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<1>
Accession Number
2037784059
Title
Disability and associated outcomes among patients suffering periprocedural
strokes after carotid artery stenting.
Source
Journal of Vascular Surgery. 81(6) (pp 1343-1350), 2025. Date of
Publication: 01 Jun 2025.
Author
Alonso A.; Kobzeva-Herzog A.J.; Levin S.R.; de Macedo K.M.; Melvin J.;
Farber A.; King E.G.; Garg K.; Shean K.E.; O'Donnell T.F.X.; Rybin D.;
Siracuse J.J.
Institution
(Alonso, Kobzeva-Herzog, Levin, de Macedo, Melvin, Farber, King, Rybin,
Siracuse) Division of Vascular and Endovascular Surgery, Department of
Surgery, Boston Medical Center, Boston University Chobanian and Avedisian
School of Medicine, Boston, MA, United States
(Garg) Division of Vascular and Endovascular Surgery, Department of
Surgery, New York University Langone Medical Center, New York, NY, United
States
(Shean) Division of Vascular Surgery, St. Elizabeth's Medical Center,
Boston University Chobanian and Avedisian School of Medicine, Brighton,
MA, United States
(O'Donnell) Division of Vascular Surgery, Columbia University, New York,
NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: Perioperative stroke after carotid artery stenting (CAS) is
rare. However, the degree of disability and long-term effects from a
postoperative stroke remain unclear. Our goal was to assess the degree of
disability from a stroke after transcarotid artery revascularization
(TCAR) and transfemoral CAS (TFCAS) for asymptomatic carotid artery
disease, and the associated 1-year impact on subsequent neurological
events and mortality. Method(s): The Vascular Quality Initiative CAS
registry (2016-2023) was queried for CAS performed for asymptomatic
disease. Patients with a postoperative stroke had their disability
stratified by modified Rankin score of 0 to 1 (mild), 2 to 3 (moderate), 4
to 5 (severe), and 6 (deceased). Postoperative stroke-related disability
based on modified Rankin scale for those recorded at discharge and its
association with long-term outcomes were analyzed. Result(s): There
were 23,435 TCAR and 7487 TFCAS procedures performed for asymptomatic
disease. Among TCAR patients, the periprocedural stroke and stroke/death
rates were 0.80% and 1.03%, respectively, with disability distributed as
33.6% mild, 31.0% moderate, 28.9% severe, and 7.5% deceased. Among TFCAS
patients, the periprocedural stroke and stroke/death rates were 0.92% and
1.19%, respectively, with disability distributed as 37.7% mild, 31.0%
moderate, 27.5% severe, and 2.9% deceased. Multivariable analysis
demonstrated that severe early postoperative disability was associated
with increased 1-year mortality (hazard ratio [HR], 11.04; 95% confidence
interval [CI], 6.9-17.7; P = .001) and increased subsequent neurological
event/death (HR, 10.82; 95% CI, 6.93-16.9; P = .001). Patients with a
stroke after TFCAS had a higher risk of 1-year mortality (HR, 1.27; 95%
CI, 1.10, 1.47; P = .001) and neurological event/death (HR, 1.27; 95% CI,
1.11-1.45; P < .001), as compared with patients with a stroke after TCAR.
Among patients who undergo a CAS procedure for asymptomatic disease,
hypertension was associated with a higher likelihood of developing severe
disability (odds ratio [OR], 4.2; 95% CI, 1.03-17.32; P = .045), whereas
preoperative aspirin (OR, 0.51; 95% CI, 0.30-0.87; P = .01) or P2Y12
inhibitor use (OR, 0.45; 95% CI, 0.27-0.74; P = .11) was associated with a
lower likelihood of developing a severe disability. Conclusion(s):
The majority of patients who undergo TCAR and TFCAS for asymptomatic
carotid artery disease who suffered a periprocedural stroke had
substantial disability. Patients with strokes from TFCAS have worse 1-year
outcomes as compared with patients with stroke after TCAR. These findings
should help to guide patient-provider discussions regarding the surgical
management of asymptomatic carotid stenosis and the risks of CAS
interventions, as well as aid in the prognostication of postoperative
stroke. Copyright © 2025 Society for Vascular Surgery

<2>
Accession Number
2038627548
Title
A pairwise and network meta-analysis of anti-inflammatory strategies after
myocardial infarction: the TITIAN study.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 11(3) (pp
218-229), 2025. Date of Publication: 01 May 2025.
Author
Laudani C.; Occhipinti G.; Greco A.; Giacoppo D.; Spagnolo M.; Capodanno
D.
Institution
(Laudani, Occhipinti, Greco, Giacoppo, Spagnolo, Capodanno) Division of
Cardiology, Azienda Ospedaliero-Universitaria Policlinico "Rodolico-San
Marco", University of Catania, Via S. Sofia 76, Catania, Italy
(Occhipinti) Institut Clinic Cardiovascular, Hospital Clinic de Barcelona,
University of Barcelona, Carrer de Villarroel 170, L'Eixample, Barcelona,
Spain
Publisher
Oxford University Press
Abstract
Background and aims: Multiple anti-inflammatory drugs have been tested for
secondary prevention after myocardial infarction (MI), giving mixed
results and questioning the efficacy of anti-inflammatory therapy. No
head-to-head comparisons between anti-inflammatory drugs have been
performed. This study aimed to compare the efficacy and safety of
anti-inflammatory drugs for secondary prevention after MI and the relative
merits of specific drugs and administration strategies. Methods and
Results: Randomized trials of anti-inflammatory therapy for secondary
prevention after MI were identified. Primary efficacy and safety endpoints
were trial-defined major adverse cardiovascular events (MACEs) and serious
adverse events. Secondary endpoints included all-cause death, individual
MACE components, serious infection, cancer, and gastrointestinal adverse
events. Pairwise meta-analyses were conducted with interaction analyses
for drug type and timing of administration, in addition to network
meta-analyses. Multiple sensitivity and meta-regression analyses were
conducted to explore potential heterogeneity sources. Twenty-eight
studies, involving 44 406 patients with a mean follow-up of 11 months,
were included. Anti-inflammatory therapy reduced the incidence of MACEs
[incidence rate ratio (IRR): 0.92; 95% confidence interval (CI):
0.86-0.98] compared to control, without increasing serious adverse events.
However, it was associated with a higher incidence of gastrointestinal
adverse events (IRR: 1.21; 95% CI: 1.07-1.36). No significant interaction
was observed between the effects of anti-inflammatory therapy on MACE and
the timing of administration. Conclusion(s): In secondary prevention
for MI, anti-inflammatory therapy significantly reduces MACE without
increasing serious adverse events, but it is associated with an increased
risk of gastrointestinal adverse events. Copyright © 2025 The
Author(s).

<3>
Accession Number
647375675
Title
Rationale and Design of the REPEAT Trial: A Multicenter Randomized Trial
Comparing Redo Surgical Aortic Valve Replacement to Valve-in-Valve
Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. 14(10) (pp e040954), 2025. Date
of Publication: 20 May 2025.
Author
Raschpichler M.; de Waha S.; Blankenberg S.; Diniz M.A.; Bagiella E.;
Gelijns A.C.; Calsavara V.F.; Gupta A.; Schofer N.; Kaneko T.; Abdel-Wahab
M.; Thiele H.; Makkar R.; Borger M.A.
Institution
(Raschpichler, de Waha, Borger) Department of Cardiac Surgery Heart Center
Leipzig at Leipzig University Leipzig Germany, Germany
(de Waha) Department of Rhythmology University Hospital
Schleswig-Holstein, Campus Lubeck Lubeck Germany
(Blankenberg, Schofer) Department of Cardiology University Heart &
Vascular Center Hamburg Hamburg Germany, Germany
(Diniz, Bagiella, Gelijns) Department of Population Health Science and
Policy Icahn School of Medicine at Mount Sinai New York NY USA
(Calsavara) Department of Computational Biomedicine Cedars-Sinai Medical
Center Los Angeles CA USA
(Gupta, Makkar) Department of Interventional Cardiology, Cedars-Sinai
Medical Center Los Angeles CA USA
(Kaneko) Division of Cardiothoracic Surgery Washington University in St.
Louis St. Louis MO USA
(Abdel-Wahab, Thiele) Department of Cardiology Heart Center Leipzig at
Leipzig University Leipzig Germany, Germany
Abstract
BACKGROUND: Redo surgical aortic valve replacement (rSAVR) has for long
been the therapeutic reference standard for degenerated surgical aortic
bioprostheses. Valve-in-valve transcatheter aortic valve replacement
(ViV-TAVR) has emerged as an alternative for patients at high surgical
risk due to its lower invasiveness. The long-term clinical efficacy of
ViV-TAVR in patients at low to intermediate surgical risk remains unknown.
METHODS AND RESULTS: To compare clinical outcomes of redo surgical aortic
valve replacement versus ViV-TAVR in low- to intermediate-risk patients
with degenerated surgical aortic bioprostheses. REPEAT (Repeat
Intervention for Deteriorated Surgical Bioprosthetic Aortic Valves) is an
investigator-initiated, international, multicenter, randomized, parallel,
open-label trial. A total of 890 patients aged <75 years with a failed
surgical aortic bioprosthesis due to structural valve degeneration and low
to intermediate surgical risk (ie, Society of Thoracic Surgeons predicted
risk of death of <8%) will be randomly assigned in a 1:1 ratio to either
redo surgical aortic valve replacement or ViV-TAVR. The primary end point
of REPEAT is a composite of all-cause death, stroke (including both
disabling and nondisabling), myocardial infarction, and rehospitalization
for heart failure or aortic valve reintervention at 5 years, based on
Valve Academic Research Consortium-3 definitions. Secondary end points
include each of the individual components of the primary composite end
point, Valve Academic Research Consortium-3-based conduction disturbances
and arrhythmia, Valve Academic Research Consortium-3-based wound and
bleeding complications, functional status (ie, 6-minute walk test, Kansas
City Cardiomyopathy questionnaire), and treatment costs.
 CONCLUSION(S): The REPEAT trial has been designed to test the
hypothesis that redo surgical aortic valve replacement is superior to
ViV-TAVR regarding clinical outcomes at 5 years in patients with
degenerated surgical aortic bioprostheses and low to intermediate surgical
risk.

<4>
Accession Number
647382339
Title
Comparing Major Gastrointestinal Bleeding in Patients Receiving Edoxaban
Versus Warfarin After Transcatheter Aortic Valve Replacement: Results From
the Randomized ENVISAGE-TAVI AF Trial.
Source
Journal of the American Heart Association. 14(10) (pp e033321), 2025. Date
of Publication: 20 May 2025.
Author
Dangas G.D.; Unverdorben M.; Nicolas J.; Hengstenberg C.; Chen C.;
Mollmann H.; Jin J.; Shawl F.; Yamamoto M.; Saito S.; Hambrecht R.; Duggal
A.; Van Mieghem N.M.
Institution
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital New York NY USA
(Dangas) School of Medicine National and Kapodistrian University of Athens
Athens Greece, Greece
(Unverdorben, Chen, Jin, Duggal) Daiichi Sankyo, Inc. Basking Ridge NJ USA
(Nicolas) Icahn School of Medicine at Mount Sinai The Mount Sinai Hospital
New York NY USA
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology
Vienna General Hospital, Medical University Vienna Austria, Austria
(Mollmann) Department of Internal Medicine St. Johannes-Hospital Dortmund
Germany, Germany
(Shawl) Interventional Cardiology, Adventist HealthCare White Oak Medical
Center Silver Spring MD USA
(Yamamoto) Department of Cardiology Toyohashi Heart Center Toyohashi
Japan, Japan
(Saito) Division of Cardiology & Catheterization Laboratories Shonan
Kamakura General Hospital Kamakura Japan, Japan
(Hambrecht) Bremer Institute for Heart and Circulation Research at
Klinikum Links der Weser Bremen Germany, Germany
(Van Mieghem) Department of Cardiology Erasmus University Medical Centre,
Netherlands
Abstract
BACKGROUND: Non-vitamin K oral anticoagulants are recommended over vitamin
K antagonists in patients with nonvalvular atrial fibrillation (AF).
However, the risk of gastrointestinal bleeding may be higher with
non-vitamin K oral anticoagulants versus vitamin K antagonists. Patients
after successful transcatheter aortic valve replacement (TAVR) who are
elderly and frail have worse outcomes with major gastrointestinal bleeding
(MGIB), including death. This study evaluated incidence, predictors, and
impact of MGIB among patients with AF after successful TAVR.
 METHOD(S): This on-treatment analysis of ENVISAGE-TAVI AF (Edoxaban
Compared to Standard Care After Heart Valve Replacement Using a Catheter
in Patients With Atrial Fibrillation) included patients who received >=1
dose of the study drug. Demographic, clinical, and procedural
characteristics were compared between patients with versus without an MGIB
event. Cox multivariable regression analysis identified predictors of
MGIB. RESULT(S): Of 1377 patients in this analysis, 83 (6.0%)
experienced MGIB, with 56 (67.5%) of these patients receiving edoxaban.
Patients with versus without MGIB were more likely to have undergone
percutaneous coronary intervention <=30 days before TAVR (9.6% versus
4.2%; P=0.03), a higher ejection fraction (mean+/-SD, 58.0+/-10.4 versus
55.3+/-11.5; P=0.04), and carotid artery disease (13.3% versus 6.6%;
P=0.04). Edoxaban without dose adjustment versus vitamin K antagonist use
(P=0.003), smoking (P=0.01), low hemoglobin levels (P<0.0001), and
percutaneous coronary intervention <=30 days before TAVR (P=0.01) emerged
as predictors of MGIB. CONCLUSION(S): In this ENVISAGE-TAVI AF
subanalysis, MGIB occurred in 6.0% of patients with prevalent or incident
AF undergoing TAVR, and those receiving edoxaban versus vitamin K
antagonists had a higher risk of MGIB. A priori identification of risk
factors for MGIB may help optimize outcomes for patients with AF
undergoing TAVR. REGISTRATION: URL: https://www.clinicaltrials.gov; unique
identifier: NCT02943785.

<5>
Accession Number
2033378299
Title
Guidelines for preoperative pulmonary function assessment in patients with
lung cancer who will undergo surgery (The Japanese Association for Chest
Surgery).
Source
General Thoracic and Cardiovascular Surgery. 73(6) (pp 385-404), 2025.
Article Number: i3571. Date of Publication: 01 Jun 2025.
Author
Ohde Y.; Ueda K.; Okami J.; Saito H.; Sato T.; Yatsuyanagi E.; Tsuchida
M.; Mimae T.; Adachi H.; Hishida T.; Saji H.; Yoshino I.
Institution
(Ohde) Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka,
Japan
(Ueda) Department of General Thoracic Surgery, Kagoshima University
Graduate School of Medical and Dental Sciences, Kagoshima, Japan
(Okami, Saito) Department of General Thoracic Surgery, Osaka International
Cancer Institute, Osaka, Japan
(Sato) Department of General Thoracic, Breast and Pediatric Surgery,
Fukuoka University School of Medicine, Fukuoka, Japan
(Yatsuyanagi) Department of General Thoracic Surgery, National Hospital
Organization Obihiro Hospital, Hokkaido, Japan
(Tsuchida) Division of Thoracic and Cardiovascular Surgery, Niigata
University Graduate School of Medical and Dental Sciences, Niigata, Japan
(Mimae) Department of Surgical Oncology, Hiroshima University, Hiroshima,
Japan
(Adachi) Department of Surgery, Yokohama City University, Kanagawa, Japan
(Hishida) Division of Thoracic Surgery, Department of Surgery, Keio
University School of Medicine, Tokyo, Japan
(Saji) Department of Chest Surgery, St. Marianna University School of
Medicine, Kanagawa, Japan
(Saji) Committee for Guideline Assessment, The Japanese Association for
Chest Surgery, Kyoto, Japan
(Yoshino) International University of Health and Welfare Narita Hospital,
Narita, Japan
(Yoshino) The Japanese Association for Chest Surgery, Kyoto, Japan
Publisher
Springer
Abstract
This article translates the guidelines for preoperative pulmonary function
assessment in patients with lung cancer who will undergo surgery,
established by the Japanese Association of Chest Surgery on May 17, 2021,
from Japanese to English. The last version of these guidelines was created
on April 5, 2011. Over the past decade, changes in clinical practice have
occurred that do not align with the current guidelines, prompting a
revision in conjunction with the introduction of new evidence this time.
This guideline was developed with reference to the internationally adopted
GRADE (Grading of Recommendations Assessment, Development, and Evaluation)
system. Extraction of evidence, systematic review, and quality assessment
are entrusted to each guideline review committee and the Pulmonary
Function Assessment Working Group. Committee members are also responsible
for determining the selection of evidence and the extraction period, with
a particular emphasis on adopting items considered to be of special
importance. The recommended assessment and management is categorized into
a general overview, pulmonary function assessment, cardiopulmonary
exercise test, pulmonary function assessment for lung cancer with
interstitial pneumonia, preoperative smoking cessation, and pulmonary
rehabilitation. These are described by the strength of recommendation, the
strength of evidence, and the consensus rate. Copyright © The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery 2025.

<6>
Accession Number
2034143699
Title
Effect of osteoporosis medications on vascular and valvular calcification:
a systematic review and meta-analysis.
Source
Osteoporosis International. 36(5) (pp 779-799), 2025. Date of Publication:
01 May 2025.
Author
Lo H.Z.; Leow K.; Hii R.; Nerlekar N.; Ebeling P.R.; Rodriguez A.J.
Institution
(Lo) Peninsula Health, 2 Hastings Road, Frankston, VIC, Australia
(Leow) Department of Cardiology, Canberra Hospital, Woden, Yamba Dr,
Garran, ACT, Australia
(Hii, Nerlekar) Department of Medicine, Monash Health, 246 Clayton Rd,
Clayton, VIC, Australia
(Nerlekar, Ebeling) Department of Medicine, School of Clinical Sciences,
Faculty of Medicine, Nursing and Health Sciences, Monash University,
Monash Medical Centre, 246 Clayton Rd, Clayton, VIC, Australia
(Nerlekar) Monash Cardiovascular Research Centre, Monash University and
Monash Heart, Monash Health, 246 Clayton Rd, Clayton, VIC, Australia
(Rodriguez) Department of Medicine, School of Clinical Sciences at Monash
Health, Bone and Muscle Health Research Group, Monash University, Monash
Medical Centre Block E, Level 5, 246 Clayton Rd, Clayton, VIC, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: Vascular calcification shares many features with skeletal
mineralisation and shares an inverse relationship with osteoporosis
(skeletal de-mineralisation). However, medications that reduce bone loss
(anti-resorptives) have had inconsistent effects on extra-skeletal
mineralisation (i.e. vascular and valvular calcification). As such, this
paper aims to synthesise existing literature examining the effect of
anti-resorptive treatments on extra-skeletal (vascular and valvular)
calcification across populations. Method(s): Medline and Embase were
searched (inception to October 2024) for studies that assessed the
association between anti-resorptive medication use and vascular/valvular
calcification. Pooled standardised mean differences (SMDs) with 95%
confidence intervals (CI) were calculated for all outcomes, using
random-effects model. Leave-one-out sensitivity analyses were performed
for internal validity. Result(s): Of 4071 articles screened, 33 were
included in the review, and 15 (2344 participants) had data available for
meta-analysis. Anti-resorptive use was associated with non-significant,
small magnitude improvements in abdominal aortic calcification (decreased
value), coronary artery calcification (decreased value) and ejection
fraction (increased value) but significant small reduction in aortic valve
area (representing less calcification on the valve) with standardised mean
difference of - 0.45 (95% confidence interval (CI) - 0.99; 0.08,
I2 = 84%), - 1.19 (95% CI - 2.92; 0.55, I2 = 91%), -
0.67 (95% CI - 1.72; 0.38, I2 = 94%), 0.26 (95% CI - 0.14;
0.66, I2 = 62%) and 0.56 (95% CI 0.07; 1.06, I2 =
76%), respectively. Conclusion(s): The significance of small positive
effect of anti-resorptives on aortic stenosis is clinically uncertain.
Despite strong biological links between vascular calcification and
skeletal mineralisation, anti-resorptives do not appear to have a strong
favourable influence on extra-skeletal mineralisation. This suggests that
mechanisms that link vascular calcification with osteoporosis may be
acting in pathways not influenced by anti-resorptives. Summary: This
systematic review and meta-analysis summarises the effect of
anti-resorptives on vascular and valvular calcification. There is a small,
positive effect of anti-resorptives on aortic stenosis, though this is of
uncertain clinical importance. Copyright © The Author(s) 2025.

<7>
Accession Number
2038644425
Title
Achieving Neuroprotection in the Setting of Early Extubation During Infant
Cardiac Surgery: A Prospective, Randomized, and Blinded Study.
Source
Cardiology Research. 16(3) (pp 178-188), 2025. Date of Publication: 2025.
Author
Naguib A.N.; Bozych M.; McNally K.; Galantowicz M.; Tobias J.
Institution
(Naguib, Bozych, Tobias) Departments of Anesthesiology and Pediatrics,
Nationwide Children's Hospital, The Ohio State University College of
Medicine, Columbus, OH, United States
(Naguib, Galantowicz) The Heart Center, Nationwide Children's Hospital,
The Ohio State University College of Medicine, Columbus, OH, United States
(McNally) Department of Pediatric Psychology and Neuropsychology,
Nationwide Children's Hospital, The Ohio State University College of
Medicine, Columbus, OH, United States
Publisher
Elmer Press
Abstract
Background: This study aimed to investigate the impact of early extubation
on stress response and neurodevelopmental outcomes after pediatric cardiac
surgery utilizing cardiopulmonary bypass (CPB). Method(s): In this
single-center prospective pilot study, we attempted to study the impact of
using dexmedetomidine as an adjunct to facilitate early extubation after
pediatric cardiac surgery requiring CPB during the first year of life. The
study was conducted between May 2014 and January 2020. Perioperative data
and stress hormone levels were collected at different points during the
perioperative period. In addition, neurodevelopmental outcome measures
including cognitive composite score, language (expressive and receptive)
and motor (fine and gross) composites were evaluated at five time points
including prior to surgery and up to 1 year after the procedure.
Two-sample ttests and Kruskal-Wallis tests were used to compare continuous
parametric and non-parametric outcomes, respectively. Fisher's exact or
Chi-squared tests were used to compare categorical outcomes.
 Result(s): A total of 30 subjects were included in the final cohort
of patients. Of the 30 subjects, 14 patients were randomized to the
dexmedetomidine group (dexmedetomidine plus fentanyl) (DEX group) and 16
patients were randomized to the no dexmedetomidine group (fentanyl only)
(no DEX group). With few exceptions, both groups demonstrated appropriate
blunting of the stress response. There was a significant increase in the
ratio of the pro-inflammatory interleukin-10 (IL-10) to the
anti-inflammatory interleukin-6 (IL-6) for the no DEX group at the end of
the procedure when compared to the DEX group (10 +/- 9 vs. 5 +/- 4, P =
0.04). When looking at the Bayley cognitive composite score, the DEX group
scored better than the no DEX group during the second visit (102 +/- 11
vs. 88 +/- 17, P = 0.023). By the fifth visit, the two groups scored
similarly (94 +/- 12 vs. 94 +/- 12, P = 0.9 for the no DEX and DEX groups,
respectively). Conclusion(s): When looking at the neurodevelopmental
outcome, both groups had no significant changes in their Bayley scores
from baseline with blunting of most stress markers. This study offers
possible evidence of the safety of early extubation after pediatric
cardiac surgery while maintaining the goal of
neuroprotection. Copyright © The authors

<8>
Accession Number
2034623984
Title
Evaluation of Integrated Arterial Filter Oxygenator vs. External Arterial
Filters on Clinical Outcomes and Neurocognitive Function in Pediatric
Cardiac Surgery: A Prospective Randomized Controlled Trial (RCT).
Source
Health Science Reports. 8(5) (no pagination), 2025. Article Number:
e70741. Date of Publication: 01 May 2025.
Author
Bhende V.V.; Krishnakumar M.; Parmar D.M.; Rudakiya A.G.; Sharma T.S.;
Kumar A.; Nerurkar P.D.; Mankad S.P.; Patel M.R.
Institution
(Bhende, Sharma) Department of Pediatric Cardiac Surgery, Bhanubhai and
Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka
University, Gujarat, Karamsad, India
(Krishnakumar) Department of Anaesthesiology, St. John's Medical College
Hospital, Bengaluru, India
(Parmar, Rudakiya, Nerurkar) Department of Perfusion Technology, Bhanubhai
and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka
Univesity, Gujarat, India
(Kumar) Department of Pediatric Cardiac Intensive Care, Bhanubhai and
Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka
University, Gujarat, Karamsad, India
(Mankad) Department of Internal Medicine, Dev Medical Hospital, Gujarat,
Vadodara, India
(Patel) Bio Central Research Services, Bhaikaka University, Gujarat,
Karamsad, India
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Innovative advancements in cardiopulmonary bypass
(CPB) configurations, such as surface coating, blood filtration, and
miniaturization, aim to reduce gaseous microemboli (GME) that contribute
to embolic organ damage, particularly neurological dysfunction. Arterial
line filters are effective in mitigating embolism risk. Neurological
complications post-cardiac surgery can result from reduced cerebral blood
flow, embolic materials, and other factors, including anesthesia. This
study evaluates the impact of integrated arterial filter oxygenator
(IAF-Oxy.) versus external arterial filters (EAF) on clinical outcomes in
pediatric patients undergoing surgery for congenital heart disease (CHD).
 Method(s): This prospective randomized controlled trial included 100
pediatric patients undergoing cardiac surgery under CPB. Patients were
randomized into two groups: Group A included external arterial filters
(EAF) with membrane oxygenators such as Capiox Baby RX 05 and others,
while Group B included integrated arterial filters (IAF) with oxygenators
like Capiox Baby FX 05. The outcomes were neurological function,
mechanical ventilation time (hours), intensive care unit stay (hours), and
hospital stay (days). Result(s): Group B demonstrated significantly
lower mean aortic cross-clamp (70.2 +/- 38.5 vs. 88.0 +/- 49.7 min; p =
0.04) and CPB times (104 +/- 48.1 vs. 128 +/- 66 min; p = 0.03).
Postoperative FOUR scores were identical (16 out of 16) in both groups.
Median ventilation time (26.5 [24.25-125.25] hours in Group A vs. 25.0
[12.0-50.0] hours in Group B; p = 0.258), CSICU stay (120.0 [72.0-216.0]
hours in Group A vs. 108.0 [72.0-162.0] hours in Group B; p = 0.358), and
hospital stay (13 +/- 11 days in Group A vs. 10 +/- 5 days in Group B; p =
0.138) were comparable between groups. Conclusion(s): Integrated
arterial filter oxygenator may serve as an alternative to external
arterial filters, potentially reducing gaseous microemboli. IAF-Oxy. could
improve clinical outcomes, reduce CSICU and hospital stays, and enhance
care for pediatric congenital heart disease (CHD) patients. Copyright
© 2025 The Author(s). Health Science Reports published by Wiley
Periodicals LLC.

<9>
Accession Number
2038687282
Title
Lung isolation with a bronchial blocker placed in the lateral position for
patients undergoing thoracic surgery: A multicenter, randomized clinical
trial.
Source
Journal of Clinical Anesthesia. 104 (no pagination), 2025. Article Number:
111869. Date of Publication: 01 Jun 2025.
Author
Li H.; Chu L.; Ye H.; Zhang Y.; Li M.; Hua Y.; Zhang J.; Hu H.; Wen T.;
Zhao J.; Wan H.; Huang L.; Lou Y.; Tang J.; Yan Z.; Duan G.; Wu J.; Wang
C.; Lu Y.; Shen X.; Huang C.; Song C.; Wang Y.; Zeng C.; Xie G.; Fang X.
Institution
(Li, Chu, Ye, Zhang, Li, Hua, Zhang, Hu, Wen, Zhao, Wan, Huang, Lou, Wang,
Xie, Fang) Department of Anesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
(Zhang, Wan) Department of Anesthesiology, Hangzhou Red Cross Hospital,
Hangzhou, China
(Li) Department of Anesthesiology, The First Hospital of Fuyang, Hangzhou,
China
(Zhao) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of
Medicine, Zhejiang University, Hangzhou, China
(Tang, Yan) Department of Anesthesiology, Affiliated Hospital of Guangdong
Medical University, Zhanjiang, China
(Duan, Wu) Department of Anesthesiology, Lishui People's Hospital, Lishui,
China
(Wang) Department of Anesthesiology, Lishui Central Hospital, Lishui,
China
(Lu, Shen) Department of Anesthesiology, The First Hospital of Jiaxing;
Jiaxing, China
(Huang, Song) Department of Anesthesiology, Affiliated Hospital of
Shaoxing University, Shaoxing, China
(Zeng) Department of Anesthesiology, Vagelos College of Physicians and
Surgeons, Columbia University, New York, United States
Publisher
Elsevier Inc.
Abstract
Study objective Accurate bronchial blocker placement is essential for
effective lung isolation during thoracic surgery. Approximately one-third
of patients experience bronchial blocker malposition during the transition
from the supine to lateral decubitus position. It has been unclear whether
bronchial blocker placement directly in the lateral position can reduce
the incidence of malposition. This study investigated the incidence of
bronchial blocker malposition in the lateral versus supine position and
evaluated the effectiveness of lateral placement. Patient(s): Adults
aged >=18 years scheduled for thoracic surgery were enrolled.
 Setting(s): Seven tertiary hospitals in China. Intervention(s):
Bronchial blockers were placed either in the lateral or supine position.
Measurements: The primary outcome was the incidence of bronchial blocker
malposition. Secondary outcomes included the times of bronchial blocker
reposition, perioperative complications, intubation duration, and
satisfaction scores. Main Result(s): Among 324 patients who underwent
randomization, 306 completed the study (152 in the lateral group and 154
in the supine group). The incidence of bronchial blocker malposition was
significantly lower in the lateral group (1/152 (0.7 %)) than in the
supine group 39/154 (25.3 %), P < 0.001). The times of bronchial blocker
reposition was also lower in the lateral group (median [interquartile
range]: 0 [0,0]) than in the supine group (1.0 [1.0, 2.0], P < 0.001).
Lateral bronchial blocker placement was associated with lower incidences
of postural injury (P < 0.001). The median intubation duration
(single-lumen tube intubation plus bronchial blocker placement) was
similar between the two groups (P = 0.089). Patients and surgeons reported
higher satisfaction scores in the lateral group (P < 0.001).
 Conclusion(s): Lateral bronchial blocker placement reduced the
incidence of malposition in patients undergoing thoracic surgery; it was
associated with fewer complications and higher satisfaction scores. These
findings indicate that lateral placement is an effective approach with
substantial advantages over conventional supine placement. Clinial trial
registration: NCT05482230. Copyright © 2025

<10>
Accession Number
2038643171
Title
Sex-based outcomes of mitral surgery for ischaemic mitral regurgitation:
Protocol for a systematic review and meta-analysis.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e097759. Date of
Publication: 07 May 2025.
Author
Rahmouni K.; Gauthier N.M.; Kang N.; Voisine P.; Edwards J.; Ramsay T.;
Chan V.
Institution
(Rahmouni, Voisine, Edwards, Chan) University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Rahmouni, Edwards, Ramsay) School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
(Gauthier, Kang, Voisine, Chan) Faculty of Medicine, University of Ottawa,
Ottawa, ON, Canada
(Ramsay) Ottawa Methods Center, Ottawa Hospital Research Institute,
Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Patients with ischaemic mitral regurgitation (MR) have
markedly increased cardiovascular mortality compared with those with
primary MR. The sex-based prognosis of patients with ischaemic MR
undergoing mitral surgery remains unclear. The goal of this systematic
review is to evaluate long-term mortality, reoperation, heart failure
rehospitalisation and MR recurrence in women who undergo mitral valve
surgery for chronic ischaemic MR, compared with men. Methods and analysis
The MEDLINE, EMBASE, Scopus and Cochrane Central Register of Controlled
Trials databases will be searched for studies reporting surgical outcomes
for ischaemic MR. Studies published before 10 June 2024 and those
stratifying outcomes by sex will be included. The primary outcome of this
systematic review is long-term (>=1 year) mortality following mitral
surgery. Secondary outcomes include operative mortality, mitral valve
reintervention, heart failure rehospitalisation and MR recurrence, as
assessed by echocardiography. Risk of bias will be ascertained with the
Newcastle-Ottawa scale. Heterogeneity will be assessed using Higgin's I 2
statistic. If the included studies demonstrate adequate homogeneity in
their design and comparator, meta-analyses with a random-effects model
will be conducted to combine estimates. Ethics and dissemination This
systematic review uses data from previously published studies and does not
involve interaction with human subjects or access to individual patient
data. Therefore, ethical approval is not required for this study. The
findings from this review will be disseminated through publication in a
peer-reviewed journal and various media, including but not limited to,
conferences, congresses and symposia. Trial registration number In
accordance with the guidelines, our systematic review protocol was
registered with the International Prospective Register of Systematic
Reviews on 5 July 2024 and was last updated on 4 April 2025 (Registration
number: CRD42024560892). Copyright © Author(s) (or their
employer(s)) 2025.

<11>
Accession Number
2032215853
Title
Analgesic benefits of regional anesthesia in the perioperative management
of transition-related surgery: a systematic review.
Source
Regional Anesthesia and Pain Medicine. 50(5) (pp 441-448), 2025. Date of
Publication: 01 May 2025.
Author
Katsnelson G.; Brenna C.T.A.; Giron-Arango L.; Abdallah Y.M.; Brull R.
Institution
(Katsnelson) University of Toronto, Temerty Faculty of Medicine, Toronto,
ON, Canada
(Brenna, Giron-Arango, Brull) Department of Anesthesiology & Pain
Medicine, University of Toronto, Temerty Faculty of Medicine, Toronto, ON,
Canada
(Brenna) Department of Physiology, University of Toronto, Toronto, ON,
Canada
(Giron-Arango) Department of Anesthesia and Pain Management, Toronto
Western Hospital, Toronto, ON, Canada
(Abdallah, Brull) Women's College Hospital Research Institute, Women's
College Hospital, Toronto, ON, Canada
(Brull) Department of Anesthesia, Women's College Hospital, Toronto, ON,
Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Transition-related surgery is an effective treatment for
gender dysphoria, but the perioperative analgesic management of
transgender patients is nuanced and potentially complicated by higher
rates of mood and substance use disorders. Regional anesthetic techniques
are known to reduce pain severity and opioid requirements; however, little
is known regarding the relative analgesic effectiveness of regional
anesthesia for transgender patients undergoing transition-related surgery.
Methods We performed a systematic review of the literature to evaluate
original reports characterizing the analgesic effectiveness of regional
anesthetic techniques for patients undergoing chest and/or genital
transition-related surgery. Our primary outcomes were pain severity and
opioid requirements on the first postoperative day. Results Of the 1863
records identified, 10 met criteria for inclusion and narrative synthesis.
These included two randomized controlled trials, three cohort studies, and
five case reports/series, comprising 293 patients. Four reports described
243 patients undergoing chest surgery, of whom 86% were transgender men
undergoing mastectomy with pectoralis nerve blocks or local anesthetic
instillation devices. The remaining six reports comprised 50 patients
undergoing genital surgery, of whom 56% were transgender women undergoing
vaginoplasty with erector spinae plane blocks or epidural anesthesia.
Three studies directly compared regional techniques to parenteral
analgesia alone. Two of these studies reported lower pain scores and
opioid requirements on the first postoperative day with nerve blocks
compared with none while the third study reported no difference between
groups. Complications related to regional anesthetic techniques were rare
among patients undergoing transition-related surgery. Discussion Despite
the ever-growing demand for transition-related surgery, the relative
analgesic effectiveness of regional anesthesia for transgender patients
undergoing transition-related surgery is very understudied and
insufficient to guide clinical practice. Our systematic review of the
literature serves to underscore regional anesthesia for transition-related
surgery as a priority area for future research. Copyright ©
American Society of Regional Anesthesia & Pain Medicine 2025. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<12>
Accession Number
2038627546
Title
Valve thrombosis and antithrombotic therapy after bioprosthetic mitral
valve replacement: a systematic review and meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 11(3) (pp
251-263), 2025. Date of Publication: 01 May 2025.
Author
Zorman M.J.; Vibhishanan J.; Dangas K.; Castle J.; Li K.H.C.; Coronelli
M.; Eastwick-Jones K.; Swan A.; Johnson N.; Choksey A.; Yan H.; Scott
S.G.C.; Henry M.; Cassar M.P.; Barnes C.; Ferreira-Martins J.; Newton J.;
Dawkins S.; Alkhouli M.; Rihal C.; Eleid M.F.; Pislaru S.V.; Guerrero
M.E.; Ordonez-Mena J.; Cahill T.J.
Institution
(Zorman, Vibhishanan, Dangas, Castle, Li, Coronelli, Eastwick-Jones, Swan,
Johnson, Choksey, Yan, Scott, Cassar, Barnes, Ferreira-Martins, Newton,
Dawkins, Cahill) Oxford Heart Centre, Oxford University Hospitals NHS
Trust, Headley Way, Oxford, United Kingdom
(Zorman, Alkhouli, Rihal, Eleid, Pislaru, Guerrero) Department of
Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN,
United States
(Henry) Health Care Libraries, University of Oxford, John Radcliffe
Hospital, Headley Way, Oxford, United Kingdom
(Ordonez-Mena) Nuffield Department of Primary Care Sciences, University of
Oxford, Radcliffe Observatory Quarter, Woodstock Road, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Transcatheter mitral valve replacement (TMVR) has become a feasible
alternative to surgical mitral valve replacement (SMVR) in selected
patients at high surgical risk. The risk of valve thrombosis following
SMVR and TMVR, and the optimal antithrombotic therapy following these
procedures, remains uncertain. We aimed to compare the incidence of
bioprosthetic mitral valve thrombosis (bMVT) after SMVR and TMVR, and the
incidence of bMVT between patients on different antithrombotic regimens.
 Methods and Results: A literature search of Medline, Embase, and
Cochrane Library was performed between January 2000 and August 2024.
Random-effects models were used to derive pooled estimates of the
incidence of bMVT in the absence of prior or active endocarditis and valve
thrombosis. A total of 47 studies (6170 patients, total follow-up 9541.8
patient-years) were eligible for inclusion. The overall incidence of bMVT
was 5.05 [95% confidence interval (CI) 3.18-8.01, I2 = 82%] per
100-patient-years. Subclinical bMVT was more common than clinically
significant bMVT: incidence 19.11 vs. 7.91 per 100-patient-years, adjusted
incidence rate ratio (aIRR) 4.62 (95% CI 1.39-15.36), P = 0.012. bMVT was
numerically more common after TMVR than SMVR, but the comparison was not
statistically significant: incidence 7.03 vs. 0.58 per 100-patient-years,
aIRR 2.19 (95% CI 0.72-6.72), P = 0.170. Patients on vitamin-K antagonists
(VKA) had a lower incidence of bMVT than patients on direct oral
anticoagulants (DOAC; incidence 5.72 vs. 17.08, aIRR 0.31, 95% CI
0.13-0.73, P = 0.007). Conclusion(s): bMVT is not uncommon, with
numerically higher incidence in transcatheter compared to surgical valves,
but the comparison was not statistically significant. VKAs are associated
with a lower incidence of bMVT compared to DOACs. Copyright ©
2025 The Author(s).

