and MV
replacement (MVR) in patients with IE. A search of PubMed was conducted on
30th August 2024, yielding 120 results. (PROSPERO CRD: CRD42023490612).
Four additional suitable studies were identified and added from Embase and
Medline (via Ovid). Statistical analyses were performed using RStudio,
SPSS, and RevMan. Pseudoindividual patient data were extracted from
Kaplan-Meier curves by converting the graphical plots into raw data
coordinates through WebPlotDigitizer. A total of 21 studies were eligible
for inclusion. The 16-year reconstructed analysis revealed that patients
undergoing MVRep have higher survival compared to the MVR group (HR: 1.41,
95% Cl: 1.30-1.53, p < 0.001). Moreover, IE recurrence was significantly
lower in MVRep (95% CI, RR:0.46, 12 = 41%, p = 0.03). Reoperation rates,
however, were similar between MVRep and MVR (95% CI, RR: 0.78, 12 = 0%, p
= 0.27). In-hospital mortality was similar between the groups (95% CI,
RR:0.40, 12 = 34%, p = 0.07). In conclusion, MV repair should be favored
over replacement in IE when there is no evidence of local extension of the
infections and if valve leaflets have not degenerated. This approach is
associated with improved overall survival and a reduced risk of IE
recurrence, making it particularly advantageous for younger
patients. Copyright © 2025 The Author(s)

<115>
Accession Number
2034196582
Title
Impact of cardiopulmonary bypass flow on the lower limit of cerebral
autoregulation during cardiac surgery: a randomized cross-over pilot
study.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2025. Date
of Publication: 2025.
Author
Desebbe O.; Berna A.; Joosten A.; Raphael D.; Malapert G.; Rolo D.;
Taccone F.S.; Gergele L.
Institution
(Desebbe, Berna, Rolo) Department of Anesthesiology and perioperative
care, Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Joosten) Department of Anesthesiology & Perioperative Care, University of
California Los Angeles, Los Angeles, CA, United States
(Raphael) Department of Anesthesiology & Perioperative Care, University of
California Irvine, Irvine, CA, United States
(Malapert) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde Clinic,
Lyon, France
(Taccone) Department of Intensive Care, Hopital Universitaire de Bruxelles
(HUB), Universite Libre de Bruxelles, Brussels, Belgium
(Gergele) Department of Anesthesiology and Perioperative Care, Ramsay
Sante, Hopital Prive de la Loire, Saint-Etienne, France
(Desebbe) Department of Anesthesiology & Perioperative Medicine, Clinique
de la Sauvegarde, 480 avenue Ben Gourion, Lyon, France
Publisher
Springer Science and Business Media B.V.
Abstract
Assessment of cerebral autoregulation is challenging under different
hemodynamic conditions during cardiac surgery and must be rapidly
calculated in order to optimize mean arterial pressure (MAP). Whether
systemic flow during cardiopulmonary bypass impacts the lower limit of
cerebral autoregulation (LLA) remains unclear. Forty patients requiring
cardiac surgery were included in this randomized crossover study. Patients
assigned to the conventional/high blood flow arm received 20 min of
conventional cardiopulmonary bypass (CPB) blood flow (2.2
L/min.m-2) followed by 20 min of high blood flow (2.8
L/min.m-2), both during aortic cross clamping. Patients
assigned to the high/conventional arm received the same flows but in
reverse order. During each 20-minute period, MAP was gradually increased
from 40 to 90 mmHg, while PaCO<inf>2</inf>, hematocrit, depth of
anesthesia, central temperature and arterial oxygen tension were kept
constant. Continuous cerebral blood flow velocities of the middle cerebral
artery (Fv) were monitored using transcranial doppler. Cerebral
autoregulation was calculated using a Pearson's correlation coefficient
(Mean flow index, Mxa) between the MAP and Fv. Mxa values were then
plotted across MAP ranges. The LLA was defined as the corresponding MAP
value when Mxa initially decreased and crossed the threshold value of 0.4.
A mixed model, including the LLA as the dependent variable, the CPB flow
and period as fixed effects and patients as a random effect was used to
compare conventional and high CPB flows. Thirty-seven patients were
analyzed. The LLA mean difference between groups, adjusted on the period,
was - 2.8 (SE 2.4) mmHg with 95% CI [-7.8, + 2.1 mmHg], p = 0.2538). 24%
of patients presented an LLA < 65 mmHg during the conventional CPB flow
phase versus 35% during the high CPB flow phase. Increasing the
cardiopulmonary pump flow did not decrease the LLA during cardiac
surgery. Copyright © The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<116>
Accession Number
2038265478
Title
TCTAP A-088 Comparative Efficacy and Safety of Low-Dose Direct Oral
Anticoagulants Versus Dual Antiplatelet Therapy Following Left Atrial
Appendage Occlusion in Patients With Atrial Fibrillation: A Systematic
Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S61-S62), 2025.
Date of Publication: 22 Apr 2025.
Author
Ibrahim A.; Shalabi L.; Zreigh S.; Mourad S.; Ramadan S.; Eljadid G.Y.
Institution
(Ibrahim, Mourad) Alexandria University, Egypt
(Shalabi) Gharyan University, Libyan Arab Jamahiriya
(Zreigh) Ankara Yildirim Beyazit University, Turkey
(Ramadan, Eljadid) Ain Shams University, Egypt
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is a common cardiac arrhythmia
associated with a high risk of stroke and thromboembolic events.
Percutaneous left atrial appendage occlusion (LAAO) has emerged as an
alternative to oral anticoagulation therapy, yet the optimal
antithrombotic strategy post-procedure remains unclear. Aim(s): To
compare the safety and efficacy of low-dose direct oral anticoagulants
(DOACs) versus dual antiplatelet therapy (DAPT) following LAAO.
 Method(s): A comprehensive literature search was conducted in October
2024 across PubMed, Scopus, Cochrane, and Web of Science databases.
Inclusion criteria encompassed adults aged 18 and older with AF who
underwent successful LAAO. Primary outcomes included device-related
thrombosis (DRT), major bleeding, and thromboembolic outcomes (strokes and
systemic embolism (SE)). Statistical analysis was conducted using R
version 4.3.2. Result(s): Four studies involving 727 patients were
included, comprising two randomized controlled trials and two cohort
studies Low-dose DOAC therapy significantly reduced the risk of DRT by 64%
compared to DAPT (OR = 0.36; 95% CI [0.16, 0.79], p = 0.011), and also
demonstrated superior efficacy (OR = 0.36; 95% CI [0.16, 0.85], p = 0.01).
However, there wasn't a significant difference in the incidence of major
bleeding (OR = 0.36; 95% CI [0.11, 1.18], p = 0.091; I2 = 0%).
The composite endpoint of efficacy and safety outcomes was significantly
reduced in the low-dose DOAC group (OR = 0.41; 95% CI [0.25, 0.67], p =
0.0003; I2 = 0%). [Formula presented] [Formula presented]
 Conclusion(s): Our findings suggest low-dose DOACs are safer and more
effective antithrombotic option than DAPT in patients with AF following
LAAO. Our findings have shown better clinical outcomes and lower rates of
complications. Further research is warranted to establish long-term safety
and efficacy in large control clinical trials Keywords: Atrial
fibrillation, Left atrial appendage occlusion, Low-dose direct oral
anticoagulant, Dual antiplatelet therapy, Device-related
thrombosis Copyright © 2025

<117>
Accession Number
2038265864
Title
TCTAP A-004 Regional Variations in Sex-Based Outcomes of Transcatheter
Aortic Valve Replacement: A Meta-Analysis of 657,850 Patients.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S2), 2025. Date
of Publication: 22 Apr 2025.
Author
Zreigh S.; Al Othman A.; Benhammou M.; Mukhlif Al-Allawee A.S.; Guerguer
W.; Haidarah A.; Almzainy S.; Shawesh Q.E.; Khalid S.; Nounou M.V.;
Elmezayen R.; Alzu'bi M.; Abuajamieh M.; Drvis M.; Elhadi M.
Institution
(Zreigh, Drvis) Ankara Yildirim Beyazit University, Turkey
(Al Othman) Near East University, Cyprus
(Benhammou) University of Oran 1, Algeria
(Mukhlif Al-Allawee) University of Fallujah, Iraq
(Guerguer) University of Algiers 1, Algeria
(Haidarah) West China Hospital, China
(Almzainy, Shawesh, Elhadi) University of Tripoli, Libyan Arab Jamahiriya
(Khalid) Benghazi University, Libyan Arab Jamahiriya
(Nounou) University of Nouakchott Al Aasriya, Mauritania
(Elmezayen) Kafr-Elsheikh University, Egypt
(Alzu'bi) The Hashemite University, Jordan
(Abuajamieh) Cairo University, Egypt
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis (AS) is a common valvular heart disease, with
an estimated prevalence ranging from 3% to 10%, affecting females and
males equally. Transcatheter aortic valve replacement (TAVR) has emerged
as a widely adopted treatment in AS, demonstrating efficacy across various
risk profiles. However, the impact of sex differences on TAVR outcomes
remains a topic of debate, with a notable gap in literature addressing
these variations across diverse geographical regions. This meta-analysis
seeks to investigate sex-based differences in TAVR outcomes and evaluate
their consistency across regions. Method(s): A comprehensive
literature search was conducted across Scopus, Cochrane Library, PubMed,
and Web of Science databases up to October 2024. Studies comparing TAVR
outcomes between males and females were included and grouped by region
based on available data: Europe, Asia, and North America. A random-effects
meta-analysis was performed to calculate the risk ratio (RR) and mean
differences (MD) with 95% confidence intervals (CI) for the outcomes, and
heterogeneity was assessed using the I2 statistic. Statistical
analysis was conducted using R Studio version 4.3.2 with the 'meta'
package. Result(s): The full Results will be updated later.
 Conclusion(s): The full Conclusion will be updated
later. Copyright © 2025

<118>
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. 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). 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]).
 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. Copyright © 2025 by the authors.

<119>
Accession Number
2038270824
Title
Concomitant Surgical Procedures and Aspirin Avoidance With Left
Ventricular Assist Device Therapy.
Source
JACC: Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Pagani F.D.; Netuka I.; Jorde U.P.; Katz J.N.; Gustafsson F.; Connors
J.M.; Uriel N.; Soltesz E.G.; Ivak P.; Bansal A.; Bitar A.; Vega J.D.;
Goldstein D.; Danter M.; Pya Y.; Ravichandran A.; Conway J.; Adler E.D.;
Chung E.S.; Grinstein J.; Dirckx N.; Iravani B.; Mehra M.R.
Institution
(Pagani, Bitar) University of Michigan, Ann Arbor, MI, United States
(Netuka, Ivak) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Jorde, Goldstein) Division of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, New York, NY, United States
(Katz) Division of Cardiology, Department of Medicine, NYU Grossman School
of Medicine and Bellevue Hospital, New York, NY, United States
(Gustafsson) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Connors, Mehra) Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Uriel) Division of Cardiology, Columbia University Irving Medical Center,
New York-Presbyterian Hospital, New York, NY, United States
(Soltesz) Thoracic and Cardiovascular Surgery, Cleveland Clinic,
Cleveland, OH, United States
(Bansal) Department of Cardiothoracic Surgery, Ochsner Clinic Foundation,
New Orleans, LA, United States
(Vega) Emory University Hospital, Atlanta, GA, United States
(Danter) Kansas University Medical Center, Kansas City, KS, United States
(Pya) Research Department of University Medical Center (Heart Center),
Astana, Kazakhstan
(Ravichandran) Ascension St Vincent, Indianapolis, IN, United States
(Conway) Stollery Children's Hospital, University of Alberta, Edmonton,
AB, Canada
(Adler) Division of Cardiology, Department of Medicine, University of
California San Diego, San Diego, CA, United States
(Chung) The Lindner Research Center at The Christ Hospital, Cincinnati,
OH, United States
(Grinstein) University of Chicago, Chicago, IL, United States
(Dirckx, Iravani) Abbott, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background: ARIES-HM3 (Antiplatelet Removal and Hemocompatibility Events
With the HeartMate 3 Pump) demonstrated that aspirin avoidance with a
fully magnetically levitated HeartMate 3 (HM3) left ventricular assist
device (LVAD) reduces bleeding complications and does not increase
thromboembolism. Whether a concomitant surgical procedure modifies the
observed safety and benefits remains uncertain. Objective(s): This
prespecified analysis of ARIES-HM3 studied clinical outcomes when
concomitant surgical procedures are performed during LVAD implantation
with excluding aspirin but maintaining a vitamin K antagonist.
 Method(s): Among 628 patients randomized to receive either placebo or
aspirin with a vitamin K antagonist, 589 (296 placebo and 293 aspirin)
contributed to the primary endpoint analysis. Sub-categorization with
receiving a concomitant surgical procedure (valvular procedure/coronary
artery bypass grafting or nonvalvular procedure) was done and the
composite primary endpoint of survival free from major nonsurgical (>14
days postimplant) hemocompatibility-related adverse events at 12 months
was assessed. Result(s): There were 155 (52%) and 145 (49%)
concomitant procedures in placebo and aspirin arms, respectively. The
percentage of subjects achieving primary endpoint success was higher with
the placebo group in patients with a concomitant procedure, and no
interaction was observed on primary outcomes between those with and
without concomitant surgical procedures (P<inf>int</inf> = 0.231, 0.298,
and 0.735 for any procedure, valvular/coronary artery bypass grafting, and
nonvalvular procedures, respectively). There was a similar reduction in
nonsurgical major hemorrhagic events with placebo compared with aspirin,
observed in patients with or without any concomitant procedure: 0.64 (95%
CI: 0.44-0.94) and 0.66 (95% CI: 0.46-0.93). Conclusion(s): Our
findings support the safety and efficacy of aspirin avoidance from the
antithrombotic regimen in HM3 LVAD patients undergoing concomitant
surgical procedures. (Antiplatelet Removal and Hemocompatibility Events
With the HeartMate 3 Pump [ARIES-HM3]; NCT04069156) Copyright ©
2025 The Authors