<13>
Accession Number
2033204239
Title
Socio-economic status and the effect of guideline-directed medical therapy
in the STRONG-HF study.
Source
ESC Heart Failure. 12(3) (pp 1594-1605), 2025. Date of Publication: 01 Jun
2025.
Author
Damasceno A.; Saidu H.; Cotter G.; Davison B.; Edwards C.; Celutkiene J.;
Adamo M.; Arrigo M.; Barros M.; Biegus J.; Cerlinskaite-Bajore K.;
Chioncel O.; Cohen-Solal A.; Deniau B.; Diaz R.; Filippatos G.; Gayat E.;
Kimmoun A.; Lam C.S.P.; Metra M.; Novosadova M.; Pagnesi M.; Pang P.S.;
Ponikowski P.; Ter Maaten J.M.; Tomasoni D.; Voors A.A.; Takagi K.;
Mebazaa A.; Sliwa K.
Institution
(Damasceno) Faculty of Medicine, Eduardo Mondlane University, Maputo,
Mozambique
(Saidu) Department of Medicine, Murtala Muhammed Specialist
Hospital/Bayero University Kano, Kano, Nigeria
(Cotter, Davison, Cohen-Solal, Deniau, Gayat, Mebazaa) Universite Paris
Cite, INSERM UMR-S 942 (MASCOT), Paris, France
(Cotter, Davison, Edwards, Barros, Novosadova, Takagi) Momentum Research
Inc, Durham, NC, United States
(Cotter, Davison) Heart Initiative, Durham, NC, United States
(Celutkiene, Cerlinskaite-Bajore) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania
(Adamo, Metra, Pagnesi, Tomasoni) Cardiology, Cardiology, ASST Spedali
Civili and Department of Medical and Surgical Specialties, Radiological
Sciences, and Public Health, University of Brescia, Brescia, Italy
(Arrigo) Department of Internal Medicine, Stadtspital Zurich, Zurich,
Switzerland
(Biegus, Ponikowski) Institute of Heart Diseases, Wroclaw Medical
University, Wroclaw, Poland
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof. C.C.
Iliescu", University of Medicine "Carol Davila", Bucharest, Romania
(Cohen-Solal) Department of Cardiology, APHP Nord, Lariboisiere University
Hospital, Paris, France
(Deniau, Gayat, Mebazaa) Department of Anesthesiology and Critical Care
and Burn Unit, Saint-Louis and Lariboisiere Hospitals, FHU PROMICE, DMU
Parabol, APHP. Nord, Paris, France
(Diaz) Estudios Clinicos Latinoamerica, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Filippatos) National and Kapodistrian University of Athens, School of
Medicine, Attikon University Hospital, Athens, Greece
(Kimmoun) Universite de Lorraine, Nancy; INSERM, Defaillance Circulatoire
Aigue et Chronique; Service de Medecine Intensive et Reanimation Brabois,
CHRU de Nancy, Vandoeuvre-les-Nancy, France
(Lam) National Heart Centre Singapore and Duke-National University of
Singapore, Singapore, Singapore
(Pang) Department of Emergency Medicine, Department of Medicine, Indiana
University School of Medicine, Indianapolis, IN, United States
(Ter Maaten, Voors) University of Groningen, Department of Cardiology,
University Medical Centre Groningen, Groningen, Netherlands
(Sliwa) Cape Heart Institute, Division of Cardiology, Department of
Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town,
South Africa
Publisher
John Wiley and Sons Inc
Abstract
Aims: Acute heart failure (AHF) impacts millions globally, with outcomes
varying based on socio-economic status (SES). Method(s): SES measured
by annual household income, years of education and medical insurance
coverage. Each patient's income and education level relative to the median
or mean, respectively, in the country was calculated, and categorized into
tertiles (0, 1 or 2 from lowest to highest). SES scores (0-5) were
computed as the sum of these levels plus insurance coverage (0 = no or 1 =
yes). Patients' baseline characteristics, outcomes (HF readmission, death
and their composite) and the effect of high-intensity care (HIC) vs. usual
care (UC) were examined by SES scores 0-2, 3 and 4-5. Result(s):
Lower SES patients, who were younger, predominantly female, Black and
non-European, had fewer comorbidities such as atrial fibrillation,
diabetes and ischaemic heart disease and exhibited milder HF, indicated by
a lower NYHA class, lower creatinine and higher cholesterol before
discharge. Despite having milder HF and less comorbidities, after
adjusting for baseline characteristics, patients with higher SES had
numerically better outcomes, though differences were not statistically
significant. 180-day hazard ratios (HRs) for HF readmission or death were
0.75 (95% CI 0.48-1.16) for SES scores of 3 and 0.85 (95% CI 0.58-1.23)
for scores of 4-5, compared to 0-2. Higher SES patients had numerically
better treatment effect from HIC, with HRs of 0.69 for SES 0-2, 0.72 for
SES 3 and 0.50 for SES 4-5. Conclusion(s): In this post hoc analysis
of the STRONG-HF study, lower SES was associated with milder acute HF but
similar 180-day outcomes. Higher SES patients benefitted more from
HIC. Copyright © 2024 The Author(s). ESC Heart Failure published
by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

<14>
Accession Number
2038684863
Title
Impact of Noninvasive Ventilation Before and After Cardiac Surgery for
Preventing Cardiac and Pulmonary Complications: A Clinical Randomized
Trial.
Source
Chest. 167(6) (pp 1727-1736), 2025. Date of Publication: 01 Jun 2025.
Author
Goret M.; Pluchon K.; Le Mao R.; Badra A.; Oilleau J.-F.; Morvan Y.;
Beaumont M.; Desanglois G.; Guegan M.; Barnier A.; Gut-Gobert C.; Tromeur
C.; Leroyer C.; Choplain J.-N.; Khalifa A.; Bezon E.; Couturaud F.
Institution
(Goret, Le Mao, Beaumont, Barnier, Gut-Gobert, Tromeur, Leroyer,
Couturaud) Institut National de la Sante et de la Recherche Medicale
U1304, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO),
Univ_Brest, Brest, France
(Badra, Bezon) Institut National de la Sante et de la Recherche Medicale
1078, Univ_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Department of Internal Medicine, Vascular
Medicine and Chest Diseases, CHU_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Institut National de la Sante et de la
Recherche Medicale CIC1412, CHU_Brest, Brest, France
(Pluchon, Badra, Oilleau, Morvan, Choplain, Khalifa, Bezon) Department of
Cardio-thoracic and Vascular Surgery, CHU_Brest, Brest, France
(Le Mao, Tromeur, Leroyer, Couturaud) F-CRIN INNOVTE, Saint-Etienne,
France
Publisher
Elsevier Inc.
Abstract
Background: The immediate postoperative period after heart surgery poses a
substantial risk of life-threatening complications, notably acute
pulmonary and cardiac failure. Use of noninvasive ventilation (NIV) may
reduce the incidence of pulmonary or heart failure, or both. Research
Question: Is the use of NIV before and after cardiac surgery associated
with a lower rate of acute pulmonary and heart failure in patients at risk
of postoperative complications? Study Design and Methods: We designed a
prospective, randomized, monocentric trial comparing preoperative and
postoperative NIV in cardiac surgery with standard care. Adult patients
classified as being at risk of postoperative cardiac or pulmonary failure
were allocated to receive NIV for 5 days before and 5 days after surgery
in addition to usual care vs usual care alone. The primary outcome was the
composite of predefined and adjudicated cardiorespiratory failure at 1
month after cardiac surgery. Result(s): Two hundred sixteen patients
were included. During the 1-month follow-up period after surgery, the
composite outcome occurred in 59 of 107 patients (55.1%) in the NIV group
and in 87 of 109 patients (79.8%) in the no NIV group (relative risk,
0.69; 95% CI, 0.57-0.84; P < .001). The benefit persisted at 3 months. No
difference between the 2 groups was found in terms of intubation need and
length of hospital stay in cardiac and pulmonary surgery ICUs and in
cardiac and pulmonary surgery units. Interpretation(s): Our results
indicate that the use of NIV before and after cardiac surgery reduces the
rate of cardiopulmonary failure after high-risk cardiac surgery. Clinical
Trial Registry: ClinicalTrials.gov; No.: NCT02302300; URL:
www.clinicaltrials.gov Copyright © 2025 American College of Chest
Physicians

<15>
Accession Number
2038009188
Title
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Journal of the American College of Cardiology. 85(22) (pp 2135-2237),
2025. Date of Publication: 10 Jun 2025.
Author
Rao S.V.; O'Donoghue M.L.; Ruel M.; Rab T.; Tamis-Holland J.E.; Alexander
J.H.; Baber U.; Baker H.; Cohen M.G.; Cruz-Ruiz M.; Davis L.L.; de Lemos
J.A.; DeWald T.A.; Elgendy I.Y.; Feldman D.N.; Goyal A.; Isiadinso I.;
Menon V.; Morrow D.A.; Mukherjee D.; Platz E.; Promes S.B.; Sandner S.;
Sandoval Y.; Schunder R.; Shah B.; Stopyra J.P.; Talbot A.W.; Taub P.R.;
Williams M.S.; Jneid H.; Beavers C.J.; Beckie T.; Blankenship J.; Diercks
D.; Lo B.; Louis C.; Merchant F.M.; Nazir N.T.; So D.; Tomey M.; Welt F.
Publisher
Elsevier Inc.
Abstract
Aim: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of
Patients With Acute Coronary Syndromes" incorporates new evidence since
the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial
Infarction" and the corresponding "2014 AHA/ACC Guideline for the
Management of Patients With Non-ST-Elevation Acute Coronary Syndromes" and
the "2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary
Intervention for Patients With ST-Elevation Myocardial Infarction." The
"2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes" and the "2021 ACC/AHA/SCAI Guideline for
Coronary Artery Revascularization" retire and replace, respectively, the
"2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease." Methods: A
comprehensive literature search was conducted from July 2023 to April
2024. Clinical studies, systematic reviews and meta-analyses, and other
evidence conducted on human participants were identified that were
published in English from MEDLINE (through PubMed), EMBASE, the Cochrane
Library, Agency for Healthcare Research and Quality, and other selected
databases relevant to this guideline. Structure: Many recommendations from
previously published guidelines have been updated with new evidence, and
new recommendations have been created when supported by published
data. Copyright © 2025 American College of Cardiology Foundation,
and the American Heart Association, Inc.

<16>
Accession Number
2034055569
Title
Intermediate-Type Atrioventricular Septal Defect Repair With
Atrioventricular Valve Annuloplasty via Minimally Invasive Approach.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 20(2) (pp 131-132), 2025. Date of Publication: 01 Mar 2025.
Author
Liao S.; Wu Z.; Zhang X.
Institution
(Liao, Zhang) Department of Cardiovascular Surgery, The First Affiliated
Hospital, Jinan University, Guangzhou, China
(Wu) Department of Cardiac Surgery, Guangdong General Hospital, Guangzhou,
China
Publisher
SAGE Publications Ltd

<17>
[Use Link to view the full text]
Accession Number
2037281110
Title
Effect of Different Doses of Dexmedetomidine on Atrial Fibrillation in
Adults After Cardiac Surgery.
Source
Journal of Cardiovascular Pharmacology. 85(5) (pp 350-357), 2025. Date of
Publication: 01 May 2025.
Author
Zhang X.; Liu J.; Shi Y.; Wang H.; Wang F.; Wang W.
Institution
(Zhang) Department of Healthcare, 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 Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Wang, Wang, Wang) Department of Anesthesiology, Jining No. 1 People's
Hospital, Shandong, Jining, China
Publisher
Lippincott Williams and Wilkins
Abstract
In this study, we compared the effects of various doses of dexmedetomidine
on the incidence of atrial fibrillation (AF) after cardiac surgery in
adults. A total of 224 adult patients who underwent elective cardiac
surgery were randomly assigned to two groups. The DEX0.5 group received a
continuous infusion of dexmedetomidine at a rate of 0.5
g.kg-1.h-1, while the DEX1 group received it at a
rate of 1 g.kg-1.h-1 during the induction of
anesthesia, which was maintained for 24 hours. The primary outcome was the
incidence of AF, while the secondary outcomes included other
tachyarrhythmias, bradycardia, hypotension, duration of mechanical
ventilation, time spent in the cardiac care unit, and length of
hospitalization. A total of 101 patients were included in the DEX0.5
group, while 104 patients were included in the DEX1 group. The incidence
of AF was significantly lower in the DEX1 group compared with the DEX0.5
group (10.6% vs. 21.8%, P = 0.029). In addition, the duration of
mechanical ventilation was shorter in the DEX1 group than in the DEX0.5
group (8.9 vs. 15.2 hours, P = 0.018). Logistic regression analyses were
conducted to investigate the factors influencing AF. The results indicated
that the dose of dexmedetomidine was the only independent predictor (odds
ratio = 0.394, 95% confidence interval 0.172 to 0.903, P = 0.028).
Compared with a continuous infusion of 0.5
g.kg-1.h-1, this study suggested that administering
dexmedetomidine at a dose of 1 g.kg-1.h-1 for 24
hours is effective in reducing the incidence of AF after cardiac
surgery. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<18>
Accession Number
2038766182
Title
Neutrophil-to-lymphocyte ratio as a potential biomarker in predicting
in-stent restenosis: A systematic review and meta-analysis.
Source
PLoS ONE. 20(5 May) (no pagination), 2025. Article Number: e0322461. Date
of Publication: 01 May 2025.
Author
Siahaan P.P.; Widiarti W.; Saputra P.B.T.; Putra R.M.; D'Oria M.
Institution
(Siahaan, Widiarti) Faculty of Medicine, Universitas Airlangga, East Java,
Surabaya, Indonesia
(Saputra, Putra) Department of Cardiology and Vascular Medicine, Faculty
of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia
(Saputra, Putra) Department of Cardiology and Vascular Medicine, Dr
Soetomo General Academic Hospital, East Java, Surabaya, Indonesia
(D'Oria) Division of Vascular and Endovascular Surgery, Department of
Clinical Surgical and Health Sciences, University of Trieste, Trieste,
Italy
Publisher
Public Library of Science
Abstract
Background In-stent restenosis (ISR) remains a significant challenge
despite advancements in percutaneous interventions, often leading to
adverse clinical outcomes. The neutrophil-to-lymphocyte ratio (NLR) has
emerged as a potential biomarker for predicting ISR, offering
opportunities for improved risk stratification and treatment
personalization. This systematic review and meta-analysis assess the
predictive value of NLR in ISR, providing insights into its clinical
applicability. Methods Systematic literature search was conducted in
scientific databases until 21st July 2024. Observational studies
evaluating NLR in stented patients were included. Random effect
meta-analysis and linear regression model were used to investigate odds
ratios (OR) as predictor and linear dose-response relationship of ISR.
Sensitivity and specificity of NLR to predict this outcome were pooled and
a summary receiver operating characteristics (sROC) curve was generated.
This study was already registered in the PROSPERO (ID: CRD42024555123).
Results 15 studies with 3 889 patients were included. High NLR was
associated with increased risk of ISR in coronary and non-coronary
stenting [aOR=1.61 (95%CI 1.14-2.25); aOR=1.69 (95%CI 1.52-1.87)]. One
unit increase of NLR is equal to 30% and 44% increased risk of ISR in
coronary and non-coronary patients. Included studies showing NLR as a
robust predictor of ISR with sensitivity and specificity of 70.5% (95%CI
60.1%-79.2%) and 74.1% (95%CI 56.7%-86.2%) for coronary stenting and 77.7%
(95%CI 69.8%-84.0%) and 66.4% (95%CI 49.6%-79.8%) non-coronary stenting,
with AUC of 0.77 (0.70-0.82) in the coronary and 0.79 (0.70-0.85) in the
non-coronary sub-groups. Conclusion In conclusion, NLR yields promising
predictive and prognostic potentials in predicting ISR in coronary and
non-coronary stents. Additionally, NLR appears to be more proficient in
predicting early ISR compared to late ISR in both coronary and
non-coronary stents. Copyright © 2025 Siahaan 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.

<19>
Accession Number
2038542926
Title
Perioperative dexmedetomidine for the prevention of postoperative delirium
after cardiac surgery: a systematic review, Bayesian meta-analysis, and
Bayesian re-analysis of the DECADE trial.
Source
British Journal of Anaesthesia. 134(6) (pp 1671-1682), 2025. Date of
Publication: 01 Jun 2025.
Author
Hunt T.; Payne T.; Brophy J.M.; Irons J.; Wang A.Y.; Cartwright C.; Moran
B.; Loadsman J.A.; Sanders R.D.
Institution
(Hunt, Payne, Loadsman, Sanders) Central Clinical School, Faculty of
Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
(Hunt, Payne, Irons, Wang, Cartwright, Loadsman, Sanders) Department of
Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District,
Camperdown, NSW, Australia
(Payne) Royal Melbourne Hospital, Melbourne Health, Parkville, VIC,
Australia
(Brophy) Department of Medicine, McGill University, Montreal, QC, Canada
(Brophy) Department of Epidemiology, McGill University, Montreal, QC,
Canada
(Brophy) Department of Biostatistics, McGill University, Montreal, QC,
Canada
(Moran) Department of Intensive Care, Gosford Hospital, Gosford, Australia
(Moran) Department of Anaesthesia and Pain Medicine, Gosford Hospital,
Gosford, Australia
(Moran) School of Medicine and Public Health, University of Newcastle,
Callaghan, NSW, Australia
(Sanders) Institute of Academic Surgery, Royal Prince Alfred Hospital,
Sydney Local Health District, NSW, Australia
(Sanders) NHMRC Clinical Trials Centre, The University of Sydney,
Camperdown, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Dexmedetomidine is seen as a promising agent for the
prevention of postoperative delirium after cardiac surgery, but the
largest study (DECADE) paradoxically suggested an increased risk of
delirium. Method(s): Studies were selected using inclusion/exclusion
criteria after conducting online database searches for randomised
controlled trials. The primary outcome was the incidence of postoperative
delirium with a minimum clinically important difference (MCID), defined as
an odds ratio >1.20 or <0.84. Publication bias was quantified using
Bayesian model averaging. A random-effects meta-analysis with weakly
informative priors was performed. Bayesian re-analysis of DECADE using
several different priors including a prior based on this meta-analysis
(excluding DECADE) was also performed. Result(s): We identified 12
eligible randomised controlled trials (3539 participants). The overall
pooled effect showed a mean benefit from dexmedetomidine in delirium
prevention (odds ratio 0.67 [95% credible interval 0.45, 0.92]), but any
definitive evidence of benefit disappeared after accounting for
publication bias (odds ratio 1.15 [95% credible interval 0.93, 2.51]).
Bayesian re-analysis of the DECADE trial under a vague prior showed a 1.5%
posterior probability of any benefit and only a 0.1% probability of an
MCID for benefit. Combining DECADE with the unadjusted
meta-analysis-derived prior increased the probability of an MCID for
benefit to 17.8%, which decreased to 0.2% using the meta-analysis-derived
prior adjusted for publication bias. Conclusion(s): Pooled evidence
suggests dexmedetomidine is associated with reduced incidence of
postoperative delirium; however, this is highly sensitive to the
possibility of publication bias. Bayesian re-analysis of the recently
published DECADE trial showed the effect of dexmedetomidine differs
markedly depending on the weight given to previous studies. Hence, any
true benefit from the use of dexmedetomidine over standard care in this
population cannot be definitively characterised at present. Systematic
review protocol: CRD42023401623 (PROSPERO). Copyright © 2025
British Journal of Anaesthesia

<20>
Accession Number
2038614376
Title
Bivalirudin infusion at standard or low regimen during elective
percutaneous coronary intervention in high-risk bleeding patients with
acute coronary syndrome: Study protocol for a prospective, single-center,
randomized controlled trial.
Source
Contemporary Clinical Trials. 154 (no pagination), 2025. Article Number:
107941. Date of Publication: 01 Jul 2025.
Author
Li Y.; Qi J.; Gong Y.; Zhou T.; Zhang L.; Li J.; Wang X.
Institution
(Li, Qi, Gong, Zhou, Zhang, Li, Wang) National Key Laboratory of Frigid
Zone Cardiovascular Disease, Cardiovascular Research Institute and
Department of Cardiology, General Hospital of Northern Theater Command,
No. 83 Wenhua Rd, Liaoning, Shenyang, China
(Li, Gong) College of Life Science and Biopharmaceutical, Shenyang
Pharmaceutical University, Liaoning, Shenyang, China
Publisher
Elsevier Inc.
Abstract
Background: Bleeding complications associated with anticoagulant therapy
should receive more attention in patients with acute coronary syndrome
(ACS) after percutaneous coronary intervention (PCI), especially in those
considered at high-risk bleeding. The recommended dosage of bivalirudin in
clinical guidelines may not be appropriate for East Asian populations. We
are performing a trial to investigate the efficacy and safety of a low
bivalirudin regimen without prolonging infusion in high-risk bleeding
patients with ACS undergoing elective PCI. Method(s): The study is a
prospective, open-label, randomized controlled, non-inferiority trial. A
total of 2510 patients will be enrolled and randomly (1,1) allocated to
either receive the low (80 % of the standard dose) or standard bivalirudin
regimen without prolonging the infusion after PCI. The primary endpoint is
net adverse clinical events (NACE) at 30 days, which is a composite of
major adverse cardiovascular and cerebrovascular events (MACCE, including
all-cause death, repeat revascularization, stroke, nonfatal myocardial
infarction, and stent thrombosis) and any bleeding events defined by the
Bleeding Academic Research Consortium (BARC). Conclusion(s): This
proposed study is the first randomized controlled trial to evaluate the
efficacy and safety of a low versus standard bivalirudin regimen during
elective PCI in high-risk bleeding patients with ACS. The results may help
achieve dose optimization for the use of perioperative bivalirudin in
high-risk bleeding ACS patients undergoing elective PCI. Trial
registration: Chinese Clinical Trial Registry ChiCTR2200064363. Registered
on October 4, 2022. Copyright © 2025 The Authors

<21>
Accession Number
2038636220
Title
SAVR and TAVI comparison across the globe based on current regional
registry evidence - A meta-analysis of reconstructed time-to-event data.
Source
IJC Heart and Vasculature. 59 (no pagination), 2025. Article Number:
101703. Date of Publication: 01 Aug 2025.
Author
Caldonazo T.; Kirov H.; Vogel A.; Runkel A.; Mukharyamov M.; Fischer J.;
Dadashzadeh A.; Doenst T.
Institution
(Caldonazo, Kirov, Vogel, Runkel, Mukharyamov, Fischer, Dadashzadeh,
Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: There is debate whether surgical aortic valve replacement
(SAVR) or transcatheter implantation (TAVI) provide better results for
treatment of aortic valve stenosis. While randomized clinical trials
(RCTs) are considered to compare the average treatment effect of two
methods in a selected patient population, registry data, although biased,
reflect every day clinical practice and provide external validation of
RCTs. We evaluated the impact of SAVR or TAVI on long-term survival based
on local reports from all available regions in the world. Method(s):
We systematically searched three databases selecting risk-adjusted
registry studies comparing outcomes for SAVR and TAVI with at least five
years of follow-up. Reports without all-cause mortality were excluded. One
time-to-event curve was reconstructed from survival curves. Cox regression
model and sensitivity analysis were performed. Result(s): From 10,399
screened studies, 13 met the inclusion criteria with 28,344 patients in
the final analysis (follow-up: 5-9 years). In ten studies, survival rates
favored SAVR, three showed no difference and none favored TAVI. Hazard
ratio (HR) for overall survival was 0.58 (95 %CI: 0.54-0.61, p < 0.01 -
favors SAVR). A landmark analysis with a 6-months split showed no
significant survival difference in the first 6 months (HR: 0.94, 95 %CI:
0.86-1.02, p = 0.14) and better survival for SAVR compared to TAVI
thereafter (HR: 0.43, 95 %CI: 0.40-0.46, p < 0.01). All sensitivity
analyses supported this outcome. Conclusion(s): This systematic
regional registry-type comparison revealed that SAVR is associated with
increased long-term survival compared to TAVI, which appears to be
independent of the world region in which the study was
performed. Copyright © 2025 The Author(s)

<22>
Accession Number
2038782723
Title
Intravenous acetaminophen for postoperative delirium in older patients
recovering from major non-cardiac surgery: A randomised-controlled study
protocol.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e097079. Date of
Publication: 15 May 2025.
Author
Zheng M.; Wang B.; Mao M.; Wu Y.; Wang Z.; Yang L.
Institution
(Zheng, Wang, Mao, Wu, Wang, Yang) Department of Anesthesiology, Shanghai
Jiao Tong University, School of Medicine, Affiliated Renji Hospital,
Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a common complication in elderly patients after
major surgeries and can lead to poor outcomes such as neurocognitive
decline. Acetaminophen is one of the most widely used adjuvants for
perioperative multimodal analgesia. Previous studies showed that it can
effectively alleviate postoperative pain, promote opioid sparing and exert
anti-neuroinflammatory response, showing strong potential for preventing
postoperative delirium. We, thus, propose to test the primary hypothesis
that postoperative intravenous acetaminophen would reduce delirium over 5
postoperative days in older patients following major non-cardiac surgery.
Methods and analysis We propose a multicentre, randomised,
placebo-controlled, parallel-group trial in patients aged>65 years old
scheduled for non-cardiac major surgery with general anaesthesia expected
to last at least 2 hours. A total of 1930 elderly patients will be
enrolled and randomised at 1:1 ratio to acetaminophen or saline placebo
groups, stratified by age, education level and trial site with randomsised
blocking. Acetaminophen or saline will be given when the surgical suture
begins at the end of surgery and, thereafter, a total of seven doses
within 48 hours after surgery. Our primary outcome will be the incidence
of delirium, assessed two times per day, through the fifth postoperative
day. Secondary and exploratory outcomes will include pain scores with
movement, total opioid consumption, severity of delirium, intensive care
unit and hospital lengths of stay. Ethics and dissemination This study has
been approved by the Ethics Committee of Ren Ji Hospital, Shanghai Jiao
Tong University School of Medicine (LY2023-239-C) and approved by each
participating centre. This report follows the Consolidated Standards of
Reporting Trials reporting guideline for randomised studies. The findings
will be shared in academic meetings and peer-reviewed academic journals.
Trial registration number NCT06653465. Copyright © 2025 BMJ
Publishing Group. All rights reserved.

<23>
Accession Number
2038643366
Title
Morphologic changes of the no-touch saphenous vein as Y-composite versus
aortocoronary grafts (CONFIG Trial).
Source
PLoS ONE. 20(5 MAY) (no pagination), 2025. Article Number: e0322176. Date
of Publication: 01 May 2025.
Author
Sohn S.H.; Kang Y.; Kim J.S.; Kang J.; Hwang H.Y.
Institution
(Sohn, Kang, Kim, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Kang) Department of Internal Medicine and Cardiovascular Center, Seoul
National University Hospital, Seoul National University College of
Medicine, Seoul, South Korea
Publisher
Public Library of Science
Abstract
Objective This randomized controlled trial was aimed to compare 1-year
morphologic changes of the no-touch saphenous vein graft as Y-composite
(Composite group) versus aortocoronary (Aorta group) configurations in
coronary artery bypass grafting. Methods The primary endpoint was
intima-media thickness of the saphenous vein graft as measured by
intravascular ultrasound (IVUS) at the 1-year angiographic evaluation.
Recruitment of 25 patients in each group was necessary based on a
superiority design. Among the 50 patients, IVUS data were obtained in 22
and 24 patients from the Composite and Aorta groups, respectively. Results
Mean age was 64.8 +/- 9.2 years, and the proportion of females was 20.0%.
The numbers of distal anastomoses per saphenous vein graft were 2.7 +/-
1.1 and 2.6 +/- 0.8 in the Composite and Aorta groups, respectively. The
intima-media thickness of the saphenous vein graft 1 year after surgery
were 0.25 +/- 0.04 mm and 0.24 +/- 0.06 mm in the Composite and Aorta
groups, respectively (P for superiority = .99). Other IVUS parameters of
saphenous vein grafts, including vessel diameter, luminal diameter, and
the ratio of intima-media thickness to vessel diameter, also demonstrated
no differences between the groups. No neointimal hyperplasia or plaque
formation was detected using IVUS. All study patients underwent 1-year
angiographic evaluation, and the patency rates were 94.7%(89 out of 94
anastomoses) and 100.0%(90 out of 90 anastomoses) in the Composite and
Aorta groups, respectively. Conclusions The intima-media thickness of the
saphenous vein graft 1 year after surgery demonstrated no significant
difference between the Y-composite and aortocoronary configurations
(NCT04782492). Copyright © 2025 Sohn et al.

<24>
Accession Number
2038825700
Title
Negative extra-abdominal pressure (NEXAP)-based lung recruitment maneuver
versus standard lung recruitment maneuver in the treatment of
postoperative atelectasis after cardiac surgery: A single-center
randomized controlled trial.
Source
Journal of Critical Care. 89 (no pagination), 2025. Article Number:
155124. Date of Publication: 01 Oct 2025.
Author
Xiong S.; Xiao J.; Hong L.; Shen X.; Tao H.; Jin R.; Xu Q.; Su L.; Zhang
C.
Institution
(Xiong, Xiao, Hong, Shen, Jin, Xu, Zhang) Department of Critical Care
Medicine, Nanjing First Hospital, Nanjing Medical University, No. 68
Changle Road, Nanjing, China
(Tao) Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing,
China
(Su) McGill University, 845 Sherbrooke St W, Montreal, Quebec, Canada
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the effect of negative extra-abdominal pressure
(NEXAP)-based lung recruitment maneuver (LRM) for atelectasis after
cardiac surgery, and compare it with stepwise positive end-expiratory
pressure (PEEP)-based LRM. Method(s): In this single-center
randomized controlled clinical trial, patients were assigned to the NEXAP
or PEEP groups. The primary outcome was the lung ultrasound score (LUSS)
on global (LUSStot) and regional (LUSSp, posterior, LUSSa, anterior and
LUSSl, lateral regions). Result(s): 29 patients in the NEXAP group
and 33 patients in the PEEP group were analyzed. The LUSStot was
significantly decreased after LRM in both the NEXAP group (20.7 +/- 3.2
vs. 15.6 +/- 3.3; p < 0.001) and PEEP group (21.5 +/- 4.2 vs. 17.1 +/-
4.6; p < 0.001), and DELTALUSStot was significantly greater in the NEXAP
group than PEEP group (-5.1 +/- 2.3 vs. -3.8 +/- 2.2, p = 0.020). Regional
LUSS showed that NEXAP reduced LUSSl and LUSSp.
PaO<inf>2</inf>/FiO<inf>2</inf>, PaO<inf>2</inf>, Vt, and Crs were
significantly improved in the two groups. Conclusion(s): NEXAP is an
effective treatment for atelectasis after cardiac surgery, which
significantly reduced patients' LUSS, improved pulmonary ventilation
(especially in the lateral and posterior regions). NEXAP can further
reduce LUSStot than the traditional PEEP-based LRM. Regional LUSS analyses
reflecting the different mechanisms between the two methods of LRMs may
require further investigation. Copyright © 2025 The Authors

<25>
Accession Number
2034589507
Title
Sugammadex or neostigmine for reversal of neuromuscular block on the
quality of postoperative recovery in elderly adults undergoing
video-assisted thoracoscopic lobectomy: a randomised controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 250. Date
of Publication: 01 Dec 2025.
Author
Yang Y.; Wang Z.; He X.; Shen X.; Jia W.; Sheng X.; Yao X.; Jiao H.
Institution
(Yang, Wang, He, Shen, Jia, Sheng, Yao, Jiao) School of Anesthesiology,
Xuzhou Medical University, 209 Tongshan Road, Jiangsu, Xuzhou, China
(Jiao) Department of Anesthesiology, The Affiliated Hospital of Xuzhou
Medical University, No.99 Huaihai West Road, Jiangsu, Xuzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Although neostigmine has been traditionally used for
neuromuscular blockade reversal in thoracic surgery, incomplete reversal
and potential pulmonary complications remain concerns. However, we did not
preclude its clinical use. In contrast, sugammadex offers more predictable
recovery of neuromuscular function with a superior safety profile. This
study aims to compare the efficacy of sugammadex versus neostigmine in
improving postoperative recovery outcomes. Method(s): This study is a
prospective, randomized, double-blind trial. Patients above 65 years old
undergoing video-assisted thoracoscopic lobectomy were randomly assigned
to receive either sugammadex (2 mg/kg) or neostigmine (0.04 mg/kg) with
atropine for neuromuscular block reversal after T2 appearance on TOF. The
primary outcome was the quality of recovery at postoperative day (POD) 1,
assessed by the QoR-15 questionnaire. Secondary outcomes included
extubation time, PACU stay, incidence of hypoxaemia, PRNB, and
postoperative pulmonary complications (PPCs). Result(s): Data
analysis included 77 patients (39 in Group S and 38 in Group N). The
QoR-15 scores were significantly higher in the sugammadex group at day 1
(125 vs. 122, P < 0.001). Sugammadex significantly reduced extubation time
(18 vs. 27.5 min, P = 0.001) and PACU stay (52 vs. 62 min, P = 0.001).
Hypoxaemia (28% vs. 53%, P = 0.029) and PRNB (5% vs. 24%, P = 0.020) were
less frequent in the sugammadex group. The sugammadex group had fewer
PPCs, the difference was not statistically significant (26% vs. 45%, P =
0.079). Conclusion(s): For elderly patients receiving VATS lobectomy,
sugammadex is beneficial for acute recovery except PONV up to POD1
recovery quality mainly in ease of breath, eating, resting but not in
postoperative outcomes over one month. Trial registration: Retrospectively
registered, Chinese Clinical Trial Registry,
ChiCTR2400089863(Date:18/09/2024). Copyright © The Author(s)
2025.

<26>
Accession Number
2034589511
Title
Individualized mean arterial pressure targets in critically ill patients
guided by non-invasive cerebral-autoregulation: a scoping review.
Source
Critical Care. 29(1) (no pagination), 2025. Article Number: 196. Date of
Publication: 01 Dec 2025.
Author
Xie J.; Carbonara A.R.; Al-Battashi A.-W.; Ross-White A.; Boyd J.G.
Institution
(Xie, Carbonara, Al-Battashi, Boyd) Department of Critical Care Medicine,
Queen's University, Kingston, ON, Canada
(Ross-White) Queen's University Library, Queen's University, Kingston, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
Background: Current guidelines recommend a uniform mean arterial pressure
(MAP) target for resuscitating critically ill patients; for example, 65
mmHg for patients with sepsis and post-cardiac arrest. However, since
cerebral autoregulation capacity likely varies widely in patients, uniform
target may be insufficient in maintaining cerebral perfusion. Personalized
MAP targets, based on a non-invasive determination of cerebral
autoregulation, may optimize perfusion and reduce complications.
 Objective(s): This scoping review summarizes the numerical values,
feasibility, and clinical data on personalized MAP targets in critically
ill patients. The focus is on non-invasive monitoring, such as
near-infrared spectroscopy and transcranial doppler ultrasound, due to
their safety, practicality and applicability to patients with- and without
brain injury. Method(s): Following PRISMA-ScR guidelines, a
systematic search of Ovid MedLine, Embase (Ovid), and the Cochrane Library
(Wiley) was conducted on September 28, 2023. Two independent reviewers
screened titles, abstracts, and full texts for eligibility and manually
reviewed references. Result(s): Of 7,738 studies were identified, 49
met the inclusion criteria. Of these, 45 (92%) were observational and 4
(8%) were interventional. Patient populations included cardiac surgery
(26, 53%), non-cardiac major surgery (4, 8%), cardiac arrest (8, 16%),
brain injury (7, 14%), respiratory failure and shock (3, 6%), and sepsis
(3, 6%). Optimal MAP was reported in 24 (49%), lower limit of
autoregulation in 23 (47%), and upper limit of autoregulation in 10
studies (20%). Thirty-four studies reported partial data loss due to
software failures, anomalous data, insufficient natural MAP fluctuation,
and workflow barriers. Available randomized controlled trials (RCT)
identified challenges with maintaining patients within their target range.
Studies explored the associations between personalized MAP targets and a
wide range of neurological and non-neurological outcomes, with the most
significant and consistent associations identified for acute kidney injury
and major morbidity and mortality. Ten studies investigated demographic
predictors identifying only few predictors of personalized targets.
 Conclusion(s): Preliminary investigations suggest considerable
variability in personalized MAP targets, which may explain differences in
clinical outcomes among critically ill populations. Key gaps remain,
including a lack of observational studies in critically ill subpopulations
other than cardiac surgery and well-designed RCTs. Resolving identified
feasibility barriers might be crucial to successfully carrying out future
studies. Copyright © The Author(s) 2025.

<27>
Accession Number
2034605509
Title
Continuation Versus Interruption of Oral Anticoagulation During TAVI: A
Systematic Review and Meta-Analysis Oral Anticoagulation Management in
TAVI.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Borges Martins J.M.; dos Santos Borges R.; Gosch Berton G.; Ferreira
Vieira P.L.; Machado Gomes de Sousa P.A.; Chaves Vieira A.L.; Ken Fukunaga
C.; Karlinski Vizentin V.; Rodrigues Macedo E.M.; Guida C.M.
Institution
(Borges Martins, Ferreira Vieira, Chaves Vieira, Rodrigues Macedo)
Department of Medicine, Federal University of Para, Belem, Brazil
(dos Santos Borges) Department of Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil
(Gosch Berton) School of Medicine, University of Passo Fundo, Passo Fundo,
Brazil
(Gosch Berton) Department of Neurology, Mater Misericordiae University
Hospital - University College Dublin, Dublin, Ireland
(Machado Gomes de Sousa) Department of Medicine, Federal University of
Uberlandia, Uberlandia, Brazil
(Ken Fukunaga, Guida) Department of Medicine, FMABC University Centre,
Santo Andre, Brazil
(Karlinski Vizentin) Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, MN, United States
(Guida) Department of Cardiology, Dante Pazzanese Institute of Cardiology,
Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Patients undergoing transcatheter aortic valve implantation (TAVI) often
require long-term oral anticoagulation (OAC), but it is unclear whether to
continue or interrupt OAC during the procedure. This meta-analysis
compares clinical outcomes of continuing versus interrupting OAC during
TAVI. PubMed, Embase, and Cochrane Central databases were searched from
inception to September 2024 for studies comparing continuation versus
interruption of OAC in patients undergoing TAVI with an indication for
OAC, including vitamin K antagonists and direct oral anticoagulants. Risk
ratios (RR) with 95% confidence intervals (CI) were pooled using a
random-effects model. Sensitivity analysis was performed using the
Hartung-Knapp-Sidik-Jonkman method. Three studies were included, one
randomized controlled trial and two cohort studies, with 2773 patients, of
whom 1314 (47.4%) continued OAC during TAVI. At a 30-day follow-up after
TAVI, there were no significant differences between groups in all-cause
mortality (RR 0.74; 95% CI 0.45-1.20; p = 0.22), any bleeding (RR 1.08;
95% CI 0.81-1.43; p = 0.60), and major bleeding (RR 0.90; 95% CI
0.67-1.21; p = 0.48). However, the continued OAC group was associated with
a lower stroke rate (RR 0.65; 95% CI 0.42-1.01; p = 0.053), also attested
after a sensitivity analysis (RR 0.65; 95% CI 0.47-0.90; p < 0.03). In
patients with an indication for OAC undergoing TAVI, uninterrupted
anticoagulation is associated with similar thrombotic and hemorrhagic
outcomes compared to interrupted OAC. Stroke risk was lower in the
continued OAC group, with a significant reduction, as demonstrated in
sensitivity analysis. Copyright © 2025 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<28>
Accession Number
2038735349
Title
L-carnitine supplementation to prevent postoperative complications after
cardiac surgery: A systematic review and meta-analysis of randomised
clinical trials.
Source
Indian Journal of Anaesthesia. 69(6) (pp 547-560), 2025. Date of
Publication: 01 Jun 2025.
Author
Shalabi L.; Ibrahim A.; Elsawy M.A.; Zreigh S.; Dervis M.; Elshabrawi
M.N.; Mourad S.; Arafa M.A.; Abuelazm M.
Institution
(Shalabi) Department of Internal Medicine, Faculty of Medicine, Gharyan
University, Gharyan, Libyan Arab Jamahiriya
(Ibrahim, Mourad) Department of Internal Medicine, Faculty of Medicine,
Alexandria University, Alexandria, Egypt
(Elsawy, Arafa) Department of Internal Medicine, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Zreigh, Dervis) Department of Internal Medicine, Faculty of Medicine,
Ankara Yildirim Beyazit University, Ankara, Turkey
(Elshabrawi) Deparment of Internal Medicine, Faculty of Medicine, Port
Said University, Port Said, Egypt
(Abuelazm) Department of Internal Medicine, Faculty of Medicine, Tanta
University, Tanta, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Cardiac surgeries often lead to postoperative
complications, which affect recovery and increase morbidity and mortality.
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 until March 2025. 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. Result(s): Thirteen randomised controlled trials(RCTs)
with 786 patients were included. L-carnitine significantly increased the
cardiac index (CI) (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). In addition, L-carnitine significantly improved the left
ventricular ejection fraction (LVEF) (MD: 7.88; 95% CI: 6.67, 9.09; P <
0.01), with a significant reduction in postoperative atrial fibrillation
(POAF) (RR: 0.53; 95% CI: 0.30, 0.95; P = 0.03). In contrast, there was no
significant reduction in in-hospital mortality (RR: 0.51; 95% CI: 0.10,
2.63; P = 1.00) and stroke incidence (RR: 0.85; 95% CI: 0.12, 5.76; P =
0.82). Conclusion(s): Preoperative administration of L-carnitine
demonstrates meaningful short-term benefits in enhancing CI, LVSWI, and
LVEF while reducing the incidence of POAF following cardiac surgery. These
findings suggest a potential role for L-carnitine supplementation in
optimising perioperative cardiac care, enhancing recovery, and reducing
complications following cardiac surgery. However, the existing studies are
limited in scope, making it challenging to draw robust
conclusions. Copyright © 2025 Indian Journal of Anaesthesia.

<29>
Accession Number
2038631320
Title
Evaluation of the efficacy of angiotensin receptor-neprilysin inhibitor in
patients with aortic stenosis undergoing transcatheter aortic valve
implantation: Protocol for a randomised, open-label, controlled study.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e095105. Date of
Publication: 28 Apr 2025.
Author
Kitahara H.; Okita S.; Sugawara T.; Yaginuma H.; Goto H.; Yamamoto H.;
Kanda T.; Matsuura K.; Inaba Y.; Hanaoka H.; Matsumiya G.; Kobayashi Y.
Institution
(Kitahara, Okita, Yaginuma, Goto, Kobayashi) Department of Cardiovascular
Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
(Sugawara) Ophthalmology, Chiba University Hospital, Chiba, Japan
(Yamamoto, Kanda, Matsuura, Matsumiya) Department of Cardiovascular
Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
(Inaba, Hanaoka) Clinical Research Center, Chiba University Hospital,
Chiba, Japan
Publisher
BMJ Publishing Group
Abstract
Introduction There are a substantial number of patients developing heart
failure after transcatheter aortic valve implantation (TAVI) for severe
aortic stenosis (AS), even though AS has been successfully treated. The
purpose of this randomised controlled trial was to determine whether the
addition of an angiotensin receptor-neprilysin inhibitor (ARNI),
sacubitril/valsartan, is superior to conventional medications in lowering
N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients
undergoing TAVI for AS. Methods and analysis The study design is a
prospective, single-centre, open-label, randomised, parallel-group,
two-arm study, in which participants will be randomised in a 1:1 ratio to
receive either conventional medications plus ARNI or conventional
medications only. In the ARNI group, if a patient was on an ACE inhibitor
or angiotensin II receptor blocker before TAVI, it will be switched to
ARNI 100 mg/day (50 mg two times per day) on the first postoperative day.
If not, candesartan 4 mg/day will be started 1-2 days before TAVI, and
switched to ARNI 100 mg/day on the first postoperative day. As the patient
has tolerability to ARNI, dosage will be increased stepwise to 400 mg/day
2-4 weeks apart. ARNI will be continued until at least 6-month follow-up.
In the control group, the patient will receive conventional medications.
The primary endpoint is the serum NT-proBNP value at 6-month follow-up
after TAVI. Each group includes 42 patients (84 total patients). Ethics
and dissemination Ethical approval for this study has been obtained from
the Chiba University Hospital Certified Clinical Research Review Board
(CRB3180015). The study is ongoing. Findings from this study will be
disseminated through peer-reviewed publications and conference
presentations. Trial registration number This trial has been registered on
the Japan Registry of Clinical Trials: jRCT1031220344. Copyright
© 2025 BMJ Publishing Group. All rights reserved.

<30>
Accession Number
2034472670
Title
Noteworthy Literature in 2024 Editorial Charting Progress: A Year of
Advances in Cardiac Surgery, Transplantation, and Anesthetic Management.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(2) (pp 97-102),
2025. Date of Publication: 01 Jun 2025.
Author
Littlejohn J.; Kertai M.D.; Abrams B.; Weitzel N.
Institution
(Littlejohn, Weitzel) Department of Anesthesiology and Pain Medicine,
University of California Davis Health, Sacramento, CA, United States
(Kertai) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
(Abrams) Department of Anesthesiology, University of Colorado, Aurora, CO,
United States
Publisher
SAGE Publications Inc.

<31>
Accession Number
2038627176
Title
Bilateral sceletonized internal mammary arteries for myocardial
revascularization in elderly patients.
Source
Journal of Geriatric Cardiology. 22(4) (pp 415-422), 2025. Date of
Publication: 2025.
Author
Jonjev Z.S.; Bjeljac I.; Milosavljevic A.M.; Todic M.; Mrvic S.; Kalinic
N.
Institution
(Jonjev, Bjeljac, Milosavljevic, Todic, Mrvic) Institute for
Cardiovascular Diseases of Vojvodina, Clinic of Cardiovascular Surgery,
Sremska Kamenica, Serbia
(Jonjev, Kalinic) University of Banja Luka, Faculty of Medicine, Republic
of Srpska, Banja Luka, Bosnia and Herzegovina
Publisher
Science Press
Abstract
BACKGROUND Bilateral internal mammary arteries (BIMAs) as the most
advanced surgical option for coronary artery bypass grafting (CABG) are
usually recommended for younger patients without traditional risk factors.
This study compares outcomes in propensity score-matched patients aged
over 70 years who received BIMAs versus those who received a single
internal mammary artery (SIMA). METHODS From 2013 to 2024, 8123 patients
underwent primary CABG for multivessel coronary artery disease at our
institution. BIMA grafting was performed in 1233 patients (15.17%), with
in situ BIMA grafting in 290 patients (3.57%). For in situ BIMA group, the
right internal mammary artery was used to revascularize the right coronary
artery, while the left internal mammary artery was utilized for the left
anterior descending artery. BIMA patients aged over 70 years (n = 79) were
compared with SIMA patients (n = 79) using propensity score matching.
Primary outcome was all-cause mortality at 30 days and 8 years. Secondary
outcomes included length of hospital stay, incidence of postoperative
major adverse cardiovascular and cerebrovascular events, sternal wound
infection and the need for subsequent percutaneous revascularization.
RESULTS There was no difference in immediate postoperative primary and
secondary outcomes. Mean follow-up was 8.3 +/- 1.0 years with an 8-year
freedom from death of 67.08% +/- 1.1% in the BIMA group versus 58.22% +/-
0.9% in the SIMA group (P < 0.05). CONCLUSIONS BIMAs as in situ grafts can
be successfully used in CABG for patients aged 70 years and older.
Consequently, the refined techniques for constructing internal mammary
artery grafts used in this study challenge traditionally accepted
limitations regarding the use of BIMAs. Copyright © 2025 JGC All
rights reserved.

<32>
Accession Number
2033462880
Title
Ticagrelor Monotherapy Following Short-Term DAPT in ACS Undergoing PCI: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(6) (pp 1381-1390),
2025. Date of Publication: 01 May 2025.
Author
Guzman R.B.; Roberson M.V.; Teixeira L.; Navalha D.D.P.; Talavera A.;
Ahmad M.; Chatzizisis Y.; Spilias N.
Institution
(Guzman, Roberson, Ahmad) Advocate Illinois Masonic Medical Center,
Chicago, United States
(Teixeira) Federal University of Campina Grande, Campina Grande, Brazil
(Navalha) University of Nebraska Medical Center, Omaha, United States
(Talavera) Mount Sinai Medical Center, Miami Beach, United States
(Chatzizisis, Spilias) University of Miami, Division of Cardiovascular
Medicine, Miami, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Dual antiplatelet therapy (DAPT) for 1 year after acute
coronary syndrome (ACS) in patients undergoing percutaneous coronary
intervention (PCI) with drug-eluting stents (DES) is the standard of care.
However, it is associated with a higher incidence of bleeding events. We
conducted a systematic review and meta-analysis of randomized controlled
trials (RCTs) to assess the safety and efficacy of short-term DAPT.
 Aim(s): This study aimed to assess the relative risk of major and
minor bleeding, net adverse clinical and cerebral events (NACCE), and
all-cause mortality in patients with ACS undergoing PCI with DES,
comparing ticagrelor-based short-term DAPT (<= 3 months) followed by
ticagrelor monotherapy for up to 12 months versus 12-month DAPT. The
secondary endpoint evaluated the relative risk of complications, including
myocardial infarction, stroke, stent thrombosis, repeat revascularization,
and cardiovascular mortality. Method(s): A systematic search of
PubMed, Scopus, and Cochrane Central was conducted for eligible RCTs. A
subgroup analysis of ultrashort-term DAPT (<= 1 month) followed by
ticagrelor monotherapy for up to 12 months was also performed. Risk ratios
(RRs) with 95% confidence intervals (CIs) were calculated using a
random-effects model. Result(s): Five RCTs were included with a total
of 21,407 patients. Short-term DAPT was associated with a significant
reduction in major bleeding (RR 0.50; 95% CI 0.38-0.66; p < 0.01), minor
bleeding (RR 0.53; 95% CI 0.35-0.80; p < 0.01), NACCE (RR 0.71; 95% CI
0.59-0.85; p < 0.01), and all-cause mortality (RR 0.78; 95% CI 0.62-0.98;
p =0.04). Conclusion(s): Short-term DAPT followed by ticagrelor
monotherapy up to 12 months was associated with a significant reduction in
major and minor bleeding, NACCE, and all-cause mortality compared to
12-month DAPT. There were no significant differences in myocardial
infarction, stroke, stent thrombosis, repeat revascularization, or
cardiovascular mortality. Major bleeding and NACCE remained consistently
reduced in the subgroup analysis. Copyright © 2025 Wiley
Periodicals LLC.

<33>
Accession Number
2034530305
Title
An individualised mobile app was beneficial for the mothers of infants
with severe congenital heart defects.
Source
Acta Paediatrica, International Journal of Paediatrics. 114(6) (pp
1238-1248), 2025. Date of Publication: 01 Jun 2025.
Author
Hjorth-Johansen E.; Borosund E.; Moen A.; Osten I.M.; Wik G.; Solevag
A.L.; Eger S.H.W.; Holmstrom H.
Institution
(Hjorth-Johansen, Osten, Solevag, Eger) Department of Neonatal Intensive
Care, Oslo University Hospital, Oslo, Norway
(Hjorth-Johansen, Holmstrom) Institute of Clinical Medicine, University of
Oslo, Oslo, Norway
(Borosund) Department of Digital Health Research, Division of Medicine,
Oslo University Hospital, Oslo, Norway
(Moen) Institute of Health and Society, Division of Medicine, University
of Oslo, Oslo, Norway
(Wik) Department of Paediatric and Adolescent Medicine, Sorlandet
Hospital, Kristiansand, Norway
(Holmstrom) Department of Paediatric Cardiology, Oslo University Hospital,
Oslo, Norway
Publisher
John Wiley and Sons Inc
Abstract
Aim: This national study focused on the individualised Heart Observation
(HOBS) mobile phone app, which helps the parents of infants with severe
congenital heart disease (CHD) with discharge preparations and decision
making at home. Method(s): We enrolled two groups of parents from
2021 to 2023, during their child's initial hospitalisation at Oslo
University Hospital, Norway. Measurements were carried out at baseline and
one and four months after discharge. The study examined 73 mothers, who
assessed the usefulness and stress-related impact of either printed
materials or the HOBS app, as the fathers' responses were insufficient.
 Result(s): The HOBS app was significantly more useful than the
printed information, with regard to discharge preparations, follow up at
home and ongoing decision making, particularly if the infants had
sustained cardiac impairment. The average total usefulness scores were
23.9/35 (95% CI 21.6-26.1) versus 17.0/35 (95% CI 14.1-20.0),
respectively. Initial stress significantly decreased from baseline in both
groups and elevated awareness of deterioration did not increase stress in
the HOBS group. Conclusion(s): Mothers who used the HOBS app found it
significantly more useful than the controls who received printed
information, particularly if their infant had sustained cardiac
impairment. Elevated awareness of deterioration did not increase
stress. Copyright © 2024 The Author(s). Acta Paediatrica
published by John Wiley & Sons Ltd on behalf of Foundation Acta
Paediatrica.

<34>
Accession Number
2033579853
Title
30-Day DAPT in Patients at High Bleeding Risk Undergoing PCI With
Biodegradable-Polymer Sirolimus-Eluting Ultra-Thin Stent.
Source
Catheterization and Cardiovascular Interventions. 105(6) (pp 1502-1509),
2025. Date of Publication: 01 May 2025.
Author
Erriquez A.; Leistner D.M.; Paradies V.; Pavasini R.; Serenelli M.;
Casella G.; Biscaglia S.; Naber C.; Campo G.; Smits P.C.
Institution
(Erriquez, Pavasini, Serenelli, Biscaglia, Campo) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Cona, Italy
(Leistner) Department of Cardiology, Angiology and Intensive Care
Medicine, Goethe University Hospital, Frankfurt, Germany
(Paradies, Smits) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
(Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy
(Naber) Facharztpraxis Baldeney, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Background: There is limited evidence on the safety and efficacy of
biodegradable-polymer sirolimus-eluting ultra-thin stent (BP-SES) in
patients at high bleeding risk (HBR) undergoing percutaneous coronary
intervention (PCI). Aim(s): This study aims to evaluate the clinical
outcomes of HBR patients treated with BP-SES and <= 30-day dual
antiplatelet therapy (DAPT) regimen. Method(s): A systematic review
was conducted to identify relevant studies involving HBR patients who
underwent PCI with BP-SES (Supraflex Cruz). Individual patient-level data
were extracted from the included studies. The primary endpoint was the
composite of cardiovascular death, myocardial infarction, or clinically
driven target lesion revascularization at 1-year. The safety endpoint was
the 1-year occurrence of Bleeding Academic Research Consortium (BARC) type
3-5. Result(s): The study population included 1691 patients. Of
these, 928 patients (55%) received a <= 30-day DAPT, while 763 patients
(45%) received a longer DAPT regimen. In the <= 30-day DAPT group, primary
outcome events occurred in 89 patients (9.5%, 95% CI: 7.7%-11.6%). The
upper limit of the one-sided 95% CI of 11.6% was below the pre-specified
non-inferiority margin of 14%. There was no significant difference in the
primary endpoint between the <= 30-day DAPT group and the >30-day DAPT
group (propensity score adjusted HR: 0.95, 95% CI: 0.67-3). Notably, the
incidence of BARC 3-5 bleeding events was significantly lower in the <=
30-day DAPT group. Conclusion(s): In HBR patients treated with
BP-SES, a <= 30-day DAPT regimen is associated with a low rate of ischemic
events and a significant reduction in major bleeding events. Trial
Registration: PROSPERO CRD42024524208. Copyright © 2025 The
Author(s). Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<35>
Accession Number
2034437178
Title
Risk factors for postoperative hypothermia in non-cardiac surgery
patients: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 223. Date
of Publication: 01 Dec 2025.
Author
Tan R.; Chen Y.; Yang D.; Long X.; Ma H.; Yang C.
Institution
(Tan, Yang, Ma, Yang) Anesthesiology Department, Chongqing University
Cancer Hospital, Chongqing, China
(Chen) School of Nursing, Guangxi University of Chinese Medicine, Nanning,
China
(Long) Nursing Department, Ruikang Hospital Affiliated to Guangxi
University of Chinese Medicine, Nanning, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative hypothermia seems to be a common problem in
surgical patients but is easily ignored. This study aimed to identify risk
factors for postoperative hypothermia in non-cardiac surgery patients.
 Method(s): We searched databases including PubMed, Embase, Web of
Science, Cochrane Library, CINAHL, VIP, Wan Fang, CNKI, and CBM from
inception to April 2025. The studies were selected using inclusion and
exclusion criteria. Two reviewers screened studies, extracted data, and
independently evaluated the risk of bias. The quality of the study was
assessed with the Newcastle-Ottawa Scale, and a meta-analysis was carried
out with Revman 5.4 software. Result(s): A total of 17 studies were
included. Age >= 60 (odds ratio [OR] = 1.80), BMI < 18.5 kg/m2
(OR = 1.83), ASA III-IV (OR = 1.87), endoscopic surgery (OR = 1.93),
intraoperative blood loss >= 100ml (OR = 2.35), intravenous fluid >=
1000ml (OR = 1.87), blood transfusion (OR = 1.80), duration of anesthesia
> 1 h (OR = 1.99) and duration of surgery > 1 h (OR = 2.34) were
significant risk factors that contributed to postoperative hypothermia in
non-cardiac surgery patients. Conclusion(s): There are many risk
factors for postoperative hypothermia in patients undergoing non-cardiac
surgery. The results of this research may improve clinician awareness,
risk stratification, and prevention of postoperative hypothermia in
non-cardiac surgery patients. Copyright © The Author(s) 2025.

<36>
Accession Number
2038632918
Title
Iron deficiency in patients with cardiogenic shock: Protocol for a scoping
review.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e092891. Date of
Publication: 19 Apr 2025.
Author
Germinario L.; Catena D.; Ott S.; Roeschl T.; Ghamri Y.; Meyer A.; O'Brien
B.; Schoenrath F.
Institution
(Germinario, Catena, Ott, Ghamri, O'Brien) Department of Cardiac
Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der
Charite - Medical Heart Center of Charite, German Heart Institute Berlin,
Berlin, Germany
(Germinario, Catena, Ott, Roeschl, Ghamri, Meyer, O'Brien, Schoenrath)
Charite - Universitatsmedizin Berlin, Corporate member of Freie
Universitat Berlin, Humboldt-Universitat zu Berlin, Campus
Virchow-Klinikum, Augustenburger Platz 1, Berlin, Germany
(Ott, Schoenrath) Dzhk (German Centre for Cardiovascular Research),
Partner Site Berlin, Berlin, Germany
(Ott) Department of Anesthesiology, Outcomes Research Consortium,
Cleveland Clinic, Cleveland, OH, United States
(Roeschl, Meyer, Schoenrath) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite - Medical Heart Center of
Charite, German Heart Institute Berlin, Berlin, Germany
(Roeschl, Meyer) Berlin Institute of Health, Charite-Universitatsmedizin
Berlin, Institute of Medical Informatics, Invalidenstrase 90, Berlin,
Germany
(O'Brien) Department of Perioperative Medicine, St Bartholomew's Hospital
and Barts Heart Centre, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiogenic shock (CS) is a severe condition characterised by
low cardiac output and often hypotension, which results in organ
hypoperfusion due to cardiac failure. As a form of acute heart failure,
this condition seems to share similar underlying pathological mechanisms.
It is well established that iron deficiency is correlated with chronic and
acute heart failure, causing worsening of the symptoms, reduction of
quality of life and survival and simultaneously increasing the
rehospitalisation rates for all causes in these patients. It remains
unclear whether there is an association between iron deficiency and CS.
The objective of this scoping review will be to determine the actual state
of the art regarding the significance of iron deficiency in patients
affected by CS. Methods and analysis We will conduct a systematic review
of the literature using MEDLINE and EMBASE via 'Ovid' (Elsevier) and Web
of Science (2024 Clarivate). The goal is to analyse the incidence and
clinical significance of iron deficiency in patients affected by
cardiogenic shock. To gain a deeper insight into the underlying
pathophysiological mechanisms, the review will include basic research
conducted on both human subjects and on animal models as well as
observational, randomised controlled studies and systematic reviews and
meta-analysis. To maximise the identification of relevant reports and
reduce loss of information, a systematic search of the literature will be
performed from inception until January 2025 using the terms "iron
deficiency"as well as "iron", "ferritin", "transferrin", "transferrin
saturation", "hepcidin"and "soluble transferrin receptor"matching these
terms with the keywords "cardiogenic shock", "acute heart failure",
"advanced heart failure", "decompensated heart failure", "lvad", "left
ventricular assist device", "mechanical circulatory support", "VA-ECMO"and
"Extracorporeal Life Support". We will also use the corresponding MeSH and
Emtree terms. In order to find grey literature, we will use the OADT.org
internet-based database. Ethics and dissemination No additional ethics
approval is required, as this review is based on existing research without
new data collection. Only studies with ethics approval will be included.
We plan to publish our findings in a peer-reviewed journal and present
them at international conferences on cardiology, intensive and acute
cardiovascular care, cardiac surgery and
cardioanaesthesiology. Copyright © Author(s) (or their
employer(s)) 2025.

<37>
Accession Number
2034491663
Title
Anaesthetic Techniques for Cardiac Ablation-A Scoping Review Protocol.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70054. Date of Publication: 01 Jul 2025.
Author
Fredensborg M.B.; Fiege S.B.; Moller A.M.
Institution
(Fredensborg, Moller) Department of Anaesthesiology, Herlev Anaesthesia
Critical and Emergency Care Science Unit (ACES), Copenhagen University
Hospital-Herlev Hospital, Herlev, Denmark
(Fredensborg, Moller) Department of Clinical Medicine, Faculty of Health
Sciences, University of Copenhagen, Copenhagen, Denmark
(Fiege) Department of Anaesthesiology, Herlev and Gentofte Hospital,
Gentofte, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiac arrhythmias, particularly atrial fibrillation, are
highly prevalent and represent a growing global health burden. Cardiac
ablation is a commonly used procedure for the treatment of cardiac
arrhythmias, often requiring anaesthesia to ensure patient safety and
procedural success. Despite its widespread use, there is no consensus on
the optimal anaesthetic strategy, and existing literature mainly addresses
isolated techniques or specific populations. The aim of this scoping
review is to systematically map the current evidence on anaesthetic
methods used during cardiac ablation procedures. Method(s): A scoping
review will be conducted in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses extension for scoping reviews
(PRISMA-ScR) guidelines. A comprehensive search strategy will be applied
across multiple databases, including Medline, EMBASE, Cochrane, Scopus and
Google Scholar. Eligible studies will include all research on adult
patients undergoing cardiac ablation, focusing on any anaesthetic or
sedative techniques used. Study selection and data extraction will be
performed by independent reviewers, and results will be summarized
descriptively. Result(s): In the final review, findings will be
presented through a descriptive and narrative summary, supplemented by
tables, figures and graphs where applicable. Conclusion(s): This
scoping review will provide a structured overview of the landscape of
anaesthesia methods in cardiac ablations. The findings will help uncover
knowledge gaps and inform future research and clinical decision-making
regarding anaesthesia strategies in the management of cardiac
arrhythmias. Copyright © 2025 The Author(s). Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<38>
[Use Link to view the full text]
Accession Number
2037744804
Title
Cost-effectiveness of angiographic quantitative flow ratio-guided coronary
intervention: A multicenter, randomized, sham-controlled trial.
Source
Chinese Medical Journal. 138(10) (pp 1186-1193), 2025. Date of
Publication: 20 May 2025.
Author
Zhao Y.; Guan C.; Wang Y.; Jin Z.; Yu B.; Fu G.; Chen Y.; Guo L.; Qu X.;
Zhang Y.; Dou K.; Wu Y.; Yang W.; Tu S.; Escaned J.; Fearon W.F.; Qiao S.;
Cohen D.J.; Krumholz H.M.; Xu B.; Song L.
Institution
(Zhao, Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Guan, Dou, Wu, Yang, Qiao, Xu, Song) Department of Cardiology, National
Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Heilongjiang, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang, Hangzhou, China
(Chen) Department of Cardiology, The Sixth Medical Center, Chinese PLA
General Hospital, Beijing, China
(Guo) Department of Cardiology, Peking University Third Hospital, Beijing,
China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhang) Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou
Medical University, Jiangsu, Xuzhou, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University of
Madrid, Madrid, Spain
(Fearon) Division of Cardiovascular Medicine, Stanford Cardiovascular
Institute, Stanford University School of Medicine, VA Palo Alto Health
Care System, Palo Alto, CA, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Krumholz) Section of Cardiovascular Medicine, Yale School of Medicine,
New Haven, CT, United States
(Krumholz) Center for Outcomes Research and Evaluation, Yale New Haven
Hospital, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The FAVOR (Comparison of Quantitative Flow Ratio Guided and
Angiography Guided Percutaneous Intervention in Patients with Coronary
Artery Disease) III China trial demonstrated that percutaneous coronary
intervention (PCI) lesion selection using quantitative flow ratio (QFR)
measurement, a novel angiography-based approach for estimating fractional
flow reserve, improved two-year clinical outcomes compared with standard
angiography guidance. This study aimed to assess the cost-effectiveness of
QFR-guided PCI from the perspective of the current Chinese healthcare
system. Method(s): This study is a pre-specified analysis of the
FAVOR III China trial, which included 3825 patients randomized between
December 25, 2018, and January 19, 2020, from 26 centers in China.
Patients with stable or unstable angina pectoris or those >=72 hours
post-myocardial infarction who had at least one lesion with a diameter
stenosis between 50% and 90% in a coronary artery with a >=2.5 mm
reference vessel diameter by visual assessment were randomized to a
QFR-guided strategy or an angiography-guided strategy with 1:1 ratio.
During the two-year follow-up, data were collected on clinical outcomes,
quality-adjusted life-years (QALYs), estimated costs of index procedure
hospitalization, outpatient cardiovascular medication use, and
rehospitalization due to major adverse cardiac and cerebrovascular events
(MACCE). The primary analysis calculated the incremental
cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of
10,000/MACCE event avoided was considered economically attractive in
China. Result(s): At two years, the QFR-guided group demonstrated a
reduced rate of MACCE compared to the angiography-guided group (10.8% vs.
14.7%, P <0.01). Total two-year costs were similar between the groups
(50,803 +/- 21,121 vs. 50,685 +/- 23,495, P = 0.87). The ICER for the
QFR-guided strategy was 3055 per MACCE avoided, and the probability of QFR
being economically attractive was 64% at a willingness-to-pay threshold of
10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI
would become cost-saving if the cost of QFR were below 3682 (current cost:
3800). Cost-utility analysis yielded an ICER of 56,163 per QALY gained,
with a 53% probability of being cost-effective at a willingness-to-pay
threshold of 85,000 per QALY gained. Conclusion(s): In patients
undergoing PCI, a QFR-guided strategy appears economically attractive
compared to angiographic guidance from the perspective of the Chinese
healthcare system. Copyright © 2025 The Chinese Medical
Association, produced by Wolters Kluwer, Inc.

<39>
Accession Number
2038207345
Title
The carbon footprint of general anaesthesia in adult patients: a
multicentre observational comparison of intravenous and inhalation
anaesthetic strategies in 35,242 procedures.
Source
British Journal of Anaesthesia. 134(6) (pp 1620-1627), 2025. Date of
Publication: 01 Jun 2025.
Author
Bernat M.; Cuvillon P.; Brieussel T.; Roche M.; Remacle A.; Leone M.;
Lukaszewicz A.-C.; Bouvet L.; Zieleskiewicz L.
Institution
(Bernat, Brieussel, Leone, Zieleskiewicz) Department of Anaesthesia and
Intensive Care Medicine, Hopital Nord, Assistance Publique des Hopitaux de
Marseille, Aix Marseille University, Marseille, France
(Cuvillon) Department of Anaesthesia and Intensive Care, CHU Caremeau,
Nimes, France
(Roche) Pharmacy Department, Service Central des Operations
Pharmaceutiques, Hopital Nord, Assistance Publique des Hopitaux de
Marseille, Aix Marseille University, Marseille, France
(Remacle) Department of Medical Information, Hopital Nord, Assistance
Publique des Hopitaux de Marseille, Aix Marseille University, Marseille,
France
(Lukaszewicz) Department of Anaesthesia and Intensive Care Medicine,
Hopital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
(Bouvet) Department of Anaesthesiology and Intensive Care Medicine,
Hopital Femme Mere Enfant, Hospices Civils de Lyon, Lyon, France
Publisher
Elsevier Ltd
Abstract
Background: General anaesthesia is a significant contributor to
healthcare-related greenhouse gas (GHG) emissions. Previous studies have
compared non-optimised anaesthesia strategies (desflurane, nitrous oxide,
or both) to evaluate the impact of green initiatives on reducing the
carbon footprint of anaesthesia. However, modern halogenated anaesthesia
techniques, including low fresh gas flow and target-controlled inhalation
anaesthesia (TCIA), offer potentially more environmentally friendly
alternatives. Thus, we aimed to compare the GHG emissions of total
intravenous anaesthesia (TIVA) with these newer techniques.
 Method(s): This multicentre study compared GHG emissions per hour of
general anaesthesia in adult surgical patients between three anaesthetic
strategies: TIVA with propofol, sevoflurane in TCIA mode, and manually
optimised sevoflurane. The study was conducted in three French university
hospitals, each using one anaesthesia strategy. The quantity of
anaesthetic drugs used was obtained from pharmacy procurement records and
converted to carbon dioxide equivalents (CO<inf>2</inf>e). The primary
outcome was the total GHG emissions per hour of anaesthesia for each
strategy, including sevoflurane, propofol, and syringe consumption.
 Result(s): TCIA, manually optimised sevoflurane, and TIVA strategies
were used in 7873, 15 461, and 10 717 anaesthetics, respectively. The
carbon footprint of the principal anaesthetic drugs per hour of
anaesthesia was significantly lower in the TIVA strategy, at 0.4 kg
CO<inf>2</inf>e per hour, compared with 3.1 kg CO<inf>2</inf>e per hour in
the TCIA strategy and 3.8 kg CO<inf>2</inf>e per hour in the manually
optimised sevoflurane strategy. Conclusion(s): TIVA with propofol was
the most effective approach for minimising greenhouse gas emissions in
anaesthesia practices. However, if TIVA were used exclusively globally, it
could lead to issues such as stock depletion, plastic pollution, and water
contamination. Copyright © 2025 British Journal of Anaesthesia

<40>
Accession Number
2038631853
Title
Effects of pre-CABG program on discharge readiness and surgery outcomes
for patients undergoing elective CABG surgery: A study protocol for a
randomised control trial.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e090256. Date of
Publication: 30 Apr 2025.
Author
Abadi P.D.; Zakerimoghadam M.; Abadi Z.A.D.; Rahmanian M.; Riahi S.M.;
Khanipour-Kencha A.
Institution
(Abadi, Zakerimoghadam, Abadi, Khanipour-Kencha) Department of
Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Rahmanian) Imam Khomeini Hospital Complex, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Riahi) Department of Community Medicine, School of Medicine,
Cardiovascular Diseases Research Center, Birjand University of Medical
Sciences, Birjand, Iran, Islamic Republic of
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiovascular diseases, a leading cause of death globally,
impose significant health and economic burdens, particularly in countries
like Iran. Coronary artery bypass grafting (CABG) is a common intervention
for ischaemic heart disease, yet it entails a long recovery process with
potential complications and psychological impacts. This study aims to
evaluate the effectiveness of a prehabilitation programme (pre-CABG) on
postoperative outcomes and discharge readiness in patients undergoing
elective CABG. Methods and analysis This randomised controlled trial
involves 60 patients diagnosed with coronary artery disease at Imam
Khomeini Hospital Complex, Tehran. Participants will be randomly assigned
to either the intervention group, receiving the pre-CABG programme, or the
control group, receiving standard care. The pre-CABG programme includes
patient education, stress management techniques, respiratory muscle
training and nutritional guidance. Primary outcomes include discharge
readiness, duration of intubation, Intensive Care Uniy (ICU) stay,
occurrence of atelectasis, onset of mobility, hospital stay and levels of
anxiety and depression. Secondary outcomes include the rate of 30-day
readmissions. Data collection will involve standardised scales and
checklists administered at various stages preoperation and postoperation.
Ethics and dissemination The research study has received approval from the
Research Ethics Committee at Tehran University of Medical Sciences' School
of Nursing and Midwifery and Rehabilitation. All participants must provide
written consent for their involvement in this study. The findings will be
shared with appropriate groups and published in peer-reviewed journals.
Trial registration number The study is registered with the Iranian
Registry of Clinical Trials under the ID
IRCT20231019059768N1. Copyright © Author(s) (or their
employer(s)) 2025.

<41>
Accession Number
2035038324
Title
Impact of diabetes mellitus on post-CABG outcomes in veterans: Insights
from the REGROUP trial.
Source
Journal of Cardiology. 85(5) (pp 418-420), 2025. Date of Publication: 01
May 2025.
Author
Faggion Vinholo T.; Stock E.; Bloom J.; Hirji S.; DeMatt E.; Biswas K.;
Quin J.A.; Haime M.; Zenati M.A.
Institution
(Faggion Vinholo, Hirji, Zenati) Division of Cardiac Surgery, Brigham &
Women's Hospital, Boston, MA, United States
(Stock, DeMatt, Biswas) Cooperative Studies Program Coordinating Center,
Office of Research and Development, Department of Veterans Affairs, Perry
Point, MD, United States
(Bloom) Department of Cardiac Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Quin, Haime, Zenati) Division of Cardiac Surgery, Veterans Affairs Boston
Healthcare System, Boston, MA, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)

<42>
Accession Number
2033384849
Title
Comparative Efficacy and Safety of Low-Dose Direct Oral Anticoagulants
Versus Dual Antiplatelet Therapy Following Left Atrial Appendage Occlusion
in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and
Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(6) (pp 1311-1319),
2025. Date of Publication: 01 May 2025.
Author
Ibrahim A.; Shalabi L.; Zreigh S.; Ramadan S.; Mourad S.; Eljadid G.;
Beshr M.; Abdelaziz A.; Elhadi M.; Sabouret P.; Mamas M.
Institution
(Ibrahim, Mourad, Abdelaziz) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Zreigh) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara,
Turkey
(Ramadan, Eljadid) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Beshr) Faculty of Medicine and Health Sciences, Sana'a University,
Sana'a, Yemen
(Elhadi) Korea University College of Medicine, Seoul, Seongbuk-gu, South
Korea
(Sabouret) National College of French Cardiologists, Paris, France
(Sabouret) ACTION Study Group, Pitie-Salpetriere Hospital, Sorbonne
University, Paris, France
(Mamas) Keele Cardiovascular Research Group, Keele University,
Stoke-on-Trent, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Left atrial appendage occlusion (LAAO) is an alternative to
chronic oral anticoagulation (OAT) for stroke prevention in nonvalvular
atrial fibrillation (NVAF) patients with contraindications to OAT.
Postprocedure antithrombotic therapy (ATT) is essential to reduce the risk
of device-related thrombosis (DRT), but the optimal regimen remains
uncertain. Aim(s): This study aims to compare the safety and efficacy
of low-dose direct oral anticoagulants (DOACs) versus dual antiplatelet
therapy (DAPT) following LAAO. Method(s): A comprehensive search of
PubMed, Scopus, Cochrane, and Web of Science was conducted in August 2024.
Studies comparing low-dose DOACs and DAPT post-LAAO were included. The
primary outcomes were a composite efficacy endpoint (DRT, strokes, and
systemic embolism [SE]) and major bleeding events as the safety endpoint.
Secondary outcomes included all bleeding events, all-cause mortality, and
a composite of efficacy and safety endpoints. Result(s): Four studies
with 727 patients were included. Low-dose DOACs were associated with lower
rates of the primary composite efficacy endpoint compared to DAPT (OR =
0.36; 95% CI [0.16, 0.85], p = 0.01). No significant difference in major
bleeding events was observed (OR = 0.36; 95% CI [0.11, 1.18]; p = 0.091;
I2 = 0%). Compared to DAPT, low-dose DOACs were also associated with lower
rates of DRT events (OR = 0.36; 95% CI [0.16, 0.79], p = 0.011).
 Conclusion(s): Low-dose DOACs effectively reduce thromboembolic
events post-LAAO without increasing bleeding risk. These findings support
their use as a viable ATT option, but larger trials are needed to confirm
optimal regimens. Copyright © 2025 Wiley Periodicals LLC.