<120>
Accession Number
2034179969
Title
Myocardial Revascularization in Patients with Diabetes and Heart Failure-A
Narrative Review.
Source
International Journal of Molecular Sciences. 26(7) (no pagination), 2025.
Article Number: 3398. Date of Publication: 01 Apr 2025.
Author
Zivkovic S.; Mandic A.; Krupnikovic K.; Obradovic A.; Misevic V.; Farkic
M.; Ilic I.; Tesic M.; Aleksandric S.; Juricic S.; Beleslin B.; Dobric M.
Institution
(Zivkovic, Mandic, Krupnikovic, Obradovic, Misevic, Farkic, Ilic, Dobric)
Cardiology Clinic, Institute for Cardiovascular Diseases "Dedinje",
Belgrade, Serbia
(Ilic, Tesic, Aleksandric, Beleslin, Dobric) Faculty of Medicine,
University of Belgrade, Belgrade, Serbia
(Tesic, Aleksandric, Juricic, Beleslin) Cardiology Clinic, University
Clinical Center of Serbia, Belgrade, Serbia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Heart failure and diabetes mellitus are major contributors to global
morbidity and mortality, with their prevalence continuously rising,
primarily due to aging populations and improvements in healthcare. These
conditions often coexist or develop sequentially, leading to complex
interactions that significantly influence the progression and management
of both diseases. Furthermore, heart failure and diabetes are commonly
associated with coronary artery disease, which presents a unique challenge
in clinical management, particularly in the context of myocardial
revascularization. The presence of diabetes exacerbates atherosclerotic
progression and impairs endothelial function, while heart failure
complicates the perfusion and recovery of myocardial tissue
post-intervention. This narrative review delves into the underlying
mechanisms contributing to revascularization failure in patients with
heart failure and diabetes, emphasizing the importance of understanding
these interactions for optimal treatment. The review also summarizes key
findings from randomized controlled trials, examining evidence both in the
general population and in specific subgroups, including the elderly and
patients with left main coronary artery disease, chronic kidney disease,
peripheral artery disease, and chronic obstructive pulmonary disease.
Understanding these complexities is critical for improving patient
outcomes. Copyright © 2025 by the authors.

<121>
Accession Number
2038270805
Title
Left Main Spontaneous Coronary Artery Dissection: Clinical Features,
Management, and Outcomes.
Source
JACC: Cardiovascular Interventions. (no pagination), 2025. Date of
Publication: 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. Objective(s): The aim of
this study was to investigate clinical features, contemporary management,
and clinical outcomes of patients with LM SCAD. 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. 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).
 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. Copyright © 2025 American College
of Cardiology Foundation

<122>
Accession Number
2036067706
Title
Association between the High-density Lipoprotein Cholesterol Efflux
Capacity and the Long-term Prognosis in Patients with Coronary Artery
Disease: A Meta-analysis.
Source
Journal of Atherosclerosis and Thrombosis. 32(4) (pp 491-501), 2025. Date
of Publication: 2025.
Author
Hisauchi I.; Ishikawa T.; Yamada K.; Ukaji T.; Shimura M.; Tamura Y.;
Kondo Y.; Takeyama T.; Mori K.; Arai M.; Hori Y.; Nakahara S.; Itabashi
Y.; Kobayashi S.; Taguchi I.
Institution
(Hisauchi, Ishikawa, Yamada, Ukaji, Shimura, Tamura, Kondo, Takeyama,
Mori, Arai, Hori, Nakahara, Itabashi, Kobayashi, Taguchi) Department of
Cardiology, Dokkyo Medical University, Saitama Medical Center, Saitama,
Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aim: We aimed to determine whether baseline high-density lipoprotein (HDL)
cholesterol efflux capacity (CEC) at the time of coronary angiography
(CAG) could serve as a prognostic marker for future major adverse
cardiovascular events (MACE) in patients with coronary artery disease
(CAD) through a systematic review and meta-analysis. Method(s): The
MEDLINE, Cochrane, and Embase databases were used for data collection. As
of April 2024, 2,871 studies have been identified. Clinical studies
comparing MACEs over an observational interval exceeding 12 months in
patients with angiographically defined CAD with estimated hazard ratios
(HRs) of MACEs in the higher or top-quartile HDL-CEC (H-HDL-CEC) group
compared with the lower or bottom-quartile HDL-CEC (L-HDL-CEC) group,
after adjusting for six confounding variables, including HDL-C, were
included. HRs of 1) overall cardiovascular outcomes, composite of
cardiovascular mortality, myocardial infarction, any coronary
revascularization, and all-cause mortality (Model-1), and 2)
cardiovascular outcomes excluding all-cause mortality from Model-1
(Model-2), compared between the L-HDL-CEC and H-HDL-CEC groups, were
estimated using a random-effects model, respectively. Result(s): In
five studies, 5,725 patients with CAD with a mean observational interval
of 4.9 years were included. The H-HDL-CEC group had significantly lower
risks for both estimates (Model-1: HR: 0.34, 95% confidence interval [CI]:
0.18-0.63 [p=0.0005], and I2 =59.8% [p =0.04]; Model-2: HR:
0.28, 95% CI: 0.13-0.60 [p=0.0013], and I2 =64% [p =0.04]).
 Conclusion(s): This is the first systematic review and meta-analysis
to demonstrate a significant inverse relationship between the baseline
HDL-CECs on CAG and long-term MACEs in CAD patients. Copyright ©
2025 Japan Atherosclerosis Society.

<123>
Accession Number
2038265592
Title
TCTAP A-031 The Use of Colchicine After Coronary Artery Stenting: One-Year
Follow-Up Results.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S24-S25), 2025.
Date of Publication: 22 Apr 2025.
Author
Ahmedov S.; Jurayev I.; Juraliyev M.; Javoxir A.; Tursunov S.; Behruz B.
Institution
(Ahmedov, Juraliyev) Ezgu Niyat, Uzbekistan
(Jurayev, Javoxir, Tursunov, Behruz) Carmen Plus Hospital, Uzbekistan
Publisher
Elsevier Inc.
Abstract
Background: Restenosis following percutaneous coronary intervention (PCI)
remains a significant challenge in cardiovascular care, often leading to
recurrent angina, myocardial infarction, and the need for repeat
revascularization. Despite advances in stent technology, including
drug-eluting stents (DES), restenosis still occurs in a subset of
patients, particularly those with diabetes, vascular calcification, and
other high-risk factors. Inflammation plays a key role in the pathogenesis
of restenosis. Following PCI, endothelial injury and inflammatory
responses contribute to neointimal hyperplasia, leading to vessel
re-narrowing. Targeting inflammation has emerged as a potential strategy
to reduce restenosis and improve long-term outcomes in PCI patients.
Colchicine, an anti-inflammatory agent traditionally used for gout, has
gained attention for its potential to modulate the inflammatory pathways
involved in atherosclerosis and restenosis. Studies have suggested that
colchicine can reduce the incidence of cardiovascular events by inhibiting
NLRP3 inflammasome activation, which is implicated in inflammation and
plaque rupture. Recent trials, such as the COLCOT (Colchicine
Cardiovascular Outcomes Trial), have shown promising results, indicating
that colchicine may help reduce major adverse cardiovascular events (MACE)
and improve outcomes in high-risk patients. The ESC and ACC guidelines
advocate for strategies that reduce inflammation, particularly in patients
with high cardiovascular risk. While colchicine's role in reducing MACE is
recognized, its specific effects on restenosis after PCI remain under
investigation. This study aims to evaluate the efficacy of colchicine in
reducing restenosis following PCI and explore its potential as an
adjunctive therapy in reducing the long-term complications of coronary
artery disease. [Formula presented] [Formula presented] Methods: This
study was a prospective, randomized, controlled trial conducted at "Ezgu
niyat" and "Carmen +" clinics between 2021 - 2024. A total of 120 patients
undergoing elective PCI for coronary artery disease were enrolled.
Patients were randomly assigned to receive either colchicine (0.5 mg
daily) or a placebo for 12 months post-PCI. The inclusion criteria were
patients aged 18-75, with stable coronary artery disease, who underwent
successful PCI with drug-eluting stent implantation. Exclusion criteria
included hypersensitivity to colchicine, active infections, severe renal
or hepatic impairment, and recent history of stroke or myocardial
infarction. Study Design* Group 1 (Colchicine group): 60 patients received
0.5 mg colchicine daily for 12 months. * Group 2 (Placebo group): 60
patients received a placebo with the same regimen for 12 months. Primary
Outcome The primary endpoint was the incidence of restenosis at 12 months,
assessed by coronary angiography. Restenosis was defined as >=50% diameter
stenosis in any coronary artery segment at the site of the stent.
Angiography was performed in two projections both before the implantation
and after 12 months, using the same angle to ensure consistency. Secondary
Outcomes Secondary outcomes included major adverse cardiovascular events
(MACE), such as non-fatal myocardial infarction, repeat revascularization,
and death. Inflammatory markers (C-reactive protein, IL-6, and TNF-alpha)
were also measured at baseline and 12 months to evaluate the effect of
colchicine on systemic inflammation. Statistical Analysis The data were
analyzed using descriptive statistics, chi-square tests for categorical
variables, and t-tests for continuous variables. The p-value for
statistical significance was set at <0.05. Kaplan-Meier survival curves
were used to estimate the time to restenosis, and Cox proportional hazards
models were used to identify independent predictors of restenosis.
 Result(s): One-Year Follow-Up Coronary Angiography Results Colchicine
Group Of the 60 patients who received colchicine (0.5mg daily), restenosis
was observed in 4 patients (6.7%). Restenosis by Vessel: LAD: 0/25
patients (0%). RCA: 3/20 patients (15%). LCX: 1/15 patients (6.7%).
Subgroup Analysis: Diabetes: Restenosis occurred in 3/41 diabetic patients
(7.3%), compared to 1/19 non-diabetic patients (5.3%). Vascular
Calcification: Restenosis occurred in 2/26 patients (7.7%) with vascular
calcification. Placebo Group In the placebo group, restenosis was observed
in 11 out of 60 patients (18.3%). Restenosis by Vessel: LAD: 2/30 patients
(6.7%). RCA: 5/20 patients (25%). LCX: 4/10 patients (40%). Subgroup
Analysis: Diabetes: Restenosis occurred in 7/42 diabetic patients (16.7%),
compared to 4/18 non-diabetic patients(22.2%). Vascular Calcification:
Restenosis occurred in 4/26 patients (15.4%) with vascular calcification.
Key Statistical Findings The p-value for restenosis between the colchicine
and placebo groups was 0.02, indicating a statistically significant
reduction in restenosis in the colchicine group. Observations
Anti-Inflammatory Effects: The reduction in restenosis rates in the
colchicine group is attributed to the drug's strong anti-inflammatory
properties. Impact of Vascular Calcification: Patients with vascular
calcification exhibited a higher risk of restenosis, particularly in the
placebo group. Conclusion(s): The use of colchicine (0.5 mg daily)
significantly reduced the rate of restenosis compared to the placebo
group, with a statistically significant p-value of 0.02. This result is
consistent with recent meta-analyses showing that colchicine's
anti-inflammatory properties can help reduce vascular inflammation, a key
factor in restenosis and other cardiovascular events. The ESC (European
Society of Cardiology) and ACC (American College of Cardiology) guidelines
recommend anti-inflammatory therapies for improving outcomes in patients
with atherosclerotic cardiovascular disease (ASCVD). Colchicine's role in
reducing inflammation following PCI aligns with these recommendations,
particularly for high-risk populations, such as patients with diabetes and
vascular calcification. In the colchicine group, the restenosis rate was
significantly lower across all vascular territories, with no restenosis in
LAD and LCX, and a minimal rate in RCA. These results are in line with the
COLCOT (Colchicine Cardiovascular Outcomes Trial) and other large studies,
which demonstrated that colchicine reduces major adverse cardiovascular
events (MACE) and improves long-term outcomes. Patients with vascular
calcification, traditionally at higher risk for restenosis, experienced
considerable benefit from colchicine therapy. This finding supports the
ESC Guidelines for the Management of Chronic Coronary Syndromes, which
emphasize personalized treatment strategies targeting inflammation in
high-risk patients. In contrast, the placebo group showed a higher rate of
restenosis, especially in vessels with significant calcification and among
diabetic patients, consistent with ACC/AHA guidelines highlighting
increased restenosis risk in these subgroups. These findings suggest that
colchicine could be a valuable adjunctive therapy in PCI to reduce
restenosis, particularly for patients at high risk of adverse outcomes.
Future studies with larger cohorts are needed to confirm these results and
optimize patient selection for colchicine therapy. Copyright ©
2025