<43>
Accession Number
2037315175
Title
Tricuspid Transcatheter Edge-to-Edge Repair in Patients With Transvalvular
CIED Leads: The TRILUMINATE Pivotal Trial.
Source
JACC: Clinical Electrophysiology. 11(5) (pp 1012-1020), 2025. Date of
Publication: 01 May 2025.
Author
Naik H.; Price M.J.; Kapadia S.; Whisenant B.K.; Tadros P.; Makkar R.;
Asgar A.W.; Fam N.; Tang G.H.L.; Mehta S.R.; Byrne T.; Singh G.; Panaich
S.S.; Peterman K.; Trusty P.M.; Hamid N.; Hahn R.T.; Adams D.H.; Sorajja
P.
Institution
(Naik) Arizona Cardiovascular Research Center, Phoenix, AZ, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Kapadia) Cleveland Clinic Foundation. Cleveland, OH, United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Tadros) Kansas University Medical Center, Kansas City, KS, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Asgar) Montreal Heart Institute, Montreal, QC, Canada
(Fam) St. Micheal's Hospital, Toronto, ON, Canada
(Tang, Adams) Mount Sinai Hospital, New York, NY, United States
(Mehta) Hamilton Health Science Centre, Hamilton, ON, Canada
(Byrne) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States
(Singh) University of California, Davis Medical Center, Sacramento, CA,
United States
(Panaich) Swedish Medical Center, Seattle, WA, United States
(Peterman, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
(Hamid, Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United
States
(Hahn) NewYork-Presbyterian/Columbia University Medical Center, New York,
NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with tricuspid regurgitation (TR) frequently have
transvalvular cardiac implantable electronic device (CIEDs).
 Objective(s): The aim of this study was to determine the safety and
efficacy of tricuspid transcatheter edge-to-edge repair in patients with
transvalvular CIED leads. Method(s): The TRILUMINATE (Trial to
Evaluate Cardiovascular Outcomes in Patients Treated With the Tricuspid
Valve Repair System) Pivotal Trial (NCT03904147) is an international
randomized, controlled trial in symptomatic subjects with severe TR.
Subjects with CIED leads were screened by an eligibility committee prior
to inclusion into the randomized or single-arm cohorts. Safety events were
adjudicated by an independent review committee. All echocardiograms were
analyzed by an independent core laboratory. Result(s): A total of 98
subjects (of 469) with attempted TriClip procedures had transvalvular CIED
leads. CIED+ subjects were older (age 80.2 +/- 8.6 years vs 78.2 +/- 7.6
years; P = 0.02), with a higher prevalence of renal disease (46.9% vs
31.5%; P = 0.004) and lower health status (Kansas City Cardiomyopathy
Questionnaire overall summary score 51.9 +/- 21.0 vs 55.0 +/- 23.1) at
baseline compared with CIED- subjects. Slightly fewer clips were implanted
in CIED+ subjects (mean 1.9) than in CIED- subjects (mean 2.2) (P =
0.0018). Procedural times were significantly shorter in CIED+ subjects
(132.9 +/- 63.3 minutes vs 155.9 +/- 71.9 minutes; P = 0.0043) although
greater in those with lead-induced TR (149.5 +/- 87.5 minutes). Major
adverse events (1.0% vs 1.1%) and major bleeding (3.1% vs 3.0%) were
infrequent in CIED+ and CIED- subjects. At 30 days, TR reduction to
moderate or less was similar in CIED+ and CIED- subjects (88% vs 87%) and
was sustained out to 1 year in the majority of subjects (81% vs 84%).
Compared with baseline, Kansas City Cardiomyopathy Questionnaire overall
summary score significantly improved through 1 year in CIED+ subjects
(18.7 +/- 22.6; P < 0.0001) and CIED- subjects (16.8 +/- 22.6; P <
0.0001). Heart failure symptoms were reduced in both groups at 30 days,
with 85% of CIED+ subjects and 87% of CIED- subjects in NYHA functional
class I or II. There were no differences in mortality, heart failure
hospitalization, and need for tricuspid valve surgery or intervention
between groups. No lead revisions, removals, or replacements were reported
through follow-up. Conclusion(s): Tricuspid transcatheter
edge-to-edge repair with the TriClip system was safe and effective in
selected CIED+ subjects and did not affect CIED function. CIED+ subjects
experienced similar TR reduction and quality-of-life improvements as CIED-
subjects. Future work should define the treatable scope of patients with
transvalvular CIED leads. (TRILUMINATE Pivotal Trial;
NCT03904147) Copyright © 2025

<44>
Accession Number
2038757618
Title
Mechanical outcomes of coronary stenting guided by intravascular
ultrasound versus optical coherence tomography: A systematic review and
meta-analysis with trial sequential analysis of randomized trials.
Source
International Journal of Cardiology. 435 (no pagination), 2025. Article
Number: 133387. Date of Publication: 15 Sep 2025.
Author
Lingamsetty S.S.P.; Doma M.; Kritya M.; Thyagaturu H.; Ubaid M.; Jitta
S.R.; Prajapati K.; Ramadan A.; Al-shammari A.S.; Martignoni F.V.; Seto
A.; Shlofmitz E.; Basir M.B.; Megaly M.S.; Goldsweig A.M.
Institution
(Lingamsetty) Mamata Medical College, Khammam, India
(Doma) Alexandria Faculty of Medicine, Alexandria, Egypt
(Kritya) Houston Methodist Research Institute, TX, United States
(Thyagaturu) West Virginia University Heart and Vascular Institute, WV,
United States
(Ubaid) Montefiore Health System, NY, United States
(Jitta) Mercy Hospital Saint Louis, MO, United States
(Prajapati) Metropolitan Hospital Center NYC Health + Hospital, NY, United
States
(Ramadan) Massachussets General Hospital, Harvard Medical School, Boston,
MA, United States
(Al-shammari) College of Medicine, University of Baghdad, Baghdad, Iraq
(Martignoni) Texas Tech University Health Sciences Center, TX, United
States
(Seto) Department of Medicine, VA Long Beach Healthcare System, Long
Beach, CA, United States
(Seto) Department of Medicine, Charles R. Drew University of Medicine and
Science, Willowbrook, CA, United States
(Shlofmitz) Department of Cardiology, St Francis Hospital and Heart
Center, Roslyn, NY, United States
(Basir) Henry Ford Hospital, Detroit, MI, United States
(Megaly) Ascension St John Medical Center-Tulsa, OK, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Intravascular imaging with intravascular ultrasound (IVUS) or
optical coherence tomography (OCT) may guide stent sizing and placement
during percutaneous coronary intervention (PCI). We compared IVUS- vs.
OCT-guided PCI in terms of mechanical outcomes. Method(s): PubMed,
Embase and Cochrane databases were systematically searched until December
2024 for randomized controlled trials (RCTs) comparing IVUS- vs.
OCT-guided PCI. Random-effects models were used to estimate mean
differences (MDs) and standard mean differences (SMDs) with 95 %
confidence intervals (CIs). Result(s): Six RCTs with 2696 patients
were included; 1396 (49.6 %) underwent IVUS-guided PCI. The mean age was
65.1 +/- 10.2 years. In the pooled analysis, the post-PCI minimum stent
area (MSA) was significantly higher with IVUS-guided PCI than with
OCT-guided PCI (MD 0.64 mm2; 95 % CI 0.17-1.10; p < 0.01), and
post-PCI mean diameter stenosis was significantly lower with IVUS (MD
-1.05 %; 95 % CI -1.90 to -0.21; p = 0.01). There were no significant
differences between groups in acute lumen gain, stent expansion index,
malapposition, tissue protrusion, or edge dissection. In a subgroup
analysis, IVUS-guided PCI yielded a greater MSA in studies that did not
size vessels by measurement of the external elastic membrane. However,
trial sequential analysis suggested that the RCTs to date have not reached
the required quantity of information to support definitive conclusions
about MSA and mean diameter stenosis. Conclusion(s): This
meta-analysis demonstrated that IVUS-guided PCI was associated with
greater MSA and reduced diameter stenosis compared to OCT-guided PCI, with
no difference in stent expansion index, more trials are required to
confirm this hypothesis. Copyright © 2025 Elsevier B.V.

<45>
Accession Number
2038672148
Title
Intranasal insulin enhances postoperative sleep quality and delirium in
middle-aged cardiac surgery patients: A randomized controlled trial.
Source
Sleep Medicine. 132 (no pagination), 2025. Article Number: 106560. Date of
Publication: 01 Aug 2025.
Author
Yang M.; Lu T.; Cao L.; Xiao C.; Liang Y.; Ding J.; Jiang X.; Wang W.;
Chen F.; Du Z.; Yang G.; Li H.
Institution
(Yang, Lu, Cao, Xiao, Liang, Ding, Jiang, Wang, Chen, Du, Yang, Li)
Department of Anesthesiology, Xinqiao Hospital of Chongqing, Second
Affiliated Hospital of Army Medical University, PLA, Chongqing, China
Publisher
Elsevier B.V.
Abstract
Background: Postoperative delirium (POD) remains a significant
complication following cardiopulmonary bypass (CPB) surgery, particularly
in middle-aged patients who constitute the majority of this surgical
population. While intranasal insulin (INI) has shown neuroprotective
potential in aging cohorts, its efficacy in younger surgical patients and
its underlying mechanisms remain under explored. This study investigates
whether INI mitigates POD through sleep-wake cycle modulation.
 Method(s): It is a single-center prospective randomized,
double-blinded controlled trial from March 4, 2024 to October 18, 2024. 76
middle-aged patients (45-65 years) undergoing elective CPB surgery were
randomized to receive INI (20 IU) or placebo preoperatively and on
postoperative days 1-2. The primary outcome was POD incidence (CAM-ICU
criteria). Secondary outcomes included Mini-Mental State Examination
(MMSE) scores, actigraphy-derived sleep metrics (sleep efficiency [SE],
total sleep time [TST]). Analyses followed intention-to-treat principles.
 Result(s): INI significantly reduced POD incidence (17.1 % vs. 38.9
%, RR = 3.45, p = 0.037) and improved cognitive recovery, as evidenced by
higher MMSE scores at postoperative day 5 with a difference of 1.71 (95 %
CI, 0.19 to 3.23; p = 0.027). Sleep analysis revealed robust improvements
in the INI group: SE increased by 21.3 % (78.2 +/- 12.1 % vs. 64.5 +/-
15.3 %, p = 0.031), and TST extended by 27.1 % (6.1 +/- 1.2h vs. 4.8 +/-
1.5h, p = 0.033) on postoperative day 1. No significant differences were
observed in hospital length of stay (p = 0.893), highlighting the
specificity of INI's sleep-mediated effects. Conclusion(s): This
trial demonstrates that INI stabilizes postoperative sleep architecture,
leading to reduced POD incidence and enhanced cognitive recovery in
middle-aged CPB patients. These findings position INI as a targeted
intervention for perioperative neurocognitive protection, particularly in
populations vulnerable to circadian disruption. Clinical trial
registration: ChiCTR 2400081444. Registered March 1, 2024,
http://www.chictr.org.cn. Copyright © 2025 Elsevier B.V.

<46>
[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. 18(5) (no pagination),
2025. Article Number: e011991. Date of Publication: 01 May 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
(Yeh) Smith Center for Outcomes Research in Cardiology, 375 Longwood Ave,
Fourth Floor, Boston, MA, United States
(Lalani, Oseran, Kazi, Strom, Wadhera, Yeh) Division of Cardiology,
Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology,
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
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.

<47>
[Use Link to view the full text]
Accession Number
2038756851
Title
"Is Intravascular Ultrasound-guided Angiography a Better Choice than
Angiography Alone for Patients with Acute Coronary Syndrome and Coronary
Artery Disease? Unveiling the Efficacy and Safety of This Modern Imaging
Method: A Systematic Review and Meta-Analysis.".
Source
Critical Pathways in Cardiology. (no pagination), 2025. Article Number:
00383. Date of Publication: 2025.
Author
Harmouch K.M.; Haider M.; Hamza M.; Upreti P.; Bahar Y.; Turkmani M.;
Rrapo T.; Kumar N.; Kumar M.; Safdar W.; Sattar Y.; Zafrullah F.; Mhafouz
A.; Alraies M.C.
Institution
(Harmouch, Kumar) Wayne State University, School of Medicine, Detroit
Medical Center, Detroit, MI, United States
(Haider) Department of Cardiology, West Virginia University, Morgantown,
WV, United States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Upreti) Sand Constellation Heart Institute, Rochester Regional Health,
Rochester, NY, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Turkmani) Department of Internal Medicine, McLaren Healthcare, Oakland,
MI, United States
(Rrapo) Biology BSc, Oakland University, Rochester, MI, United States
(Kumar) John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United
States
(Safdar) Albert Einstein College of Medicine, Montefiore Medical Center
(Wakefield), Bronx, NY, United States
(Sattar) Division of Cardiology, West Virginia University, Morgantown, WV,
United States
(Zafrullah) Division of Cardiology, Western Michigan University,
Kalamazoo, MI, United States
(Mhafouz, Alraies) Cardiovascular Institute, Detroit Medical Center,
Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Coronary angiography has been an established standard for
over six decades for percutaneous coronary interventions (PCI), but its
role is limited to assessing vascular lumen and anterograde flow. In the
1980s, intravascular ultrasonography (IVUS) gained traction in
interventional cardiology for its advantages over angiography. Despite its
precise evaluation of plaque burden and vessel wall structure for
optimizing stent implantation, the literature reports varying outcomes on
the efficacy and safety of IVUS-guided angiography in patients presenting
with acute coronary syndrome (ACS) or coronary artery disease (CAD). To
address this discrepancy, we conducted a comprehensive systematic review
and meta-analysis to assess the efficacy and safety of utilizing IVUS vs
angiography alone for PCI in these groups of patients. Method(s): We
conducted a comprehensive systematic review and meta-analysis to assess
the efficacy and safety of IVUS-guided angiography in these patients.
Electronic databases were searched, and 25 studies were included.
Inclusion criteria were: 1) patients aged > 18 years, 2) patients with ACS
or CAD undergoing IVUS-guided PCI or angiography-guided PCI, and 3)
Randomized Clinical Trials (RCTs). Exclusion criteria comprised
observational, non-randomized studies, case reports, clinical spotlights,
and review articles. Studied outcomes included all-cause mortality,
cardiac death, myocardial infarction (MI), target lesion revascularization
(TLR), need for coronary artery bypass graft (CABG), and stent thrombosis
(ST). Result(s): Compared to angiography alone, IVUS-guided PCI
demonstrated a significant reduction in cardiac death, TLR, and ST
regardless of the follow-up period. No significant difference was observed
between the two groups concerning all-cause mortality, and MI regardless
of the follow-up period, and the need for CABG at one-year follow-up.
 Conclusion(s): Compared to angiography-guided PCI, IVUS-guided PCI is
associated with a lower incidence of cardiac death, TLR, and
ST. Copyright © 2025 Wolters Kluwer Health, Inc.

<48>
Accession Number
2038748993
Title
Paravertebral analgesia versus wound infiltration in children recovering
from cardiac surgery: A randomized controlled trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Article
Number: 10.1136/rapm-2025-106506. Date of Publication: 2025.
Author
Guo J.; Jia Y.; Tian L.; Kang W.; Zhao Y.; Yuan S.; Sessler D.I.
Institution
(Guo, Jia, Tian, Kang, Zhao, Yuan) Fuwai Hospital, Beijing, China
(Sessler) Outcomes Research, Cleveland Clinic, Cleveland, OH, United
States
Publisher
BMJ Publishing Group
Abstract
Introduction: Optimal analgesia for thoracotomies remains unclear.
Paravertebral blocks are more complex than local anesthetic infiltration
but may be more effective. We therefore tested the hypothesis that
paravertebral blocks provide better postoperative analgesia than local
anesthetic infiltration in children recovering from cardiac surgery
thoracotomies. Method(s): This was a single-center randomized
double-blind trial. We recruited children aged 6-14 years with atrial or
ventricular septal defects scheduled for cardiac surgery with
cardiopulmonary bypass via thoracotomy were recruited. 100 patients were
enrolled and randomized to either postoperative paravertebral blocks
(n=50) or local anesthetic wound infiltration (n=50). We recorded opioid
consumption during the initial 24 hours after surgery, along with pain
scores at 6hour intervals. Complications including postoperative nausea
and vomiting and respiratory failure were also recorded. Result(s):
100 patients (mean 7 years, 43% male) were included in the analysis. The
only postoperative opioid used was sufentanil. Total sufentanil
consumption in the first 24 hours postsurgery was 0.3+/-0.4mug/kg for
those receiving paravertebral blocks, significantly lower than the
0.6+/-0.5mug/kg for wound infiltration (p=0.002). Faces Pain Scale-Revised
pain scores were consistently lower in the paravertebral block group
across all measured time points (6, 12, 18, and 24 hours), with the most
pronounced difference observed at 6hours postoperatively (1.7+/-2.2 vs
3.3+/-2.2; p<0.001). Postoperative mechanical ventilation time, ICU stay,
hospitalization, and incidence of postoperative nausea and vomiting were
comparable. Conclusion(s): Paravertebral blocks reduced opioid
consumption and pain during the first postoperative day in pediatric
cardiac thoracotomies but did not accelerate recovery. Copyright
© American Society of Regional Anesthesia & Pain Medicine 2025.

<49>
Accession Number
2034574020
Title
Dual ProGlide Versus ProGlide and Angio-Seal for Femoral Access
Hemostasias in Transcatheter Aortic Valve Replacement: A Meta-Analysis of
Up-to-Date Evidence.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Naeem F.; Tabassum S.; Burhan M.; Qamar U.; Alraies M.C.; Abramov D.
Institution
(Naeem) Department of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Tabassum) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Burhan) Department of Internal Medicine, Rawalpindi Medical University,
Lahore, Pakistan
(Qamar) Department of Internal Medicine, Mayo Clinic, Rochester, NY,
United States
(Alraies) Department of Cardiology, Department of Medicine, Detroit
Medical Center, Detroit, MI, United States
(Abramov) Department of Medicine, Division of Cardiology, Loma Linda
University Health, Loma Linda, CA, United States
Publisher
John Wiley and Sons Inc

<50>
Accession Number
2034564069
Title
Surgical Outcomes After Minimally Invasive Versus Full Sternotomy Aortic
Valve Replacement: Meta-Analysis of 75 Comparative Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Article Number: 15569845251335969. Date
of Publication: 2025.
Author
Servito M.; Ramsay H.; Mann S.; Ramelli L.; Fernandez A.-L.; Diasty M.E.
Institution
(Servito) Division of Cardiac Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Servito) Institute of Health Policy, Management, and Evaluation,
University of Toronto, ON, Canada
(Ramsay, Mann, Ramelli) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University Hospital, University of
Santiago de Compostela, Spain
(Diasty) Cardiac Surgery Department, Harrington Heart and Vascular
Institute, University Hospitals, Cleveland, OH, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Whether minimally invasive aortic valve replacement (MIAVR)
offers an advantage over conventional AVR (CAVR) remains a matter of
debate. Although some studies have suggested better postoperative outcomes
with MIAVR, technical challenges and longer operative times remain major
obstacles to the adoption of these techniques. In this meta-analysis, we
compare the reported immediate postoperative outcomes of both approaches.
 Method(s): Cochrane, MEDLINE, and Embase databases were
searched from inception until January 2022 for studies reporting immediate
postoperative outcomes of MIAVR and CAVR. Studies were excluded if they
reported on concomitant procedures or enrolled pediatric patients.
Random-effects meta-analysis was performed using the restricted maximum
likelihood estimator with Hartung-Knapp adjustment. Result(s): The
literature search yielded 3,921 articles, of which 75 were included in
this meta-analysis. The most common techniques were ministernotomy and
minithoracotomy. MIAVR was associated with lower 30-day mortality than
CAVR (odds ratio [OR] = 0.65, 95% confidence interval [CI]: 0.54 to 0.78,
I2 = 0%, P < 0.001). The length of stay (LOS) in the hospital
(standardized mean difference [SMD] = -0.44, 95% CI: -0.61 to -0.26, P <
0.001) and in the intensive care unit (SMD = -0.36, 95% CI: -0.57 to
-0.15, P < 0.001) were shorter for MIAVR. Individual comparisons of
ministernotomy and minithoracotomy to CAVR also yielded similar results.
However, aortic cross-clamping and cardiopulmonary bypass times were
longer for MIAVR. Conclusion(s): Our meta-analysis suggests that
minimally invasive approaches to AVR may provide advantages beyond
cosmesis. Despite longer operative times, MIAVR was associated with
earlier recovery and shorter hospital LOS. These findings were consistent
for both minithoracotomy and ministernotomy. Copyright © The
Author(s) 2025.

<51>
Accession Number
2038801721
Title
Clinical Response to Resynchronization Therapy: Conduction System Pacing
vs Biventricular Pacing. CONSYST-CRT trial.
Source
JACC: Clinical Electrophysiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Pujol-Lopez M.; Graterol F.R.; Borras R.; Garcia-Ribas C.; Guichard J.B.;
Regany-Closa M.; Jimenez-Arjona R.; Niebla M.; Poza M.; Carro E.; Castel
M.A.; Arbelo E.; Porta-Sanchez A.; Sitges M.; Roca-Luque I.; Doltra A.;
Guasch E.; Tolosana J.M.; Mont L.
Institution
(Pujol-Lopez, Graterol, Borras, Guichard, Regany-Closa, Jimenez-Arjona,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut Clinic Cardiovascular (ICCV),
Hospital Clinic, Universitat de Barcelona, Catalonia, Spain
(Pujol-Lopez, Graterol, Borras, Garcia-Ribas, Guichard, Regany-Closa,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut d'Investigacions Biomediques
August Pi i Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
(Borras) Centro de Investigacion Biomedica en Red;, Salud Mental
(CIBERSAM), Instituto de Salut Carlos III, Madrid, Spain
(Guichard, Castel, Arbelo, Sitges, Roca-Luque, Guasch, Tolosana, Mont)
Centro de Investigacion Biomedica en Red, Enfermedades Cardiovasculares
(CIBERCV), Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Randomized studies comparing conduction system pacing (CSP)
with biventricular pacing (BiVP) are scarce and do not include clinical
outcomes. Objective(s): The CONSYST-CRT (Conduction System Pacing vs
Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide
QRS) trial aimed to test the noninferiority of CSP as compared with BiVP
in patients with an indication for cardiac resynchronization therapy, with
respect to a combined clinical endpoint at 1-year follow-up.
 Method(s): CONSYST-CRT is a randomized, controlled, noninferiority
trial (NCT05187611). One hundred thirty-four patients with cardiac
resynchronization therapy indication were randomized to BiVP or CSP and
followed up for 12 months. Crossover was allowed when the primary
allocation procedure failed. The atrioventricular interval was optimized
to obtain fusion with intrinsic conduction. The primary combined endpoint
was all-cause mortality, cardiac transplant, heart failure
hospitalization, or left ventricular ejection fraction (LVEF) improvement
<5 points at 12 months. Secondary endpoints were LVEF increase, LV
end-systolic volume (LVESV) decrease, echocardiographic response (>=15%
LVESV decrease), QRS shortening, septal flash correction, NYHA functional
class improvement, and a combined endpoint of all-cause mortality, cardiac
transplantation, and heart failure hospitalization. Result(s):
Sixty-seven patients were allocated to each group. Eighteen patients
(26.9%) crossed from CSP to BiVP; 5 (7.5%) crossed over from BiVP to CSP.
Noninferiority (NI) was observed for CSP compared with BiVP for the
primary endpoint (23.9% vs 29.8%, respectively; mean difference -5.9; 95%
CI: -21.1 to 9.2; P = 0.02) and for the combined endpoint of all-cause
mortality, cardiac transplantation, and heart failure hospitalization
(11.9% vs 17.9%; P < 0.01 NI); echocardiographic response (66.6% vs 59.7%;
P = 0.03 NI); NYHA functional class (P < 0.001 NI); and QRS shortening (P
< 0.01). LVEF, LVESV, and septal flash endpoint values were similar, but
noninferiority was not met (14.1 +/- 10% vs 14.4 +/- 10%, -27.9 +/- 27% vs
-27.9 +/- 28%, -2.2 +/- 2.7 mm vs -2.7 +/- 2.4 mm, respectively).
 Conclusion(s): CSP was noninferior to BiVP in achieving clinical and
echocardiographic response, suggesting that CSP could be an alternative to
BiVP. (Conduction System Pacing vs Biventricular Resynchronization Therapy
in Systolic Dysfunction and Wide QRS [CONSYST-CRT];
NCT05187611) Copyright © 2025 The Authors

<52>
Accession Number
2038767145
Title
Perioperative Oral decontamination and ImmunoNuTrition (POINT) to prevent
postoperative pulmonary complications in elderly patients scheduled for
elective non-cardiac surgeries: Protocol for a multicentre, randomised
controlled trial.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e092068. Date of
Publication: 14 May 2025.
Author
Yu J.; Che L.; Zhu Q.; Xu L.; Fu J.; Zhang Y.; You M.; Zheng X.; Liu C.;
Huang L.; Wang W.; Yao L.; Fan G.; Chen J.; Zhang J.; Huang Y.
Institution
(Yu, Che, Zhu, Xu, Huang) Department of Anesthesiology, Peking Union
Medical College Hospital, Beijing, China
(Fu) Department of Clinical Nutrition, Peking Union Medical College
Hospital, Beijing, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Beijing, China
(You, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou,
China
(Liu, Huang) Department of Anesthesiology, The Second Hospital of Hebei
Medical University, Shijiazhuang, China
(Wang, Yao) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Fan, Chen) Clinic Center of Anesthesiology and Pain, Ningbo No.2
Hospital, Ningbo, China
(Zhang) Department of Anesthesiology, Shenzhen Qianhai and Shekou Free
Trade Zone Hospital, Shenzhen, China
Publisher
BMJ Publishing Group
Abstract
Introduction Elderly patients are known to be vulnerable to postoperative
pulmonary complications (PPCs), especially pneumonia. Apart from elder
age, preoperative pulmonary diseases, anaemia, malnutrition, dysphagia and
frailty may all be contributing factors to PPCs. Poor oral hygiene is a
risk factor for PPC as well, as oropharyngeal microflora might be
introduced to the lower respiratory tract following endotracheal
intubation for general anaesthesia during surgery. Immune regulation,
nutrition supplementation and improvement of oropharyngeal microflora
might regulate immune and stress response and can be beneficial to elderly
patients exposed to surgical stress. In this study, we will explore the
effects of perioperative oral decontamination and immunonutrition
supplementation on the incidence of postoperative pneumonia in high-risk
elderly surgical patients. Methods and analysis This study is a
multicentre, two-by-two factorial randomised controlled trial evaluating
the efficacy of immunonutrition supplementation and oral chlorhexidine
decontamination. A total of 592 patients aged 65 years and older who are
scheduled for elective non-cardiac surgeries in seven tertiary hospitals
in China will be recruited. Patients will be excluded if they have
contraindications to the intervention. Patients will be randomised into
four groups in a 1:1:1:1 ratio (oral decontamination vs routine oral care,
immunonutrition supplementation vs routine nutrition advice). The primary
outcome is the incidence of PPCs within 7 days after surgery. The
secondary outcomes are the incidence of postoperative pneumonia,
infectious complications, Comprehensive Complication Index, postoperative
functional recovery, length of hospital stay and hospital expenses.
Intention to treat principles will be applied to all outcomes. Descriptive
analysis will be used to compare patients' baseline characteristics.
Logistic regression will be used to compare the incidence of PPCs within 7
days after surgery between different groups. Ethics and dissemination The
study protocol has been approved by the Research Ethics Committee of
Peking Union Medical College Hospital (I-23PJ953). All participants will
provide written informed consent. Study results will be published in
peer-reviewed journals and presented at academic conferences. Trial
registration number NCT05971810. 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.

<53>
Accession Number
2034565049
Title
Safety and Efficacy of Outpatient Parenteral Antibiotic Therapy (OPAT) in
Patients With Infective Endocarditis: A Systematic Review and
Meta-Analysis.
Source
Clinical Cardiology. 48(5) (no pagination), 2025. Article Number: e70147.
Date of Publication: 01 May 2025.
Author
Ashraf H.; Nadeem Z.A.; Rehman K.A.; Akhtar S.; Ashfaq H.; Khan M.S.; Butt
M.; Nagmeldin I.; Fatima E.; Waqas M.; Saleh A.; Jain H.; Ahmed R.
Institution
(Ashraf, Nadeem, Ashfaq, Khan, Butt) Department of Medicine, Allama Iqbal
Medical College, Lahore, Pakistan
(Rehman) Department of Medicine, CMH Lahore Medical College, Lahore,
Pakistan
(Akhtar) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Nagmeldin) Department of Medicine, University of Khartoum, Khartoum,
Sudan
(Fatima) Department of Medicine, Services Institute of Medical Sciences,
Lahore, Pakistan
(Waqas) Department of Medicine, Wah Medical College, Wah, Pakistan
(Saleh) Faculty of Medicine, Lebanese University, Beirut, Lebanon
(Jain) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jodhpur, India
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Infective endocarditis (IE) is a life-threatening infection
requiring prolonged intravenous antimicrobial therapy. Outpatient
parenteral antibiotic therapy (OPAT) has emerged as an alternative to
prolonged hospitalization, but its safety and efficacy in IE remain
debated. Hypothesis: This systematic review and meta-analysis aimed to
evaluate the outcomes of OPAT in IE patients. Method(s): We
systematically searched MEDLINE, Cochrane CENTRAL, Google Scholar, and
Scopus for studies assessing OPAT in IE. Eligible studies included
randomized controlled trials and observational studies reporting at least
one relevant outcome (mortality, relapse, readmission, valve surgery, and
adverse events). Pooled estimates were calculated using a random-effects
model, and heterogeneity was assessed using the I2 statistic. Risk of bias
was evaluated using the ROBINS-I tool. Result(s): A total of 25
studies involving 2654 patients were included in the analysis. Patients
treated with OPAT had a mortality rate of 0% during the treatment period
and 5% during follow-up. The readmission rate was 16% during the treatment
period, 4% of the patients had relapse, while 16% of patients underwent
cardiac surgery. During follow-up, the readmission rate was 19%, with a
relapse rate of 2%, and 14% of patients underwent cardiac surgery.
Sensitivity analyses did not significantly affect the results,
highlighting the robustness of the findings. Conclusion(s): OPAT
appears to be safe and effective for IE patients, with low mortality and
relapse rates. However, increased readmission rates and IV-line
complications warrant careful patient selection and monitoring. Further
prospective trials are needed to refine OPAT protocols. Copyright
© 2025 The Author(s). Clinical Cardiology published by Wiley
Periodicals LLC.

<54>
Accession Number
2034570283
Title
Use of an insulin titration protocol based on continuous glucose
monitoring in postoperative cardiac surgery patients with type 2 diabetes
and prediabetes: a randomized controlled trial.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
210. Date of Publication: 01 Dec 2025.
Author
Moon S.-J.; Kim M.-S.; Kim Y.T.; Lee H.-E.; Lee Y.-W.; Lee S.-J.; Chung
E.-S.; Park C.-Y.
Institution
(Moon, Lee, Park) Division of Endocrinology and Metabolism, Department of
Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University
School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim, Lee, Lee, Chung) Thoracic and Cardiovascular Surgery, Kangbuk
Samsung Hospital, Sungkyunkwan University School of Medicine, 29
Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim) Division of Biostatistics, Department of Academic Research, Kangbuk
Samsung Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Maintaining optimal glucose control is critical for
postoperative care cardiac surgery patients. Continuous glucose monitoring
(CGM) in this setting remains understudied. We evaluated the efficacy of
CGM with a specialized titration protocol in cardiac surgery patients with
type 2 diabetes (T2D) and prediabetes. Method(s): In this
randomized-controlled trial, 54 cardiac surgery patients were randomized
one day post-surgery, with 27 CGM and 25 point-of-care (POC) patients
completing the study. The CGM group used Dexcom G6 with a CGM-specialized
titration protocol, while the POC group used standard monitoring with
blinded CGM. The primary outcome was time-in-range (TIR) 100-180 mg/dL for
7 days post-surgery. Secondary outcomes included various glycemic metrics
and surgical outcomes. Multiple comparison adjustments were performed
using false-discovery-rate (FDR). Result(s): Thirty-one (59.6%) had
diabetes and 21 (40.4%) had prediabetes. While TIR 100-180 mg/dL showed no
difference (74.7% vs. 71.6%, FDR-adjusted p = 0.376), the CGM group
demonstrated improvements in TIR 70-180 mg/dL (83.8% vs. 75.8%,
FDR-adjusted p = 0.026), time-in-tight-range (TITR) 100-140 mg/dL (46.3%
vs. 36.3%, FDR-adjusted p = 0.018), and TITR 70-140 mg/dL (55.3% vs.
40.5%, FDR-adjusted p = 0.003). Both groups maintained very low rates of
time below range (< 70 mg/dL: 0.03% vs. 0.18%, FDR-adjusted p = 0.109).
The CGM group showed lower postoperative atrial fibrillation (AF) (18.8%
vs. 55.6%, FDR-adjusted p = 0.04999). Conclusion(s): While the
primary outcome was not achieved, CGM with a specialized titration
protocol demonstrated safe glycemic control with improvements in TIR
70-180 mg/dL and TITRs in cardiac surgery patients with T2D and
prediabetes. The observed reduction in postoperative AF warrants further
investigation. Trial Registration: ClinicalTrials.gov
NCT06275971 Copyright © The Author(s) 2025.

<55>
Accession Number
2034582372
Title
Prophylactic corticosteroids in neonatal cardiac surgeries using
cardiopulmonary bypass: a systematic review and meta-analysis.
Source
Journal of Anesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Kataoka K.; Cheng S.; Sumie M.; Adam R.-I.; Niimi N.; Cunningham J.; Yang
A.; Ng W.C.K.; Hayes J.; Maynes J.T.; Aoyama K.
Institution
(Kataoka, Sumie, Niimi, Ng, Hayes, Maynes, Aoyama) Department of
Anesthesia and Pain Medicine, The Hospital for Sick Children, 555
University Ave, #2211, Toronto, ON, Canada
(Kataoka, Cheng, Sumie, Niimi, Cunningham, Hayes, Maynes, Aoyama) Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Sumie, Yang, Aoyama) Program in Child Health Evaluative Sciences,
SickKids Research Institute, Toronto, ON, Canada
(Sumie) Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan
(Sumie) Department of Anesthesiology and Critical Care Medicine, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan
(Adam) Department of Psychology, Queen's University, Kingston, ON, Canada
(Cunningham) The Hospital for Sick Children, Health Sciences Library, 555
University Avenue, Toronto, ON, Canada
(Ng) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States
(Maynes) Program in Molecular Medicine, SickKids Research Institute,
Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Neonates undergoing cardiopulmonary bypass (CPB) are at a high
risk of a systemic inflammatory response leading to cardiac, respiratory,
and renal dysfunction due to their small body size and insufficient
adrenal stress response. We hypothesized that corticosteroids reduce
systemic inflammatory response and improve clinical outcomes in neonates
undergoing cardiac surgery with CPB. Method(s): A systematic search
was conducted on six databases including MEDLINE from their inceptions to
August 20, 2024. Inclusion criteria were randomized controlled trials
(RCTs) comparing corticosteroids and placebo in neonates undergoing
cardiac surgery with CPB. The primary outcomes were IL-6 and IL-10 serum
levels. The secondary outcomes were postoperative clinical outcomes such
as length of intensive care unit (ICU) stay, mortality, and incidence of
acute kidney injury. Pooled risk ratios or mean differences (MDs) and 95%
confidence intervals (CIs) were calculated using random-effects
meta-analysis. Certainty of evidence were assessed following GRADE. This
study was registered in PROSPERO (CRD42024548217). Result(s): Seven
RCTs met all inclusion criteria, consisting of 316 patients.
Administration of corticosteroids significantly decreased plasma IL-6 on
POD1 (MD -64.21 pg/mL, 95% CI -118.26 to -10.16) and plasma IL-10 on POD1
(MD - 4.60 pg/mL, 95% CI - 8.07 to - 1.12). We confirmed corticosteroids
administration did not improve clinical outcomes. Conclusion(s):
Corticosteroids significantly reduced inflammatory cytokines on POD1.
Routine prophylactic use of corticosteroids is not recommended even in
neonatal cardiac surgery, however, because of high incidence of adrenal
insufficiency in neonates after cardiac surgery with CPB, neonates with
clinically suspected adrenal insufficiency could benefit from
perioperative corticosteroids administration. Copyright © The
Author(s) under exclusive licence to Japanese Society of Anesthesiologists
2025.