<124>
Accession Number
2038265620
Title
TCTAP A-090 L-Carnitine to Prevent Postoperative Complications After
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S62-S63), 2025.
Date of Publication: 22 Apr 2025.
Author
Shalabi L.; Ibrahim A.; Elsawy M.A.; Zreigh S.; Dervis M.; Elshabrawi
M.N.; Mourad S.; Arafa M.A.; Abuelazeem M.
Institution
(Shalabi) Gharyan University, Libyan Arab Jamahiriya
(Ibrahim, Mourad) Alexandria University, Egypt
(Elsawy, Arafa) Al-Azhar University, Egypt
(Zreigh, Dervis) Ankara Yildirim Beyazit University, Turkey
(Elshabrawi) Port Said University, Egypt
(Abuelazeem) Tanta University, Egypt
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgeries often lead to postoperative complications,
impacting recovery and increasing morbidity and mortality. L-carnitine, an
endogenous molecule crucial for fatty acid metabolism, has shown promise
in reducing inflammation and improving cardiac and renal functions. This
systematic review aims to assess L-carnitine's effect on preventing
postoperative complications across various cardiac surgeries, addressing
gaps in current literature on its potential therapeutic benefits.
 Method(s): We systematically searched Web of Science, Cochrane,
Embase, PubMed, and Scopus databases from inception to October 2024.
Studies included randomized clinical trials (RCTs) involving patients
undergoing cardiac surgery who received L-Carnitine supplementation
pejoratively compared to placebo or standard care. Statistical analysis
was performed using R version 4.3.2. Effect sizes were measured with
relative risks (RR) for dichotomous outcomes and mean differences (MD) for
continuous outcomes, while heterogeneity was evaluated using the
I2 statistic. Subgroup analyses were performed as needed, and a
leave-one-out sensitivity analysis was conducted to assess the robustness
of the results. Result(s): In this meta-analysis, 13 RCTs with a
total of 786 patients were included. Our analysis demonstrated that
L-carnitine administration led to a statistically significant increase in
cardiac index (MD, 0.14; 95% CI, 0.07-0.20; P < 0.01) and left ventricular
stroke work index (LVSWI) (MD, 0.42; 95% CI, 0.06-0.78; P = 0.02), with no
heterogeneity among studies. In addition, L-carnitine resulted in a
significant improvement in left ventricular ejection fraction (LVEF) (MD,
7.88; 95% CI, 6.67-9.09; P < 0.01) with minimal heterogeneity
(I2 = 18%). We also found a significant reduction in the risk
of postoperative atrial fibrillation (POAF) (RR, 0.53; 95% CI, 0.30-0.95;
P = 0.03), though this finding was not robust across sensitivity analysis.
In contrast, there was no significant reduction in in-hospital mortality
(RR, 0.51; 95% CI, 0.10-2.63; P = 1.00) or stroke incidence (RR, 0.85; 95%
CI, 0.12-5.76; P = 0.82). Furthermore, L-carnitine was associated with
lower Troponin I level at various postoperative intervals, suggesting a
potential cardioprotective effect, although the heterogeneity and
differing postoperative follow-up times among studies precluded formal
meta-analysis for this outcome. [Formula presented] [Formula presented]
 Conclusion(s): In conclusion, preoperative administration of
L-carnitine demonstrates meaningful short-term benefits in enhancing
cardiac index, LVSWI, LVEF, and reducing the incidence of POAF following
cardiac surgery. However, the existing studies are limited in scope,
making it challenging to draw robust conclusions. Future trials should aim
for larger, more homogeneous patient populations and extended follow-up
periods to thoroughly assess the clinical benefits of L-carnitine in
cardiac surgery contexts. Copyright © 2025

<125>
Accession Number
2038249409
Title
Results of the Clip-II Cryopreserved Versus Liquid Platelets Phase III
Randomised Controlled Trial (NCT03991481).
Source
Heart Lung and Circulation. Conference: The ANZSCTS Annual Scientific
Meeting. Noosa Australia. 34(Supplement 1) (pp S12), 2025. Date of
Publication: 01 Apr 2025.
Author
Reade M.; Smith J.
Institution
(Reade, Smith) The University of Queensland, Brisbane, Qld, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Liquid-stored platelets have a 7-day shelf-life. Cryopreservation
extends this to 2 years, avoiding shortages, preventing wastage, and
allowing smaller hospitals to transfuse platelets. However, evidence is
limited to preclinical studies and small clinical trials. Cryopreservation
might enhance haemostatic activity, but this remains uncertain.
Methodology: CLIP-II was a double-blind randomised non-inferiority trial
conducted between August 2021 and April 2024 in 11 Australian hospitals.
High-risk cardiac surgery patients deemed by their clinicians to require
platelet transfusion were randomised to up to three units of cryopreserved
group O platelets resuspended in plasma or liquid-stored platelets.
Additional platelets, if necessary, were liquid-stored platelets. The
primary outcome was chest drain blood loss in the first 24 hours after
intensive care unit (ICU) admission. Pilot data showed 202 transfused
patients would provide >90% surety that the limit of a 95% confidence
interval was not above the set 20% non-inferiority margin if this were the
case. Result(s): In total, 388 patients were randomised, of whom 105
received liquid-stored and 98 received cryopreserved platelets. One
transfused patient was palliated before outcome data was collected.
Patients were well-matched at baseline: mean age 64.3 years; 30% urgent or
emergency surgery; median [IQR] Euroscore risk 3.39 [2.16-7.05]. Patients
most commonly underwent aortic valve replacement (51%), aortic root
surgery (38%), or coronary artery bypass grafts (35%); often a combination
of these or other procedures. A median of 2 [1-2] study platelet units
were transfused, most commonly (87%) initiated in the operating theatre.
Hospital mortality was 6.9%. Full outcome data is currently being
validated against source information, and will be available in mid-2024.
 Conclusion(s): If cryopreserved platelets are non-inferior or
superior to liquid-stored platelets, CLIP-II will support registration and
widespread use in bleeding patients. Copyright © 2025

<126>
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. 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. 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.
 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. Copyright 2025
Methner, Schwaneberg, Wikidal, Schmid, Zipfel, Iller, Schuhmann, Georgiev,
Magunia, Berger, Schlensak, Nordmeyer and Neunhoeffer.

<127>
Accession Number
2038265882
Title
TCTAP A-021 The Antiplatelet Therapy in Chinese Post Stenting Patients
With High Bleeding Risk Patients With Acute Coronary Syndrome: Insights
From BRIC Study.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S17-S18), 2025.
Date of Publication: 22 Apr 2025.
Author
Li D.; Zheng Y.; Chen H.; Qian J.; Qin Q.; Yin C.; Chen J.; Shen C.; Chen
Y.
Institution
(Li, Chen) The Sixth Medical Center of Chinese PLA General Hospital, China
(Zheng) The First Hospital of Jilin University, China
(Chen) Beijing Friendship Hospital, China
(Qian) Zhongshan Hospital, China
(Qin) Tianjin Chest Hospital, China
(Yin) Xuanwu Hospital, China
(Chen) Guangdong General Hospital, China
(Shen) Shanghai Sixth People's Hospital, China
Publisher
Elsevier Inc.
Abstract
Background: The prospective BRIC study revealed the incidence of post
discharge bleeding (PDB) (post)cardiovascular events in Chinese acute
coronary syndromes (ACS) patients with real-world. To evaluate the optimal
dual antiplatelet therapy (DAPT) in ACS patients with high bleeding risk
(HBR), we performed an explorative analysis of the BRIC study.
 Method(s): A total of 7531 ACS patients treated with PCI and followed
up for 1-year in 30 Chinese hospitals from May 2014 to January 2016 and
October 2017 to April 2019 were enrolled, of which 1361 (18%) were with
HBR. [Formula presented] Results: Compared with non-high bleeding risk
(NBHR) patients, HBR patients were more frequently developed post
discharge bleeding(BARC type2) (6.8% vs. 5.2%,95% confidence interval
[CI]:0.895-1.255; P=0.000) and main adverse cardiovascular events (MACE)
(a composite of all-cause death, myocardial infarction, ischemic stroke,
or urgent coronary revascularization) (7.1% VS 2.2%, 95% confidence
interval [CI]:2.259-3.574; P=0.000). BMI, Hypertension, chronic renal
insufficiency, heart rate, LVEF and White Blood cell count (WBC) were the
risk factors in HBR ACS patients who face MACE risk. The incidence of NACE
(net adverse clinical events: DB and MACE) in Clopidogrel DAPT group was
significantly lower than that in Ticagrelor group in HBR ACS patients
(11.6% VS 14.2%, OR=1.251, [CI]:(1.043,1.500); P=0.016). [Formula
presented] [Formula presented] [Formula presented] Conclusion(s): In
Chinese ACS patients with HBR, the incidence of PDB and MACE were both
higher than non-HBR patients. Among HBR patients, 13.3% had NACE events
within 1 year after PCI, and DAPT with ticagrelor increased the NACE
events rates. Copyright © 2025

<128>
Accession Number
2038249424
Title
Thrombocytopenia Following Implantation of Perceval Versus Other
Bioprosthetic Aortic Valves: A Systematic Review.
Source
Heart Lung and Circulation. Conference: The ANZSCTS Annual Scientific
Meeting. Noosa Australia. 34(Supplement 1) (pp S24), 2025. Date of
Publication: 01 Apr 2025.
Author
Nezafati P.; Grant R.; Uchime C.; Macemon J.; Wolfenden H.; Yadav S.
Institution
(Nezafati, Grant, Uchime, Macemon, Wolfenden, Yadav) Liverpool Hospital,
Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Studies show that Perceval valve for aortic valve replacement
(AVR) is associated with postoperative thrombocytopenia. This study aims
to compare postoperative thrombocytopenia from Perceval valve in
comparison with other bioprosthetic aortic valves based on a systematic
review. Methodology: A systematic literature review was conducted in
October 2023 based on studies sourced in PubMed/Medline, Cochrane Central
Register of Controlled Trials (CENTRAL), Embase, and ClinicalTrials.gov.
Outcomes assessed included lowest postoperative platelet count, day of
lowest postoperative platelet count, platelet transfusion and return to
theatre for bleeding re-exploration; in different bioprosthetic valves
including Perceval S, Labcor TLPB-A, Hancock II, CE Perimount, Mitroflow,
CE Perimount Magna, 3f Enable, Freedom SOLO, Pericarbon Freedom, and
Edwards Intuity. Result(s): All studies comparing Perceval with other
bioprosthetic valves revealed that patients receiving Perceval experienced
a more significant decrease in platelet counts. This systematic review
showed that the utilisation of the Perceval valve consistently correlates
with a decrease in platelet count from the first to the sixth day after
surgery which typically occurs on the second and third postoperative days
that leads to a decrease in platelet counts by 30% to 60%. Advanced age,
preoperative low platelet count and a sternotomy approach account as
significant risk factors for postoperative thrombocytopenia. However, it
is important to note that these findings did not result in an increased
occurrence of platelet transfusion or return to theatre for postoperative
bleeding. Conclusion(s): Based on this systematic review,
thrombocytopenia post bioprosthetic aortic valve implantation is common.
The decrease in platelet count with Perceval is the highest compared with
other bioprosthetic valves, however, this does not significantly translate
into higher morbidity. Copyright © 2025