<56>
Accession Number
2038634761
Title
Comparison of Magnesium Sulphate and Esmolol for Attenuation of
Hemodynamic Stress Response to Laryngoscopy and Intubation in Elective ENT
Procedures.
Source
European Journal of Cardiovascular Medicine. 15(5) (pp 99-102), 2025. Date
of Publication: 01 May 2025.
Author
Sree K.U.; Vegiraju B.V.V.; Nagaraju C.H.
Institution
(Sree) Department of Anaesthesiology, Alluri Sitarama Raju Academy of
Medical Sciences, West Godavari District, Andhra Pradesh, Eluru, India
(Vegiraju) Department of Anaesthesiology, Government Medical College,
Andhra Pradesh, Anantapuramu, India
(Nagaraju) Department of Anaesthesiology, Government medical college,
Nizamabad, India
Publisher
Healthcare Bulletin
Abstract
Background: The induction of anaesthesia, laryngoscopy, tracheal
intubation and surgical stimulation evoke cardiovascular responses leading
to alteration in heart rate, cardiac rhythm and blood pressure. The
response starts in 5 seconds, peaks within 1-2 minutes and returns to
baseline in 5 minutes. The goal is to compare the effectiveness of Esmolol
and Magnesium Sulphate for attenuation of haemodynamic stress response to
laryngoscopy and intubation. Material(s) and Method(s): After
approval from the ASRAMS Institutional Ethics Committee, the procedure was
clearly explained to patients and informed written consent was obtained.
The study was conducted during the period, April 2024- March 2025 at ASRAM
General and Super-Specialty Hospital, Eluru, Andhra Pradesh. 90 patients
of age group 15 to 60 yrs of ASA physical status I and II who underwent
elective ENT surgery under general anesthesia were selected and randomly
allocated into 3 groups. Baseline heart rate and blood pressure was
measured. They were premedicated with Inj. Glycopyrrolate 0.2mg and Inj.
Midazolam 0.04mg/kg intramuscular 45 minutes before surgery. Patients were
then shifted into the theatre. Inj. Fentanyl 2microg/kg was given 5
minutes before intubation to all patients. They were induced with Inj.
Propofol 2mg/kg and Vecuronium 0.1mg/kg. Group M received Inj. Magnesium
Sulphate 50mg/kg in 100ml of normal saline infusion over 10 minutes before
induction. Group P received 15ml of normal saline 5 minutes before
induction. Group E received Esmolol 1.5mg/kg in 15ml normal saline over
15-20 seconds one minute after vecuronium and intubation was done after 2
minutes. Group P received 15ml of normal saline 5 minutes before
induction. The heart rate, systolic and diastolic blood pressure and mean
arterial pressure were recorded baseline, after premedication, one min
after test drug, after induction, immediately after intubation, thereafter
1, 3 and 5 minutes following intubation. Laryngoscopy duration was noted.
 Result(s): 1) Group E showed maximum attenuation of heart rate and
blood pressure. 2) Group M also showed significant attenuation of blood
pressure response but produced tachycardia on infusion of the drug. Heart
rate response was not statistically significant compared to group E. 3)
All patients recovered well. 4) Incidence of side effects was not
significant between the groups. Conclusion(s): From this study, it is
concluded that hemodynamic changes to laryngoscopy and intubation can be
attenuated by giving intravenous Esmolol 1.5mg/kg. Esmolol is effective in
blunting the response followed by Magnesium Sulphate which blunts the
hypertensive response but produces tachycardia during infusion of the
drug. Placebo was ineffective in blunting hemodynamic stress response to
laryngoscopy and intubation.. Copyright © 2025 Healthcare
Bulletin. All rights reserved.

<57>
Accession Number
2034574383
Title
Quercetin Reduces Vascular Senescence and Inflammation in Symptomatic Male
but Not Female Coronary Artery Disease Patients.
Source
Aging Cell. (no pagination), 2025. Date of Publication: 2025.
Author
Mury P.; Dagher O.; Fortier A.; Diaz A.; Lamarche Y.; Noly P.-E.; Ibrahim
M.; Page P.; Demers P.; Bouchard D.; Bernier P.-L.; Poirier N.; Moss E.;
Durrleman N.; Jeanmart H.; Pellerin M.; Lettre G.; Thorin-Trescases N.;
Carrier M.; Thorin E.
Institution
(Mury, Dagher, Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier,
Poirier, Moss, Durrleman, Jeanmart, Pellerin, Lettre, Thorin-Trescases,
Carrier, Thorin) Montreal Heart Institute, Research Center, Universite de
Montreal, Montreal, QC, Canada
(Mury, Dagher) Department of Pharmacology & Physiology, Faculty of
Medicine, Universite de Montreal, Montreal, QC, Canada
(Dagher) Department of Cardiac Sciences, Libin Cardiovascular Institute,
Calgary, AB, Canada
(Fortier) Department of Biostatistics, Montreal Health Innovations
Coordinating Centre (MHICC), Montreal, QC, Canada
(Diaz) CIUSSS-MCQ, Universite de Montreal, Campus Mauricie,
Trois-Rivieres, QC, Canada
(Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier, Poirier, Moss,
Durrleman, Jeanmart, Pellerin, Carrier, Thorin) Faculty of Medicine,
Department of Surgery, Universite de Montreal, Montreal, QC, Canada
(Lettre) Department of Medicine, Faculty of Medicine, Universite de
Montreal, Montreal, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Recent studies suggest that vascular senescence and its associated
inflammation fuel the inflammaging to favor atherogenesis; whether these
pathways can be therapeutically targeted in coronary artery disease (CAD)
patients remains unknown. In a randomized, double-blind trial, 97 patients
(78 men) undergoing coronary artery bypass graft surgery were treated with
either quercetin (500 mg twice daily, 47 patients) or placebo (50
patients) for two days pre-surgery through hospital discharge. Primary
outcomes were reduced inflammation and improved endothelial function ex
vivo. Exploratory analyses included plasma proteomics and single-nuclei
RNA sequencing of internal thoracic artery (ITA) samples. Quercetin
treatment showed a trend toward reduced C-reactive protein at discharge (p
= 0.073) and differentially modulated circulating inflammatory protein
expression between men and women, with a pro-inflammatory effect of
quercetin in females. Endothelial acetylcholine-induced relaxation
improved significantly with quercetin (p = 0.049), with effects in men (p
= 0.043) but not in women (p = 0.852). ITA transcriptomics revealed the
overexpression of senescence and inflammaging pathways in male vascular
cells, which quercetin reversed. In female cells, quercetin had minimal
endothelial benefit and increased inflammaging in fibroblasts. In male
cells, a candidate target of quercetin involves interactions between the
receptor PLAUR and its ligands PLAU and SERPINE1. Post-operative atrial
fibrillation incidence was significantly lower with quercetin,
representing 4% of the patients compared to 18% in the placebo group (p =
0.033). In conclusion, short-term quercetin treatment effectively targeted
vascular senescence in male CAD patients, improving inflammatory and
functional outcomes. However, these benefits were not observed in female
patients. Trial Registration: https://clinicaltrials.gov,
NCT04907253. Copyright © 2025 The Author(s). Aging Cell published
by Anatomical Society and John Wiley & Sons Ltd.

<58>
Accession Number
2038681798
Title
Comparison of Outcomes Between Total Arterial Off-Pump Versus On-Pump
Coronary Artery Bypass Surgery: A Meta-Analysis and Meta-Regression.
Source
American Journal of Cardiology. 249 (pp 43-50), 2025. Date of Publication:
15 Aug 2025.
Author
Comanici M.; Bithi N.; Raja S.G.
Institution
(Comanici, Bithi, Raja) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
An essential aspect of achieving early optimal outcomes in coronary artery
bypass grafting (CABG) is the careful selection of conduits. Total
arterial grafting (TAG) has been debated, and recent studies suggest its
benefits, especially when combined with off-pump coronary artery bypass
grafting (OPCAB). We conducted a systematic review and meta-analysis of
studies comparing outcomes of TAG in OPCAB versus on-pump CABG (ONCAB),
using data from OVID MEDLINE, EMBASE, SCOPUS, and PUBMED. Seven studies
with a total of 5417 patients were included. Short-term outcomes showed no
significant differences in perioperative complications between TAG-OPCAB
and TAG-ONCAB, but TAG-OPCAB was associated with reduced short-term
mortality (OR 0.48, 95% CI [0.26, 0.89], p = 0.02), lower incidence of
postoperative low cardiac output, atrial fibrillation, and MACCEs, as well
as shorter intubation duration and hospital stay. Meta-regression did not
reveal any associations between pre- or intraoperative variables and
short-term mortality. In conclusion, TAG-OPCAB demonstrates favorable
short-term outcomes and may be considered a safe and effective strategy in
selected patients, while long-term outcomes remain inconclusive due to
limited data. Copyright © 2025 Elsevier Inc.

<59>
Accession Number
2034540820
Title
Lipid-Lowering Effect and Safety of Ezetimibe and Atorvastatin 5 mg in
Patients With Primary Hypercholesterolemia or Mixed Dyslipidemia: A
Randomized, Double-Blind, Parallel, Multicenter, Phase 3 Clinical Trial.
Source
Clinical Cardiology. 48(5) (no pagination), 2025. Article Number: e70138.
Date of Publication: 01 May 2025.
Author
Ki Y.-J.; Kim W.; Lee K.H.; Han S.-J.; Kim Y.-H.; Doh J.-H.; Kim T.N.;
Chung C.H.; Kim D.Y.; Cho J.-M.; Yoon H.-J.; Jeong I.-K.; Park S.; Song
K.-H.; Yu C.W.; Cho D.-K.; Choi S.H.; Oh S.-J.; Shin S.; Jeong H.; Park
Y.; Kim H.-S.
Institution
(Ki) Cardiovascular Center, Department of Internal Medicine, Uijeongbu
Eulji Medical Center, Uijeongbu, South Korea
(Kim) Cardiovascular Division, Department of Internal Medicine, Kyung Hee
University Hospital, Kyung Hee University, Seoul, South Korea
(Lee) Cardiovascular Division, Department of Internal Medicine, Chonnam
National University Medical School & Hospital, Gwangju, South Korea
(Han) Division of Cardiology, Department of Internal Medicine, Hallym
University Sacred Heart Hospital, Anyang, South Korea
(Kim) Department of Endocrinology, Bundang Jesaeng Hospital, Gyeonggido,
Bundang-gu, South Korea
(Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea
(Kim) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
(Chung) Department of Internal Medicine and Research Institute of
Metabolism and Inflammation, Yonsei University Wonju College of Medicine,
Wonju, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Ajou
University Hospital and Ajou School of Medicine, Suwon, South Korea
(Cho) Department of Cardiovascular Medicine, Kyung Hee University Hospital
at Gangdong, Seoul, South Korea
(Yoon) Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu,
South Korea
(Jeong) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University
College of Medicine, Seoul, South Korea
(Park) Cardiovascular Research Institute, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Division of Endocrinology and Metabolism, Konkuk University Medical
Center, Konkuk University School of Medicine, South Korea
(Yu) Department of Cardiology, Cardiovascular Center, Korea University
Anam Hospital, Seoul, South Korea
(Cho) Yongin Severance Hospital, Yonsei University College of Medicine,
South Korea
(Choi) Department of Internal Medicine, Seoul National University College
of Medicine, Seoul National University Bundang Hospital, Seongnam-City,
South Korea
(Oh) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, Goyang, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Ewha
Womans University Seoul Hospital, Seoul, South Korea
(Jeong) Division of Cardiology, Department of internal medicine, Myongji
Hospital, Hanyang University Medical Center, Goyang, South Korea
(Park) Division of Cardiology, Department of Internal Medicine, Gyeongsang
National University Changwon Hospital, Changwon, South Korea
(Kim) Cardiovascular Center, Department of Internal Medicine, Seoul
National University Hospital, Seoul, South Korea
Publisher
John Wiley and Sons Inc
Abstract
Objective: This study aimed to compare the lipid-lowering effect and
safety of low-intensity atorvastatin (5 mg) plus ezetimibe (10 mg)
combination therapy (A5E10) with monotherapy regimens-atorvastatin 5 mg
[A5], ezetimibe 10 mg [E10], and atorvastatin 10 mg [A10])-in dyslipidemia
patients. Method(s): A randomized, double-blind, placebo-controlled
trial involving 252 dyslipidemia patients was conducted at 25 centers in
South Korea (NCT05970679). Participants aged >= 19 years were randomized
into four groups: A5E10, A5, E10, and A10. The primary endpoint was the
percentage change in low-density lipoprotein cholesterol (LDL-C) levels
from baseline to 8 weeks. Secondary endpoints included changes in other
lipid parameters, lipid ratios, LDL-C goal achievement rates and safety
assessments. Result(s): The mean age of the patients was 63 years,
and 51.2% were male. The A5E10 group showed significantly greater LDL-C
reduction (47.6%) compared with A5 (33.4%), E10 (19.4%), and A10 (40.1%)
at 8 weeks (p < 0.0001). A5E10 also significantly reduced triglyceride,
non-high-density lipoprotein cholesterol, and apolipoprotein B levels. In
addition, a significant reduction in LDL-C levels was observed over the 4
weeks, with a 46.7% reduction in LDL-C levels after 4 weeks of A5E10
administration. No severe adverse events were observed in the A5E10 group.
 Conclusion(s): The combination of low-intensity atorvastatin and
ezetimibe was more effective than moderate-intensity atorvastatin
monotherapy in lowering LDL-C levels and improving other lipid parameters.
It was well-tolerated and demonstrated rapid benefits within a month,
offering a promising alternative for patients with low to moderate
cardiovascular risk who do not achieve adequate control with statin
monotherapy. Copyright © 2025 The Author(s). Clinical Cardiology
published by Wiley Periodicals LLC.

<60>
Accession Number
2038613243
Title
At the heart of couple conflict: Emotion regulation and cardiac
reactivity.
Source
International Journal of Psychophysiology. 212 (no pagination), 2025.
Article Number: 112581. Date of Publication: 01 Jun 2025.
Author
Salo K.I.; Pauw L.S.; Schubotz R.I.; Milek A.
Institution
(Salo, Milek) Witten/Herdecke University, Alfred-Herrhausen-Strase 44,
Witten, Germany
(Pauw) Utrecht University, Heidelberglaan 1, CS, Utrecht, Netherlands
(Schubotz) University of Munster, Fliednerstrase 21, Munster, Germany
Publisher
Elsevier B.V.
Abstract
Adaptive emotion regulation can buffer against cardiac reactivity under
acute stress. However, research on the effectiveness of emotion regulation
in the face of interpersonal stress is scarce. We therefore conducted an
experiment investigating whether emotion regulation might buffer against
parasympathetically mediated cardiac reactivity during conflict. Couples
engaged in a 10-min conflict discussion (N = 253 participants included in
the final analyses). Prior to the discussion, one partner per couple was
randomly assigned to one of three experimental conditions (acceptance,
cognitive reappraisal, control group). In both emotion regulation groups,
the manipulated partner was instructed to apply either acceptance or
cognitive reappraisal during the following conflict. Vagal (i.e.,
parasympathetic) activity as indexed by the heart rate variability (HRV)
parameter RMSSD was assessed at baseline and during conflict. Cardiac
reactivity was operationalized as the difference between baseline vagal
activity and vagal activity during conflict. Both emotion regulation
strategies significantly reduced cardiac reactivity in the manipulated
partner as compared to the control group. We thus found preliminary
support that emotion regulation may beneficially alter parasympathetically
mediated cardiac reactivity during acute interpersonal
stress. Copyright © 2025

<61>
Accession Number
2038682037
Title
Risk factors for infection in patients undergoing hip replacement: a
systematic review and meta-analysis.
Source
Journal of Hospital Infection. 160 (pp 60-73), 2025. Date of Publication:
01 Jun 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, Hunan Province,
Hengyang, China
(Lei, Lei, Wang, Xiao, Wen, Yan) Department of Neurosurgery, Chenzhou
Third People's Hospital and the Second Affiliated Hospital of Xiangnan
University, Hunan Province, Chenzhou, China
(Zeng) Department of Gynecology, The Second Affiliated Hospital, Hengyang
Medical School, University of South China, Hunan Province, Hengyang City,
China
(Luo) Department of Spine Surgery, Lishui Hospital of Wenzhou Medical
University, Lishui People's Hospital, Zhejiang, Lishui, China
(Li, Yan) Department of Joint Surgery, The Second Affiliated Hospital,
Hengyang Medical School, University of South China, Hunan Province,
Hengyang City, China
Publisher
W.B. Saunders Ltd
Abstract
A meta-analysis was conducted to determine the risk of infection following
hip replacement and risk factors were identified for surgical site
infection. PubMed/Medline, Embase and Cochrane Library databases were
systematically searched, 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. 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), American Society of Anesthesiologists
(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. In conclusion, 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. Copyright © 2025

<62>
Accession Number
2037282988
Title
Prognostic impact of intravascular imaging in percutaneous coronary
intervention according to atherothrombotic risk: a post hoc analysis of a
randomized clinical trial.
Source
Revista Espanola de Cardiologia. 78(6) (pp 542-552), 2025. Date of
Publication: 01 Jun 2025.
Author
Hong D.; Ha J.; Choi K.H.; Lee S.H.; Shin D.; Lee J.-Y.; Lee S.-J.; Lee
S.Y.; Kim S.M.; Yun K.H.; Cho J.Y.; Kim C.J.; Ahn H.-S.; Nam C.-W.; Yoon
H.-J.; Park Y.H.; Lee W.S.; Yang J.H.; Choi S.-H.; Gwon H.-C.; Song Y.B.;
Hahn J.-Y.; Park T.K.; Lee J.M.
Institution
(Hong, Ha, Choi, Yang, Choi, Gwon, Song, Hahn, Park, Lee) Division of
Cardiology, Department of Medicine, Heart Vascular Stroke Institute,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seul,
South Korea
(Lee) Department of Internal Medicine and Cardiovascular Center, Chonnam
National University Hospital, Gwangju, South Korea
(Shin) Department of Cardiology, St Francis Hospital and Heart Center,
Roslyn, Nueva York, United States
(Lee, Lee) Division of Cardiology, Department of Internal Medicine,
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine,
Seul, South Korea
(Lee, Kim) Division of Cardiology, Department of Internal Medicine,
Chungbuk National University Hospital, Chungbuk National University
College of Medicine, Cheongju, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Chung-Ang
University College of Medicine, Chung-Ang University Gwangmyeong Hospital,
Gwangmyeong, South Korea
(Yun, Cho) Division of Cardiology, Department of Internal Medicine,
Wonkwang University Hospital, Iksan, South Korea
(Kim, Ahn) Division of Cardiology, Department of Internal Medicine, The
Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seul, South
Korea
(Nam, Yoon) Division of Cardiology, Department of Internal Medicine,
Keimyung University Dongsan Hospital, Daegu, South Korea
(Park) Department of Cardiology, Samsung Changwon Hospital, Sungkyunkwan
University School of Medicine, Changwon, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Chung-Ang
University College of Medicine, Chung-Ang University Hospital, Seul, South
Korea
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Recent randomized controlled trials support
the use of intravascular imaging-guided percutaneous coronary intervention
(PCI) to improve patient prognosis. However, the subsequent risk of
clinical events in patients with coronary artery disease is not determined
solely by lesion characteristics or how these lesions are treated. The
current study investigated whether the effects of intravascular imaging in
complex PCI vary according to atherothrombotic risks. Method(s): This
study was a post hoc analysis of the RENOVATE-COMPLEX-PCI trial, which
compared intravascular imaging-guided PCI with angiography-guided PCI in
patients with complex coronary artery lesions. The study population was
stratified by atherothrombotic risk, assessed using the Thrombolysis in
Myocardial Infarction risk score for secondary prevention (TRS-2P). TRS-2P
is calculated based on the presence of the following factors: age >= 75
years, diabetes mellitus, hypertension, smoking, peripheral arterial
disease, stroke, coronary artery bypass grafting, heart failure, and renal
dysfunction. Patients were categorized into low-risk (TRS-2P < 3) or
high-risk (TRS-2P >= 3) groups. The primary endpoint was target vessel
failure, a composite of cardiac death, target vessel-related myocardial
infarction, or clinically driven target vessel revascularization.
 Result(s): Among the total study population, 1247 patients were
categorized as low-risk, and 392 as high-risk. The risk of target vessel
failure was significantly higher in the high-risk group than in the
low-risk group (15.5% vs 7.2%; HR, 2.13; 95%CI, 1.51-3.00; P < .001). The
benefits of intravascular imaging-guided PCI over angiography-guided PCI
did not differ between the low-risk group (5.6% vs 10.4%; HR, 0.56; 95%CI,
0.36-0.86) and the high-risk group (14.1% vs 18.5%; HR, 0.71; 95%CI,
0.41-1.24), with no significant interaction (interaction P = .496).
 Conclusion(s): In this hypothesis-generating post hoc analysis of the
RENOVATE-COMPLEX-PCI trial, patients with high atherothrombotic risk had
significantly worse clinical outcomes than those with low atherothrombotic
risk. Nevertheless, the prognostic impact of intravascular imaging-guided
PCI compared with angiography-guided PCI was similarly observed in both
low- and high-risk groups. RENOVATE-COMPLEX-PCI clinical trial register
number: NCT03381872. Copyright © 2024 Sociedad Espanola de
Cardiologia

<63>
Accession Number
2038464129
Title
Efficacy of the Glucagon-Like Peptide-1 Agonist Exenatide in Patients
Undergoing CABG or Aortic Valve Replacement: A Randomized Double-Blind
Clinical Trial.
Source
Circulation: Cardiovascular Interventions. 18(5) (no pagination), 2025.
Article Number: e014961. Date of Publication: 01 May 2025.
Author
Kjaergaard J.; Moller C.H.; Wiberg S.; Mikkelsen A.D.; Moller-Sorensen H.;
Ravn H.B.; Ravn J.; Olsen P.S.; Hofsten D.E.; Boesgaard So.; Kober L.;
Nilsson J.C.; Hassager C.
Institution
(Kjaergaard, Mikkelsen, Hofsten, Boesgaard, Kober, Hassager) Department of
Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
(Kjaergaard, Wiberg, Kober, Hassager) Department of Clinical Medicine,
Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Moller, Ravn, Olsen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital Rigshospitalet, Rigshospitalet, Denmark
(Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic
Anesthesiology, Copenhagen University Hospital Rigshospitalet,
Rigshospitalet, Denmark
(Ravn) Department of Anesthesiology and Intensive Care, Odense University
Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: GLP-1 (glucagon-like peptide-1) agonists have been proven
beneficial in reducing the risk of and injury associated with several
cardiovascular diseases. The efficacy in cardiopulmonary bypass-assisted
cardiac surgery is unknown. This trial aimed to investigate the efficacy
of an infusion of the GLP-1 agonist exenatide during and after open-heart
surgery in reducing the risk of death and major organ failure.
 METHOD(S): Randomized, double-blinded, 2-by-2 factorial design,
single-center clinical trial, also including liberal (FiO<inf>2</inf> of
100%) or restrictive (FiO<inf>2</inf> of 50%) oxygenation during and after
bypass. The present article presents the results of the exenatide
intervention. We included adult patients undergoing elective
cardiopulmonary bypass-assisted coronary artery bypass grafting or aortic
valve replacement. Patients were predominantly low risk. The intervention
was an infusion of 17.4 mug of exenatide or placebo during cardiopulmonary
bypass and the first hour after weaning thereof. The main outcome was time
to a composite end point consisting of death, stroke, renal failure
requiring dialysis, or new/worsening heart failure during follow-up.
Secondary end points included occurrence of prespecified adverse events.
 RESULT(S): A total of 1389 patients were included in the analyses.
Within a follow-up period of a median of 5.9 years (min-max; 2.5-8.3
years), 170 (24%) patients in the exenatide group and 165 (24%) patients
experienced a primary end point. We found no difference in time to the
first event between patients randomized to FiO<inf>2</inf> 50% versus
FiO<inf>2</inf> 100% (hazard ratio, 1.0 [95% CI, 0.83-1.3]; P=0.80). We
found no significant difference in rates of adverse events between the 2
groups. CONCLUSION(S): Exenatide during cardiopulmonary bypass and
weaning thereof did not significantly reduce the incidence of death,
stroke, renal failure, or new/worsening heart failure in patients
undergoing coronary artery bypass grafting and aortic valve replacement.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02673931. Copyright © 2025 Lippincott Williams and Wilkins.
All rights reserved.

<64>
[Use Link to view the full text]
Accession Number
2038725169
Title
Impact of Natriuretic Peptide and Prior Hospitalization in Patients With
Severe Mitral Regurgitation: COAPT Trial.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2025. Article
Number: e015192. Date of Publication: 2025.
Author
Goel S.S.; Guha A.; Lindenfeld J.; Abraham W.T.; Kar S.; Kapadia S.R.;
Little S.H.; Lim D.S.; Reardon M.J.; Kleiman N.S.; Aiyer J.; Kotinkaduwa
L.; Mack M.; Stone G.W.
Institution
(Goel, Guha, Little, Reardon, Kleiman) Houston Methodist Hospital, TX,
United States
(Lindenfeld) Vanderbilt University Medical Center, Nashville, TN, United
States
(Abraham) The Ohio State University Wexner Medical Center, Columbus,
United States
(Kar) Los Robles Regional Hospital, Thousand Oaks, CA, United States
(Kapadia) Cleveland Clinic, OH, United States
(Lim) University of Virginia School of Medicine, Charlottesville, United
States
(Aiyer) Abbott Laboratories, Santa Clara, CA, United States
(Kotinkaduwa) Cardiovascular Research Foundation, New York, NY, United
States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The clinical significance of elevated baseline natriuretic
peptide level and prior heart failure hospitalization (HFH) within the
prior year in mitral transcatheter edge-to-edge repair outcomes is
unclear. This analysis examined the impact of BNP (B-type natriuretic
peptide) or N-terminal prohormone BNP NT-proBNP (N-terminal pro-B-type
natriuretic peptide) and prior HFH on outcomes in patients with severe
secondary mitral regurgitation. METHOD(S): The COAPT trial
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation) was a
randomized controlled trial of subjects assigned to mitral valve
transcatheter edge-to-edge repair with the MitraClip device versus
guideline-directed medical therapy alone. COAPT patients were grouped by
BNP/NT-proBNP levels and prior HFH within 1 year: (1) Mild heart failure
(HF): no prior HFH with BNP/NT-proBNP<median; (2) Moderate HF: prior HFH
with BNP/NT-proBNP<median or no prior HFH with BNP/ NT-proBNP>=median; and
(3) Severe HF: prior HFH and BNP/NT-proBNP>=median. The primary measures
were 2-year rates of death or HFH. RESULT(S): Of 572 patients, mild,
moderate, and severe HF were present in 125 (21.9%), 288 (50.3%), and 159
(27.8%) patients, respectively. With guideline-directed medical therapy
alone, the 2-year rates of death or HFH in mild, moderate, and severe HF
were 56.4%, 60.5%, and 84.1%, respectively (P<inf>trend</inf>=0.001).
These rates were 48.7% and 73.4% among patients with moderate HF and a
prior HFH only versus elevated BNP/NT-proBNP>=median only (P=0.003).
Mitral transcatheter edge-to-edge repair reduced death/HFH compared with
guideline-directed medical therapy alone regardless of HF severity
(P<inf>interaction</inf>=0.50). CONCLUSION(S): In patients with HF
with severe secondary mitral regurgitation enrolled in the COAPT trial,
2-year rates of death/HFH were increased with an elevated baseline
BNP/NT-proBNP>=median, and more so if HFH within 1 year prior had
occurred. Treatment with mitral transcatheter edge-to-edge repair reduced
all-cause mortality and HFH consistently in mild, moderate, and severe
HF. Copyright © 2025 American Heart Association, Inc.

<65>
Accession Number
2034544093
Title
Quality of Life After Minimally Invasive Aortic Valve Replacement Surgery:
A Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Article Number: 15569845251337405. Date
of Publication: 2025.
Author
Hackney M.; Caputo M.; Angelini G.; Vohra H.
Institution
(Hackney) University of Bristol, United Kingdom
(Caputo, Angelini, Vohra) Bristol Heart Institute, University Hospitals
Bristol NHS Foundation Trust, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: Aortic valve replacement surgery (AVR) via median sternotomy
(MS) is the standard surgical intervention used for AVR. However, the
minimally invasive approach is becoming more widely adopted. This review
focuses on quality of life (QoL) after minimally invasive AVR (MIAVR). The
aim of this review is to comprehensively analyze the current body of
evidence for QoL after MIAVR. A second aim is to determine whether a
conclusion can be made based on the literature to indicate whether MIAVR
is more beneficial to the patient compared with MS and should be the
preferred approach. Method(s): A literature search was conducted in
the PubMed database using relevant searches. Papers were either included
or excluded based on their title. Through a cross-reference check from the
papers identified by the search, further articles were identified.
Initially, 375 manuscript titles and abstracts were screened, with 11
being included in this review. Result(s): The 11 studies comparing
postoperative QoL between MIAVR and MS were comprehensively analyzed.
Three studies showed no significant differences between the groups;
however, 8 identified better QoL after surgery in the MIAVR group. Three
studies investigated pulmonary function after MIAVR and MS, concluding
that MIAVR demonstrated superior pulmonary function. Conclusion(s):
Overall, MIAVR can be performed with acceptable postoperative QoL.
However, the current literature is sparse, and it is not possible to say
whether one approach is better than the other. MIAVR is certainly not
inferior to MS in terms of QoL. Well-designed, randomized controlled
trials are needed to draw more definitive conclusions. Copyright
© The Author(s) 2025.

<66>
Accession Number
647415140
Title
Bleomycin for Malignant Pericardial Effusion: A Systematic Review of
Efficacy and Adverse Events.
Source
Journal of cardiovascular pharmacology. (no pagination), 2025. Date of
Publication: 19 May 2025.
Author
Siahaan P.P.; Kurniawan R.B.; Tri Saputra P.B.; Arnindita J.N.; Savitri
C.G.; Andira L.H.; Meitavany E.N.; Eko Putranto J.N.; Alkaff F.F.
Institution
(Siahaan, Kurniawan) Faculty of Medicine, Universitas Airlangga, Surabaya,
Indonesia
(Tri Saputra, Arnindita, Savitri, Andira, Eko Putranto) Department of
Cardiology and Vascular Medicine, Faculty of Medicine, Universitas
Airlangga
(Tri Saputra, Arnindita, Savitri, Andira, Eko Putranto) Department of
Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital,
Surabaya, Indonesia
(Meitavany) School of Biomedical Engineering and Imaging Sciences (BMEIS),
King's College London, London, United Kingdom
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, University of Groningen, Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Abstract
Malignant pericardial effusion (MPE) is a progressive fluid accumulation
in the pericardial space that can lead to pericardial tamponade. Despite
the high recurrence rate associated with pericardiocentesis, it remains
the mainstay therapy. Bleomycin has emerged as an intrapericardial
sclerosing therapy that may reduce recurrence and improve patients'
quality of life. This systematic review aimed to assess the efficacy and
safety profile of Bleomycin instillation in patients with MPE. An
exhaustive search was conducted in PubMed, Web of Science, Scopus,
ProQuest, EBSCO, and ClinicalTrials.gov databases. Eligible studies
included MPE patients as participants who were treated with
intrapericardial Bleomycin, reporting the patients' outcomes and using
English in the full text. Individual studies were assessed for quality
using the Newcastle-Ottawa Scales for cohort studies and the Jadad Scale
for trial studies. Eight studies were included in this systematic review
involving 242 MPE patients treated with Bleomycin. Bleomycin demonstrated
lower recurrence rates than other sclerosing agents, with only <=5% of
patients requiring repeated drainage due to recurrence. Bleomycin
treatment resulted in 3.5 days less hospitalisation compared to
doxycycline. Bleomycin is also safe to use, with reported less severe pain
compared to other treatment agents for MPE, such as doxycycline and
pericardiocentesis. Bleomycin may benefit patients by reducing recurrence
rates and improving patients' quality of life. Moreover, it is safe and
has low rates of adverse events following the instillation. Copyright
© 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<67>
Accession Number
2034637219
Title
Metrics to assess the quality of anesthesia, perioperative care, and acute
pain management in Canada: a scoping review.
Source
Canadian Journal of Anesthesia. (no pagination), 2025. Article Number:
e010006. Date of Publication: 2025.
Author
Ke J.X.C.; Sparrow K.; Smith M.A.; Yoo K.M.; Yee M.-S.; Sun L.Y.; Beattie
W.S.; Lim E.; Gorges M.
Institution
(Ke, Gorges) Department of Anesthesiology, Pharmacology & Therapeutics,
The University of British Columbia, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Providence Health
Care, Vancouver, BC, Canada
(Ke) Department of Anesthesia, Pain Management & Perioperative Medicine,
Dalhousie University, Halifax, NS, Canada
(Sparrow) Discipline of Anesthesia, Memorial University of Newfoundland,
St. John's, NL, Canada
(Smith) Department of Family Medicine, Michigan State University, East
Lansing, MI, United States
(Yoo) MD Undergraduate Program, Faculty of Medicine, The University of
British Columbia, Vancouver, BC, Canada
(Yee) Department of Anesthesiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(Sun) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Perioperative and Pain Medicine, Stanford University
School of Medicine, Stanford, CA, United States
(Beattie) Department of Anesthesiology & Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Lim) Woodward Library, The University of British Columbia, Vancouver, BC,
Canada
(Gorges) BC Children's Hospital Research Institute, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Third Floor,
Providence Building, 1081 Burrard Street, Vancouver, BC, Canada
Publisher
Springer
Abstract
Purpose: The aim of this scoping review was to consolidate a list of
metrics that can be used to measure quality in anesthesiology,
perioperative medicine, and acute pain management in Canada.
 Method(s): We included English-language full-text articles involving
metrics (including patient-reported outcome and patient-reported
experience measures, quality and safety indicators, and practice
standards) for adults aged 18 yr and older undergoing inpatient
non-cardiac surgery requiring an anesthesiologist. We searched MEDLINE,
Embase, CINAHL, Web of ScienceTM, the Cochrane Database of Systematic
Reviews, and grey literature to find articles on the topic from January
2015 to March 2022. In addition, we contacted 64 Canadian hospitals for
existing anesthesia quality assurance and improvement metrics; they
responded from June to October 2022. Two independent reviewers performed
screening and data extraction. We grouped and condensed similar candidate
metrics using thematic analysis. Result(s): We assessed 4,493
publications, of which 63 met the inclusion criteria. We extracted 662
candidate metrics and consolidated them into 94 distinct metrics. Metrics
reflected themes of perioperative management (n = 47), safety and
standards (n = 23), patient-centredness (n = 11), intraoperative
anesthetic care (n = 5), perioperative team leadership (n = 4), and
efficiency (n = 4). Metrics spanned all quality-of-care categories
(process, outcome, and structure) and perioperative phases but were
limited by poor supporting evidence. Conclusion(s): We consolidated a
list of 94 metrics that can be used to evaluate the quality of anesthesia
care. Further work will require verification of feasibility and validity
prior to adoption, with operationalization of these metrics into practical
indicators that are measurable and comparable. Copyright ©
Canadian Anesthesiologists' Society 2025.