<129>
Accession Number
2038265574
Title
TCTAP A-068 Sex-Based Differences in Outcomes Following Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis of
Propensity-Matched Studies.
Source
Journal of the American College of Cardiology. Conference: 30th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Seoul South Korea. 85(15 Supplement) (pp S48), 2025. Date
of Publication: 22 Apr 2025.
Author
Al Othman A.; Zreigh S.; Benhammou M.; Guerguer W.; Mukhlif Al-Allawee
A.S.; Haidarah A.; Almzainy S.; Shawesh Q.E.; Khalid S.; Nounou M.V.;
Elmezayen R.; Alzu'bi M.; Abuajamieh M.; Drvis M.; Elhadi M.
Institution
(Al Othman) Near East University, Cyprus
(Zreigh) Yildirim Beyazit University, Turkey
(Benhammou) University of Oran 1, Algeria
(Guerguer) University of Algiers 1, Algeria
(Mukhlif Al-Allawee) University of Fallujah, Iraq
(Haidarah) West China Hospital, China
(Almzainy, Shawesh, Elhadi) University of Tripoli, Libyan Arab Jamahiriya
(Khalid) Benghazi University, Libyan Arab Jamahiriya
(Nounou) University of Nouakchott Al Aasrya, Mauritania
(Elmezayen) Kafr-Elsheikh University, Egypt
(Alzu'bi) The Hashemite University, Jordan
(Abuajamieh) Cairo University, Egypt
(Drvis) Ankara Yildirim Beyazit University, Turkey
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis (AS) is one of the frequent valvular diseases,
particularly among the elderly, with a prevalence of 2-4 % in ages over 65
years in high-income countries. It has an impact on the hemodynamics of
the heart and affects females and males equally, transcatheter aortic
valve implantation(TAVI) is one of the treatment strategies for AS; both
males and females have variations in the outcomes following TAVI, which is
still controversial, with lacking in the existing literature
propensity-matched studies (PMSs) to reduce the bias between sexes
regarding of baselines characteristics, our meta-analysis analyzed several
PMSs, to understand matched groups how would affect the outcomes.
 Method(s): An electronic search was performed on the following
databases: PubMed, Scopus, Cochrane Library, and Web of Science till
October 2024, including all PMSs that compared males and females who
underwent TAVI, no restrictions on age, year, or types of valve devices.
We analyzed the data by using R Studio version 4.3.2, Risk Ratio (RR) for
dichotomous values, Mean Difference (MD) for continuous values with
95%confidence intervals (CI), a random-effect model was applied, and
heterogeneity was tested using the I2 statistic.
 Result(s): Nine studies were meta-analyzed, pooled 73,207 patients
(36,939 in the male group and 36,268 in the female group), in-hospital, 30
days mortality showed no significant difference between females and males
(RR 1.25,95% CI 0.94-1.64, p = 0.12), (RR 0.99, %95CI 0.87-1.12, p = 0.86)
in respectively. However, 1-year mortality females have a lower risk than
males (RR 0.78, %95 CI 0.67-0.91,p < 0.01), and cardiovascular mortality
(CVM) has no significant difference among females and males (RR 0.87,%95
CI 0.56-1.35,p = 0.54). Short-term stroke, major bleeding complications,
and vascular complications major demonstrated that females in higher risk
than males (RR 1.35,%95 CI 1.23-1.49,p < 0.01), (RR 1.25, %95 CI
1.08-1.44,p <0.01), and (RR 1.66, %95 CI 1.36-2.02, p < 0.01) in
respectively, otherwise the previous outcomes in acute kidney injury (AKI)
females associated with lower risk in comparison with males (RR 0.91, %95
CI 0.83-0.99, p = 0.04), while in myocardial infarction (MI), permanent
pacemaker implantation (PPI), and procedural success no significant
difference found (RR 0.96,%95 CI 0.86-1.08, p = 0.54), (RR 0.94,%95CI
0.82-1.07,p = 0.33), (RR 1.00, %95 CI 0.97-1.03,p = 0.96) in respectively.
 Conclusion(s): Our meta-analysis reveals significant sex-based
differences in outcomes following TAVI. Females are at greater risk for
procedural complications, including stroke, major bleeding, and vascular
events. Yet, they exhibit lower one-year mortality, and a reduced risk of
acute kidney injury compared to males. These findings suggest that
anatomical and physiological differences may influence procedural
outcomes. Addressing these disparities requires refining procedural
approaches and optimizing post-procedure care for females and males
accordingly. Copyright © 2025

<130>
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. 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.
 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. Copyright
© 2025 Sasi, Abid, Alamin, Iqbal, Al-Maslamani, licensee HBKU Press.

<131>
[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. Copyright © 2023 Wolters Kluwer
Health, Inc. All rights reserved.

<132>
Accession Number
646989923
Title
A Comprehensive Review of Effusive-Constrictive Pericarditis, Diagnosis,
and Management.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 26 Mar
2025.
Author
Jamaleddin Ahmad F.A.; Ali Abdi S.I.; Verma T.; Barsinge T.; Banderas
Echeverry W.M.; Sampath N.; Fathima A.; Khelifi A.; Ashraf Sanour O.;
Zerin A.; Mowo-Wale A.; Khan S.
Institution
(Jamaleddin Ahmad) From the American University of The Caribbean Medical
School, Cupecoy, Sint Maarten, Netherlands
(Ali Abdi, Khan) Thumbay University Hospital, Ajman, United Arab Emirates
(Verma) Indira Gandhi Medical College, Shimla, India
(Barsinge) Seth GS Medical College and King Edward Memorial Hospital,
Mumbai, India
(Banderas Echeverry) Universidad Libre, Cali, Colombia
(Sampath, Fathima) Sri Ramachandra Medical College, Chennai, India
(Khelifi) University of Jordan, Amman, Jordan
(Ashraf Sanour) Hawler Medical University, Erbil, Iraq
(Zerin) All India Institute of Medical Sciences, Bhubaneswar, India; and
(Mowo-Wale) Obafemi Awolowo College of Health Sciences/Olabisi Onabanjo
University, Nigeria
Abstract
Effusive-constrictive pericarditis (ECP) is characterized by fluid
accumulation in the pericardial space and a rigid, fibrotic pericardium
that restricts heart filling. Its diverse causes include infectious
agents, systemic inflammatory conditions, malignancies, and iatrogenic
factors. ECP is more prevalent in areas burdened by contagious diseases,
such as tuberculous pericardial effusion, and it is found in about 6.7% of
patients with tuberculous pericardial effusion. The diagnosis of ECP has
improved with advanced imaging techniques, yet challenges persist.
Although Doppler echocardiography is sensitive, it lacks specificity, and
cardiac catheterization remains the gold standard. Emerging biomarkers
such as interleukin-10 may enhance diagnosis, but further validation is
needed. Techniques such as cardiac magnetic resonance imaging and computed
tomography are used to identify structural abnormalities, but their
routine application is still developing. Management of ECP is based on its
underlying cause and severity, often starting with pericardiocentesis
followed by anti-inflammatory treatments. For severe cases with
significant fibrosis, pericardiectomy is the definitive solution.
Prognosis varies, with malignancy-related cases typically yielding poorer
outcomes than infectious origins. This review explores ECP's
pathophysiology, diagnostic challenges, and treatment strategies. It
highlights knowledge gaps and suggests future research directions. A
multidisciplinary approach is crucial for understanding and improving
patient care for this complex condition. Copyright © 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<133>
Accession Number
2034108578
Title
A multifactorial intervention to improve cardiovascular outcomes in adults
with type 2 diabetes and current or previous diabetic foot ulcer disease:
Protocol for a multi-centre randomised control trial (MiFoot study).
Source
Diabetic Medicine. (no pagination), 2025. Date of Publication: 2025.
Author
Onuwe T.; Highton P.J.; Batchelor D.; Brennan A.; Caba M.; Davies M.J.;
Funnell M.P.; Game F.; Gillies C.L.; Glab A.; Gray L.J.; Gregg E.;
Hadjiconstantinou M.; Hall V.; Johnson V.; Petrie J.R.; Pollard D.;
Rowntree H.; Tesfaye S.; Valabhji J.; Webb D.; Zaccardi F.; Khunti K.
Institution
(Onuwe, Highton, Caba, Davies, Funnell, Gillies, Hadjiconstantinou, Webb,
Khunti) Diabetes Research Centre, Leicester General Hospital, University
of Leicester, Leicester, United Kingdom
(Onuwe, Highton, Funnell, Gray, Hadjiconstantinou, Khunti) National
Institute for Health and Care Research Applied Research Collaboration East
Midlands, Leicester, United Kingdom
(Batchelor) Patient and Public Involvement and Engagement Representative,
Leicester, United Kingdom
(Brennan, Pollard) School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom
(Davies, Gray) National Institute for Health and Care Research Leicester
Biomedical Research Centre, Leicester, United Kingdom
(Game) Department of Research and Development, University Hospitals of
Derby and Burton NHS Foundation Trust, Derby, United Kingdom
(Gillies, Zaccardi) Leicester Real World Evidence Unit, Leicester Diabetes
Centre, University of Leicester, Leicester, United Kingdom
(Glab, Hall, Johnson, Rowntree) Leicester Diabetes Centre, University
Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester,
United Kingdom
(Gray) Department of Population Health Sciences, University of Leicester,
Leicester, United Kingdom
(Gray) Leicester British Heart Foundation Centre of Research Excellence,
University of Leicester, Leicester, United Kingdom
(Gregg) School of Population Health, RCSI University of Medicine and
Health Sciences, Dublin, Ireland
(Gregg) School of Public Health, Imperial College London, London, United
Kingdom
(Petrie) School of Health and Wellbeing, College of Medical Veterinary and
Life Sciences, University of Glasgow, Glasgow, United Kingdom
(Tesfaye) Diabetes Research Unit, Sheffield Teaching Hospitals NHS
Foundation Trust, Sheffield, United Kingdom
(Valabhji) Department of Metabolism, Digestion and Reproduction, Faculty
of Medicine, Chelsea and Westminster Hospital Campus, Imperial College
London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: In the United Kingdom, the prevalence of diabetes-related foot
ulcer disease (DFUD) is 6.3%, and cardiovascular disease (CVD) is the
leading cause of mortality in people with DFUD. This study aims to
evaluate the effectiveness of a multifactorial intervention to reduce CVD
events and mortality in adults with type 2 diabetes (T2D) and DFUD.
 Method(s): The MiFoot study is a multi-centre, pragmatic randomised
controlled trial to test intervention effectiveness and cost-effectiveness
compared to usual care that will include an internal feasibility study and
a process evaluation. English-speaking adults (>=18 years; n = 392) with
T2D and current/previous (within 5 years) DFUD will be recruited from
multiple sites across the United Kingdom and randomised 1:1 to
intervention (MiFoot multifactorial intervention plus usual care) or
control (usual care), with data collected at baseline, 12- and 24-month
follow-up. The MiFoot intervention comprises an individualised assessment
with a healthcare practitioner to optimise treatment and assess the
suitability of physical activity participation; group-based disease self
management education and physical activity sessions; and a digital-based
programme, consisting of cohort-relevant topics, physical activity
guidance and peer support functionality. The primary outcome will be
extended major adverse cardiovascular events (MACE, i.e. myocardial
infarction, stroke, cardiovascular death, peripheral arterial bypass,
coronary artery bypass, coronary angioplasty or peripheral artery
angioplasty) at 24 months. DISCUSSION(S): This study will provide
evidence on the feasibility and clinical effectiveness, and
cost-effectiveness of a multifactorial intervention to prevent or slow the
progression of CVD-related complications in the extremely high-risk
population with T2D and DFUD. Copyright © 2025 The Author(s).
Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes
UK.