<68>
Accession Number
647408859
Title
Arrhythmogenic cardiomyopathy diagnosis and management: a systematic
review of clinical practice guidelines and recommendations with insights
for future research.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2025. Date of Publication: 19 May 2025.
Author
Iezzi L.; Sorella A.; Galanti K.; Gallina S.; Chahal A.A.; Bauce B.;
Cipriani A.; Providencia R.; Lopes L.R.; Ricci F.; Khanji M.Y.
Institution
(Iezzi, Sorella, Galanti, Gallina, Ricci) Department of Neuroscience,
Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara,
Chieti, Italy
(Gallina, Ricci) University Cardiology Division, Heart Department, Chieti,
Italy
(Gallina, Ricci) Institute for Advanced Biomedical Technologies, G.
D'Annunzio University of Chieti-Pescara, Via Luigi Polacchi, 11 - 66100
Chieti, Italy
(Chahal, Providencia, Khanji) Barts Heart Centre, St. Bartholomew's
Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK
(Chahal) Center for Inherited Cardiovascular Diseases, Department of
Cardiology, WellSpan Health, 30 Monument Rd, York, PA, United States
(Chahal, Khanji) William Harvey Research Institute, NIHR Barts Biomedical
Centre, Queen Mary University of London, Charterhouse Square, London,
United Kingdom
(Chahal) Department of Cardiovascular Medicine, Mayo Clinic, SW Rochester,
200 First Str, United States
(Bauce, Cipriani) Department of Cardiac, Thoracic and Vascular Sciences,
University of Padua, Via Giustiniani, 2 - 35128 Padua, Italy
(Lopes) Department of Cardiology, Creighton University School of Medicine,
Omaha, NE 68124, USA
(Lopes) Institute of Cardiovascular Science, University College London,
London, United Kingdom
(Khanji) Newham University Hospital, Barts Health NHS Trust, London,
United Kingdom
Abstract
Arrhythmogenic cardiomyopathy (ACM) is addressed in international
guidelines and expert consensus statements. To assist clinicians in their
routine practice and support decision-making, we performed a systematic
review of the most relevant guidelines and recommendations for ACM
diagnosis and management. Our search, covering MEDLINE, EMBASE, and
resources from scientific societies over the last 10 years, identified two
guidelines and three consensus statements that met rigorous inclusion
criteria for detailed analysis. In the examined documents, key areas of
agreement included the critical role of cardiac imaging for initial
diagnosis and ongoing monitoring, genetic testing in index patients,
ventricular arrhythmia management, catheter ablation indications, heart
failure treatment strategies, and exercise recommendations. However,
significant differences were found in definitions and diagnostic criteria
for ACM, interpretation of phenocopies, management of family members, and
criteria for ICD implantation. Additional discrepancies emerged regarding
the role of multidisciplinary teams, non-cardiac surgical considerations,
atrial fibrillation management, and reproductive issues. Crucially, there
remain considerable gaps in evidence, especially in areas such as the
management and follow-up of patients with potential or borderline ACM
diagnoses, as well as the care of their relatives. The clinical
implications of genetic findings, along with the clinical management of
left-dominant, biventricular phenotypes, and hot phases of disease, are
also insufficiently addressed. Furthermore, a critical shortfall is the
lack of externally validated risk assessment tools to guide clinical
decision-making. Bridging these gaps could help guiding future research
and guideline development towards improving patient
outcomes. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<69>
Accession Number
2034672009
Title
Effectiveness of amino acid supplementation in preventing acute kidney
injury following cardiac surgery: A systematic review and meta-analysis of
randomized controlled trials.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70037. Date of Publication: 01 Jul 2025.
Author
Majeed M.W.; Finnegan E.; Gallo Ruelas M.; Lopes L.M.; Righetto B.B.;
Salha I.; Delgado D.; Quiros M.C.; Tomo A.T.J.; Ahmad R.; Andrabi S.;
Abujaber S.
Institution
(Majeed) Government Medical College Srinagar, VMMC and Safdarjung
Hospital, New Delhi, India
(Finnegan) School of Medicine, Trinity College Dublin, Dublin, Ireland
(Gallo Ruelas) Department of Nutrition, Instituto de Investigacion
Nutricional (IIN), Lima, Peru
(Lopes) Department of Epidemiology, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
(Righetto) Department of Medicine, Universidade Positivo, Curitiba, Brazil
(Salha) Department of Global Health, Trinity Centre for Global Health,
Trinity College Dublin, Dublin, Ireland
(Delgado) Universidad Peruana de Ciencias Aplicadas, Lima District, Peru
(Quiros) Facultad de Medicina, Universidad de Costa Rica, San Jose, Costa
Rica
(Tomo) Department of Medicine, Universidade Eduardo Mondlane, Maputo,
Mozambique
(Ahmad) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Andrabi) Department of Nephrology, Columbia University Vagelos College of
Physicians and Surgeons, NYC Health + Hospitals/Harlem, New York, NY,
United States
(Abujaber) Department of Pulmonary and Critical Care, SUNY Downstate
Medical Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Acute kidney injury (AKI) is a frequent complication of
cardiac surgery, contributing to increased morbidity, longer hospital
stays, and higher mortality. Evidence suggests amino acid (AA)
supplementation may enhance renal blood flow and glomerular filtration
rate (GFR), potentially reducing AKI risk; however, findings remain
inconclusive. This study evaluated the efficacy of perioperative AA
supplementation in preventing AKI and related complications post-cardiac
surgery. Method(s): PubMed, Embase, and Cochrane databases were
searched for randomized controlled trials (RCTs) comparing AA
supplementation versus standard care in preventing cardiac
surgery-associated AKI. Main outcomes included AKI incidence (defined by
the Kidney Disease Improving Global Outcomes (KDIGO) criteria), 30-day
mortality, and renal replacement therapy (RRT) requirement. Pooled risk
ratios (RRs) with 95% confidence intervals (CIs) were calculated using
random-effects models. Statistical significance was set at p < 0.05. The
certainty of the evidence (CoE) was assessed using the GRADE approach.
 Result(s): Six RCTs involving 4501 cardiac surgery patients were
included. AA mixture interventions significantly reduced the risk of AKI
stage 1 (RR: 0.56; 95% CI: 0.77-0.96; p =.009; CoE: Moderate) and Stage 3
(RR: 0.53; 95% CI: 0.34-0.83; p =.005; CoE: Moderate), but not stage 2
(RR: 1.24; 95% CI: 0.60-2.55; p =.568; CoE: Low). Preliminary findings
from glutamic acid and glutamine (single AA interventions) showed
potential benefits in reducing AKI incidence (CoE: Very low) and improving
surrogate biomarkers, respectively. No significant effects were observed
on mortality or RRT incidence for any intervention. Conclusion(s): AA
mixtures likely reduce AKI incidence following cardiac surgery but show
limited effects on mortality and RRT. Further trials are needed to confirm
the benefits of glutamic acid and glutamine supplementation. Editorial
Comment: Use of amino acid supplementation for the prevention of acute
kidney injury after cardiac surgery may be effective, but more trial data
and confidence in a beneficial effect is needed for this to be implemented
in everyday clinical practice. Copyright © 2025 Acta
Anaesthesiologica Scandinavica Foundation.

<70>
Accession Number
2034644801
Title
The Efficacy of Magnesium Sulfate in Perioperative Multimodal Analgesia.
Source
Current Pain and Headache Reports. 29(1) (no pagination), 2025. Article
Number: 88. Date of Publication: 01 Dec 2025.
Author
Lopez-Ruiz A.A.; Trinchet L.P.; Morozowich S.; Misra L.
Institution
(Lopez-Ruiz, Trinchet) Alix School of Medicine, Mayo Clinic, Phoenix, AZ,
United States
(Morozowich, Misra) Department of Anesthesiology and Perioperative
Medicine, Mayo Clinic, Phoenix, AZ, United States
Publisher
Springer
Abstract
Purpose of Review: Patients frequently report inadequate pain management
following surgical procedures. Physicians must often prescribe analgesics,
notably opioids, as a means of providing pain relief. Due to the addictive
nature of this class of medications, improper post-surgical pain
management propagates the United States opioid crisis. The administration
of multimodal analgesia is a strategy implemented to decrease long-term
outpatient prescription opioid use. Magnesium sulfate has recently
attracted interest for its potential use as an adjunct in multimodal
analgesia in addition to its other diverse uses in medicine. This review
aims to highlight the most recent data validating the use of magnesium
sulfate in perioperative multimodal analgesia. Recent Findings: A
narrative review was conducted using PubMed and Ovid MEDLINE(R) Epub Ahead
of Print, In-Process & Other Non-Indexed Citations. Articles that examined
the effects of intravenous magnesium sulfate on perioperative pain and/or
recovery from 1946 to present were considered. 15 articles met the
inclusion criteria and discussed the use of magnesium sulfate as an
adjunct in multimodal analgesia across the following surgical specialties:
cardiac surgery, general surgery, gynecologic surgery, orthopedic surgery,
urologic surgery, neurosurgery, and otolaryngology surgery. Summary:
The results of the cited studies indicate that magnesium sulfate is a
well-tolerated multimodal analgesic agent that reduces postoperative pain,
reduces opioid consumption, and increases patient
satisfaction. Copyright © The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2025.

<71>
Accession Number
2034672381
Title
Association between venous to arterial carbon dioxide tension gap and
clinical outcome in cardiac surgery patients: A systematic review and
meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251344858. Date of Publication: 2025.
Author
Lin D.; Luo H.; Long F.; Liu M.-H.; Zhang Y.; Liu T.; Zhou R.-H.
Institution
(Lin, Long, Liu, Zhang, Liu, Zhou) Department of Anesthesiology, West
China Hospital of Sichuan University, Chengdu, China
(Luo) Operating Room, West China Hospital, Sichuan University, West China
School of Nursing, Sichuan University, China
Publisher
SAGE Publications Ltd
Abstract
Background: Cardiac surgery is associated with increased risk of major
adverse outcomes. Venous to arterial carbon dioxide tension gap
(Pv-aCO<inf>2</inf> gap) showed significant prognostic value of
non-cardiac surgery, while their prognostic value after cardiopulmonary
bypass (CPB) remains controversial. Method(s): We conducted a
systematic research of PubMed, MEDLINE, EMBASE and Web of science
electronic database and ClinicalTrials.gov to analysis the association
between high Pv-aCO<inf>2</inf> gap and adverse outcomes in adult cardiac
surgery patients. Random effect model was used to pool data.
 Result(s): Eight studies (n = 2136 patients) were enrolled. High
Pv-aCO<inf>2</inf> gap was mainly defined as Pv-aCO<inf>2</inf> >= 6-8
mmHg. In cardiac surgery, high Pv-aCO<inf>2</inf> gap was not associated
with increased hospital mortality (odds ratio, 0.63; 95% CI, 0.17-2.32; p
= 0.49)), but was related with higher ICU mortality (odds ratio, 5.27; 95%
CI, 2.31-12.00; p < 0.001), higher incidence of major complications (p <
0.05), longer ICU length of stay (p = 0.03) and prolonged ventilation time
in the ICU (p < 0.001). Moreover, high Pv-aCO<inf>2</inf> gap was linked
to postoperative lower cardiac index (p < 0.01) and lower ScvO<inf>2</inf>
(p < 0.001). Interesting, high Pv-aCO<inf>2</inf> gap was not associated
with increased postoperative lactate level and longer hospital length of
stay. Conclusion(s): An elevated Pv-aCO<inf>2</inf> gap seems to be
associated with adverse outcomes in very short time and indicates tissue
hypoperfusion rather than tissue hypoxia. Therefore, interventions aiming
at normalizing Pv-aCO<inf>2</inf> gap may potentially improve clinical
outcomes, while further validation is required. Copyright © The
Author(s) 2025.

<72>
Accession Number
2038787446
Title
Impact of Cigarette Smoking on Heart Transplant Outcomes: A Review.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000941. Date of Publication: 2025.
Author
Annabi C.; Keeler A.; Bailey I.; Annabi J.; Frishman W.H.
Institution
(Annabi, Keeler, Bailey, Annabi, Frishman) School of Medicine, New York
Medical College, Valhalla, NY, United States
(Frishman) Department of Medicine, Westchester Medical Center, Valhalla,
NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Heart transplantation is a life-saving procedure for patients with
end-stage heart failure, but long-term success is influenced by multiple
factors, including smoking. Smoking has been associated with negative
cardiovascular outcomes in both the general population and transplant
recipients. This review examines the impact of smoking on heart transplant
outcomes, focusing on donor smoking history, pretransplant smoking in
recipients, and posttransplant smoking relapse. A literature review was
conducted using PubMed and Google Scholar-indexed articles that analyzed
smoking and heart transplantation. Studies evaluating donor smoking
history, recipient smoking history before transplantation, and
posttransplant smoking relapse were included and assessed for the impact
of smoking on heart transplant outcomes. Findings demonstrated that donor
smoking history negatively impacted long-term survival and graft failure
rates. Pretransplant smoking history in recipients was linked to higher
rates of acute rejection, infections requiring hospitalization,
malignancy, and worse survival. Posttransplant smoking relapse was
associated with higher rates of graft coronary artery disease and
malignancy and was the strongest predictor of mortality. Smoking in both
donors and recipients is associated with worse heart transplant outcomes,
and more aggressive smoking cessation interventions, pre- and
post-transplant, are necessary to mitigate these risks and improve
transplant success rates. Copyright © 2025 Wolters Kluwer Health,
Inc. All rights reserved.

<73>
Accession Number
2038903438
Title
S100B in postoperative cognitive impairment: systematic review and
meta-analysis.
Source
Clinica Chimica Acta. 576 (no pagination), 2025. Article Number: 120380.
Date of Publication: 15 Aug 2025.
Author
Lu S.; Zhang J.; He X.; Huang J.
Institution
(Lu) General Practice, The 924th Hospital of Joint Logistics Support Force
of the PLA, No.1, Xinqiaoyuan Road, Xiangshan District, Guangxi Zhuang
Autonomous Region, Guilin, China
(Zhang, He, Huang) Department of Neurosurgery, Quanzhou First Hospital,
NO.1028, Anji South Road, Fengze District, Fujian, Quanzhou, China
Publisher
Elsevier B.V.
Abstract
Background: Postoperative cognitive dysfunction (POCD) is prevalent after
cardiac and non-cardiac surgeries. It has been generally accepted that
POCD is caused by an inflammatory response. This study aimed to determine
whether mini-mental state examination (MMSE) scores and the serum levels
of two prominent inflammatory factors, S-100B protein (S-100B) and
neuron-specific enolase (NSE), can predict POCD among patients undergoing
non-cardiac surgeries. Method(s): A comprehensive literature search
was conducted using electronic databases such as PubMed, Web of Science,
Scopus, Google Scholar, and Embase up to 14, January 2025 to identify
eligible observational studies evaluating the relationship between the
incidence of POCD and the serum levels of S100B, NSE, and MMSE score
before surgery and 24 h and 7 days after surgery among patients undergoing
non-cardiac surgeries. Result(s): Our findings demonstrated that
patients who developed POCD had higher S100B levels 24 h after surgery
compared to before surgery. Compared to pre-operative levels, there were
no significant differences in S100B levels at 7 days, NSE levels at 24 h
or 7 days, and MMSE scores at 24 h or 7 days after surgery. Age-based
analysis revealed that patients with POCD aged >=60 had higher S100B
levels at 24 h post-operative. Among different surgery types, S100B and
NSE levels increased significantly 24 h after spinal surgery, while MMSE
scores significantly decreased after spinal surgery. Conclusion(s):
S100B may help the early detection of POCD, and the prognostic value of
S100B can be evaluated in future studies. Unlike S100B, NSE and MMSE did
not show significant differences between POCD and non-POCD
groups. Copyright © 2025 Elsevier B.V.

<74>
Accession Number
2038831089
Title
Stroke Prevention in Atrial Fibrillation: A systematic Review and
Meta-Analysis of Left Atrial Appendage Occlusion Versus Direct Oral
Anticoagulants.
Source
Cardiology in Review. (no pagination), 2025. Date of Publication: 2025.
Author
Thapa S.; Mandal B.; Shah S.; Mehta R.; Sah S.; Thapa A.; Chand S.;
Medicherla C.; Kitago T.; Frishman W.H.; Aronow W.S.
Institution
(Thapa, Medicherla, Kitago) Department of Neurology, Westchester Medical
Center, New York Medical College, Valhalla, NY, United States
(Mandal, Shah) Department of Public Health, Institute of Medicine,
Tribhuvan University, Kathmandu, Maharajgunj, Nepal
(Mehta) Department of Medicine, National Public Health Laboratory Teku,
Kathmandu, Nepal
(Sah) Department of Medicine, Korea University, Seoul, South Korea
(Sah) Department of Public Health Dentistry, D.Y. Patil Dental College and
Hospital, Maharashtra, India
(Thapa) Department of Medicine, Universal College of Medical Sciences,
Bhairahawa, Nepal
(Chand, Aronow) Departments of Cardiology and Medicine, Westchester
Medical Center, New York Medical College, Valhalla, NY, United States
(Frishman, Aronow) Department of Medicine, New York Medical College,
Valhalla, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Atrial fibrillation significantly increases the risk of ischemic stroke,
with thrombi primarily originating in the left atrial appendage (LAA).
While direct oral anticoagulants (DOACs) are the standard for stroke
prevention, LAA occlusion (LAAO) has emerged as a nonpharmacologic
alternative, particularly for patients at high bleeding risk. A systematic
review and meta-analysis included 15 studies (1 randomized control trial
and 14 observational studies) encompassing 22,420 patients (10,704 LAAO,
11,716 DOAC). LAAO and DOACs demonstrated comparable thromboembolic event
rates. LAAO was associated with significantly lower risks of
stroke/transient ischemic attack (risk ratio: 0.86, P = 0.0004), major
bleeding [hazard ratio (HR): 0.74, P = 0.03], cardiovascular mortality
(HR: 0.57, P < 0.00001), and all-cause mortality (risk ratio 0.66, P =
0.006). The composite outcome significantly favored LAAO (HR: 0.67, P =
0.0008). No significant difference was found in intracranial bleeding
rates. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<75>
Accession Number
2038786493
Title
Pharmacokinetics and Pharmacodynamics of Analgesic and Anesthetic Drugs in
Patients During Cardiac Surgery With Cardiopulmonary Bypass: A Narrative
Review.
Source
Anesthesia and Analgesia. (no pagination), 2025. Date of Publication:
2025.
Author
Beukers A.; Breel J.; Brom C.V.D.; Saatpoor A.; Kluin J.; Eleveld D.;
Hollmann M.; Hermanns H.; Eberl S.
Institution
(Beukers, Breel, Brom, Hollmann, Hermanns, Eberl) Department of
Anesthesiology, Amsterdam UMC, Amsterdam, Netherlands
(Brom) Department of Intensive Care Medicine, Amsterdam UMC, Amsterdam,
Netherlands
(Saatpoor) Faculty of Medicine, University of Amsterdam, Amsterdam,
Netherlands
(Kluin) Department of Cardiothoracic Surgery, Erasmus MC, Erasmus
University Rotterdam, Rotterdam, Netherlands
(Eleveld) Department of Anesthesiology, UMC Groningen, Rijksuniversiteit
Groningen, Groningen, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiopulmonary bypass (CPB) impacts pharmacokinetics and -dynamics of
drugs used during cardiac surgery. These alterations can lead to changes
in drug efficacy resulting in under- or overdosing. This review summarizes
current knowledge on the effects of CPB on commonly used intraoperative
and continuously administered anesthetics and analgesics. Out of 197
articles initially identified, 22 were included in the final review. The
breakdown of studies by main topic was as follows: propofol (9 articles),
sevoflurane (4), remifentanil (3), isoflurane (2), fentanyl (2), and
sufentanil (2), and alfentanil (1). The initiation of CPB typically
results in hemodilution and hypothermia, leading to a decrease in total
plasma concentration combined with an increase in unbound plasma
concentrations. This phenomenon has varying implications for different
drugs: For propofol and sevoflurane, lower doses may be required during
CPB to achieve the same anesthetic effect. Fentanyl and sufentanil plasma
concentrations decrease by 25% on average at CPB initiation due to an
increased volume of distribution, followed by an increase during CPB, with
sufentanil, showing an almost 50% increase post-CPB. This implies that an
additional bolus before CPB initiation should be considered, followed by a
reduction of the maintenance dose to prevent prolonged sedation.
Remifentanil plasma concentration decreases at CPB initiation, which
implies that higher initial- or adjusted maintenance dose should be
considered in normothermic patients. However, under hypothermic
conditions, infusion rates should be decreased by 30% for every 5degreeC
decrease in temperature. Alfentanils, total plasma concentration decreases
during CPB, while its free fraction remains unaltered, indicating that no
further adjustments are necessary. Target-controlled infusion (TCI) models
for propofol (Schnider, Marsh, and PGIMER [Postgraduate Institute of
Medical Education and Research]) and remifentanil (Minto) were found to be
inaccurate in the context of CPB. Based on the included studies, the use
of these pharmacokinetic models is not recommended. In conclusion, dosing
inaccuracies resulting in adverse events in on-pump cardiac surgery
underscore the importance of understanding the pharmacokinetics and
-dynamics of anesthetic and analgesic drugs during CPB. The clinical
implication of the altered drug responses after CPB remains challenging in
this high-risk population. Key takeaways include the necessity of
considering patient-specific factors, utilizing objective monitoring
tools, and recognizing potential drug alterations due to CPB. (Anesth
Analg 2025;XXX:00-00) Copyright © 2025 The Author(s)

<76>
Accession Number
2038848472
Title
Osteosarcopenia in older adults undergoing transcatheter aortic valve
replacement: A narrative review of mortality and frailty implications.
Source
World Journal of Cardiology. 17(5) (no pagination), 2025. Article Number:
107320. Date of Publication: 26 May 2025.
Author
Li P.; Zhang H.-P.
Institution
(Li) Department of Geriatrics, Beijing Hospital, National Center of
Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
(Zhang) Department of Cardiology, Beijing Hospital, National Center of
Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
Publisher
Baishideng Publishing Group Inc
Abstract
This narrative review examines osteosarcopenia, characterized by the
concurrent loss of muscle mass and bone density, as a pivotal marker of
frailty in older adults. Its implications for patients undergoing
transcatheter aortic valve replacement (TAVR) for severe aortic stenosis
remain underexplored. This review examines the association between
osteosarcopenia and adverse clinical outcomes in older adults undergoing
TAVR, with an emphasis on mortality. It also evaluates the integration of
osteosarcopenia into pre-procedural risk assessments. Contemporary studies
were reviewed, focusing on older adults undergoing TAVR. Key parameters
included pre-procedural assessments of muscle mass (psoas cross-sectional
area) and bone density (lumbar trabecular attenuation) using computed
tomography. Clinical correlations with frailty indices, nutritional
deficiencies, functional disability and mortality were analyzed. Studies
including the FRAILTY-AVR cohort indicate that osteosarcopenia affects
15%-20% of TAVR patients and independently predicts 1-year mortality.
Combined deficits in muscle and bone health are associated with elevated
risks of post-TAVR complications, prolonged hospitalizations, and
worsening disability compared to isolated sarcopenia or osteoporosis (P <
0.05). Incorporating osteosarcopenia into risk stratification models could
enhance predictive accuracy for adverse outcomes. Osteosarcopenia serves
as a critical biomarker for frailty and should be routinely assessed in
pre-TAVR evaluations. Targeted interventions, such as resistance training
and nutritional optimization, may mitigate its impact and improve clinical
outcomes. Early identification facilitates personalized management
strategies, enhancing survival and quality of life in this high-risk
cohort. Copyright ©The Author(s) 2025. Published by Baishideng
Publishing Group Inc. All rights reserved.

<77>
Accession Number
2038848628
Title
Methylprednisolone for Infant Heart Surgery: Subpopulation Analyses of a
Randomized Controlled Trial.
Source
Critical Care Medicine. (no pagination), 2025. Article Number: 6721. Date
of Publication: 2025.
Author
Sunthankar S.D.; Hill K.D.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.; Li
J.S.; Graham E.M.; Blasiole B.; Husain S.A.; Bleiweis M.S.; Mettler B.;
Benscoter A.; Wald E.; Karamlou T.; Van Bergen A.H.; Eghtesady P.; Scott
J.P.; Anderson B.R.; Alfieris G.; Vener D.F.; Kannankeril P.J.
Institution
(Sunthankar, Baldwin, Kannankeril) Thomas P. Graham Jr. Division of
Pediatric Cardiology , Center for Pediatric Precision Medicine, Department
of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt ,
Vanderbilt University Medical Center, Nashville, TN, United States
(Hill, Li) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
(Jacobs, Bleiweis) Division of Cardiac Surgery, University of Florida,
Gainesville, FL, United States
(Jacobs, Mettler) Division of Cardiac Surgery, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Graham) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Blasiole) Division of Pediatric Cardiac Anesthesiology, UPMC Children's
Hospital of Pittsburgh, Pittsburgh, PA, United States
(Husain) Division of Cardiac Surgery, Primary Children's Hospital, Salt
Lake City, UT, United States
(Benscoter) Division of Pediatric Cardiology, Cincinnati Children's
Hospital, Cincinnati, OH, United States
(Wald) Division of Pediatric Cardiology, Northwestern University Feinberg
, School of Medicine, Chicago, IL, United States
(Karamlou) Division of Cardiac Surgery, Cleveland Clinic, Cleveland, OH,
United States
(Van Bergen) Division of Pediatric Cardiology, Advocate Children's
Hospital, Chicago, IL, United States
(Eghtesady) Division of Cardiac Surgery, Washington University , School of
Medicine, St. Louis, MO, United States
(Scott) Division of Pediatric Cardiology, Medical College of Wisconsin,
Madison, WI, United States
(Anderson) Division of Pediatric Cardiology, Icahn School of Medicine at
Mt Sinai, New York, NY, United States
(Alfieris) Division of Cardiac Surgery, University of Rochester,
Rochester, NY, United States
(Vener) Division of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Evaluate benefits and harms of prophylactic intraoperative
methylprednisolone in subpopulations undergoing infant heart surgery.
 Design(s): Subpopulation analyses of The Steroids to Reduce Systemic
Inflammation after Infant Heart Surgery (STRESS) trial, a double-blind
randomized placebo-controlled trial. Setting(s): Twenty-four
congenital heart centers. Patient(s): Infants (< 1 yr old) undergoing
heart surgery with cardiopulmonary bypass. Patients stratified by Society
of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery
Congenital Heart Surgery (STAT) mortality category, age, gestational age,
and presence of chromosomal or syndromic diagnosis (CSD).
 Intervention(s): Methylprednisolone (30 mg/kg) vs. placebo
administered into cardiopulmonary bypass pump-priming fluid.
 Measurements and Main Results: Six postoperative outcomes: steroid
use, acute kidney injury (AKI), thrombosis, infections, prolonged
mechanical ventilation, peak blood glucose levels, and insulin exposure.
One thousand two hundred patients received methylprednisolone or placebo.
Beneficial effects associated with methylprednisolone included reduced use
of postoperative hydrocortisone in neonates (odds ratio [OR], 0.39
[0.25-0.60]), both STAT category groups (1-3: OR, 0.64 [0.46-0.89]; 4-5:
OR, 0.57 [0.34-0.97]), term infants (OR, 0.63 [0.47-0.83]), and those
without CSD (OR, 0.63 [0.46-0.86]). Methylprednisolone was associated with
lower thrombosis occurrence among neonates (OR, 0.37 [0.16-0.87]) and term
infants (OR, 0.38 [0.19-0.75]). Adverse associations included increased
thrombosis among premature infants (p = 0.005), increased AKI among
neonates (OR, 1.55 [1.02-2.37]) and those following STAT category 1-3
operations (OR, 1.34 [1.02-1.75]), and increased peak blood glucose levels
and insulin exposure (all subgroups; p < 0.001). No increase in overall
infection or reduction in prolonged mechanical ventilation with
methylprednisolone. Conclusion(s): Both beneficial and adverse
associations were observed with prophylactic methylprednisolone. Reduction
in postoperative hydrocortisone administration and absence of increased
infection rates are arguments favoring prophylactic methylprednisolone
use. Methylprednisolone was associated with increased peak blood glucose
levels and a neutral to harmful association with odds of AKI. These data
suggest certain subpopulations may benefit from prophylactic
intraoperative methylprednisolone without significant harm. Copyright
© 2025 by the Society of Critical Care Medicine and Wolters Kluwer
Health, Inc. All Rights Reserved.

<78>
Accession Number
2038848516
Title
Multimodal analgesia in cardiac surgery: Impact on postoperative
medication consumption and cognitive function.
Source
World Journal of Cardiology. 17(5) (no pagination), 2025. Article Number:
103168. Date of Publication: 26 May 2025.
Author
Wang Q.; Yan X.-Q.; Ma X.-M.; Yan R.; Wang Z.-H.; Ma Y.-J.; Wang H.-B.
Institution
(Wang, Yan, Ma, Yan, Wang, Ma, Wang) Department of Anesthesiology and
Perioperative Medicine, General Hospital of Ningxia Medical University,
Ningxia Hui Autonomous Region, Yinchuan, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Patients who undergo cardiac surgery often face postoperative
pain and potential cognitive issues. Multimodal analgesia may address
these problems. We hypothesized that multimodal analgesia can reduce
opioid use and improve cognitive recovery. AIM To investigate the effects
of multimodal analgesia on postoperative opioid consumption and cognitive
recovery in patients who underwent cardiac surgery. METHODS A prospective,
randomized controlled trial at General Hospital from January 2020 to April
2023 recruited a total of 150 adult patients who underwent elective
cardiac surgery. The patients were randomly divided into two groups. Group
A had patient-controlled intravenous analgesia with sufentanil and
flurbiprofen axil. Group B had flurbiprofen axil and paravertebral nerve
block. Data were analyzed with appropriate statistical methods. RESULTS
Group B had lower postoperative patient-controlled intravenous analgesia
drug consumption (2.21 mL/hour vs 4.26 mL/hour, P < 0.001), shorter
extubation time (2.32 hours vs 3.81 hours, P < 0.001), and intensive care
unit stay (15.32 h vs 28.63 h, P < 0.001). Visual Analogue Scale pain
scores were lower in group B (P < 0.001). Group B had fewer postoperative
complications (no respiratory depression vs 37.9% in group A, P < 0.05), a
lower postoperative cognitive dysfunction incidence (16.0% vs 28.0%, P <
0.05), and higher Barthel Index scores (P < 0.05). CONCLUSION Multimodal
analgesia with paravertebral nerve block and flurbiprofen axil reduces
opioid use and improves cognitive outcomes in patients who underwent
cardiac surgery. Copyright ©The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<79>
Accession Number
2038844351
Title
2025 American Association for Thoracic Surgery (AATS) Expert Consensus
Document: Surgical management of acute myocardial infarction and
associated complications.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Kaczorowski D.J.; Takeda K.; Atluri P.; Cevasco M.; Cogswell R.;
D'Allesandro D.; Daneshmand M.A.; Jeevanandam V.; Kapur N.K.; Milano C.;
Ono M.; Potapov E.; Ramzy D.; Silvestry S.C.; Soltesz E.; Uriel N.
Institution
(Kaczorowski) Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Takeda) Department of Surgery, Columbia University Medical Center, New
York, NY, United States
(Atluri, Cevasco) Department of Surgery, Hospital of the University of
Pennsylvania, Philadelphia, Pa, United States
(Cogswell) Cardiovascular Division, University of Minnesota, Minneapolis,
Minn, United States
(D'Allesandro) Department of Surgery, Massachusetts General Hospital,
Boston, Mass, United States
(Daneshmand) Department of Surgery, Emory University, Atlanta, GA, United
States
(Jeevanandam) Department of Surgery, University of Chicago Medicine,
Chicago, Ill, United States
(Kapur) Division of Cardiology, Tufts Medicine, Boston, Mass, United
States
(Milano) Department of Surgery, Duke University, Durham, NC, United States
(Ono) Department of Surgery, The University of Tokyo Hospital, Tokyo,
Japan
(Potapov) Department of Thoracic and Cardiovascular Surgery, Deutsches
Herzzentrum der Charite, Berlin, Germany
(Ramzy) Department of Cardiothoracic and Vascular Surgery, UT Health
Houston McGovern School of Medicine, Houston, Tex, United States
(Silvestry) Department of Surgery, University of Arizona College of
Medicine, Tucson, Ariz, United States
(Soltesz) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Uriel) New York Presbyterian-Columbia University Irving Medical Center,
New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Complications of acute myocardial infarction (AMI) can result
in significant morbidity and mortality. This document reports the findings
and recommendations of a multidisciplinary group of experts on the
management of patients with complications of AMI, with particular focus on
the use of mechanical circulatory support in this context. Method(s):
Through the American Association of Thoracic Surgery Clinical Practice
Standards Committee, a committee of multidisciplinary experts, including
both cardiologists and cardiothoracic surgeons, was established. A list of
topics was developed. Committee members were divided into subgroups that
developed relevant questions. A systematic literature review was then
performed, and the results were synthesized into clinical recommendations.
Expert consensus was then established using the Delphi process.
 Result(s): Based on the results of the systematic literature review,
as well as the clinical expertise of the committee, clinical
recommendations were developed. Each of these recommendations, the
strength of each recommendation, and the level or quality of evidence on
which the recommendation was based are presented here. Topics addressed
include general considerations, revascularization strategies, cardiogenic
shock, papillary muscle rupture, postinfarction ventricular septal defect,
free wall rupture, arrhythmias, and the use of durable therapies in this
context. Conclusion(s): AMI may result in cardiogenic shock,
malignant arrhythmias, or mechanical complications, each of which is
associated with high mortality. Prompt management of these complications,
including consideration for mechanical circulatory support, is
warranted. Copyright © 2025

<80>
Accession Number
647408393
Title
Safety and Feasibility of Novel Single-Port Robotic-Assisted
Lobectomy/Segmentectomy for Lung Cancer.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 15 May 2025.
Author
Liang H.; Wang W.; Zhang M.; Wang R.; Jiang S.; Xu F.; Yang C.; Huang J.;
Li S.; Zhang Z.; Wu W.; Gonzalez-Rivas D.; He J.
Institution
(Liang, Wang, Zhang, Wang, Jiang, Xu, Yang, Huang, Li, He) Department of
Thoracic Surgery, National Clinical Research Center for Respiratory
Disease, First Affiliated Hospital of Guangzhou Medical University,
Guangzhou, China
(Zhang) Department of Operating Room, First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Wu) Mingyi SuperMed View Technology Company
(Gonzalez-Rivas) Department of Thoracic Surgery, Coruna University
Hospital, A Coruna, Spain
Abstract
BACKGROUND: Robotic-assisted thoracic surgery (RATS) has advanced lung
cancer treatment with precise robotic arm maneuvers and 3D visualization.
While conventional RATS systems require multiple incisions, a uniportal
approach is increasingly favored. However, current systems face challenges
with maneuverability and incision size. The SHURUI SP robotic system, with
its total-flex single-arm design, addresses these limitations, especially
for patients with narrow intercostal spaces or limited intrathoracic
space. METHOD(S): This phase I/II single-arm registry trial assessed
the safety and feasibility of lobectomy/segmentectomy using the SHURUI SP
robotic system. The study enrolled patients aged 18-75 with lung cancer
from November 2023 to April 2024. The SHURUI single portal (SP) system's
"deformable dual continuum mechanism" technology enabled precise surgical
maneuvers, evaluating primary endpoints like conversion rates, blood loss,
lymph node retrieval, transfusion needs, and intraoperative complications.
 RESULT(S): Thirty-five patients, median age 58, underwent
lobectomy/segmentectomy, with successful procedures in all cases. No
conversions to video-assisted thoracic surgery or open surgery were
needed, and no additional trocars were used. Median operative time was 155
minutes, docking time 3 minutes, and console time 81 minutes. Median blood
loss was 10 mL, with no transfusions required. The 30-day morbidity rate
was 11.43%, with no major complications or rehospitalizations. All
patients were discharged after a mean hospital stay of 4 days.
 CONCLUSION(S): The SHURUI SP robotic system demonstrates safety and
feasibility for RATS in lung cancer. A large-scale, multicenter randomized
controlled trial is needed to further validate this technology's efficacy
and safety across a broader patient population. Copyright © 2025.
Published by Elsevier Inc.

<81>
Accession Number
647405181
Title
The safety and feasibility of same day discharge for patients undergoing
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
The Canadian journal of cardiology. (no pagination), 2025. Date of
Publication: 16 May 2025.
Author
Litkouhi P.N.; Rao K.; Baer A.; Hansen P.S.; Bhindi R.
Institution
(Litkouhi, Rao, Hansen, Bhindi) Department of Cardiology, Royal North
Shore Hospital, St Leonards, Australia; School of Medicine, University of
Sydney, Camperdown, Australia
(Baer) Department of Cardiology, Royal North Shore Hospital, St Leonards,
Australia
Abstract
BACKGROUND: Next day discharge (NDD) after transcatheter aortic valve
replacement (TAVR) has been shown to be safe in appropriately selected
patients and has since been implemented into clinical practice. As the
demand for TAVR grows, improving its accessibility is crucial. Several
studies have trialled same day discharge (SDD) after TAVR, but a review
has not been performed. METHOD(S): Five databases were searched.
Baseline demographics, study characteristics and the assessment criteria
used to determine eligibility for SDD were extracted and compared.
Proportional meta-analysis was used to compare post-TAVI outcomes between
SDD and NDD patients. RESULT(S): Six studies were included from 1734
screened articles. Of 3519 patients, 318 (9.0%) underwent SDD (mean age
78.2 +/- 8.7 years; 59.3% male). Balloon-expanding valves were used in
91.6% of cases, and self-expanding valves in the remaining 8.4%. Patients
that underwent SDD experienced lower rates of mortality (OR 0.104, 95% CI:
0.015 - 0.998), all-cause readmission (OR 0.194, 95% CI 0.052 - 0.717),
cardiovascular readmissions (OR 0.155, 95% CI 0.026 - 0.971), and new
pacemaker requirement (OR 0.167, 95% 0.028 - 0.995) at 30 days after TAVR,
compared to patients that underwent NDD. There was no difference in rates
of stroke (OR 0.407, 95% CI: 0.015 - 16.694) or major vascular
complications (0.0% vs 0.0%). CONCLUSION(S): Current evidence
supports the safety and feasibility of SDD after elective, transfemoral
TAVR in appropriately selected patients. Heterogeneity between eligibility
criteria used to select patients for SDD, especially related to conduction
disease, poses a barrier to implementation. Further research on
self-expanding valves is needed. Copyright © 2025. Published by
Elsevier Inc.