<134>
Accession Number
2038239325
Title
Advances in Cardiovascular Pharmacotherapy. II. Ivabradine, an Inhibitor
of the Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Pagel P.S.; Hang D.; Freed J.K.; Crystal G.J.
Institution
(Pagel, Hang, Freed) Department of Anesthesiology, the Medical College of
Wisconsin, Milwaukee, WI, United States
(Crystal) Department of Anesthesiology, University of Illinois College of
Medicine, Chicago, IL, United States
Publisher
W.B. Saunders
Abstract
Ivabradine selectively reduces heart rate by inhibiting the
hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in the
sinoatrial node. Unlike other medications that produce negative
chronotropic effects [beta-blockers, calcium channel blockers], ivabradine
does not affect systemic, pulmonary, and coronary hemodynamics. Despite
several proof-of-concept clinical studies suggesting that ivabradine may
exert anti-ischemic effects, two large randomized trials did not support
its use in patients with chronic stable angina. Preliminary data also did
not support the use of ivabradine in patients with acute ST-segment
elevation myocardial infarction or acutely decompensated heart failure.
However, ivabradine improved outcome in patients with heart failure with
reduced ejection fraction (HFrEF), leading to its approval by the Food and
Drug Administration, but the drug failed to do so in those with heart
failure with preserved ejection fraction (HFpEF). Ivabradine may also be
useful in cardiac electrophysiology disorders characterized by tachycardia
(e.g., inappropriate sinus tachycardia, postural orthostatic tachycardia
syndrome), but it has not yet gained wide acceptance for these
indications. In this article, the authors briefly review the structure and
function of the cardiac HCN channel; discuss the development and actions
of drugs, including ivabradine, that modulate the channel's activity;
describe in detail the potential clinical applications of ivabradine in
patients with coronary artery disease, HFrEF and HFpEF, and cardiac
electrophysiology; comment on the adverse effects of ivabradine therapy;
and finally, consider the potential anesthetic implications of ivabradine
in patients undergoing noncardiac and cardiac surgery. Copyright
© 2025 Elsevier Inc.

<135>
Accession Number
2038253991
Title
Effectiveness of Point-of-Care High-Sensitivity Troponin Testing in the
Emergency Department: A Randomized Controlled Trial.
Source
Annals of Emergency Medicine. (no pagination), 2025. Date of Publication:
2025.
Author
Thulin V.I.L.; Jordalen S.M.F.; Myrmel G.M.S.; Lekven O.C.; Krishnapillai
J.; Steiro O.T.; Body R.; Collinson P.; Apple F.S.; Cullen L.; Norekval
T.M.; Wisloff T.; Vikenes K.; Bjorneklett R.O.; Omland T.; Aakre K.M.
Institution
(Thulin, Jordalen, Lekven, Krishnapillai, Bjorneklett) Emergency Care
Clinic, Haukeland University Hospital, Bergen, Norway
(Myrmel, Lekven, Krishnapillai, Steiro, Norekval, Vikenes, Aakre)
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
(Body) Division of Cardiovascular Sciences, Faculty of Biology, the
University of Manchester, Manchester, United Kingdom
(Body) Emergency Department, Manchester University NHS Foundation Trust,
Manchester, United Kingdom
(Collinson) St George's University of London, London, United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/HCMC, Minneapolis, MN, United States
(Apple) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Cullen) Department of Emergency Medicine, Royal Brisbane and Women's
Hospital, Brisbane, Australia
(Cullen) School of Medicine, University of Queensland, Brisbane, Australia
(Cullen) Faculty of Health, Queensland University of Technology, Brisbane,
Australia
(Norekval, Vikenes, Aakre) Department of Clinical Science, University of
Bergen, Bergen, Norway
(Wisloff) Health Services Research Unit, Akershus University Hospital,
Lorenskog, Norway
(Wisloff, Omland) Institute of Clinical Medicine, University of Oslo,
Oslo, Norway
(Bjorneklett) Department of Clinical Medicine, University of Bergen,
Bergen, Norway
(Omland) Department of Cardiology, Akershus University Hospital,
Lorenskog, Norway
(Aakre) Department of Medical biochemistry and Pharmacology, Haukeland
University Hospital, Bergen, Norway
Publisher
Elsevier Inc.
Abstract
Study objective: To compare the effectiveness of high-sensitivity cardiac
troponin (hs-cTn) point-of-care testing to central laboratory hs-cTn
measurements when investigating patients presenting to the emergency
department (ED) with symptoms of acute coronary syndrome. Method(s):
The WESTCOR point-of-care study was a single-center prospective randomized
controlled trial where we randomized patients presenting with possible
acute coronary syndrome in a 1:1 fashion to receive either 0/1-hour
centralized hs-cTnT measurements (control) or 0/1-hour point-of-care
hs-cTnI testing (intervention). We defined length of stay (LOS) in the ED
as the primary endpoint and the minimum clinically meaningful difference
as 15 minutes. Result(s): We included 1,494 patients in the final
analysis, 728 in the point-of-care group, and 766 in the control group.
The median (interquartile range) age was 61 (22) years, and 635 (42.5%)
were women. Median LOS in the ED was 174 (95% confidence interval [CI] 167
to 181) and 180 (95% CI 175 to 189) minutes in the point-of-care and
control group, respectively, resulting in a reduction in median LOS of 6
minutes (95% CI -4 to 17). Acute myocardial infarction, death, or acute
revascularization occurred in 83/728 (11.4%) of point-of-care and 72/766
(9.4%) of control patients. Conclusion(s): We found that implementing
point-of-care hs-cTnI testing in the ED with a 0/1-hour diagnostic
algorithm did not lead to a clinically meaningful reduction in ED LOS. We
observed no difference in the incidence of myocardial infarction, acute
coronary revascularization, or death during 30 days
follow-up. Copyright © 2025 American College of Emergency
Physicians

<136>
Accession Number
646987010
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 : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 25 Mar 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,
Greece
(Apostolidou-Kiouti, Haidich) Department of Hygiene, Social-Preventive
Medicine and Medical Statistics, Aristotle University of Thessaloniki
School of Medicine, Greece
(Argiriadou) Department of Anesthesiology and Intensive Care, Aristotle
University of Thessaloniki School of Medicine, Greece
Abstract
OBJECTIVES: The question whether minimal 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
CPB (cCPB) on adverse clinical outcomes after cardiac surgery.
 METHOD(S): We searched PubMed, Scopus and Cochrane databases for
appropriate articles as well as conference proceedings from major
congresses up to August 31st, 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. RESULT(S): Of the 738 records identified, 36 RCTs were
included in the meta-analysis with a total of 4,849 patients. MiECC was
associated with significantly reduced mortality (OR 0.66; 95% CI:
0.53-0.81; p = 0.0002; I2=0%) as well as risk of postoperative myocardial
infarction (OR 0.42; 95% CI: 0.26-0.68; p = 0.002; I2=0%) and
cerebrovascular events (OR 0.55; 95% CI: 0.37-0.80; p = 0.007; I2=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. 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. Copyright ©
The Author(s) 2025. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<137>
Accession Number
646988351
Title
The Clinical Impact of Surgical Left Atrial Appendage Occlusion During
Cardiac Surgery in Sinus Rhythm Patients: A Meta-Analysis.
Source
Heart rhythm. (no pagination), 2025. Date of Publication: 23 Mar 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
(Ahmed) Keele University School of Medicine, Keele, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi, Asopa) Southampton General Hospital, Southampton, United Kingdom
Abstract
BACKGROUND: The clinical efficacy of surgical occlusion of the left atrial
appendage in sinus rhythm patients receiving cardiac surgery remains
controversial. OBJECTIVE(S): This meta-analysis attempts to
demonstrate the impact of left atrial appendage occlusion (LAAO) on early
and late outcomes in patients with sinus rhythm undergoing cardiac
surgery. 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 by odds ratio, and
long-term outcomes were extracted from Kaplan-Meier curves to reconstruct
individual time-to-event patient data and allow for proportional hazard
regression. Bias-treated data was selected when available. RESULT(S):
Six studies, comprising 2742 patients, were included from an initial 1431
reports. Pooling demonstrated no significant association between LAAO and
the development of postoperative atrial fibrillation (odds ratio (OR)
1.157, 95% confidence interval (CI) 0.904-1.481, I2 = 46%, p = 0.246).
Reconstruction of Kaplan Meier data revealed a higher freedom from
cerebrovascular events in the LAAO group than in no-LAAO (hazards ratio
(HR) 0.482, 95%CI 0.361-0.643, p <0.001). The LAAO study group also
demonstrated improved mid-term survival (HR 0.701, 95%CI 0.554-0.886,
p=0.003). CONCLUSION(S): Analysis of patients in sinus rhythm
undergoing cardiac surgery and receiving surgical LAAO has demonstrated
improved freedom from cerebrovascular events and a mid-term survival
benefit. This meta-analysis did not demonstrate an increased occurrence of
postoperative atrial fibrillation in the LAAO study group. Larger
randomised controlled trials stratified by cardiac pathology are required
to validate these findings. Copyright © 2025. Published by
Elsevier Inc.

<138>
Accession Number
646985641
Title
Innovation Lecture: Current Understanding of the Molecular Mechanisms of
Unloading and Recovery - Past, Present and Future.
Source
Interventional Cardiology: Reviews, Research, Resources. Conference: 6th
Annual Acute Cardiac Unloading and REcovery (A-CURE) Symposium. Virtual.
17(Supplement 1) (pp 13-15), 2022. Date of Publication: 2022.
Author
Kapur N.
Institution
(Kapur) Tufts University, School of Medicine, Boston, MA, United States
Publisher
Radcliffe Medical Media
Abstract
Dr Kapur's talk covered the new and rising areas of research interest in
the field of ventricular unloading. In the field of cardiac unloading,
emerging research topics include heart failure and heart recovery. Despite
advances in drug and device therapies, the prognosis for heart failure is
poor and the disease burden is increasing in the US. This continued
clinical need provides the rationale for gaining a better understanding of
the physiology and biology of heart failure and remodelling. Research
efforts have uncovered many molecular players in the myocardial response
to damage and compensatory mechanisms.1 Dr Kapur noted that the big
question is whether the damaged heart reverse remodel back in the current
era (Figure 1). Another topic in the field is the question of elective
coronary revascularisation. In patients with acute MI (AMI) presenting
with or without shock, revascularisation is a must to rescue the
myocardium from ischaemia. However, recent surgical and percutaneous
coronary intervention (PCI) literature has reported that patients with
ischaemic cardiomyopathy (ICM), early or late stage, may also benefit from
revascularisation. From a metabolic perspective, the normal myocardium
prefers fatty acid oxidation and oxidative phosphorylation to generate
ATP, whereas myocardium under ischaemia has to shift to inefficient
glycolysis (Figure 2), limiting its recovery potential. The other key
factor in this setting is that adverse cardiac remodelling is load
dependent: analysis of large randomised control trials showed that reduced
left ventricular (LV) end systolic volume is indicative of favourable
clinical outcomes in revascularisation, suggesting that load reduction is
beneficial in ischaemia.2 Studies are underway to evaluate whether
unloading during revascularisation in AMI or ICM additionally promotes
myocardial recovery. Bringing these concepts together, the ultimate
question for the cardiac unloading community is whether acute cardiac
unloading can be harnessed as a therapeutic approach to improve myocardial
recovery. It will be important to test unloading as a therapeutic strategy
beyond its current role as an enabler of adjustive procedures, in
particular in reversible damage settings such as AMI. The concept of
unloading as a therapy is supported by historical haemodynamic science,
going back to Drs Frank and Starling in the 1800s. Fundamental studies in
haemodynamics demonstrated that myocardial oxygen consumption is
proportional to mechanical work, and calcium cycling and basal metabolism
constitute basal oxygen consumption.3,4 The advent of LV assist devices in
the 2000s presented a major paradigm shift in the field of cardiac
replacement and recovery. This was the beginning of a shift to
understanding how reduced pressure- volume area and work aid in heart
recovery. As a result, there are now a range of opportunities to intervene
with unloading in the clinical setting, including AMI with or without
cardiogenic shock (CS), high-risk PCI, acute decompensated heart failure
(ADHF), ADHF with or without CS and advanced HF. The concept of reducing
myocardial oxygen demands in AMI was first introduced in 1971.5 That
seminal study demonstrated that, in addition to restoring the blood flow,
reducing myocardial oxygen demand further reduced the infarct scar and
damage. Ventricular load in ischaemia refers to any variable that
increases myocardial oxygen demand, such as heart rate, LV wall stress, LV
systolic and diastolic pressures and stroke work. These variables are now
being considered through the lens of unloading, and many interesting
studies are underway. Most cardioprotective approaches in MI have
historically focused on reducing reperfusion injury, but new approaches
are investigating how reducing ischaemic burden can change the trajectory
of myocardial damage. The concept that 'time is muscle' is extremely
important; however, it is also important to recognise that unloading may
now create a window in the time trajectory to allow other strategies of
intervention. The development of transvalvular pumps, such as Impella, has
expanded the field of ventricular unloading. One of the earliest
mechanistic studies with Impella showed that the mechanism of myocardial
salvage involved not only increased myocardial perfusion, but also a
reduction in metabolic requirements.6 In that study, Meyns et al. showed
that reduced myocardial oxygen consumption under unloading was correlated
with reduced infarct scar. This occurred not only during the reperfusion
phase, but also during the ischaemic phase, uncoupling ischaemia from
reperfusion.6 The timing of unloading is another important research topic.
A number of ongoing studies are investigating the timing of unloading with
regard to reperfusion, as well as the impact of unloading on coronary
blood flow. For example, recent work showed that Impella unloading prior
to reperfusion increases coronary collateral flow, which continues to
increase over 30 minutes and optimises flow prior to opening a blocked
artery.7 Dr Kapur and colleagues demonstrated that mechanical unloading
for 30 minutes prior to reperfusion not only reduced infarct size, but
also produced measurable changes in the cardioprotective signalling
pathways;8 this was further improved by lengthening the unloading prior to
reperfusion to 60 minutes.9 Dr Kapur's group also performed transcriptomic
profiling of the hearts after primary reperfusion versus primary
unloading, identifying an array of differentially altered genes and
pathways (Figure 3),10 which warrants continued investigation and
therapeutic development. One of the major pathways altered was
mitochondrial metabolism; genes related to mitochondrial integrity, as
well as the physical structure, were protected in the primary unloaded
hearts.10 This has highlighted the need to study the role of dysfunctional
mitochondria in myocardial recovery. Hypoxia, and particularly the gene
hypoxia inducible factor 1 (HIF-1), is a marker of the level of ischaemia
in a tissue. Dr. Kapur noted the possibility that HIF1 may be a
therapeutic target in ischaemia, as well as in unloading and myocardial
recovery. Dr Kapur's recent work showed that unloading promotes increases
in myocardial HIF- 1 expression; using molecular tools, his group showed
that increased HIF-1 was necessary for reductions in infarct size with
unloading.11 Furthermore, unloading increased HIF-1 expression even after
reperfusion, suggesting that pharmacological manipulation of HIF-1, in
tandem with unloading, could be a novel strategy in further reducing
infarct size. Finally, calcium cycling is another exciting new target for
unloading research. Recent work has revealed that there are changes in
calcium handling that occur days and weeks after a period of unloading,
which is beginning to unravel the long-term implications of calcium
cycling on myocardial recovery.12 A deeper dive into extracorporeal
membrane oxygenation (ECMO) is also ongoing, because how ECMO affects
right ventricular or LV biology, vascular biology or the kidney is
currently poorly understood. Dr Kapur closed by highlighting the great
scientific achievements the A-CURE research community has brought forth
over the years: many more exciting findings are to come .

<139>
Accession Number
646985642
Title
Keynote Lecture: Treatment of Stage D Heart Failure - Devices, Drugs,
Biology and Genes: Evidence and Guidelines.
Source
Interventional Cardiology: Reviews, Research, Resources. Conference: 6th
Annual Acute Cardiac Unloading and REcovery (A-CURE) Symposium. Virtual.
17(Supplement 1) (pp 15-17), 2022. Date of Publication: 2022.
Author
Yancy C.
Institution
(Yancy) Northwestern University, Feinberg School of Medicine, Chicago, IL,
United States
Publisher
Radcliffe Medical Media
Abstract
Dr Yancy opened his lecture by reviewing the American College of
Cardiology (ACC)/American Heart Association (AHA) guideline for Stage D
heart failure (HF) management.1 By the modern definition, HF is
partitioned into various stages by the level of left ventricular ejection
fraction (LVEF) exhibited.2 In particular, Dr Yancy aimed to illustrate
how unloading the left ventricle (LV) can improve LVEF in HF with
mid-range ejection fraction and HF with improved ejection fraction
(HFimpEF). By definition, HFimpEF patients must have received
guideline-directed medical therapy (GDMT) and subsequently improved LVEF
at least 10 percentage points to >=40% from a previously reduced
baseline.3 This improvement is not thought to be a measurement phenomenon,
but rather represents a distinct biological phenotype with corresponding
clinical outcomes. As such, the new definition of HF accounts for the
specific symptoms and signs of HF, and these symptoms and signs must be
corroborated by either elevated natriuretic peptide levels, objective
evidence of cardiogenic, pulmonary or systemic congestion or both.2 This
altered definition, which provides quantifiable metrics for determining
the stage of HF, changes the algorithm for the use of GDMT to include the
concept of HF in remission. Dr Yancy emphasised that patients with Stage D
HF are a population with a number of unmet needs, including effective
treatments to improve long-term survival (Figure 1).4 Current therapeutic
options for select patients with advanced HF include heart transplant,
mechanical circulatory support (MCS) as a bridge to transplant or bridge
to candidacy and long-term MCS as destination therapy (DT). Dr Yancy
highlighted that current ACC/AHA guidelines do not contain any Class I
recommendations for the use of MCS in HF; however, there are several Class
IIa recommendations in place. He noted the current evidence level in
support of MCS is rated 'B'; more robust data are needed to move that
recommendation to Class I. In order to achieve recovery in these patients,
clinicians must focus not only on the macro effects of LV unloading, such
as flow rate, or the incidence of complications, like thrombosis, but also
study the micro effects of unloading. In particular, consideration must be
given to the biological changes in myocytes, changes to the myocardial
tissue and changes in circulating systemic markers.5 In a recent study,
five HF patients with an LV assist device (LVAD) were analysed with
pairwise tissue sampling at the time of LVAD implementation and LVAD
removal at autopsy to compare proteomic and metabolomic alterations.6 The
researchers found significantly decreased expression of genes associated
with fibrosis, extracellular signal-regulated kinase 1/2 regulation and
immune response at LVAD implantation, whereas the expression of genes
associated with tissue regeneration, heart morphogenesis, vacuolar
transplant and myocyte metabolism was significantly increased after >=1
year of LVAD support (Figure 2). Of note, connexin-43, a gene involved in
the development of gap junctions between cells, was among those
significantly increased with LVAD support, and may be a marker of
recovery. This was further supported by improved transverse tubule
(t-tubule) histology, t-tubules being invaginations of the cell membrane
critical to the process of excitation-contraction in cardiomyocytes. After
LVAD, the t-tubules were observed to have structurally recovered,
indicating the patient experienced restored biological function in the
myocardium.6 Dr Yancy emphasised how using these types of analyses is more
sophisticated and informative than a simplified list of clinical symptoms,
and that examining these types of datasets can help more precisely refine
study populations in future studies. Although there is a paucity of
large-scale randomised control trials (RCTs) on Impella and LVAD, Dr Yancy
highlighted two ongoing trials that are addressing this issue. The Danish
Cardiogenic Shock Trial (DanShock) aims to determine whether Impella
provides a benefit in the context of acute myocardial infarction with
cardiogenic shock (AMICS). Meanwhile, the Impella-supported PCI in
High-Risk Patients with Complex Coronary Artery Disease and Reduced Left
Ventricular Function (PROTECT IV) trial is of an adaptive design,
investigating Impella use during high-risk percutaneous coronary
intervention (PCI) in patients with reduced left-sided heart function. Dr
Yancy also highlighted another trial that examined intramyocardial
injection of mesenchymal precursor cells and subsequent temporary weaning
from LVAD support in patients with advanced HF.7 Although no benefit was
observed in that study, it still functioned as a proof of concept for
combining device and biological interventions in clinical trials.
Furthermore, data presented as supplementary material for that publication
showed a signal that patients with ischaemic cardiomyopathy had better
success rate than those with non-ischaemic disease, suggesting that
recalibration of the patient population to target specific patients, such
as that performed by Shahinian et al.,6 could reveal more information on
this form of potential therapy. The recent first pig-to-human heart
transplant has also opened up further discussion on the subject of
xenotransplantation. This concept comes with numerous crucial targets,
including the prevention of hyperacute rejection, delayed xenograft
rejection and the prevention of injection transmission.8 However, the
long-term function of these xenotransplantations poses new questions,
including whether the heart will adapt to cardiometabolic stress demands,
whether sufficient graft tolerance will allow for reduced
immunosuppression, how this transplant will compare to outcomes of human
cardiac transplants and other support methods and whether there will be
novel ethical considerations. A recent successful kidney xenotransplant
into a brain-dead patient revealed the kidney could function normally, and
was a successful proof of concept for future investigations and
applications.9 Dr Yancy next discussed the hurdles to receiving
endorsement for novel devices and tools from the ACC, AHA, Heart Failure
Society of America and, ultimately, the Food and Drug Administration
(FDA). The level of RCT evidence required for the highest class of
recommendation (A) has decreased, whereas that for the second (B) class of
evidence has increased and that for the third class (C) has markedly
decreased.10 Thus, the bar for Class A is deliberately very high, and
achieving these recommendations requires careful calibration of studies.
Meanwhile, there are several paths to FDA approval, including: 510(k),
which is the most common and involves an iterative process demonstrating
that new devices are as safe and effective as prior approved devices; de
novo, which is for innovative, lower-risk devices that are not comparable
to pre-existing devices; and pre-market approval (PMA), which has the most
stringent data requirements, is reserved for high-risk devices or when
controls cannot be written and that usually uses performance to
demonstrate safety and efficacy. To help researchers navigate these
considerations, Dr Yancy provided insight from his 10 years at the FDA
(Box 1). Dr Yancy stated that there must truly be an unmet need, and not
simply a market opportunity, and there must be at least some historical or
observation comparator data. In addition, although placebo-controlled data
are the preferred standard, an alternative could be 'objective performance
criteria' (OPC), which can be derived from previous case reports or data.
The mode of analysis is also important, and a Bayesian analysis is the
preference, as is an intention-to-treat population analysis rather than
per-protocol analysis. Finally, as always, the therapy must be ventricular
assist device that is both Class I recommended and FDA-approved via PMA.
Dr Yancy proposed that as biological targets evolve and devices improve,
the type, quality and precision of evidence should also evolve.
Traditional forms of evidence, such as case reports/series, observation
studies and phased trials, are slow and expensive, often with small
numbers, hidden safety signals and bias. More contemporary forms of
evidence, such as single-arm trials with OPC, Bayesian analyses and
quality-of-life endpoints, are promising but unproven. The preference
remains with RCT design, and the default endpoints remain morbidity and
mortality. Dr Yancy anticipates that the future will include more genomic
analyses, such as identification of at-risk phenotypes, treatment with
induced pluripotent stem cells, gene therapy and genetic engineering. He
foresees that data science, Mendelian randomisation, network
meta-analyses, 'n of 1' trials, and bioengineering will be at the
forefront. These tools may help better collate patient cohorts and speed
the process of clinical trials. However, the costs, evidence requirements
and implementations of these new frontiers and tools remain to be
determined. Dr Yancy concluded that although the need in the arena of
unloading and improving LV performance is great, the science is actively
evolving. Breakthroughs should come not just from MCS, but also from
biology and genomics, and this will require new surrogate endpoints,
including those related to quality of life, proteomics, metabolomics and
genomics. Dr Yancy encouraged the exploration of radically new designs,
noting that guideline endorsement and FDA approval are possible for new
technology, but evidence is paramount .