<82>
Accession Number
647395152
Title
The efficacy and safety of low dose colchicine in atherosclerotic
cardiovascular disease - A systematic review and meta-analysis.
Source
European journal of preventive cardiology. (no pagination), 2025. Date of
Publication: 16 May 2025.
Author
Tucker B.; Tucker W.J.; Chung J.S.; Figtree G.A.; Keech A.; Patel S.
Institution
(Tucker, Chung, Keech, Patel) Department of Cardiology, Royal Prince
Alfred Hospital, Camperdown, NSW, Australia
(Tucker, Keech, Patel) Clinical Trials Centre, Faculty of Medicine and
Health, University of Sydney, Camperdown, NSW, Australia
(Tucker) Tweed Valley Hospital, NSW, Australia
(Figtree) Sydney Medical School, Faculty of Medicine and Health,
University of Sydney, NSW, Sydney, Australia
(Figtree) Cardiovascular Discovery Group, Kolling Institute of Medical
Research, NSW, St Leonards, Australia
(Figtree) Department of Cardiology, NSW, Royal North Shore Hospital, St
Leonards, Australia
(Patel) Coronary Diseases Group, Heart Research Institute, Newtown, NSW,
Australia
Abstract
AIM: Colchicine has recently been approved for the treatment of
atherosclerotic cardiovascular disease (ASCVD). Since then, three large
trials of colchicine in ASCVD have failed to reach their primary
endpoints. METHOD(S): A systematic search of PubMed, Embase and
Cochrane Central Register of Controlled Trials was performed (PROSPERO
registration: CRD42024616378). The primary endpoint of major adverse
cardiovascular events (MACE) was defined as a composite of myocardial
infarction, stroke and cardiovascular death. The key secondary endpoint of
extended MACE (eMACE) was defined as MACE plus coronary revascularisation.
Pooled estimates were calculated using a random-effects model and are
presented as risk ratio (95% confidence interval). RESULT(S): 1624
articles were screened. 12 met inclusion criteria, yet one trial reported
zero endpoint events in both arms. As such, 11 trials were included in the
meta-analysis, with a total of 1983 primary endpoint events across 30,808
participants. Colchicine was associated with a 17% reduction in the
incidence of MACE (0.83 [0.73, 0.95]; p=0.006) and 23% reduction in the
incidence of eMACE (0.77 [0.63, 0.94]; p=0.01). This reduction was driven
by a lower rate of myocardial infarction (0.78 [0.63, 0.95]; p=0.02) and
coronary revascularisation (0.73 [0.55, 0.97]; p=0.03). There were also
numerically fewer strokes in the colchicine treated population (0.81
[0.63, 1.04]; p=0.11). Colchicine had no effect on cardiovascular (0.96
[0.79, 1.15]; p=0.64) or non-cardiovascular mortality (1.04 [0.76, 1.41];
p=0.81). CONCLUSION(S): Colchicine reduces the risk of non-fatal
ischaemic events in patients with ASCVD. Further studies are required to
identify a population(s) who stands to benefit most from this promising
therapy. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For commercial re-use, please contact reprints@oup.com
for reprints and translation rights for reprints. All other permissions
can be obtained through our RightsLink service via the Permissions link on
the article page on our site-for further information please contact

<83>
Accession Number
2038809707
Title
Comparative effects of transcatheter versus surgical pulmonary valve
replacement: A systematic review and meta-analysis.
Source
PLoS ONE. 20(5 MAY) (no pagination), 2025. Article Number: e0322041. Date
of Publication: 01 May 2025.
Author
Chongmelaxme B.; Kua K.P.; Amornvetchayakul C.; Chawviriyathep N.;
Kerdklinhom T.
Institution
(Chongmelaxme, Amornvetchayakul, Chawviriyathep, Kerdklinhom) Department
of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences,
Chulalongkorn University, Bangkok, Thailand
(Chongmelaxme, Kua) Revolution Health Research Consulting (RHRC) Group,
Bangkok, Thailand
(Kua) Sultan Idris Shah Hospital, Selangor, Serdang, Malaysia
(Kua) A.S. Watson Group, Kuala Lumpur, Malaysia
(Kua) Stanford Alumni Association, Stanford University, Stanford, CA,
United States
(Kua) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Kua) MIT Alumni Association, Massachusetts Institute of Technology,
Cambridge, MA, United States
Publisher
Public Library of Science
Abstract
Introduction Transcatheter pulmonary valve replacement (TPVR) is developed
as a non-surgical, minimally invasive procedure to reduce the need for
re-do cardiac surgical interventions. However, its impacts on patient
outcomes are less clear. This study aims to investigate the effects of
TPVR among patients with pulmonary valve or right ventricular outflow
tract dysfunctions. Materials and methods In this systematic review and
meta-analysis, we searched PubMed, Cochrane CENTRAL, EMBASE, CINAHL
Complete, and Web of Science, from database inception to March 1, 2024, to
identify studies that assessed the comparative effectiveness of
transcatheter pulmonary valve replacement (TPVR) and surgical pulmonary
valve replacement (SPVR). The key outcomes of interest included mortality,
pulmonary regurgitation (PR), infective endocarditis (IE),
re-intervention, improvements in cardiac failure based on the New York
Heart Association (NYHA) functional classification, and adverse events.
Meta-analyses using a random-effects model were performed. Results A total
of 28 studies (n = 16,150) were included. The meta-analyses depicted that
when compared with SPVR, TPVR reduced risks of mortality by 36% (odds
ratio [OR] = 0.64 [95% confidence interval, CI: 0.43, 0.95]), but
conferred a three-fold greater odd of IE over the follow-up duration (OR =
3.10 [95% CI: 2.22, 4.33]). No significant differences were observed for
30-day mortality, and the early PR, IE and re-intervention, as well as the
PR and re-intervention during follow-up. Meta-analyzed results across the
outcome measures varied according to geographical region, publication year
cut-off, and income status of country. All patients who had undergone
valve replacement showed improvements in heart function and experienced
relevant post-procedural complications. Conclusions TPVR afforded
significant clinical benefits in patient survival, but nonetheless, it was
associated with an elevated risk for infective endocarditis. Copyright
© 2025 Chongmelaxme 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.

<84>
Accession Number
2038843067
Title
ACURATE neo2 valve versus commercially available transcatheter heart
valves in patients with severe aortic stenosis (ACURATE IDE): a
multicentre, randomised, controlled, non-inferiority trial.
Source
The Lancet. (no pagination), 2025. Date of Publication: 2025.
Author
Makkar R.R.; Ramana R.K.; Gnall E.; Ramlawi B.; Cheng W.; Diamantouros P.;
Potluri S.; Kleinman N.; Gupta A.; Chakravarty T.; Samy S.; Rassi A.;
Rajagopal V.; Yakubov S.; Sorajja P.; Patel D.; Garcia S.; Yadav P.;
Thourani V.; Wang J.; Rinaldi M.; Kapadia S.; Waksman R.; Webb J.; Ren
C.B.; Gregson J.; Modolo R.; Sathananthan J.; Reardon M.J.
Institution
(Makkar, Cheng, Gupta, Chakravarty, Patel) Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Ramana, Ramlawi) Lankenau Hospital, Wynnewood, PA, United States
(Gnall) Advocate Christ Medical Center, Mokena, IL, United States
(Diamantouros) London Health Sciences Centre, London, ON, Canada
(Potluri) Baylor Scott & White The Heart Hospital, Plano, TX, United
States
(Kleinman, Reardon) Houston Methodist Hospital, Houston, TX, United States
(Samy) Albany Medical Center, Albany, NY, United States
(Rassi) Kaiser Permanente, San Francisco, CA, United States
(Rajagopal, Yadav, Thourani) Piedmont Hospital, Atlanta, GA, United States
(Yakubov) OhioHealth Research and Innovation Institute-Riverside Methodist
Hospital, Columbus, OH, United States
(Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Garcia) Lindner Center for Research and Education at Christ Hospital,
Cincinnati, OH, United States
(Wang) Union Memorial Hospital, Baltimore, MD, United States
(Rinaldi) Carolinas Medical Center, Charlotte, NC, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Waksman) Washington Hospital Center, Washington, DC, United States
(Webb) Providence Health-St Paul's Hospital, Vancouver, BC, Canada
(Ren) Cardialysis, Rotterdam, Netherlands
(Gregson) London School of Public Hygiene, London, United Kingdom
(Modolo, Sathananthan) Boston Scientific, Minneapolis, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: ACURATE neo2 is an open-cell, supra-annular, self-expanding
transcatheter heart valve that is commercially available in over 50
countries but has not previously been evaluated in a randomised trial.
ACURATE-IDE aimed to prospectively evaluate the safety and efficacy of
transcatheter aortic valve replacement (TAVR) with the ACURATE neo2 valve
compared with commercially available valves for the treatment of severe
symptomatic aortic stenosis. Method(s): In this multicentre,
randomised, controlled, non-inferiority trial, patients with symptomatic
severe aortic stenosis and any level of surgical risk were recruited from
71 medical centres in the USA and Canada. Eligible patients were randomly
assigned (1:1) to TAVR with ACURATE neo2 or one of the control valves,
SAPIEN 3 (SAPIEN 3 or SAPIEN 3 Ultra) or Evolut, using permuted block
randomisation with a pseudo-random number generator, and stratified by the
clinical investigation site and type of control valve. All devices were
implanted according to the manufacturer's instructions. The primary
endpoint was a composite of all-cause mortality, all stroke, and
rehospitalisation at 1 year, tested for non-inferiority using a Bayesian
approach. The primary analysis was performed in the intention-to-treat
population and sensitivity analyses were done in the implanted population.
The non-inferiority margin was 8.0%. This study is registered with
ClinicalTrials.gov, NCT03735667, and is ongoing. Finding(s): Between
June 10, 2019, and April 19, 2023, 1500 patients were recruited, of whom
752 were randomly assigned to the ACURATE neo2 group and 748 to the
control group. The median age of participants was 79 years (IQR 74-83).
778 (51.9%) of 1500 patients were female and 721 (48.1%) were male. At 1
year, the posterior median probability of the primary composite endpoint
was higher in the ACURATE neo2 group (16.2% [95% Bayesian credible
interval 13.4-19.1) than in the control group (9.5% [7.5-11.9];
between-group difference 6.6% [3.0-10.2]). The upper bound of treatment
difference exceeded the prespecified non-inferiority margin of 8%, with a
posterior probability of treatment difference of >0.999. At 1 year, the
ACURATE neo2 group, had significantly higher Kaplan-Meier rates of the
composite endpoint of all-cause mortality, all stroke, and
rehospitalisation (14.8% [95% CI 12.5-17.6] vs 9.1% [7.2-11.4]; hazard
ratio [HR] 1.71 [95% CI 1.26-2.33]; p=0.0005). At 1 year, all-cause
mortality occurred in 36 of 752 patients in the ACURATE neo2 group versus
28 of 748 patients in the control group (HR 1.30 [95% CI 0.80-2.14]),
stroke in 41 patients versus 25 patients (1.68 [1.02-2.75]), and
rehospitalisation in 38 patients versus 25 patients (1.57 [0.95-2.61]).
Cardiovascular mortality (3.7% vs 1.8%, p=0.024) and spontaneous
myocardial infarction at 1 year (2.4% vs 0.7%, p=0.0092) were more
frequent in the ACURATE neo2 group than in the control group. Prosthetic
valve aortic regurgitation (central plus paravalvular) at 1 year was
significantly more frequent in the ACURATE neo2 group than in the control
group (mild aortic regurgitation 42.5% vs 24.8%, p<0.0001; moderate 4.4%
vs 1.8%, p=0.0070; severe 0.5% vs 0%; p=0.12). Interpretation(s): In
patients with symptomatic severe aortic stenosis, TAVR with ACURATE neo2
did not meet non-inferiority and resulted in significantly worse outcomes
with respect to the primary endpoint of composite of all-cause mortality,
all stroke, and rehospitalisation at 1 year when compared with commercial
valves. Funding(s): Boston Scientific. Copyright © 2025
Elsevier Ltd

<85>
Accession Number
2038854057
Title
Goal-directed therapy with continuous SvcO<inf>2</inf> monitoring in
pediatric cardiac surgery: the PediaSat single-center randomized trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(4) (no
pagination), 2025. Article Number: 844614. Date of Publication: 01 Jul
2025.
Author
Ferreira F.M.; Araujo D.D.; Dantas G.M.; Cunha L.C.C.; Zeferino S.P.;
Galas F.B.
Institution
(Ferreira, Araujo, Dantas, Cunha, Zeferino, Galas) Faculdade de Medicina
da Universidade de Sao Paulo, SP, Sao Paulo, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Introduction: Low Cardiac Output Syndrome (LCOS) remains a significant
perioperative challenge in pediatric cardiac surgery. This study evaluated
whether a hemodynamic protocol aimed at optimizing continuous central
venous Oxygen Saturation (SvcO<inf>2</inf>) using the PediaSat catheter
could reduce postoperative complications in pediatric patients undergoing
congenital heart surgery. Method(s): Conducted at the Instituto do
Coracao in Sao Paulo, this randomized clinical trial compared a group
receiving SvcO<inf>2</inf>-based goal-directed therapy via PediaSat
(intervention) against conventional care (control). The main objective was
assessing 24-hour lactate clearance post-surgery, with secondary outcomes
including Vasoactive-Inotropic Score (VIS), Mechanical Ventilation (MV)
duration, vasopressor use, and ICU/hospital stay lengths. Result(s):
From July 13, 2014, to March 17, 2016, 391 patients were evaluated for
eligibility. After applying inclusion and exclusion criteria, 65 patients
were included and randomized - 33 to the control group and 32 to the
PediaSat group. There were no losses to follow-up in either group. Lactate
clearance did not significantly differ between the intervention and
control groups. However, the PediaSat group showed significantly shorter
mechanical ventilation times, reduced vasopressor use, and shorter ICU
stays. No significant differences were observed in hospital stay length or
incidence of postoperative complications between the group.
 Conclusion(s): While optimizing SvcO<inf>2</inf> did not affect
overall lactate clearance, it was associated with shorter MV duration,
decreased vasopressor need, and shorter ICU stays in pediatric cardiac
surgery patients. These findings highlight the potential benefits of
continuous SvcO<inf>2</inf> monitoring in postoperative
care. Copyright © 2025 Sociedade Brasileira de Anestesiologia

<86>
Accession Number
2034647734
Title
Ticagrelor vs. clopidogrel in dual antiplatelet therapy after coronary
artery bypass surgery: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1542437. Date of Publication: 2025.
Author
Wang L.; Zhao Y.; Zhang S.; Zhang T.; Song J.; Yun Y.; Wu Y.; Wang Z.; Ma
X.
Institution
(Wang, Zhang, Song, Wang, Ma) Department of Cardiovascular Surgery,
Shandong Provincial Hospital Affiliated to Shandong First Medical
University, Shandong, Jinan, China
(Zhao) Department of Anesthesiology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Shandong, Jinan, China
(Zhang) Department of Cardiovascular Surgery, Shandong Provincial
Hospital, Qilu College of Medicine, Shandong University, Shandong, Jinan,
China
(Yun, Wu) Department of Radiology, Qilu Hospital of Shandong University,
Shandong, Jinan, China
Publisher
Frontiers Media SA
Abstract
Background: Following coronary artery bypass grafting (CABG), the standard
treatment regimen typically involves dual antiplatelet therapy (DAPT),
which includes a P2Y12 receptor antagonist in combination with aspirin.
There is currently no clear consensus regarding the optimal DAPT strategy
after CABG. The aim of this meta-analysis was to evaluate and compare the
safety and efficacy of ticagrelor vs. clopidogrel in patients post-CABG.
 Method(s): A meta-analysis of eligible studies of patients undergoing
CABG and receiving either aspirin plus clopidogrel (A + C) or aspirin plus
ticagrelor (A + T) as antiplatelet therapy, was carried out. The outcomes
of interest included all-cause mortality, cardiovascular mortality, major
adverse cardiovascular and cerebrovascular events (MACCEs), major
bleeding, myocardial infarction, stroke, revascularization, saphenous vein
occlusion and total graft occlusion. Result(s): 4 randomized
controlled trials and 3 observational studies (n = 2,424) were eligible
for final analysis. A + T was associated with a decreased risk of
all-cause mortality (OR = 0.47, 95% CI 0.31-0.70, p < 0.001, p
heterogeneity = 0.80, I2 = 0%) and cardiovascular mortality (OR
= 0.50, 95% CI 0.31-0.82, p = 0.006, p heterogeneity = 0.71, I2
= 0%), compared with A + C group. No statistically significant difference
was found in the rates of major bleeding (OR = 1.16; 95% CI 0.69-1.96; p =
0.57; p heterogeneity = 0.26; I2 = 23%) between two groups.
Besides, the rates of MACCEs, myocardial infarction, stroke, total graft
occlusion, revascularization and saphenous vein occlusion were comparable
between two groups (p > 0.05). Conclusion(s): The meta-analysis
presented the evidence supporting the use of A + T post-CAVG in reducing
all-cause mortality and cardiovascular mortality, with no increase in
bleeding events, in comparison with A + C. Additional RCTs are needed to
determine the optimal DAPT after CABG. Copyright 2025 Wang, Zhao,
Zhang, Zhang, Song, Yun, Wu, Wang and Ma.

<87>
Accession Number
2034647114
Title
Development and validation of a nomogram to pediatric postoperative
pulmonary complications following thoracic surgery.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 255. Date
of Publication: 01 Dec 2025.
Author
Wang L.; Xiao T.; Du Z.; Chen T.; Pei D.; Qu S.
Institution
(Wang, Xiao, Du, Pei, Qu) Department of Anesthesiology, the Affiliated
Children's Hospital Of Xiangya School of Medicine, Central South
University (Hunan children's hospital), Yuhua District, 86 Ziyuan Road,
Hunan, Changsha, China
(Chen) Department of Neurosurgery, Xiangya Hospital, Central South
University, Hunan, Changsha, China
Publisher
BioMed Central Ltd
Abstract
Background: Since the respiratory anatomy and physiology of children
differ from those of adults, they are more susceptible to postoperative
pulmonary complications after thoracic surgery that requires one-lung
ventilation. Hypothesizing that the incidence of postoperative pulmonary
complications could be predicted using easily accessible perioperative
variables, we aimed to develop a nomogram specifically for children
receiving thoracic surgery with one-lung ventilation. Method(s): A
total of 361 children undergoing thoracic surgery with one-lung
ventilation were randomly assigned to two groups: a training cohort (80%)
and a validation cohort (20%). The training cohort was utilized to develop
a nomogram, whereas the validation cohort was used to assess its
performance. The outcome of this study was the incidence of postoperative
pulmonary complications. Univariate analysis and the least absolute
shrinkage and selection operator regression model were applied to select
the most relevant prognostic predictors. Multivariable logistic regression
was used to develop a nomogram based on the selected prediction factors.
Internal validation was conducted to evaluate its performance. The C-index
and calibration plots were used to assess its discriminative ability and
calibration. Result(s): Among the included patients, 109 (30.2%)
presented postoperative pulmonary complications. Four predictive factors
were ultimately selected to develop the nomogram. They were preoperative
neutrophil-to-lymphocyte ratio, intraoperative ventilation mode, maximum
peak airway pressure and minimum oxygenation index during one-lung
ventilation. By incorporating these factors, the nomogram demonstrated
strong C-indices of 0.909 (95% confidence interval (CI) [0.809-0.82]) and
0.871 (95% CI [0.795-0.945]) in the training and validation cohorts,
respectively, along with well-matched calibration curves.
 Conclusion(s): The nomogram, based on four objective and easily
assessed factors, demonstrates excellent predictive performance for
pediatric postoperative pulmonary complications after one-lung
ventilation, enabling early risk assessment and targeted interventions to
improve patient outcomes. Trial registration: This study is registered at
the Chinese Clinical Trial Registry (Registration number:
ChiCTR2300072042, Date of Registration: 1/6/2023). Copyright ©
The Author(s) 2025.

<88>
Accession Number
2038843472
Title
Escalation and De-escalation of Temporary Mechanical Circulatory Support:
Joint Consensus Report of the PeriOperative Quality Initiative and the
Enhanced Recovery After Surgery Cardiac Society.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Spelde A.E.; Barron L.M.; Cangut B.; Hickey G.W.; Lorusso R.; Silvestry
S.C.; Tong M.Z.; Engelman D.T.; Shaw A.D.; Chatterjee S.
Institution
(Spelde) Department of Anesthesiology & Critical Care, University of
Pennsylvania, Philadelphia, PA, United States
(Barron, Chatterjee) Division of Cardiothoracic Surgery, Michael E.
DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX,
United States
(Barron, Chatterjee) Department of Cardiovascular Surgery, Texas Heart
Institute, Houston, TX, United States
(Cangut) Department of Cardiovascular Surgery, Mount Sinai School of
Medicine, New York, NY, United States
(Hickey) Division of Cardiology, University of Pittsburgh School of
Medicine, Pittsburgh, PA, United States
(Lorusso) Department of Cardio-Thoracic Surgery, Maastricht University
Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Silvestry) Division of Cardiothoracic Surgery, Department of Surgery,
University of Arizona School of Medicine, Phoenix, AZ, United States
(Tong) Department of Thoracic and Cardiovascular Surgery, Heart, Vascular
and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Engelman) Heart and Vascular Program, Baystate Health, University of
Massachusetts Chan Medical School-Baystate, Springfield, MA, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
(Chatterjee) Division of Acute Care Surgery/Trauma, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
Publisher
Elsevier Inc.
Abstract
Background: Temporary mechanical circulatory support (tMCS) for
cardiogenic shock (CS) is increasing despite knowledge gaps and variations
in management practices. This document was created to provide clinicians
with guidance regarding initiation, escalation, and de-escalation of tMCS
in patients with CS. Method(s): An interdisciplinary, international
expert panel using a structured literature appraisal and modified Delphi
method derived consensus statements regarding triggers for prompt patient
assessment and initiating tMCS in CS, assessing adequacy of support,
readiness for tMCS weaning, and next steps in nonrecovery. Individual
statements were graded on the basis of the quality of available evidence.
 Result(s): The panel addressed 4 main questions aimed at initiation,
escalation, and de-escalation of tMCS. On the basis of available
literature review and expert consensus, 11 recommendations were
formulated. Key principles included recognition of the need for patients
with CS who have ongoing hemodynamic compromise, tissue hypoperfusion, and
metabolic derangements to be considered for early tMCS initiation. An
interdisciplinary shock team should be involved in management, with early
referral when patient conditions require care beyond center capabilities.
Discussions providing anticipatory guidance should be performed with
patients and decision makers before initiating tMCS. Management of tMCS
involves frequent, timely hemodynamic and tissue perfusion reassessments
to determine the need for escalation or weaning. For patients unable to be
weaned from tMCS, evaluation should include interdisciplinary assessment
for advanced therapies, with palliation included as a consideration in
care discussions. Conclusion(s): A practical guide to initiation,
escalation, and de-escalation of tMCS is provided. Center-specific
approaches that are based on local capabilities should be
implemented. Copyright © 2025 The Society of Thoracic Surgeons

<89>
Accession Number
2038843419
Title
Outcomes After DCD Cardiac Transplantation: An International, Multicenter
Retrospective Study.
Source
JACC: Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Louca J.O.; Ochsner M.; Bhagra S.; Shah A.; Schlendorf K.; Lima B.; Wang
C.C.; Siddiqi H.; Irshad A.; Schroder J.; Casalinova S.; Milano C.; Khush
K.; Skoda A.; Luikart H.; Ashley E.; Moazami N.; James L.; Dar O.;
Konicoff M.; Urban M.; Um J.; Castleberry A.; Hoffman J.R.H.; Park S.Y.;
Cain M.T.; Fetten K.; Meyer D.; Xu A.; Gonzalez-Vilchez F.; Dominguez-Gil
B.; Royo-Villanova M.; Garrido I.; Brouckaert J.; Rega F.; Tchana-Sato V.;
Berman M.; Bae J.; Sinha S.; Pettit S.; Messer S.; Large S.
Institution
(Louca, Sinha) University of Cambridge, Cambridge Stem Cell Institute,
Cambridge, United Kingdom
(Louca, Ochsner, Bhagra, Berman, Bae, Pettit, Large) Royal Papworth
Hospital, Cambridge, United Kingdom
(Louca) University of Oxford, Nuffield Department of Population Health,
Oxford, United Kingdom
(Ochsner) LMU University Hospital, Munich, Germany
(Shah, Schlendorf, Lima, Wang, Siddiqi, Irshad) Vanderbilt University
Medical Center, Nashville, TN, United States
(Schroder, Casalinova, Milano) Duke University Medical Center, Durham, NC,
United States
(Khush, Skoda, Luikart, Ashley) Stanford University, Palo Alto, CA, United
States
(Moazami, James) NYU Langone Health, New York, NY, United States
(Dar, Konicoff) Harefield Hospital (a division of Guys and St Thomas' NHS
Foundation Trust), London, United Kingdom
(Dar) School of Cardiovascular Medicine and Sciences Kings College London,
United Kingdom
(Urban, Um, Castleberry) Univeristy of Nebraska, Medical Center, Omaha,
NE, United States
(Hoffman, Park, Cain) University of Colorado, Anschutz Medical Center,
Aurora, CO, United States
(Fetten, Meyer, Xu) Baylor Scott and White Health, Baylor University
Medical Center, Dallas, TX, United States
(Gonzalez-Vilchez) Hosp Marques de Valdecilla, Santander, Spain
(Dominguez-Gil) Organizacion Nacional de Trasplantes, Madrid, Spain
(Royo-Villanova, Garrido) Hospital Universitario Virgen de la Arrixaca,
Murcia, Spain
(Brouckaert, Rega) University Hospitals Leuven, Leuven, Belgium
(Tchana-Sato) CHU Liege, Liege, Belgium
(Messer) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: As donation after circulatory determination of death (DCD)
heart transplantation (HT) becomes more widely adopted, there is a need to
establish the most clinically effective method of organ procurement.
 Objective(s): This international, multicenter study compares outcomes
of DCD HT across Europe and the United States between recipients whose
donor hearts were retrieved using thoraco-abdominal normothermic regional
perfusion (taNRP) with those whose hearts were recovered using direct
procurement and perfusion (DPP). Method(s): This was a retrospective
observational study across 22 heart transplant centers in Belgium, Spain,
the United Kingdom, and the United States. This study included all
patients undergoing DCD HT at participating centers, from the start of
each center's DCD program through January 1, 2023. DCD HT with recovery
using either taNRP or DPP were compared with one another. Posttransplant
outcomes included: 1) survival at 1 year; 2) incidence of severe primary
graft dysfunction (PGD); and 3) episodes of treated, biopsy-proven
acute-cellular rejection (ACR) in the first year following
transplantation. Result(s): A total of 504 DCD HTs took place in the
study period. Survival at 1 year was similar for taNRP and DPP recipients
(91% vs 88%; P = 0.100). taNRP recipients had a lower rate of severe PGD
(7.6% vs 19.2%; P < 0.001) and fewer episodes of biopsy-proven, ACR
requiring treatment in the first year post-transplantation (13% vs 25%; P
< 0.001). Conclusion(s): In an international study of DCD HT,
recipients of hearts retrieved by taNRP technique had lower rates of
severe PGD and fewer episodes of biopsy-proven ACR in the first year when
compared with those retrieved by using DPP. These results should be
further investigated with randomized control trials. Copyright ©
2025 The Authors

<90>
Accession Number
2034649754
Title
The utility of real-time transthoracic 3-dimensional echocardiography in
congenital heart disease in current clinical practice.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 2025.
Author
Saengsin K.; Intamul K.; Sittiwangkul R.
Institution
(Saengsin, Intamul, Sittiwangkul) Division of Cardiology, Department of
Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the utility of three-dimensional transthoracic
echocardiography (3D TTE) in the assessment and management of congenital
heart disease (CHD). The use of three-dimensional TTE with both pediatric
and adult patients has helped to clarify the cardiac anatomy and
hemodynamic physiologic lesions in CHD. However, few practical aspects of
3D TTE have undergone systematic review. A retrospective study of CHD
patients from January-December 2022 who underwent 3D TTE was conducted to
determine the utility of 3D TTE with respect to answering the primary
diagnostic question, adding diagnostic information to 2D imaging,
concordance with 2D TTE or cardiac CT, and impact on management. During
the study period, 76 CHD patients underwent 3D TTE at a median age of 104
months (IQR 29-175.5). The common cardiac segment under investigation was
related to the atrioventricular valve. The mean heart rate was 89 +/- 20
BPM. The mean volume rate was 17 +/- 5. The single beat acquisition was
used in all cases. Sedation use was infrequent (22.67%). Three-dimensional
TTE answered the primary diagnostic question and added diagnostic
information to 2D TTE imaging in all cases (100%). Additionally, 3D TTE
impacted the management of the following: provided guided intervention
(3/76, 4%), provided information before cardiac surgery (27/76, 36%), and
increased understanding of the cardiac anatomy (76/76, 100%).
Three-dimensional TTE can be applied in simple to complex CHD cases,
across all age groups, from infants to adults. It provides real-time
performance, requires no radiation, and infrequent use of sedation. This
study showed that 3D TTE was accurate, answered the diagnostic questions
in all cases, and frequently added diagnostic information that impacted
management. Copyright © The Author(s) 2025.

<91>
[Use Link to view the full text]
Accession Number
2038799179
Title
Meta-Analysis of Dual Antiplatelet Therapy Versus Low-Dose Direct Oral
Anticoagulation After Left Atrial Appendage Occlusion.
Source
American Journal of Therapeutics. 32(3) (pp e312-e315), 2025. Date of
Publication: 01 May 2025.
Author
Singh S.; Bliden K.; Tantry U.S.; Gurbel P.A.; Kanjwal M.Y.; Lundgren S.W.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, United States
(Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore,
Baltimore, MD, United States
(Lundgren) Division of Cardiology, University of Nebraska Medical Center,
Omaha, NE, United States
Publisher
Lippincott Williams and Wilkins

<92>
Accession Number
2038852765
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Interventional Cardiology Clinics. 14(3) (pp 351-366), 2025. Date of
Publication: 01 Jul 2025.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
Elsevier Inc.

<93>
Accession Number
2038828647
Title
Navigating Family Leave in Cardiothoracic Surgery Training.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Russo M.G.; Tompkins A.K.; Akinade O.; Woodard G.A.; Cooke D.T.; Antonoff
M.B.; Erkmen C.P.
Institution
(Russo, Akinade, Erkmen) Lewis Katz School of Medicine at Temple
University, Philadelphia, Pennsylvania, United States
(Tompkins) Center for Asian Health, Lewis Katz School of Medicine at
Temple University, Philadelphia, Pennsylvania, United States
(Woodard) Division of Thoracic Surgery, Department of Surgery, Yale
University School of Medicine, New Haven, Connecticut, United States
(Cooke) Division of General Thoracic Surgery, University of California,
Davis Health, Sacramento, California, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, UT MD
Anderson Cancer Center, Houston, Texas, United States
(Erkmen) Department of Thoracic Medicine and Surgery, Temple University
Hospital, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiothoracic surgery (CTS) training may coincide with family
needs including pregnancy, illness, birth/adoption/fostering of a child,
and care for family members. Certifying bodies set requirements and limits
on family leave, complicating the navigation of family needs during
training. Our goal is to examine policies of medical boards and their
alignment with the 2022 Accreditation Council for Graduate Medical
Education policy and to develop a practical tool to help trainees and
program directors navigate family leave. Method(s): A literature
review was conducted with PubMed of publications published from July 2022
to September 2024 focusing on family leave within surgical specialties.
This study reviews family leave policies, requirements, and benefits of
certifying bodies. Data from the American Association of Medical Colleges,
American Boards of Surgery and Thoracic Surgery, and Accreditation Council
for Graduate Medical Education were analyzed to understand gender
distribution and policy variations between surgical specialties.
 Result(s): There was no publication discussing family leave in CTS.
Of 40 reviewed publications, 12 concluded that parental leave policies are
unclear or insufficient. Publications were found to focus on perspectives
and experiences but to lack actionable solutions. Family leave policies
vary, with inconsistencies in duration and flexibility. The duration of
leave was not linked with gender representation in specialty.
 Conclusion(s): Comprehensive family leave policies are needed to
assist programs and trainees in navigating family leave in
CTS. Copyright © 2025 The Society of Thoracic Surgeons

<94>
Accession Number
2034624306
Title
Clevidipine for the management of hypertension in the perioperative
cardiac and noncardiac surgical settings: a systematic review.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1562681.
Date of Publication: 2025.
Author
Bottussi A.; D'Andria Ursoleo J.; Agosta V.T.; Piazza E.; Mongardini E.;
Monaco F.
Institution
(Bottussi, D'Andria Ursoleo, Agosta, Piazza, Mongardini, Monaco)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Frontiers Media SA
Abstract
Introduction: Perioperative hypertension is a common occurrence in
anesthetic practice, potentially leading to cardiac complications
resulting in unfavorable patient outcomes. Clevidipine emerges in the
current drug scenario as an antihypertensive agent with advantageous
properties like ultra-short half-life, titratable effect, and ease of use.
 Method(s): A systematic search of PubMed/MEDLINE, EMBASE, Cochrane
Central Register of Controlled Trials and Google Scholar databases was
performed aided by a specific search string, to provide a synthesis of the
available body of literature regarding clevidipine administration for the
management of hypertension in the perioperative cardiac and noncardiac
surgical settings. Result(s): Eighteen documents (summarizing data
from 2,066 patients) published between 1997 and 2023 were included in the
present review. Clevidipine was extensively compared to both placebo and
other commonly used antihypertensive medications. Discussion(s):
Clevidipine demonstrated favorable efficacy and promising safety profiles.
Moreover, it may represent a promising aid for the intraoperative
management of hypertension, and a valuable addition to traditional
antihypertensive drugs. However, significant gaps in research still
persist, and further studies are warranted to better dissect its effects
in frail populations and patients of different ethnicities. Systematic
review protocol: PROSPERO (CRD42024568584). Copyright © 2025
Bottussi, D'Andria Ursoleo, Agosta, Piazza, Mongardini and Monaco.

<95>
Accession Number
2038832744
Title
The Effect of Nicorandil on Cardiac Function and Clinical Outcomes in
ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary
Percutaneous Coronary Intervention: A Randomised Trial.
Source
Heart Lung and Circulation. Conference: The Cardiac Society of Australia
and New Zealand Annual Scientific Meeting (New Zealand) 2025. Rotorua .
34(Supplement 2) (pp S44), 2025. Date of Publication: 01 May 2025.
Author
Lee H.
Institution
(Lee) Pusan National University Hospital, Busan, South Korea
Publisher
Elsevier Ltd
Abstract
Background: We investigated the effect of nicorandil on infarct size,
cardiac function assessed by cardiac magnetic resonance imaging (CMR) and
outcomes in ST-segment elevation myocardial infarction (STEMI) patients
undergoing primary percutaneous coronary intervention (PCI).
 Method(s): In a prospective, randomised, controlled trial, 83
patients with STEMI receiving primary PCI were randomised into the
nicorandil (n=40) or placebo (n=43) groups. Nicorandil was administered in
the emergency room before primary PCI as an intravenous bolus of 4 mg
followed by a continuous infusion of 6 mg/h for 24 h and as 2-mg
intracoronary injections prior to balloon dilatation and coronary
stenting. Nicorandil was continued orally at 10-20 mg/day for 6 months.
Infarct size and cardiac function were measured by CMR at 5 days and 6
months after primary PCI. Furthermore, major adverse cardiac events
(MACEs) including all-cause death, nonfatal myocardial infarction, any
revascularisation, stroke, and definite/probable stent thrombosis were
compared. Result(s): There were no significant differences in
baseline clinical characteristics between the groups. Infarct size at
baseline and 6 months as well as infarct size changes during 6 months as
measured by CMR were similar between the groups. Similarly, other CMR
parameters were comparable at baseline and 6 months between the groups.
MACEs occurred in four patients (4.8%) during 6 months. No significant
difference in the risk of MACEs was observed between the groups.
 Conclusion(s): Treatment with nicorandil for 6 months after primary
PCI was not associated with any improvement in infarct size,
CMR-determined cardiac function, and outcomes in STEMI
patients. Copyright © 2025

<96>
Accession Number
2038828266
Title
Optimizing Tranexamic Acid Use in Adult Cardiac Surgery: From Rationale to
Clinical Practice.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
La Via L.; Cuttone G.; Terranova C.; Sorbello M.; Martucci G.; Pappalardo
F.
Institution
(La Via) Department of Anesthesia and Intensive Care, University Hospital
Policlinico "G. Rodolico-San Marco", Catania, Italy
(Cuttone, Sorbello, Pappalardo) Faculty of Medicine and Surgery, "Kore"
University of Enna, Enna, Italy
(Cuttone, Terranova, Pappalardo) Policlinico Centro Cuore GB Morgagni,
Catania, Italy
(Sorbello) Department of Anesthesia and Intensive Care, Giovanni Paolo II
Hospital, Ragusa, Italy
(Martucci) Department of Anesthesia and Intensive Care, IRCCS-ISMETT,
UPMC, Palermo, Italy
Publisher
W.B. Saunders
Abstract
Tranexamic acid (TXA) has emerged as a cornerstone in blood conservation
strategies for cardiac surgery. This comprehensive review synthesizes
current evidence on TXA's efficacy, safety, and optimal use in various
cardiac surgical procedures. We examine the pharmacological properties of
TXA, its historical development as an antifibrinolytic agent, and its
evolution in cardiac surgical practice. The review critically evaluates
key clinical trials and meta-analyses demonstrating TXA's efficacy in
reducing blood loss and transfusion requirements across a spectrum of
cardiac surgeries, including coronary artery bypass grafting, valve
procedures, and aortic surgery. Special consideration is given to its use
in pediatric cardiac surgery. We address ongoing debates surrounding
optimal dosing strategies, timing of administration, and integration with
other hemostatic interventions. The safety profile of TXA is thoroughly
examined, with particular focus on the risk of seizures and thromboembolic
events. The review also explores practical aspects of TXA implementation
in clinical practice, including its role in comprehensive blood management
protocols and potential cost-effectiveness. Emerging research areas, such
as pharmacokinetic-guided dosing and topical TXA application, are
discussed. Finally, we outline future directions and research priorities,
including the need for long-term outcome studies and refinement of
patient-specific protocols. This review provides a balanced assessment of
TXA's role in modern cardiac surgery, offering clinicians and researchers
a comprehensive resource for optimizing its use to improve patient
outcomes while minimizing potential risks. Copyright © 2025
Elsevier Inc.

<97>
[Use Link to view the full text]
Accession Number
2038766010
Title
Use of Antibacterial Envelopes in Neuromodulation Surgeries With
Implantable Device Insertion: A Systematic Review and Meta-Analysis.
Source
Neurosurgery. 96(6) (pp 1193-1199), 2025. Date of Publication: 01 Jun
2025.
Author
De Oliveira H.M.; Barbosa L.M.; Zamora F.V.; De Paula B.O.; De Paula G.O.;
Pilitsis J.G.; Da Costa P.R.F.
Institution
(De Oliveira, De Paula, De Paula) Department of Medicine, Federal
University of Mato Grosso, Mato Grosso, Sinop, Brazil
(Barbosa) Department of Medicine, Federal University of Minas Gerais,
Minas Gerais, Belo Horizonte, Brazil
(Zamora) Department of Medicine, State University of Rio de Janeiro, Rio
de Janeiro, Rio de Janeiro, Brazil
(Pilitsis) Professor and Chair of the Department of Neurosurgery,
University of Arizona, Tucson, AZ, United States
(Pilitsis) Physician Executive for Functional Neurosurgery, Banner Health
System , Tucson, AZ, United States
(Da Costa) Department of Functional Neurosurgery, Sinedor Clinic, Mato
Grosso, Sinop, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND AND OBJECTIVES:Neuromodulation is an advanced therapeutic
intervention for managing various neurological, psychiatric, and
functional disorders. However, a significant challenge is the risk of
infections at the device implantation site. Previous studies have shown
that antibacterial envelopes used in cardiovascular surgeries
significantly reduce infection risk. It is postulated that similar
benefits could occur in neurosurgeries involving implant insertion, but
the literature lacks studies analyzing this efficacy. This study aimed to
evaluate the effectiveness of antibacterial envelopes in reducing
infection rates associated with neuromodulation implants.
 METHOD(S):We systematically searched PubMed, Embase, and the Cochrane
Central Register of Controlled Trials databases up to August 2024 for
clinical trials comparing the use of antibacterial impregnated envelopes
in patients undergoing neuromodulation-related implant insertion. This
study followed Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines. Statistical analyses were performed using R
version 4.3.2. Risk of bias was assessed using the Risk Of Bias In
Nonrandomized Studies - of Interventions tool, and the quality of evidence
was evaluated using the Grading of Recommendations Assessment, Development
and Evaluation assessment. The study was registered in Prospective
Register of Systematic Reviews. RESULT(S):Four studies, comprising
1242 patients, were included, of whom 704 (56.7%) received antibacterial
envelopes. The pooled analysis showed that the odds of infection were 77%
lower in patients using the antibacterial envelope compared with the
control group (odds ratios = 0.23; 95% CI = 0.10-0.51; P <.001;
I2 = 2%). CONCLUSION(S):The use of an antibacterial
envelope significantly reduces the odds of infection in patients
undergoing neuromodulation-related implant insertion by 77%. These
findings underscore the potential of antibacterial envelopes to improve
postoperative outcomes. Copyright © Congress of Neurological
Surgeons 2024. Unauthorized reproduction of this article is prohibited.