<140>
Accession Number
646987020
Title
A New Role for Circulatory Support Devices to Limit Ischaemia-Reperfusion
Injury.
Source
Interventional Cardiology: Reviews, Research, Resources. Conference: 5th
Annual Acute Cardiac Unloading and REcovery (A-CURE) Symposium. Virtual.
16(Supplement 1) (pp 8-9), 2021. Date of Publication: 2021.
Author
Kapur N.
Institution
(Kapur) CardioVascular Center for Research and Innovation, Tufts Medical
Center, Boston, MA, United States
Publisher
Radcliffe Medical Media
Abstract
Dr Kapur began his talk by describing the global burden of heart failure
(HF), which affects over 23 million individuals worldwide. Acute
decompensated HF is currently the leading cause of hospital admissions and
rehospitalisation for persons over the age of 65 years in the US.1,2
Approximately 1.8 million people are admitted for HF each year, with
annual treatment and readmission costs of US$31 billion and US$7 billion,
respectively.3-6 Patients who have a heart attack are at high risk for
developing HF, generating a major healthcare burden. Rapid coronary
reperfusion or opening a blocked artery after acute MI can reduce the risk
of HF. However, the size of the infarct impacts the magnitude of potential
benefit from reperfusion. Larger infarcts drive mortality and HF. Data
from patients receiving primary reperfusion after a heart attack indicate
that 18% of total left ventricular mass remains infarcted after
reperfusion.7 The same dataset also demonstrated that 1-year all-cause
mortality and hospitalisation for HF increase by approximately 20% for
every 5% increase in myocardial infarct size. Time to treatment is also
critical for ST-segment elevation MI (STEMI). Every minute of delay from
symptoms of chest pain to the point that a coronary artery is opened with
angioplasty counts towards mortality, as well as infarct size. Every
30-minute delay in total ischaemic time, or time from symptom onset to
reperfusion, is associated with a 7.5% increase in 1-year mortality and a
30% increase in infarct size.8,9 Rapid reperfusion is one option to try to
terminate ischaemic injury, yet may contribute to approximately 50% of
myocardial damage in the setting of a heart attack.10 As a result, a
significant volume of research has been conducted to identify the
molecular mechanism(s) of reperfusion injury. Activation of the
reperfusion injury salvage kinase and survivor activating factor
enhancement signalling pathways prevents reperfusion injury in cardiac
muscle cells by protecting mitochondria.11 Mitochondria provide energy to
the cell, thus protection of mitochondria prevents energy loss and
subsequent cell death. Ischaemia disrupts these pathways, reducing
mitochondrial structural and functional integrity to produce reperfusion
injury.12 Clinical trials to identify cardioprotective pharmacological
agents targeting the ischaemia-reperfusion injury cascade remain
inconclusive.13 Dr Kapur's research hypothesis is that primary mechanical
unloading could be a potential cardioprotective strategy to reduce
ischaemia- reperfusion injury. In the past 15 years, his team demonstrated
that mechanical devices, such as the Impella CP transvalvular pump, unload
the heart, decreasing stress during a heart attack and reduce infarct size
by approximately 50% in preclinical models. Dr Kapur also demonstrated
that 30 minutes of left ventricular (LV) unloading before reperfusion is
necessary and sufficient to reduce infarct size.14 In addition, a
meta-analysis of preclinical studies from around the world over the past
40 years established that LV unloading reduces infarct size using a
variety of different pump configurations.15 Reperfusion without unloading
is the current MI standard of care. Dr Kapur's STEMI-Door-to-Unload (DTU)
pilot clinical trial was designed to assess whether mechanical unloading
for 30 minutes prior to reperfusion would increase or decrease infarct
size.16 Fifty anterior STEMI patients received an Impella CP device to
assess device safety and feasibility during a heart attack. The patients
were randomised to receive unloading with immediate reperfusion or
unloading for 30 minutes prior to reperfusion. The results confirmed the
safety, feasibility and technical performance of the Impella CP in STEMI
patients, and demonstrated that unloading with delayed reperfusion by 30
minutes limits infarct size, irrespective of the MI area at risk.
Additional data from the STEMI-DTU pilot trial indicated that mechanical
unloading reduces myocardial ischaemia prior to reperfusion. Increased
exposure time to unloading prior to reperfusion time correlated with a
decrease in infarct size in patients with large anterior MI.16,17 These
data correlate with anecdotal evidence of chest pain resolution and
decreased ST-segment elevation after mechanical unloading. These
encouraging data from the STEMI-DTU pilot trial enabled the initiation of
Dr Kapur's currently enrolling STEMI-DTU pivotal randomised clinical trial
to compare the impact of unloading and delayed reperfusion against
reperfusion without unloading on infarct size in a larger patient
population.

<141>
Accession Number
646981363
Title
Risk factors for surgical site infection after hip replacement: A
systematic review and meta-analysis.
Source
The Journal of hospital infection. (no pagination), 2025. Date of
Publication: 22 Mar 2025.
Author
Yang B.; Lei Y.; Zeng Y.; Luo M.; Li Z.; Lei K.; Wang Y.; Xiao Q.; Wen J.;
Yan W.; Yan H.
Institution
(Yang) Hengyang Medical School, University of South China, No. 28
Changsheng West Road, Hengyang, Hunan, China
(Lei, Lei, Wang, Xiao, Wen, Yan) Department of Neurosurgery, Chenzhou
Third People's Hospital and the second Affiliated Hospital of Xiangnan
University, Jiankang Road No.8Hunan Province, Chenzhou, China
(Zeng) Department of Gynecology, Second Affiliated Hospital, Hengyang
Medical School, University of South China, Hunan Province, China
(Luo) Department of Spine Surgery, Lishui Hospital of Wenzhou Medical
University, Lishui People's Hospital, Lishui, Zhejiang, China
(Li) Department of Joint surgery, Second Affiliated Hospital, Hengyang
Medical School, University of South China, Hunan Province, China
(Yan) Department of Joint surgery, Second Affiliated Hospital, Hengyang
Medical School, University of South China, Hunan Province, China
Abstract
BACKGROUND: We conducted a meta-analysis to determine the risk of
infection following hip replacement and identified risk factors for
surgical site infection. METHOD(S): We systematically searched the
PubMed/Medline, Embase and Cochrane Library databases, as well as the
reference lists of previous systematic reviews and meta-analyses. The
pooled odds ratio (OR) was estimated using a random effects model for each
investigated factor. The evidence of observational studies was classified
as high quality (class I), moderate quality (class II or III) or low
quality (class IV) based on the GRADE system. RESULT(S): A total of
25,383 potential articles met the inclusion criteria in the database
search. After reviewing the titles, abstracts, and full texts, 27 articles
were included in the final analysis, encompassing 699,473 patients who
underwent hip arthroplasty. High-quality evidence shows that BMI (>=30
kg/m2) (OR 2.16; 95% CI 1.72-2.70), male sex (OR 1.39; 95% CI 1.26-1.53),
operation time (>=120 min) (OR 1.72; 95% CI 1.39-2.14), ASA class >=3 (OR
2.05; 95% CI 1.49-2.83), diabetes (OR 1.33; 95% CI 1.23-1.43), and heart
disease (OR 1.99; 95% CI 1.48-2.68) are associated with a greater risk of
infection. The meta-analysis revealed that age and renal disease were not
associated with infection. CONCLUSION(S): This meta-analysis
identified significant risk factors for infection after hip replacement
surgery, including BMI, male sex, operation time, heart disease, diabetes,
and ASA class. LEVEL OF EVIDENCE: Level IV, systematic review of Level III
and Level IV studies. TRIAL REGISTRATION NUMBER: The review protocol was
registered in PROSPERO. Unique Identifying Number (UIN) is
"CRD42024535902".Hyperlink to the specific registration (must be publicly
accessible and will be checked):
"https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=535902". Copyright © 2025. Published by Elsevier Ltd.

<142>
Accession Number
2038211027
Title
Transcatheter or Surgical Aortic Valve Replacement in Pregnant Women? A
Comprehensive Review of the Current Literature.
Source
Journal of Invasive Cardiology. 37(3) (no pagination), 2025. Date of
Publication: 01 Mar 2025.
Author
Kuchibhatla A.; Soghrati N.; Saleh Y.; Rushing G.; Halim M.A.; Pelletier
M.; Baeza C.; El-Diasty M.
Institution
(Kuchibhatla, Soghrati) School of Medicine, Queen's University, Kingston,
ON, Canada
(Saleh) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
(Rushing, Halim, Pelletier, Baeza, El-Diasty) Cardiac Surgery Department,
University Hospitals Cleveland Medical Centre, Cleveland, OH, United
States
Publisher
Cliggott Publishing Co.
Abstract
Surgical aortic valve replacement (SAVR) has traditionally been the gold
standard for managing severe aortic stenosis (AS); however, it may carry
maternal and fetal risks during pregnancy. Transcatheter aortic valve
replacement (TAVR) has been proposed as an alternative in this patient
population, though its role during pregnancy remains largely undefined.
This review aims to consolidate the current literature on the role of TAVR
during pregnancy, focusing on its potential benefits and limitations.
Electronic database search identified 10 case reports of pregnant women
who underwent a TAVR procedure. All pregnancies resulted in uncomplicated
deliveries with no fetal complications. The reported post-procedural
complications included maternal left bundle branch block, premature
rupture of membrane, and residual paravalvular leak. In conclusion, TAVR
may be a feasible option for the treatment of aortic stenosis and failed
aortic valve bioprosthesis, as demonstrated in the published case reports.
Comprehensive patient care and preoperative assessment by heart and
high-risk pregnancy teams remain essential in mitigating maternal and
fetal risks. Copyright © 2024 HMP Global. All Rights Reserved.

<143>
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. 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. 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. 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. Copyright
© 2024 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights
reserved.

<144>
Accession Number
646977636
Title
SILENT CEREBRAL EMBOLISM DURING CAROTID ARTERY STENTING: DISTAL VERSUS
PROXIMAL PROTECTION IN PATIENTS WITH STABLE CAROTID STENOSIS.
Source
Giornale Italiano di Cardiologia. Conference: 46degree Congresso Nazionale
ANMCO. Milano Italy. 16(5 Supplement 1) (pp e179), 2015. Date of
Publication: 2015.
Author
Pacchioni A.; Mugnolo A.; Penzo C.; Nikas D.; Sacca S.; Turri R.; Ferro
J.; Torabi S.; Versaci F.; Reimers B.
Institution
(Pacchioni, Penzo, Nikas, Sacca, Turri, Ferro, Reimers) Ospedale Civile,
Mirano, Italy
(Mugnolo) Ospedale Mater Salutis, Legnago, Italy
(Torabi) Villa Maria Cecilia, Cotignola, Italy
(Versaci) Ospedale Civile, Campobasso ed Isernia, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Hypothesis. Previous study revealed high incidence (up to 80%) of new
asymptomatic cerebral lesion after CAS, with conflicting results comparing
proximal protection with filter. Heterogeinity in patient selection, CAS
techniques and operators' experience could have biased previous results.
Objectives. To establish if proximal protection with flow reversal,
performed by experienced operators in a high volume center, may be more
effective than filters in preventing cerebral embolization during CAS in
patients with stable carotid disease. Design and methodology. Patients
with internal carotid artery >70%, without recent (<6 months) ischemic
cerebral events, were randomly assigned to CAS with flow reversal (FR) or
filter protection (FP). Primary endpoint was the incidence of new cerebral
ischemic lesions assessed by diffusion-weighted magnetic resonance
(DW-MRI) imaging. Secondary endpoints were: number and diameter of new
ischemic lesions; number of microembolic signals (MES) assessed by
bilateral transcranial Doppler monitoring during all phases of the
procedure. Major cardiovascular and cerebral events (MACCE) at 30 days
were recorded. Expected rate of new cerebral lesion was 50% in FP, 17% in
FR (as reported by previous studies); with alfa 5% and 1-beta 80%, sample
size was 30 patients/group. Results. 60 patients were randomized. No
difference in baseline and procedural characteristics were present.
Incidence, number and diameter of new cerebral ischemic lesions, as number
of MES and 30 days MACCEs were not significantly reduced by FR compared to
FP (table). Conclusions. This randomized trial of patients with stable
severe carotid disease undergoing CAS showed a very low incidence of new
ischemic lesions in both group. FR protection did not significantly reduce
cerebral embolization. (Table Presented).