<98>
Accession Number
2038818242
Title
Anxiety during transcatheter aortic valve replacement under local
anesthesia - the ART-VR trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Chatterjee S.; Ooms J.; de Ronde M.; van Gorsel S.; Mattace-Raso A.M.;
Goudzwaard J.; Mattace-Raso F.; Kardys I.; Nuis R.-J.; Daemen J.; Van
Mieghem N.
Institution
(Chatterjee, Ooms, de Ronde, van Gorsel, Mattace-Raso, Kardys, Nuis,
Daemen, Van Mieghem) Department of Interventional Cardiology,
Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, Netherlands
(Goudzwaard, Mattace-Raso) Department of Internal Medicine, Section of
Geriatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The use of local anesthesia during transcatheter aortic valve
replacement (TAVR) could result in patient discomfort. Application of
immersive virtual reality (VR) during TAVR might distract the patient and
enhance the overall experience. Objective(s): To evaluate the effect
of an immersive VR environment on periprocedural anxiety and patient
discomfort, compared to standard of care in patients undergoing
transfemoral (TF) TAVR under local anesthesia. Method(s): In this
single-center, randomized controlled pilot study, patients were randomized
to either VR immersion during TAVR or standard of care. The intervention
was a VR headset to create 3D experiences during percutaneous transfemoral
TAVR. The main outcome was patient-reported procedural anxiety assessed
directly after the procedure on a visual analog scale (VAS). Secondary
outcomes were procedural satisfaction, pain, and change in anxiety.
Personality scores were obtained at baseline to explore associations
between personality types and relevant outcomes. Result(s): A total
of 75 patients (VR = 37, control = 38) were included between September
2021 and January 2023. The median age was 79 (25th-75th: 75-84) years and
32 patients (43 %) were female. Overall procedural anxiety VAS was 1.0
(0.0-3.0) and satisfaction was 9.0 (8.0-10.0). There was no difference in
procedural anxiety between VR and control (VAS: 1.0 [25th-75th: 0.0-3.0]
versus 1.0 [25th-75th: 0.0-3.0], p = 0.59). Procedural satisfaction, pain
perception and change in anxiety were not affected by VR use.
 Conclusion(s): Patients undergoing TF-TAVR under local anesthesia
experienced mild procedural anxiety and high satisfaction levels.
Procedural VR use did not affect procedural anxiety or pain
perception. Copyright © 2025

<99>
Accession Number
2034562486
Title
Qu-shi-hua-tan decoction's efficacy and safety for patients with angina
following coronary revascularization: a randomized, double-blind,
placebo-controlled trial study protocol.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1512385. Date of Publication: 2025.
Author
Xu W.; Wen J.; Li X.; Zhang Y.; Lu W.
Institution
(Xu, Wen, Li, Li, Zhang, Lu) The Second Clinical Medical College of
Guangzhou University of Chinese Medicine, Guangzhou, China
(Lu) State Key Laboratory of Traditional Chinese Medicine Syndrome,
Guangdong Provincial Hospital of Chinese Medicine, China
(Lu) Guangzhou University of Chinese Medicine, Guangzhou, China
(Lu) Chinese Medicine Guangdong Laboratory, Guangdong, Guangzhou, China
Publisher
Frontiers Media SA
Abstract
Introduction: The Qu-shi-hua-tan decoction (QSHTD), formulated by
academician Chen Keji, is an empirical decoction for coronary heart
disease (CHD). We conducted a randomized controlled trial to assess the
effectiveness and safety of QSHTD in managing angina after coronary
revascularization (AACR) in CHD patients. Methods and design: This
double-blind randomized controlled trial will be conducted at Guangdong
Provincial Hospital of Traditional Chinese Medicine. We will allocate 98
qualified participants to either the experimental or control group in a
1:1 ratio through random selection. The experimental group will be given
standard care along with QSHTD, whereas the control group will receive
standard care and a placebo. The study will span 26 weeks, consisting of a
2-week initial phase, a 12-week intervention phase, and a 12-week
monitoring phase. The main outcome measure will be myocardial blood flow
(MBF) assessed using adenosine stress real-time myocardial perfusion
echocardiography (RTMPE). The secondary outcomes will be Canadian
Cardiovascular Sociation Classification, Seattle Angina Questionnaire,
Traditional Chinese Medicine (TCM) symptom evaluation; and major adverse
cardiac events (MACE). Discussion(s): This study seeks to deliver
compelling proof of the superior methodological and reporting standards of
QSHTD's effectiveness and safety within AACR treatment. Clinical Trial
Registration: Chinese Clinical Trial Registration Center
[www.chictr.org.cn]. The trial was registered on November 26, 2020
[ChiCTR2000040270]. Copyright 2025 Xu, Wen, Li, Li, Zhang and Lu.

<100>
Accession Number
2034636587
Title
Impact of Periprocedural Statin Therapy on Mortality and Cardiovascular
Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and
Meta-Regression.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Goyal A.; Maheshwari S.; Mashkoor Y.; Singh A.; Rafique F.; Sheikh A.B.;
Bansal K.
Institution
(Goyal) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Maheshwari) Department of Internal Medicine, University of Alabama at
Montgomery, Montgomery, AL, United States
(Mashkoor, Singh, Rafique) Department of Internal Medicine, Dow University
of Health Sciences, Karachi, Pakistan
(Sheikh) Department of Internal Medicine, University of New Mexico,
Albuquerque, NM, United States
(Bansal) Department of Family and Community Medicine, Baylor College of
Medicine, Houston, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) stands as a
notable alternative to surgical valve replacement for severe aortic
stenosis (AS). Despite the established benefits of statins in
cardiovascular pathologies, their specific impact in patients with severe
AS undergoing TAVR remains uncertain. Aim(s): Our meta-analysis aims
to assess whether periprocedural statin therapy improves survival and
outcomes post-TAVR, thus addressing this gap in literature.
 Method(s): A comprehensive literature search using various databases
with relevant keywords terms was conducted to identify studies on the
impact of periprocedural statin therapy on TAVR outcomes. We assessed the
primary outcome of all-cause mortality alongside various secondary
outcomes including stroke/transient ischemic attack (TIA), myocardial
infarction, acute kidney injury (AKI), 30-day mortality, in-hospital
mortality, rehospitalization, cardiovascular complications, and pacemaker
requirement. A random-effects model using Comprehensive Meta Analysis
Software was employed to analyze the data for each outcome. Statistical
significance was set at a p < 0.05. Result(s): Our analysis of 19
observational studies revealed that periprocedural statin therapy
significantly reduces all-cause mortality following TAVR surgery (OR =
0.71, 95% CI: 0.61-0.83, p < 0.001). However, the influence of statins on
other outcomes remains inconclusive. These outcomes include stroke/TIA (OR
= 0.90, 95% CI: 0.68-1.19, p = 0.455), risk of MI (OR = 1.72, 95% CI:
0.73-4.04, p = 0.214), AKI (OR = 0.99, 95% CI: 0.75-1.31, p = 0.968),
30-day mortality (OR = 0.71, 95% CI: 0.46-1.10, p = 0.126), in-hospital
mortality (OR = 0.42, 95% CI: 0.13-1.38, p = 0.151), rehospitalization (OR
= 0.92, 95% CI: 0.66-1.29, p = 0.645), cardiovascular complications (OR =
1.12, 95% CI: 0.91-1.37, p = 0.297), and pacemaker requirement (OR = 0.83,
95% CI: 0.65-1.06, p = 0.133). Conclusion(s): Our meta-analysis
indicates a potentially promising role for periprocedural statin therapy
in enhancing patient outcomes post-TAVR surgery. We found a notable
association between statin therapy and a reduction in all-cause mortality.
However, the effects on secondary outcomes did not reach statistical
significance, which warrants further investigation through larger,
well-designed, randomized controlled trials. Copyright © 2025
Wiley Periodicals LLC.

<101>
Accession Number
647374564
Title
Effect of thymosin alpha1 on Immune response and organ function in acute
aortic dissection surgery: PANDA II trial protocol.
Source
Future cardiology. (pp 1-8), 2025. Date of Publication: 14 May 2025.
Author
Liu H.; Qian S.-C.; Zhang Y.-Y.; Tang C.-B.; Yue H.-H.; Fan G.-L.; Zhao
X.; Jiang Y.-Y.; Huang F.-H.; Zeng Z.-H.; Wang W.; Lu X.-R.; Luo X.-K.;
Bai X.-F.; Zheng X.-X.; Xie P.; Ma C.; Zhao S.; Zhang H.-J.
Institution
(Liu, Zhao) Department of Cardiovascular Surgery, First Affiliated
Hospital of Nanjing Medical University, Nanjing, China
(Qian, Zhang) Department of Cardiovascular Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Zhang) Department of Cardiovascular Surgery, First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Tang) Department of Cardiovascular Surgery, Subei People Hospital of
Jiangsu Province, Yangzhou, China
(Yue) Department of Cardiovascular Surgery, West China Hospital of Sichuan
University, Chengdu, China
(Fan) Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji
University, Shanghai, China
(Zhao) Department of Cardiovascular Surgery, Qilu Hospital of Shandong
University, Jinan, China
(Jiang) Department of Cardiovascular Surgery, First Affiliated Hospital of
Bengbu Medical College, Bengbu, China
(Huang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing Medical University, Nanjing, China
(Zeng) Department of Cardiovascular Surgery, Second Affiliated Hospital of
Nanchang University, Nanchang, China
(Wang) Department of Cardiovascular Surgery, Teda International
Cardiovascular Hospital, Tianjin University, Tianjin, China
(Lu) Department of Cardiovascular Surgery, Seventh Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
(Luo) Department of Cardiovascular Surgery, Guangdong Provincial People's
Hospital, Southern Medical University, Guangzhou, China
(Bai) Department of Cardiovascular Surgery, First Affiliated Hospital of
Kunming Medical University, Kunming, China
(Zheng) Department of Cardiovascular Surgery, Friendship Hospital of Yili
Kazak Autonomous Prefecture, China
(Xie) Department of Cardiovascular Surgery, Xiamen Cardiovascular
Hospital, Xiamen University School of Medicine, Xiamen, China
(Ma) Department of Cardiothoracic Surgery, Third Affiliated Hospital of
Soochow University, Changzhou, China
Abstract
This multicenter randomized controlled trial evaluates the efficacy of
thymosin alpha 1 (Talpha1) supplementation in preventing organ dysfunction
following acute type A aortic dissection (ATAAD) repair. Over 330 patients
will be equally assigned to receive either Talpha1 plus standard care or
placebo with standard management. The primary endpoint involves
calculating the difference in mean postoperative Sequential Organ Failure
Assessment (SOFA) scores between groups, measured daily from postoperative
days 7. By targeting post-operative immune system imbalance, this study
aims to establish a novel therapeutic approach for reducing systemic
inflammatory response syndrome (SIRS)-mediated organ injury and improving
long-term outcomes in this high-risk population. Results will be
disseminated through peer-reviewed publications and international
conferences.Trial registration: ClinicalTrials.gov Registry (NCT05339529).

<102>
Accession Number
647380922
Title
PERCUTANEOUS CORONARY INTERVENTION VS CORONARY ARTERY BYPASS GRAFTING IN
LEFT MAIN DISEASE ACCORDING TO PATIENTS' SEX: A META-ANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 45. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 25(11 Supplement 2) (pp e29-e30), 2024. Date of Publication: 2024.
Author
Meynet P.; Improta R.; Carbone M.L.; Pecoraro M.; Pagliassotto I.; Di
Pietro G.; Demetres M.; Bruno F.; Comitini G.; Leone A.; Martinengo E.;
D'Ascenzo F.; Chieffo A.; De Ferrari G.M.; Gaudino M.; Mancone M.; Di
Franco A.; De Filippo O.
Institution
(Meynet, Carbone, Pecoraro, Pagliassotto, Bruno, Martinengo, D'Ascenzo, De
Ferrari, De Filippo) Division of Cardiology, Cardiovascular and Thoracic
Department, 'Citta della Salute e della Scienza' Hospital, Turin, Italy
(Meynet, Carbone, Pecoraro, Pagliassotto, Martinengo, D'Ascenzo, De
Ferrari) Department of Medical Sciences, University of Turin, Turin, Italy
(Improta, Di Pietro, Comitini, Mancone) Department of Clinical, Internal,
Anesthesiology and Cardiovascular Sciences 'Sapienza', University of Rome,
Policlinico Umberto I, Roma, Italy
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Leone) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Leone) Division of Cardiology, SG Moscati Hospital, Avellino, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Chieffo) Vita Salute San Raffaele University, Milan, Italy
(Gaudino, Di Franco) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Although coronary artery bypass grafting (CABG) has consistently
demonstrated superior long-term outcomes, percutaneous coronary
intervention (PCI) has gained increasing interest as an alternative
revascularization strategy for unprotected left main (ULM) disease. In
this context, the role of the sex category has gained mounting interest in
the view of a tailored approach for coronary revascularization. The aim of
this meta-analysis was to investigate outcomes after PCI or CABG for ULM
disease according to patients' sex. Methods Randomized controlled trials
(RCTs) and adjusted observational studies comparing PCI vs CABG in
patients with ULM disease and reporting outcomes according to sex category
were included. Major adverse cardiovascular events (MACE) was the primary
composite endpoint. All-cause mortality and repeated revascularization
were the secondary endpoints. Results Ten studies (3 RCTs, 7 adjusted
observational), encompassing 22141 patients with ULM disease (13411
patients in the PCI group and 8730 in the CABG group) and a median
follow-up of 5 years were included. Among male patients, PCI was
associated with an increased risk of MACE (HR 1.18, 95% CI 1.01-1.38)
while no difference was observed for female patients. No significant
differences between PCI and CABG were found in all-cause mortality for
both sex categories. Repeated revascularization risk was significantly
higher in the PCI group for both sexes (HR 3.51, 95% CI 2.21-5.59 and HR
4.20, 95% CI 2.57-6.87 for males and females respectively) compared with
CABG. Conclusions Among male patients with ULM disease, CABG was
associated with a significantly lower risk of MACE, while no differences
between PCI and CABG were observed in females. In both male and female
patients with ULM disease, PCI was associated with a higher risk of
repeated revascularization compared with CABG..

<103>
Accession Number
647380904
Title
CLINICAL FEATURES, MANAGEMENT, AND OUTCOMES OF LEFT MAIN SPONTANEOUS
CORONARY ARTERY DISSECTION: A PATIENT-LEVEL META-ANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 45. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 25(11 Supplement 2) (pp e13), 2024. Date of Publication: 2024.
Author
Morosato M.; Gaspardone C.; Romagnolo D.; Pagnesi M.; Baldetti L.;
Scandroglio A.; Chieffo A.; Godino C.; Margonato A.; Adamo M.; Metra M.;
Beneduce A.
Institution
(Morosato, Gaspardone, Baldetti, Scandroglio, Chieffo, Godino, Margonato)
Universita Vita-Salute San Raffaele, Milano, Italy
(Romagnolo) Istituto Clinico Humanitas, Milano, Italy
(Pagnesi, Adamo, Metra) Spedali Civili di Brescia, Brescia, Italy
(Beneduce) Clinique Pasteur, Toulouse, France
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
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. This study aimed to investigate clinical
features, contemporary management, and outcomes of LM-SCAD patients.
Methods We conducted a systematic review and patient-level meta-analysis
of literature using 'left main' and 'dissection' as search keywords. We
sought to determine if reported outcomes were associated with initial
management strategy. Results We screened 492 manuscripts in MEDLINE and
EMBASE published between 1990 and 2023. The final analysis included 135
patients (40+/-11 years, 80% women) diagnosed with LM-SCAD. Remarkably,
36% of cases were associated with pregnancy. Almost all patients (95%)
presented with acute coronary syndrome, two-thirds of which were diagnosed
with ST-elevation MI. Cardiogenic shock was documented in 22% of patients
at presentation, while serious ventricular arrhythmias occurred in 10%.
Among published cases, early revascularization strategy with percutaneous
coronary intervention (PCI) or coronary artery bypass grafting (CABG) was
superior to conservative management for the composite endpoint of
all-cause death, left ventricular assist device implantation, heart
transplant, recurrent MI, and urgent myocardial revascularization
(adjusted HR 0.37, 95% CI 0.20-0.69, p<0.001). Conclusions LM-SCAD is
associated with significant acute morbidity and mortality.
Revascularization (PCI or CABG) was associated with a lower incidence of
early adverse outcomes compared to a conservative strategy, largely driven
by the occurrence of recurrent myocardial infarction and urgent
revascularization. Management CENTRAL ILLUSTRATION.

<104>
Accession Number
647380887
Title
LONG-TERM DURABILITY OF BALLOON-EXPANDABLE VS SELFEXPANDING TRANSCATHETER
AORTIC VALVE PROSTHESES.
Source
Giornale Italiano di Cardiologia. Conference: 45. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 25(11 Supplement 2) (pp e4), 2024. Date of Publication: 2024.
Author
Continisio S.; Montonati C.; Terzi R.; Boldi E.; Ielasi A.; Silvestro A.;
Munafo A.R.
Institution
(Continisio, Boldi, Silvestro) Istituto Clinico San Rocco, Ome, Italy
(Montonati, Ielasi) IRCSS Galeazzi, Milano, Italy
(Terzi) Centro Cardiologico Monzino, Milano, Italy
(Munafo) Ospedale Niguarda, Milano, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Aims To compare long-term durability of balloon-expandable (BEV) and
selfexpanding (SEV) transcatheter aortic valve prostheses in patients
undergoing transcatheter aortic valve implantation (TAVI). Methods In this
systematic review and meta-analysis, all observational studies and
randomized controlled trials comparing long-term durability of SEV and BEV
in patients with severe aortic stenosis (AS) treated with TAVI were
evaluated for inclusion. Electronic databases were searched up to March
2024. Pooled odds ratios (OR) with 95% confidence interval (CI) were used
as summary statistics and were calculated using a random-effects model.
Primary endpoint was the occurrence of all-cause bioprosthetic valve
failure (BVF) at the longest available follow-up. As secondary endpoints,
we considered the rate of moderate and severe structural valve
deterioration (SVD) and the occurrence of all-cause death at the longest
available follow-up. BVF and SVD were defined according to the criteria
used in each included study. Results A total of eighteen studies and 7,132
patients were included in the meta-analysis; 49.2% of patients (n=3,508)
were treated with a BEV, while a SEV was used in 50.8% of cases (n=3,624).
In more than 90% of cases, an old generation bioprosthetic valve was used.
In all included studies, prostheses durability was evaluated during a
follow-up period of at least 5 years (for 12 studies outcomes occurring
after 5 years from TAVI were reported). Overall, the pooled estimate of
allcause BVF was 4% (95% CI: 3-5%), and no difference was observed between
patients treated with BEV and SEV (OR: 1.38; 95% CI: 0.89- 2.15; p-value:
0.147). The pooled estimate of moderate and severe SVD in the entire
population was 4% (95% CI: 4-5%), and it mainly occurred due to prosthetic
valve stenosis (50% of cases). When compared to those undergoing TAVI with
a SEV, patients treated with a BEV experienced a significantly higher rate
of any SVD (OR: 1.85; 95% CI: 1.52-2.24; p-value <0.001). Finally, the
risk of all-cause death did not differ between patients who received a BEV
and those who received a SEV (OR: 1.07; 95% CI: 0.74-1.54; p-value: 0.729;
overall pooled estimated 55%, 95% CI: 41-68%). Conclusions In patients
with severe AS undergoing TAVI, the design of the platform used could have
an impact on long-term durability of transcatheter aortic valve
prostheses. After more than 5 years from TAVI procedure, patients treated
with a BEV experienced a higher risk of any SVD compared to those for whom
a SEV was implanted. Nevertheless, no difference in the occurrence of
all-cause BVF and all-cause death was observed..

<105>
Accession Number
647380920
Title
LONG-TERM CLINICAL FOLLOW-UP IN PATIENTS UNDERGONE DRUG ELUTING BALLOONS
ANGIOPLASTY.
Source
Giornale Italiano di Cardiologia. Conference: 45. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 25(11 Supplement 2) (pp e28-e29), 2024. Date of Publication: 2024.
Author
Zimatore F.R.
Institution
(Zimatore) Azienda ospedaliera integrata di Verona, Verona, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background So far little is known about long-term follow-up in patients
undergone to drug eluting balloons (DEB) angioplasty. DEB angioplasty
offers a valuable alternative to drug eluting stent (DES), especially in
specific scenarios such as intrastent restenosis (ISR) and small vessel
disease. Its primary advantages include reduced restenosis rates, the
absence of a permanent implant, and a lower risk of late thrombosis.
However, long term positive effects are unknown and studies are needed to
fully establish its role in the treatment of coronary artery disease.
Methods We retrospectively analyzed a consecutive series of patients
undergoing DEB angioplasty for both de novo lesions and ISR in Legnago
Hospital between January 2017 and December 2019. Baseline and procedural
data as well as last available follow-up were collected with the aim to
evaluate long-term safety and efficacy of DEB angioplasty. Primary
endpoint was the rate of major adverse and cerebrovascular events (MACCE)
including death or rehospedalization from myocardial infarction, stroke,
major bleeding or clinical driven target vessel revascularization. All of
our patients were treated with DEB angioplasty, considering both de novo
lesions and in ISR to have a bigger sample. A longterm clinical follow was
made, by evaluating clinical conditions of our patients at 5 years after
angioplasty. We used NYHA classification and Canadian clinical
classification to estimate the clinical status of our patients. Our aim
was to highlight if there is a declination regarding symp- toms and if any
hemodynamic deterioration comes out. Concerning the procedure we used
different type of DEB such as In Pact Falcon, Prevail and Magic Touch,
with different diameters and lenght. Results A total of 68 patients, with
an average age of 65 years old, were treated with DEB angioplasty in the
selected period. 11.7% were women (n=8), 52.4% de novo lesions. The data
showed that DEBs with a 20 mm length were used in 87% of cases and a
diameter of 2mm were applied more frequently. The majority of the lesions
treated with DEB was located on the mid-segment of the left anterior
discending artery, with a 17%. The median follow-up for clinical events
was 56,02 months. The mortality rate was 16,2 % ,11 patients deceased,
just one of them faced the death because of a cardiovascular related
complication. The rate of MACCE was 8% of all the rehospidalizations we
registered. Only one of our patients was rehospidalized because of a
myocardial infarction with ST elevation (STEMI), he also had a clinical
deterioration that led to Heart Failure (HF). There wasn't any episode of
stroke or major bleeding, but 3 patients had respiratory insufficiency.
However 15% of our patient needed to be admitted to our Hospital because
angina or acute coronary syndrome. Twice a positive stress testing was the
reason of a urgent angioplasty. Only for two patients a surgical strategy
was necessary and there was the indication to do a Coronary Artery Bypass
Grafting (CABG). At last clinical follow-up 52 % of the population was
classified as NYHA class 2, overall there wasn't a worsening in term of
clinical status from the one at the discharge. Conclusion In our single
center experience DEB proved to be a valid alternative to stent
angioplasty for both de novo lesions and ISR at long-term follow- up. This
retrospective analysis has many limitations and is not supposed to suggest
new treatment philosophy, but could be a suggestion for ideation of novel
RCT. In conclusion DEBs represent a valuable tool in the interventional
cardiologist's armamentarium, particularly for patients with ISR, small
vessel disease, or those who need to minimize the duration of antiplatelet
therapy. Ongoing research and longer-term follow- up studies are essential
to further define the role of DEBs in different clinical settings and to
compare their performance against the latest generation DES..

<106>
Accession Number
647374012
Title
IN-HOSPITAL OUTCOMES AFTER EMERGENCY OR PROPHYLACTIC VENOARTERIAL
EXTRACORPOREAL MEMBRANE OXYGENATION DURING TRANSCATHETER AORTIC VALVE
IMPLANTATION: A COMPREHENSIVE REVIEW OF THE LITERATURE.
Source
European Heart Journal, Supplement. Conference: 50th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
21(Supplement E) (pp E52), 2019. Date of Publication: 01 May 2019.
Author
Romano G.; Raffa G.; Gandolfo C.; Pilato M.
Institution
(Romano, Raffa, Gandolfo, Pilato) 1Irccs - Ismett, Palermo; Irccss -
Ismett, Palermo; Irccs - Ismett, Palermo
Publisher
Oxford University Press
Abstract
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has been used
to deal with life-threatening complications as well as back-up or active
cardiovascular support during high-risk procedures in patients undergoing
transcatheter aortic valve implantation (TAVI). PubMed and Medline
electronic databases were searched in order to identify studies with
emergency or prophylactic V-A ECMO application in association with TAVI
procedures. From November 2012 to November 2017, 14 relevant studies were
identified that included 5,115 TAVI patients of whom 102 (2%) required
ECMO (22 prophylactically, 66 as an emergency and 14 without a reported
indication). The reason for emergency V-A ECMO institution was detailed in
64 patients: left ventricle free wall rupture (n=14), haemodynamic
instability (n=12), ventricular arrhythmias (n=7), aortic annulus rupture
(n=6), coronary obstruction (n=6), low left ventricular output (ejection
fraction<35%) (n=5), uncontrollable bleeding (n=5), severe aortic
regurgitation (n=4), prosthesis embolisation (n=3), aortic dissection
(n=1) and respiratory failure (n=1). Femoral arterial and vein cannulation
was the most common access technique for V-A ECMO institution. Major
bleeding (n=7) and vascular access complications (n=7) were reported after
ECMO institution. The overall in-hospital survival was 73% (61% in the
emergency vs 100% in the prophylactic group). V-A ECMO support should be
available at any centre performing TAVI and provides effective mechanical
circulatory support in an emergency setting. We present an algorithm to
aid decisions about prophylactic circulatory assistance with ECMO and it
should form part of the heart team discussion before a TAVI procedure is
undertaken.

<107>
Accession Number
2038782589
Title
Study protocol of the multicentre, randomised, triple-blind,
placebo-controlled MERCURI-2 trial: promoting effective renoprotection in
cardiac surgery patients by inhibition of sodium glucose cotransporter
(SGLT)-2.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e095504. Date of
Publication: 16 May 2025.
Author
Oosterom-Eijmael M.; Monteiro De Oliveira N.P.; Niesten E.D.; Tolsma M.;
Snellen F.T.F.; Gerritse B.M.; Scohy T.V.; Rettig T.; Godfried M.B.; Voogd
M.F.; Wink J.; Van Der Werff L.M.M.; Eberl S.; Preckel B.; Hermanides J.;
Van Raalte D.H.; Hulst A.H.
Institution
(Oosterom-Eijmael, Eberl, Preckel, Hermanides, Hulst) Department of
Anesthesiology, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Oosterom-Eijmael, Van Raalte) Department of Endocrinology, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, Van Raalte) Amsterdam Cardiovascular Sciences Research
Institute, Amsterdam, Netherlands
(Monteiro De Oliveira, Niesten) Department of Anesthesiology, Medisch
Spectrum Twente, Enschede, Netherlands
(Tolsma, Snellen) Department of Anesthesiology and Intensive Care, Isala
Clinics, Zwolle, Netherlands
(Gerritse, Scohy) Anaesthesiology, Amphia Ziekenhuis, North Brabant,
Breda, Netherlands
(Rettig) Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital
Site Molengracht, Noord-Brabant, Breda, Netherlands
(Godfried) Department of Anesthesiology, Onze Lieve Vrouwe Gasthuis,
Noord-Holland, Amsterdam, Netherlands
(Voogd) Department of Anesthesiology, Medisch Centrum Leeuwarden,
Leeuwarden, Netherlands
(Wink, Van Der Werff) Department of Anesthesiology, Leiden University
Medical Center, Leiden, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Acute kidney injury (AKI) is a major complication after
cardiac surgery and is associated with postoperative morbidity and
mortality. Currently, no effective therapy exists to reduce the incidence
of postoperative AKI. Sodium-glucose cotransporter-2 (SGLT2) inhibitors
are effective in reducing AKI in outpatient settings for patients with
chronic kidney disease. We hypothesised that perioperative SGLT2
inhibition will also reduce AKI incidence after cardiac surgery according
to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods and
analysis We designed a multicentre, randomised, placebo-controlled,
triple-blinded, superiority trial. A total of 784 patients, aged above 18
years, undergoing cardiac surgery will be included with stratification for
sex and type 2 diabetes in a 1:1 ratio. Patients will receive either
dapagliflozin 10 mg or placebo from the day before until 2 days after
surgery. Serum creatinine will be measured preoperatively and daily for
the first 7 days after the operation, and urine output will be measured
until the urinary catheter is removed. The primary outcome is the
incidence of postoperative AKI according to the KDIGO criteria. Ethics and
dissemination The medical ethics committee of the Amsterdam University
Medical Centre (UMC) and the Dutch competent authority approved the study
protocol (currently, version 9, 19 January 2024). This is an
investigator-initiated study. The Amsterdam UMC, as sponsor, retains
ownership of all data and publication rights. After completion of the
trial, results will be disseminated to participants, patient societies and
physicians via a network meeting and digital newsletter. Results will be
submitted for publication in a peer-reviewed international medical journal
and presented on (inter)national congresses. Trial registration number
Clinicaltrials.gov identifier: NCT05590143. Copyright © 2025 BMJ
Publishing Group. All rights reserved.

<108>
Accession Number
2038817632
Title
Effects of various hydrotherapeutic procedures on heart rate variability
and blood pressure: A systematic review.
Source
Advances in Integrative Medicine. (no pagination), 2025. Article Number:
100500. Date of Publication: 2025.
Author
Abinaya S.; Vijay A.; Nivethitha L.; Mooventhan A.; Manavalan N.
Institution
(Abinaya, Vijay, Nivethitha, Manavalan) Department of Naturopathy,
Government Yoga and Naturopathy Medical College, Tamilnadu, Chennai, India
(Mooventhan) Department of Research, Government Yoga and Naturopathy
Medical College, Tamilnadu, Chennai, India
Publisher
Elsevier Australia
Abstract
Background: The autonomic nervous system (ANS) regulates involuntary
physiological processes including blood pressure. Hydrotherapy uses water
to treat various conditions and research on effect of different
hydrotherapy modalities at varying temperatures on the heart rate
variability (HRV) is increasing for the past few years. However, there is
no systematic review of on it. Hence, this systematic review was performed
to provide evidence-based effects of hydrotherapy on HRV. Material(s)
and Method(s): We have searched PubMed/Medline and google scholar
electronic databases to find relevant articles using following keywords:
hydrotherapy, balneotherapy, cryotherapy, sauna bath, immersion bath, foot
bath, spinal bath, hip bath, arm and foot bath, ice massage and heart rate
variability. Out of 121 articles found, 24 potentially eligible articles
were reported in this review. Result(s): In this systematic review 24
articles (including 6 RCTs) with 961 participants with various condition,
underwent various hydrotherapy modalities with different temperatures were
reported. The finding showed that majority of the hydrotherapy modalities
produces improvements in parasympathetic activity and regulation of
autonomic nervous system. However, only one study showed increased
sympathetic activity during the session and transitioned into
parasympathetic activity after 15-120 min of session. Conclusion(s):
Literature suggests that hydrotherapy is effective in reducing blood
pressure and improving HRV as an adjuvant in healthy volunteers,
sportspeople, and in patients with hypertension, heart failure, migraines,
allergic rhinitis, and chronic fatigue syndrome. However, the quality of
the studies included in this review low. Hence, we recommend high quality
long-term RCTs to determine the efficacy and safety of
hydrotherapy. Copyright © 2025 Elsevier Ltd

<109>
[Use Link to view the full text]
Accession Number
2038741234
Title
Dr Shao-Wei Chen's contribution to Analysis of outcomes of patients
undergoing cardiac surgery for aortic disease: Big data analytics.
Source
Formosan Journal of Surgery. (no pagination), 2025. Article Number:
e000219. Date of Publication: 2025.
Author
Chen S.-W.
Institution
(Chen) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung
University, Taoyuan City, Taiwan (Republic of China)
(Chen) Center for Big Data Analytics and Statistics, Chang Gung Memorial
Hospital, Linkou Medical Center, Taoyuan City, Taiwan (Republic of China)
Publisher
Wolters Kluwer Medknow Publications
Abstract
This retrospective review underscores Dr. Shao-Wei Chen's significant
contributions to aortic disease research, utilizing big data analytics to
advance understanding and optimize treatment outcomes. With a focus on
aortic dissection and aneurysm management, Dr. Chen's studies cover a
range of critical topics, including genetic predisposition, pharmacologic
impacts, and procedural approaches. His research highlights the strong
correlation between family history and early-onset aortic disease,
underscoring the importance of screening and personalized interventions
for genetically at-risk populations. Notably, his work has demonstrated
the adverse effects of fluoroquinolones on aortic outcomes, revealing
increased mortality and complication rates, which has implications for
clinical guidelines on medication management in aortic patients. Dr.
Chen's comparative analyses of endovascular versus open repair for aortic
conditions, such as traumatic thoracic aortic injuries, suggest superior
outcomes with endovascular approaches for certain high-risk patients,
offering insights that support tailored procedural choices. Additionally,
his translational research into the role of lumican in aortic pathology
adds a valuable dimension to understanding connective tissue integrity and
potential biomarker applications, bridging the gap between basic science
discoveries and clinical care. Dr. Chen's work advances the field of
aortic disease through interdisciplinary collaboration, large-scale data
analysis, and translational research. Future studies should continue
refining surgical techniques, investigating innovative therapeutic
strategies, and integrating advanced analytics to further enhance
patient-specific care and improve long-term outcomes in aortic disease
management. Copyright © Wolters Kluwer Health, Inc. All rights
reserved.

<110>
[Use Link to view the full text]
Accession Number
2038728383
Title
Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After
Surgical Bioprosthetic Valve Replacement: A Randomized Clinical Trial.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2025. Article
Number: e015108. Date of Publication: 2025.
Author
Izumi C.; Amano M.; Yoshikawa Y.; Fukushima S.; Yaku H.; Eishi K.;
Sakaguchi T.; Ohno N.; Hiraoka A.; Okada K.; Saiki Y.; Miura T.; Komiya
T.; Minami M.; Yamamoto H.; Omae K.
Institution
(Izumi, Amano) Department of Heart Failure and Transplantation, National
Cerebral and Cardiovascular Center, Suita, Japan
(Yoshikawa) Department of Bio-statistics, National Cerebral and
Cardiovascular Center, Suita, Japan
(Fukushima) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Suita, Japan
(Minami, Yamamoto, Omae) Department of Data Science, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Japan
(Eishi) Department of Cardiovascular Surgery, Hakujyuji Hospital, Fukuoka,
Japan
(Sakaguchi) Department of Cardiovascular Surgery, Hyogo Medical
University, Nishinomiya, Japan
(Ohno) Department of Cardiovascular Surgery, Kokura Memorial Hospital,
Kitakyushu, Japan
(Hiraoka) Department of Cardiovascular Surgery, Sakakibara Heart Institute
of Okayama, Japan
(Okada) Department of Cardiovascular Surgery, Kobe University Graduate
School of Medicine, Japan
(Saiki) Department of Cardiovascular Surgery, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Miura) Department of Cardiovascular Surgery, Nagasaki University Graduate
School of Biomedical Sciences, Japan
(Komiya) Department of Cardiac Surgery, Kurashiki Central Hospital, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Anticoagulant therapy with vitamin K antagonists is
recommended in the current guidelines for 3 to 6 months following
bioprosthetic valve replacement. However, in the era of direct oral
anticoagulants, there is a paucity of evidence regarding the efficacy and
safety of direct oral anticoagulants in this patient group.
 METHOD(S): The ENBALV trial (Edoxaban in Anticoagulant Therapy After
Surgical Bioprosthetic Valve Replacement) was an investigator-initiated,
phase 3, randomized, open-label, multicenter study that aimed to evaluate
the efficacy and safety of edoxaban compared with warfarin within 3 months
following bioprosthetic valve replacement at the aortic and mitral
positions. The primary outcome was stroke or systemic embolism. The
secondary outcomes included major bleeding, intracardiac thrombus, and a
composite of stroke, systemic embolism, or major bleeding. Given the
limited study period and the low event rate of the primary outcome, this
study assessed the difference in the point estimates of the event rate.
 RESULT(S): Of the 410 enrolled patients, 389 were included in the
final analysis (73+/-6 years, 56.8% male, 79.4% sinus rhythm; edoxaban
group: n=195, warfarin group: n=194). The primary outcome occurred in 0.5%
(n=1) in the edoxaban group, whereas in 1.5% (n=3) in the warfarin group
(risk difference, -1.03% [95% CI, -4.34 to 1.95%]). Major bleeding
occurred in 4.1% (n=8) in the edoxaban group and in 1.0% (n=2) in the
warfarin group (risk difference, 3.07% [95% CI, -0.67 to 7.27%]). No fatal
bleeding or intracranial hemorrhage was observed in patients treated with
edoxaban, whereas 1 fatal intracranial hemorrhage occurred in the warfarin
group. Intracardiac thrombus did not occur in any of the patients in the
edoxaban group, but did occur in 1.0% (n=2) in the warfarin group.
 CONCLUSION(S): Edoxaban is a potential alternative anticoagulant
therapy early after bioprosthetic valve replacement Copyright ©
2025 American Heart Association, Inc.

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