<145>
Accession Number
646977808
Title
CHLORHEXIDINE PROPHYLAXIS FOR PREVENTION OF VENTILATOR-ASSOCIATED
PNEUMONIA IN TRAUMA AND SURGICAL INTENSIVE CARE UNITS.
Source
Surgical Infections. Conference: 35th Annual Meeting of the Surgical
Infection Society. Westlake Village, CA United States. 16(Supplement 1)
(pp S27-S28), 2015. Date of Publication: 01 Apr 2015.
Author
Kesinger M.; Puyana J.C.; Duque M.; Sperry J.
Institution
(Kesinger, Puyana, Duque, Sperry) University of Pittsburgh, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Ventilator-associated pneumonia (VAP) is an important cause of
morbidity and mortality in intensive care units (ICUs) ranging between 15%
and 41%. Mortality in this population may exceed 50%, and recent evidence
suggests that ICU patients who develop VAP have an increased risk of worse
functional and neurological outcomes. Chlorhexidine (CX) decontamination
of the oropharynx may decrease the incidence of VAP. Previous systematic
reviews and meta-analyses investigating CX oropharynx decontamination have
either combined medical and surgical ICU patients, or have investigated
special populations such as cardiac surgery patients. No metaanalysis has
investigated the potential effects of CX in decreasing VAP specifically in
trauma and surgical ICUs. Hypothesis: CHX decreases VAP and mortality in
trauma and surgical ICUs. Method(s): MEDLINE, PubMed, clinical trial
registries and Google were searched for randomized controlled trials (RCT)
of CX prophylaxis vs. either placebo or standard treatment for VAP in
mechanically ventilated patients treated in a general surgical or trauma
ICU. Studies were excluded that investigated CX vs. another experimental
intervention. Result(s): We identified 278 results. 253 records were
excluded and 25 full-text records were assessed for eligibility. We
included 4 studies published between 2004 and 2011 and one study completed
in 2013 with reported results but that has not been published. The
population totaled 337 patients. The quality of evidence was moderate.
Patients receiving CX prophylaxis were one-half as likely to contract VAP
compared to placebo or standard of care (RR 0.52, 95%CI 0.32-0.83, p =
0.006). However, there were insufficient outcomes reported to determine
the effect of CX in this population as regards mortality.
 Conclusion(s): Evidence suggests that the use of CX for
decontamination of the oropharynx in mechanically ventilated patients
treated in trauma/surgical ICUs decreases the incidence of VAP. However,
the quality of evidence is moderate and the quantity is low. The evidence
is less clear regarding the effect of CX on mortality, length of
mechanical ventilation, and length of ICU stay in this patient population.
(Figure Presented).

<146>
Accession Number
646977777
Title
THE REAL LIFE EXPERIENCE OF NEW ANTIPLATELET DRUGS: THE ROAD STUDY.
Source
Giornale Italiano di Cardiologia. Conference: 46degree Congresso Nazionale
ANMCO. Milano Italy. 16(5 Supplement 1) (pp e147), 2015. Date of
Publication: 2015.
Author
Giordana F.; D'Ascenzo F.; Conrotto F.; Cerrato E.; Gagnor A.; Bianco M.;
Picardi E.; Marchetti M.; Omede P.; Moretti C.; D'Amico M.; Sebastiano M.;
Gaita F.
Institution
(Giordana, D'Ascenzo, Bianco, Marchetti, Omede, Moretti, Sebastiano) Citta
della Salute e della Scienza, Division of Cardiology, University of Turin,
Turin, Italy
(Conrotto, D'Amico, Gaita) Citta della Salute e della Scienza, Division of
Cardiology, Turin, Italy
(Cerrato, Gagnor) Riuniti Hospital, Rivoli, Italy
(Picardi) Maria Vittoria Hospital, Turin, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. Clopidogrel and ticlopidine have been the only available
antiplatelet drugs used along with aspirin in patients (pts) affected by
acute coronary syndrome (ACS), until prasugrel and ticagrelor have become
available. Aim. To evaluate the safety and the efficacy of the new
antiplatelet drugs in this setting, at one year follow-up Methods. This is
a prospective, multicentre study, which has included all the pts admitted
for ACS in the Cardiology Departments of 5 European centers, for three
consecutive months. The safety end-point was in-hospital and oneyear FU
bleeding (TIMI classification). The efficacy primary end-point was the
cardiovascular death at one-year follow-up (FU). The secondary end-point
was in-hospital MACE (a composite of cardio-vascular death, re-acute
myocardial infarction (AMI), in-stent thrombosis (IST), TIA/stroke).
Results. 195 pts were enrolled between July and September 2013. 70% (137)
were male, mean age was 65+/-11.8; the prevalence of diabetes mellitus was
20% (39), previous TIA/stroke 7% (14) and previous AMI 28% (55). 37% (73)
of pts were admitted for STEMI, 30% (58) for NSTEMI and 33% (64) for
unstable angina. At admission, the mean platelets count was 225.8+/-71.3
U/mclx103 (median 224 U/mclx103) and C-troponin 2+/-4.8 ng/L (median 0,31
ng/L); in-hospital GRACE score risk of death was 133.5+/-33.8 (median
129). At discharge, 85% (166) of pts assumed Aspirin, 43% (85) Clopidogrel
group 1, 13% (25) Prasugrel group 2, 25% (48) Ticagrelor group 3, 17% (34)
any P2Y12 inhibitor group 4 and 1% (2) Ticlopidine. 3% (3) of pts in group
1 and 3% (1) in group 4 had in-hospital MACE (all of them were confirmed
IST, p=0.61), while 4% (1) in group 2, 2% (1) in group 3 and 6% (2) in
group 4 had in-hospital non CABG-related bleeding (p=0.31). At FU
(mean+/-DS: 417+/-108 days, median 441 days) the Kaplan Meier curves
showed a rate of mortality among groups, respectively, 2.2% (1), 5% (1),
2.7% (1) and 11% (2) (p=0.09). No difference in MACE (5%, 8%, 2%, 6%,
respectively, p=0.41) was found. Overall, non- related-CABG bleeding
didn't significantly differ among groups (respectively, 8%, 15%, 12%, 9%,
p=0.69), while minor bleeding (respectively 2%, 15%, 8%, 6%,) was more
frequent in group 2 (p=0.04). Moreover, 1 pts in group 2, 4 pts in group 3
and 1 pts in group 4 switched to clopidogrel (p=0.54). Conclusion. New
antiplatelet drugs in real world are safe compared to the "old" molecules,
as they do not increase risk of bleeding, neither of MACE, at more than
one year follow-up.

<147>
Accession Number
646977225
Title
UTILITY AND BENEFITS OF PHYSICAL TRAINING IN ELDERLY PATIENTS WITH CHRONIC
HEART FAILURE.
Source
Giornale Italiano di Cardiologia. Conference: 46degree Congresso Nazionale
ANMCO. Milano Italy. 16(5 Supplement 1) (pp e66), 2015. Date of
Publication: 2015.
Author
Ascione A.; Borgia M.; Miceli D.; Attena E.; Parato V.M.; Sangiuolo R.
Institution
(Ascione, Attena, Sangiuolo) Ospedale Buonconsiglio Fatebenefratelli,
Napoli, Italy
(Borgia) AORN dei Colli V. Monaldi, Napoli, Italy
(Miceli) AORN dei Colli CTO, Napoli, Italy
(Parato) Ospedale Madonna del Soccorso, San Benedetto del Tronto, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Aim. Cardiovascular rehabilitation provides an important aid in the
recovery of patients after myocardial infarction, coronary artery bypass
graft surgery and percutaneous coronary intervention. However, the
information available on the usefulness of rehabilitation programs in
chronic heart failure stabilized (CHF), are limited. The aim of our study
was to evaluate the outcome of the training and aerobic exercise of
moderate resistance in elderly patients with CHF measuring the functional
capacity with common laboratory examinations. Methods. This has been one
prospective randomized study, conducted with 43 male patients with CHF.
(NYHA) class II, mean age 73 years. At the beginning of treatment were
carried out the following measurements: peak VO2 and AT to cardiopulmonary
exercise testing, 6-minute walking test, plasma levels of brain
natriuretic peptide (pro-BNP), echocardiography for assessment of
diastolic function and left ventricular ejection fraction, measurement of
pulmonary gas ventilation and quality of life questionnaire. Thereafter,
patients were randomly assigned to a training group (TG n = 21) or a
control group (CG n = 22). The training group had supervised program of
aerobic and resistance training three times a week for three months. After
the training program has been completed, all measurements were repeated in
both groups. Results. There were no reported serious adverse events
related to training, with the exception of a case of paroxysmal
tachycardia. Significant improvement was found between the groups in the
six-minute walk test (37.1 m vs. 5.3 m, p = 0.01), workload on the bicycle
exercise test (+ 6.1 W against +2, W 1, p = 0.03), the time the stress
test bike (s +41 s vs 0, p = 0.02) and peak VO2 adjusted for age, weight
and body surface. Peak VO2 was higher in TG than in CG: 17.3 +/- 6.1 mL *
kg -1 * min-1 versus 11.5 +/- 3.9 mL * kg -1 * min-1 (range, 5.2 to 49.7
mL * kg -1 * min-1) -P<0.0001. Quality of life factors that reflect
exercise tolerance and overall health has improved significantly in the TG
compared to the CG. No significant change was found between the two
groups. Conclusion. Supervised physical training as used in this study
appears safe, useful and beneficial for CHF elderly patients in NYHA class
II. The improvement in functional capacity observed in the training group
seems to be related to peripheral factors rather than in your
cardiovascular fitness.

<148>
Accession Number
646977791
Title
THE START-ANTIPLATELETS REGISTER: A MULTICENTER OBSERVATIONAL PROSPECTIVE
STUDY TO ASSESS THE RISK-BENEFITS OF ANTITHROMBOTIC THERAPY IN ACS
PATIENTS.
Source
Giornale Italiano di Cardiologia. Conference: 46degree Congresso Nazionale
ANMCO. Milano Italy. 16(5 Supplement 1) (pp e148), 2015. Date of
Publication: 2015.
Author
Marcucci R.; Pengo V.; Patti G.; Gresele P.; Antonucci E.; Valente S.;
Bracco A.; Fierro T.; Cavallari I.; Gensini G.F.; Palareti G.
Institution
(Marcucci, Antonucci, Gensini) Dipartimento di Medicina Sperimentale e
Clinica, Universita degli Studi di Firenze, Firenze, Italy
(Pengo, Bracco) Universita degli Studi di Padova, Padova, Italy
(Patti, Cavallari) Policlinico Universitario Campus Biomedico, Roma, Italy
(Gresele, Fierro) Universita degli Studi di Perugia, Perugia, Italy
(Valente) AOU Careggi, Firenze, Italy
(Palareti) Universita degli Studi di Bologna, Bologna, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. The treatment of ACS has been modified in recent years by the
introduction of the more potent P2Y12 inhibitors, such as prasugrel and
ticagrelor. European guidelines recommend to treat ACS patients, as a
first choice, with the novel antiplatelets. In the real world, scarce data
are available on the adherence to these recommendations and on the
follow-up of ACS patients - in terms of thrombotic and bleeding
complications - with respect to antithrombotic therapy. Finally, the
significant prevalence of atrial fibrillation and of other conditions
requiring an oral anticoagulant therapy in ACS patients, raise complex
clinical decision problems for the association of antithrombotic
therapies. Methods. Participant centers to the START-ANTIPLATELETS
Register, a collaborative observational study, enroll all patients who
meet predefined eligibility criteria (ACS). Data of each individual
patient, including diagnosis, underlying conditions, type of antiplatelet
treatment and causes of its variation, or of temporary or definitive
interruption, and finally events occurring during 6- and 12-month
follow-up, are collected on the web-site of the register. Results. 175
patients were registered so far (41 F; 134 M/age: 67 +-12.5 yrs).
Diagnoses included: 75 STEMI; 74 NSTEMI and 26 UA. 141 (80.5%) patients
underwent PCI; 130 were revascularized with stent implantation (127/130
DES); 29 (16.5%) were medically treated and 9 (5.1%) underwent coronary
artery bypass graft surgery. Hypertension was present in 124 (70.9%);
smoking habit in 78 (44.6%); hypercholesterolemia in 81 (46.3%); diabetes
in 40 (22.9%) and family history of CAD in 55 (31.4%). At discharge
antithrombotic therapy included: aspirin in 171/175 (98%); P2Y12
inhibitors in 161/175 (92%): 77 (47.8%) clopidogrel; 65 (40.3%)
ticagrelor; 19 (11.8%) prasugrel. 15/175 (8.6%) pts were treated with a
triple antithrombotic therapy: 13 patients with VKA+aspirin+clopidogrel; 1
with dabigatran+aspirin +clopidogrel and 1 with ticagrelor+VKA+aspirin.
Conclusion. START- ANTIPLATELETS Register, a multicenter observational
prospective and non-interventional register, will allow us to enhance our
understanding of the risk-benefits of the antithrombotic therapy in ACS
patients.

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